HealingWell
Search Close Search
☰

Help, I need a new BT med - appointment at 1PM eastern

Support Forums
>
Chronic Pain
✚ New Topic ✚ Reply
❬ ❬ Previous Thread |Next Thread ❭ ❭
Posted 11/25/2014 4:48 PM (GMT 0)
Okay, so I think I told you earlier this week that the 10 mg opana did NOT agree with me, but the 5 mg is not effective. I got squeezed in to see my PM doc again today and want something different but I'm out of ideas at this point.

Those of you that are on morphine, which one do you take and what dosage? Besides tramadol, percocet, norco, opana, what are some of the BT meds you're on?

Thanks for any advice ASAP - appointment is in a little over an hour.
Posted 11/25/2014 5:06 PM (GMT 0)
Hey BTL...Sending (((HUGS))) of support, though I have no recommendations.  I'm still in the "trial phase" of PM, unable to afford ER anything.  Either my IR Oxycodone is NOT the answer, or....I'm doing this wrong.  Good luck this afternoon, sweetie!

~~Dixie

Posted 11/25/2014 5:17 PM (GMT 0)
My PM doctor switched me to just plain morphine sulphate ER (extended release), away from Lortab/Norco and the immediate release version, because he said he wanted to keep things simple without the acetaminophin.

I take one 100 mg pill every twelve hours. For the first few days, I noticed an increase in pain as it wore off, which I dealt with just by planning to take it easy around then. But after four or five days it built up in my body to the point that I don't notice any downward dip near the 12-hour mark.

I currently have 30 mg morphine sulfate immediate release pills for breakthrough pain, with a recommendation to first take half if needed, but I've not needed to take it at all since the doctor increased my ER version.

This works for me right now, but I have a steady, fairly high pain situation that's predictable, so I know I'll need an underlying painkiller working 24/7. (Edited to add: I really do suspect that my dosage is higher than most pain situations would require, but I dunno--I was in the range of 30 mg equivalent morphine previously and it wasn't working very well. This is a palliative care situation where long-term effects beyond a year or two aren't an issue.) I was increased to this amount via an IV morphine drip in the hospital, then switched to the pills, though they gave me the option of a pain pump to dispense it.
Posted 11/25/2014 5:18 PM (GMT 0)

JamesBW said...
though they gave me the option of a pain pump to dispense it.

An intrathetical pump?

So - you take both ER and IR morphine, right? MS for ER and then MS Contin for IR?
Posted 11/25/2014 5:45 PM (GMT 0)

Backtolife said...
An intrathetical pump?

I don't know--sorry! A "pain pump" was all they called it and they said it would be a little pack I'd carry, connected to a needle under the skin. I've never had one or seen one, so don't know any more about it than that. We agreed I could get by without it, so we never went into more detail. Hopefully that makes sense to somebody. :-)

Backtolife said...
So - you take both ER and IR morphine, right? MS for ER and then MS Contin for IR?

Just looked at the labels, cause I'm so lousy at remembering names. I take "morphine sulfate ER generic for MS Contin" 100 mg, every twelve hours every day, and that's the only opiate I actually take.

I don't actually take the breakthrough medicine, even though it's prescribed, because I haven't needed it, so I guess my wife put it away in the storage safe and I'm not sure how to dig it out easily. I know it's labeled "morphine sulfate" as a generic and is immediate release (not ER) but I'm not sure about the exact name beyond that.

As far as non-opiate painkillers, I should add that I take a total of 1200 mg neurontin daily, split into three doses, for nerve pain, and that's all the painkillers total that I take.

Hope that's helpful, but of course it's just what works for me in my current situation--subject to change!
Posted 11/25/2014 7:04 PM (GMT 0)
I'm on generic morphine sulfate 15mg tablets, one pill twice a day. If I'm in a lot of pain, sometimes I'll take both at once in the morning and skip my nighttime dose. For breakthrough pain, I have 5mg oxycodone tablets, and I typically take 2, though not more than 4. I also have 10mg baclofen (a muscle relaxant) tablets, which aren't particularly effective by themselves but combined with the oxy work wonders. They also put me to sleep, which is great at night, especially on the days I took my 2 morphine in the morning. When the pain is 9+, I have injectable toradol (non-narcotic strong NSAID for those not familiar) that goes IM and that's super effective. I can't take NSAIDs by mouth anymore so that's the best route for it really.

