what med "comes next"?

Sunny,
There are no likely next steps when it comes to opiates. The doctor will ultimately make the decision based on your complete medical history, reactions to other meds, current meds, and what he is comfortable with prescribing. Is this a pm doctor or your primary?
What he may want to try may be extended release tramadol and perhaps a short acting opiate, but whether it would be hydrocodone or percocet depends on what he is comfortable with.

Hi Sunny, I hope you are recovering well from the multiple surgeries. It stinks to get something fixed then something else crops up.

Be as it may we understand trying to avoid the pain meds but sometimes there is no choice. Something I want to ask you & you can think it is, what did you take for the post op pain? Did any of it seem to help the overall pain that you have? If it did that may be something to discuss with your PM dr.

I know Rick mentioned a friend that took Nucynta & had a bad reaction. But, you already know that doesn't mean it would happen to you. Blanket statements like that about a medication are not true. We do have some people here at the forum on Nucynta & they say it does help, but they are taking it in conjunction with an ER medication & something for BT pain.

Best thing is just talk to your dr & tell him how you are feeling & ask him to help you find something that will work better for the pain.

Take care.

I'll bet the tramadol does more than you might think. I find that I tolerate a lot more pain with it, because it raises serotonin, which makes me happier and I can put up with the pain better. I've tried just switching to Norco (hydrocodone and Tylenol), but I don't get nearly the pain relief (spine problems and fibromyalgia among many other things) as with the supposedly not very strong tramadol.

If you're on the 100 mg tramadol, I presume it's the extended release type. I tried those for a while but they didn't work as well as the immediate release 50 mg. I get 3 of the IR a day, nothing at night :( but I also get a couple of Norco a day for breakthrough. Make sure if you ask about those that they are the ones with not so much Tylenol in them. I need one of the Norco first thing in the morning because after a night with nothing, pain is back to 7 or 8. I have had spells where I needed a bit of melatonin to get to sleep at night, but don't need them now, especially if I can get a little exercise during the day. I'm getting used to my pain now and often can get away with only 1 1/2 of the Norco 7.5 mg.

It's possible to get insurance complaints about taking 2 IR meds instead of an ER and an IR, but it's in my record that I tried the ER and it didn't work. Maybe it would have if I'd been given 3 a day, but back then they were only allowing me 2 because they were supposed to last 12 hours, which is laughable.

I've had to back to using my back brace too. Today I went up the hill with the kiddos to look for morels, but they weren't out. That and a bit of gardening and I needed the brace. It doesn't feel like it's doing anything, but it must be because it keeps me from crunching over in pain. My docs don't want me to use it all the time because it lets the muscles get weak.

You might also try a TENS instead of more meds.

But it's nice to have at least 1 Norco available for breakthrough pain.

I've had so many RFAs that my doc doesn't want to do them again for along time. From my position, I have so many spine ares that have bad discs, spurs, retrolisthesis ... he could do one every other month and not keep up with the areas and have a year between each place. I have to see him next month for Norco scripts - paper scripts for each month, allowed to have 3 at a time which I give to the pharmacist to hold.

Good luck!

Thanks for all the responses. I feel like a have a better idea of what to expect and what to get more info on, etc.

Waiting for a call back from pain clinic this afternoon, neck injection did not help at all.

I'm guessing they won't do anything w/ the pain meds until after the liver stuff gets sorted out. If it's not one thing it's another.

I am grateful for all the advice and the kind words. Makes me feel so much better-- calmer, more hopeful, not alone.

Will keep you updated!!

Yeah, liver enzymes are messed up. First was noticed about a month ago. They've done tons of bloodwork since then and more detailed blood tests, as well as an ultrasound today. Should have results in a few days.

Keep us posted on what you find out....Please.

Vickie is right on that.My PMD doesn't prescribe any of the combination meds with tylenol in them.

My PMD does Lab Work every 6 months.My Liver Enzimes had been a little high when I was taking Norco 3x a day.

Now that I take Morphine my Lab Work has been fine.

Hope you're feeling better.

Take care and God Bless.

Rick

Aw Sunny, so sorry to read about what is going on gal. Hopefully the tests will show where this problem is at. I have crohns disease & I am very familiar with those lovely tests you are scheduling. The tests are a breeze, its the prep for the colonoscopy is what is so bad. Endo is an easy one too.

Tramadol, yes people that stop it do have withdrawals. So, you were given some bad info about that medication. Go to Drugs.com & read up on it. So glad to read the liver situation is pretty much resolved.

Hang in there & keep us posted on how you are doing.

Thanks Rick and Susie.

Doing the best I can Most of the time the medical stuff doesn't get me too down, but it's the combination of severe depression (had for 20 years) along w/ the medical that gets me frustrated. I honestly don't mind some of the testing and stuff, I tend to get overwhelmed in trying to schedule everything and organize dates and times and what should get done first and what meds to stop or not take a certain day. Ugh!!

So, i guess Monday it's back to calling pain doc again (his office staff are useless unless you get just the right person on the right day), and then scheduling the Gi tests. Already have the autonomic fxn testing set up, so that's one less thing to figure out.

And the colonoscopy prep will likely be easy for me to drink (before my colostomy this Jan, I used to have to drink that stuff every 2 weeks, so I'm sort of numb to it), but it will be interesting to see how that works with the new colostomy and the bag--I think based on past situations w/ prep, I am gonna need a much bigger bag than I usually wear!!! LoL.

Thanks again for caring and sharing your experiences and info Really honestly does mean the world to me to have such caring people in my life. Thanks.


Sunny