My new med regimen

Hi All,

It is my third day on the new regimen my PM wanted me to follow. For almost a year now, I've been asking to add another time-release opioid, either on top of or replacing my Ultram ER.

My PM has said no, since I don't use enough BT medication. He has been encouraging me to use more and I did start over the past three months. But I did my best to keep the doses down, and went 3-5 days per month without BT meds, opting often just to stay in bed through the day, and generally taking as little as possible.

At this appointment, he and his new PA asked that I just try taking 20-30mg of hydrocodone every day, at set times.

So, I decided to take 15mg late morning and 15mg late afternoon (I might pull back to 10 and 10 or 10 and 15 depending upon pain levels).

Although it used to make me a bit hyper, surprisingly, it is now making me a bit more sluggish, but not too bad -- and one good thing is that I was able to go out with my wife today for lunch.

Meals are usually agony for me since I can't lean forward even a few degrees. Thus we've stopped going out for meals, though that is something we used to really enjoy. But we went out today to a new mexican restaurant and we both realized in the middle of the meal that I was causally leaning forward as I ate.

By the end of the meal, my back was hurting some, but not the overwhelming pain I'm used to. At home, I would often lie down for a bit during dinner since I couldn't make it all the way through, or I would right after dinner, have to lie down for a few hours. But with the new regimen: Ultram ER 300mg (as usual) plus 2x15mg of hydrocodone daily, I'm seeing a difference.

Sadly, it looks like I have to finally give up on my militant efforts to limit the buildup of tolerance, but I am definitely doing better (for now). I'm also going in for more trigger point injections next week, btw, and am going to start looking into other options, such as nerve ablation.

HI SE,

It is difficult for me to think of 20-30mg of hydrocodone every day as a low dose. I've been in pain now for over seven years and until about two years ago, held to a rule that I could only take one BT med a day and can't take BT meds two days in a row. So, I militantly fought to slow down the rise of tolerance and also make sure I don't become chemically dependent. During the bad days, I would just stay in bed or one way or another, limit myself.

Looking at my records, it was about this time in 2010 when my PM convinced me to take an extra 1/2 a hydrocodone if I was in pain later in the day and eventually, after just too many bad days in a row, gave up on my other rule. So, it is still quite weird for me to take hydrocodone every day, never mind 30mg.

But the past few days have been great. I've done so much around the house (repainted three areas that needed some touching up, replaced some sprinkler heads and installed a new timer, cleaned up leaves, repaired a bit of guttering, etc. etc.). And as noted above, went out for lunch with my wife. We're planning on a nice dinner out tomorrow.

When I wake up, the pain is mild -- usually I wake up o.k. unless it is cold and damp or I slept in a bad position. So today I took my first dose of hydrocodone around 11am and took my second around 5pm -- after I started to get into pain from moving our stove (it was a bit askew).

So far in the evenings, I've been o.k. and haven't needed any oxycodone. That's another victory since I would like to save them for just the worst days, which before Wednesday, were coming too frequently.

I haven't done any writing since Tuesday as I've been too busy with chores, taxes, insurance hassles, etc.. But I hope that the hydrocodone doesn't impair my focus when I finally get back to it.

I have to commend you Cogito!….I think at times, it may be easy to have the desire of having our med's upped when were in so much pain. At the moment I'm at the same dose or less than you, but am really paying a price for it. I'm hoping that this non-narcotic med (Gabapentin) will eventually lessen my pain, but so far, I have not had a whole lot of luck with it. At first I thought it was working, but the last few days, I have been disappointed. However, the dose I'm on is a starting point, and its a very low dose (300mg x4)….but I will see my Dr at my next script refill…as he wants to monitor my progress or lack thereof as we look for something that will work better.

I myself requested the Gabapentin, and he has balked at this for over a year now, but he has been showing signs and hinting around about the high dose of Oxycodone products I have been taking. I believe I have been on them way too long as well, and have told him about this for quite some time. It seems to be a battle, and of course we are the ones who suffer, because of these Dr's fears. I understand what is going on around this country has the Dr's nervous, but at the same time…when a patient has an arm load of MRI's and test to show the cause of our pain, you would think Dr's would be able to treat a patient without worrying what the DEA is doing in their office.

Sorry if I have strayed of subject here! LOL ….I hope you can stay on the lower dose of your pain med's and understand your thoughts on it. I think it's the wish of every good pain patient, and hope you do not have to suffer too much doing so. Good luck to you.

SE

Cogito,

I'm glad to hear that your new med regimen seems to be working.... I know you were resistant to the extra jump up on your BT meds - but I'm just glad it seems to be helping. That's great news.

Re: your refills - yes, you can get refills on Class III meds. I'm thinking that it just may be office policy?

--Tina