Hope that helps! Best of luck.
Posted 11/25/2014 7:43 PM (GMT 0)
No intent to hijack BTL's thread, but hey...our issues are similar (even James).  I'll explain.  Stage IV endometriosis has technically been "terminal", as in it's ended MY life.  I just suffer the misery and pain without the knowledge that this will end...I admire your strength and perseverance, James.  I truly do.  I also give kudos to you for your supportive posts here.  For me personally, I've had many "cancer" scares.  I exist, but don't "live".  If specialists would approach our pain treatment similar to a cancer patient, rather than deny the existence of this disease...perhaps I'd feel differently.  My story is LONG and painful, so I won't repeat previous posts.  I've put most of it "out there" but I feel like few understand.

BTL...I STILL believe some of your pain is endo/adhesion related.  I just DO.  My nut case PM doctor told me that he "does not treat pelvic pain, but would treat my spine/bone pain".  He added that "pain is pain".  I, too, tried Morphine, but the constipation issues could not be overcome with my gastric anatomy.  He wanted Fentanyl from day one, but I went there in 2005-06 (briefly) then swore off PM entirely until this year.  I think Morphine had potential for me, but...I'm taking Oxycodone IR with no BT.  I have no PA so I can't afford the ER costs. I am very sensitive to medications, period.  The Oxycodone hits hard, leaves fast.  I can't seem to level out the serums.  Any advice?

JAU...How did you discover the injectable NSAID?  Is that something I could ask my PM for?  I self-inject B12 for life, so would that process be similar?  I suffer horribly from bloating/distention/inflammation, but cannot tolerate oral solutions such as Voltaren.  Any advice?

James...You speak so eloquently of your diagnosis/prognosis.  I love to read your posts, though I have great empathy for you.  I admire you so much, with your "acceptance and courage to fight" while lending your compassion for others.

This has grown even more complicated since starting PM in January.  I often wish I could have consulted with Dr. Jack.  I'm beyond my expiration date, and in a dangerously dark place.  I understand Brittany Maynard's decision.  I was never able to have children.  I think my husband would be better off starting over.

BTL...You've GOT TO muster the strength for those babies...no matter what.  Find some relief, then immerse yourself in whatever activity with them...even if it's just coloring in coloring books or Spiro-graph.  I LOVE kids...always wanted a houseful.  I know at this point in my life I couldn't be the mother I'd need to be.  I am similar to AngMichelle...I find great joy in my nieces and nephews.  I rarely get to see them, but oh what fun we have when we are together.

Ang is SO ON POINT with her reply to your other thread...Sweetie, you've gotta find the flower seeds amongst the load of fertilizer.  I promise you they are THERE, even though right now all you've got is the SMELL.

Please let us know what happens with your PM today.

Always, (((HUGS)))

Dixie 

Posted 11/25/2014 8:07 PM (GMT 0)
Dixie - Whenever I'd go to the ER for pain, in addition to dilaudid, they'd give me the "headache cocktail" for the inevitable rebound migraine I'd get - IV toradol, metoclompramide (Reglan) and benadryl. The toradol seemed pretty effective at helping the pain, but I can't tolerate oral NSAIDs, so I couldn't take it by mouth, so I never really got the opportunity to experiment with it. However, I kept it in the back of my mind.

One day I asked my doctor about the possibility of trying it IM (since it can be done either IM or IV) just to see if it did anything. I wasn't expecting much, if anything at all, but I was already trained in IM injections and I was willing to try anything that might help. We did one in-office and bam, complete pain relief for 8 full hours about 20-30mins after the shot. And I mean COMPLETE pain relief. The downside is that it is a rather painful injection with some intense burning, but it's short-lived - about 15mins.

The one downside to toradol is that you can't use it very often. I've been told no more than three times a month due to potential kidney toxicity, which is a very sad state of affairs for me, considering how effective the toradol is. But I 100% recommend it. I keep it on-hand for when the pain is severe and I'd go to the hospital otherwise, OR I have something really important to do that requires me to be able to focus 100%.

I hope that helps!! Best of luck!

