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Posted 4/3/2013 6:39 PM (GMT 0)
Howdie All,

This is a follow up to a prior thread where I discussed my unilateral decision to stop my oxycontin a few weeks back.

As mentioned previously, the withdrawal wasn't really a problem for me and after a few days was fine.

However, concern was raised on this board about my making this change without informing my PM in advance.

I saw him today and the meeting went by without a hitch. I explained my issues and he was perfectly fine with my decision. We then discussed what to move on to. He wants me to try the Butrans Patch (10mcg/hr), see how that goes for a month. My preference would be for Cymbalta, but as I would have to stop the Tramadol first, he wanted to see if my pain is managed well with the Butrans, and then if so, stop the Tramadol. After that, either stay with the Butrans and/or move to Cymbalta.

We briefly discussed the perplexing issue regarding what the nurse said about Hydrocodone (i.e. even though I was prescribed it for daytime BT, use only the oxycodone). He didn't have much to say about it and redirected the discussion. I suspect that it was an error on the part of a PA.
Posted 4/3/2013 6:51 PM (GMT 0)
Glad to hear that things went well....I still think that people should always speak with their Drs. first before making any medication changes....So, even though this is something that worked out ok for you....I don't think it's a good recommendation for anyone else so this is why I expressed my concern in the other thread.

I'm a bit confused on why you would want to go to the Butrans patch or add anything else back in that is an opiate? I was thinking that you were doing fine pain wise without the Oxycontin? Maybe I misunderstood...sorry about that!

I know that there is a slight risk for Serotonin Syndrome with those on Tramadol and Cymbalta....but for me, I was on this combo for close to 3 years and didn't have a single issue and worked very well. But I guess that was before SS was more well knows so ignorance is bliss! LOL

Thanks for giving us an update!
Posted 4/3/2013 8:55 PM (GMT 0)
I agree that my relationship with my PM is (generally) very good. I've been with him for four years, and on top of that, I am in the same professional class -- that may be a crude point, but it definitely lets him see me as someone focused on his career over everything else.

As for the Butrans, he's mentioned it a few times over the years and so I thought I would give it a one-month trial. Overall, pain is more noticeable without the oxycontin, but not over-the-top worse. It can be managed with just a bit additional oxycodone over the day, but I would ideally prefer a long-acting med so I don't have as much BT.

Assuming the Butrans works out, I'll actually try to wean off the Tramadol this month and then in May, will see whether to stick with the Butrans or move on to Cymbalta.
Posted 4/3/2013 8:58 PM (GMT 0)
Ahh..thanks for sharing more about your pain levels and plan. Hopefully you get some good pain relief with the Butrans patch!
Posted 4/3/2013 11:36 PM (GMT 0)
sounds like a productive meeting, and feel you did all the right things.

glad it went so well for you

david
Posted 4/4/2013 6:26 AM (GMT 0)
Glad it all worked out for then and hope you get the relief you need from the butrans. I think some misunderstood the origional post in as you were eliminating the oxy-c and using just the oxy ir? correct as you were using hydro for daytime b/t and oxy ir for later and somehow at the previous visit the PA or NP took the hydro out of the mix upping the oxy ir and thats when you started off the oxy=c correct? Oh man now I am confused!! I will have to go back to read the previous thread now and see if I got it right!!

Anyway its all working and thats the good thing right?

Vickie
Posted 4/4/2013 10:43 AM (GMT 0)
Hey Cogito --

Good to read your update...! I'm glad that things went well w/ your PM doctor.... and that your new med plan helps you pain-wise.

--Tina
Posted 4/4/2013 12:46 PM (GMT 0)
I' m glad your pm visit went good, many well wishes in what you chose to do and keep us posted.
Posted 4/4/2013 2:34 PM (GMT 0)
Thanks all.

I plan on starting the Butrans later today or tomorrow. The pharmacy had to order it. I'm not sure how long it takes before it is effective and how swiftly is leaves the system -- so I have a bit of reading to do.
This weekend, I have to get the final touches on a paper finished, then prepare for an invited talk next week -- hopefully it won't get in the way of any of that!

I also see our Screaming Eagle next week as my invited talk is in his neck-of-the-woods.

(nvrthesame98 -- despite my using hydro for daytime BT and oxy for evening BT for years, they wanted me to use only oxy for BT -- on top of the oxycontin for ER -- but that didn't work out -- hence the change to Butrans -- with oxy at first for BT -- will see how it works out).
Posted 4/4/2013 11:35 PM (GMT 0)
…sounds like you have a good relationship with your Dr there! Good deal!

…see you soon! wink

SE
Posted 4/5/2013 1:19 PM (GMT 0)
Take a camera and posts pictures of your visit with Screaming Eagle. Hope you get relief with the patch. Many well wishes.
Posted 4/5/2013 2:45 PM (GMT 0)
So far so good with the patch. I did, however, have a headache this morning and worried that the Butrans doesn't mix well with the Tramadol -- since both release serotonin. So, I'm delaying taking my morning Tramadol and will see how that goes (I've forgotten the Tramadol various morning and know what to look out for -- mostly just extra pain).

Got some good news from my publisher today -- (a) they agreed to my title; (b) the first blurb for the back of the book already came in and it is very generous. On (a), I wanted the title to be set us so that specialists in my field will know that the book is connected to a famous book with a similar title (written by my dissertation advisor). Now, just to get my crotchety old advisor to read it (there's no one else alive who is as much like TV's "House" than this guy!!!)
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