EDIT: One thing to note is that 90% of my endometriosis is in the hip socket and on leg ligaments, dunno if that would affect whether an NSAID is more or less effective.
Posted 11/25/2014 8:18 PM (GMT 0)
Thanks, Jaux, for the info.  Again, do I ask my PM for the injectable?  I don't know if he'd prescribe it with my history of liver failure, though it was due to endo.  Yes, toxicity is a problem.  I'm at a point where I think "really? will I need my kidneys/liver @ six feet under?  I, like BTL, need SOME RELIEF...yesterday=(

HUGS~~Dixie

Posted 11/25/2014 9:50 PM (GMT 0)
You could definitely ask your pain management doctor for it. Both my PCP and my PM have administered it, though my PCP is ultimately the one that prescribed it. It's non-narcotic so I've never had a doctor hesitate in giving it to me when I asked (even post-op, where I though they wouldn't because of the NSAID bleeding risk). I haven't heard anything about toradol and liver function and a quick search tells me it doesn't look like it's associated with liver issues (it appears to be processed mostly in the kidneys, hence the renal toxicity) but it does mention that cirrosis = no toradol.

Apparently, it takes a LOT of paperwork to give it to someone for home use though, and can be expensive. Thankfully, my insurance and my doctor's office are exceptional at filling this stuff out so it was no headache for me. I bought a supply of 100 needles from a medical supply shop online, came to exactly $23 and didn't need a prescription. I personally use 21G needles, though that might be way huge for you, I don't know what you're used to.

I TRULY hope you're able to at least try it and hopefully get some relief. It is very helpful for me and I hope it helps a fellow endo warrior. :) Best of luck! I will keep you in my prayers and warm wishes.
Posted 11/25/2014 10:49 PM (GMT 0)
Toradol for home use is a no-no because it can only be used for a really short period of time. My PM doc told me today though he'd give me a few doses for emergencies. He really understands how ER docs treat PM patients like crap.

He switched my IR med to Nucynta. I haven't gotten it yet because it's going to take a while for my insurance to allow it since there's no generic. Thoughts on Nucynta? A search of the forum brings up tons of results, but most of them old.

Thanks everyone, as always.
Posted 11/26/2014 5:44 PM (GMT 0)
BTL...I think Toradol may be the med that Quik Clinic prescribed for me back in June.  I already had pain meds from my PM, so I said "no thanks". My regular PCP's office "couldn't see me for a week" when I realized the shingles virus was in my eye.  If you don't get strong meds within 36 hours, it gets much worse. (Note:  Don't really know how it could have gotten much worse.)  It was (is) horrible, has left me deeply scarred in my eyebrow/forehead and the ongoing feeling of fire ants in my face and scalp.

Okay, BTL, for what it's worth I'm going to make some very valid points.  I know that you suffer.  I know you've been trying hard to find help/relief.  I KNOW what that feels like.  I've known NOTHING but tragedy since a near fatal car crash in HS, where my mom, my sister (8 mos. pregnant) and I were airlifted to trauma centers.  We remained there for weeks with facial lacerations and bones broken like glass.  We all survived, by the Grace of God, and my niece was born healthy.

I am 53.  I was 17 when that accident occurred.  I would like to tell you that my problems ended there.  Nope...That was only the beginning.  My husband and I wanted children.  I was never able to conceive.  My struggles with endometriosis stage 4 and the Lupron chemotherapy are well documented here.  The Lupron has assassinated my skeletal health.  I battle issues with my entire spine, hips, and knees.  I have severe (will eventually cripple me) arthritis everywhere, but frightening in my hands and feet.  I take NOTHING for granted, from sleep deprivation to inability to poop.  Mine is not a happy place, but I soldier on.  I don't want to.  This is not the life I wanted (or want).  However, I look around and invariably find those who are FAR WORSE off than I.  Yes, I suffer relentlessly.  You do, too.  Sunny...Bless your heart, I read your posts and admire your courage.  (Please email me any time you like, as I've said to BTL)  We have a lot in common.

I have a strong faith in God, but still find myself crying out WHY?  I realize we must have a test to have a testimony, but I think I've learned enough lessons already shocked I get angry and feel overwhelming RAGE or I feel SO SAD that I can't stop weeping.  I joke that my therapist left his profession because I depressed HIM.  Sweetie, I don't think 1 visit per month is enough.  Sunny has good advice for you to seek weekly visits.  Please DO IT.  You are overwhelmed by your pain and your emotions.

I still truly believe your issues (some, anyway) are related to your surgery this summer and hormonal imbalance.  I may have asked you this, but have you seen an endocrinologist?  If not, he/she could be your MIRACLE.  For today, focus on your family as best you can.  As Sunny said...one moment at a time.  More than that can push us over the proverbial edge.

We're here for one another.

HUGS~~Dixie

✚ New Topic ✚ Reply