Pain meds not working

I have been on pain meds for 6 yrs ( hydrocodone 10/500 for 5 yrs and 10/325 for 1 yr ). I had a failed back surgery, the reason for the pain meds. When I was taking the 10/500 5 times a day, everything was fine. The 10/500 was reduced to 10/325, that where the problem began. I was still only taking 5 a day of the 10/325, I told the Dr I was having pain and waking up in the middle of the night in pain, he increased my dosage to 7 times a day. I recently changed PM Dr's and the new Dr reduced me back to 5 10/325 a day. Now I am still having pain and feel the effects of withdrawls, you know the symptoms so I won't describe. I work everyday and sometimes work without a day off for weeks, now I'm doing good if I am able to work 5 days. I'm not a drug seeker, although I get treated that way. I'm 60 yrs old and have maybe 10 to 15 more yrs to live and I don't won't to live it in pain. I understand the abuse of meds, I get it. What they need to do is start where the problem begins, the Dr's who prescribe meds to people who don't really need them. Meanwhile people who do need these meds to have some quality of life are getting screwed, because of the misuse by others and the Dr's who prescribe those meds to them.
Anyway I will explain to my new PM Dr what I am feeling and see what he says, although once again, if I say the meds aren't working anymore, I'm looked at like I'm a junkie and treated the same.

Definitely talk to you Dr about extended release meds. These meds would probably be the most helpful in getting a better nights sleep.

I hope your appointment is soon and a plan can be made to help you be in less pain.

Welcome DK to the CP forum at HW. I can honestly say that I too am surprised you have been kept on a IR med for 6 years but not at all surprised that the hydro isn't providing relief after you have been on it continuously for that long. There's not much chance it's coming anywhere close to providing the same amount of pain relief now at any dose as it did in the first few years therefore the need for increase as well as the w/d symptoms. Tolerance is inevitable and I certainly would expect the new Dr to be implementing changes in the future. As everyone has stated so many changes have occurred in 6 years in the world of CP and the agency's who regulate our pain meds. I also am not surprised that the pharmacy wasn't giving you a hard time about filling 210 hydro 10s or that many of any narcotics since the Fda and dea guidelines suggest that no more than 120 be prescribed of any b/t or short acting med.

Anyway it's going to be in your best interests to switch to a ER or LA med even if it were hydro based but I think you probably have squeezed about all the relief from hydro your going to get an it's always going to fall short of helping you at any dose after that length of time. ER or base meds are designed to give you smoother more consistency in coverage of your pain versus the highs and lows of Ir meds.


I can certainly see the need for working but are you truly doing yourself any favors if doing so requires you to need and rely on a high dose of narcotics to accomplish this?

Something to think about and I hope you are able to work with your new Dr to find a comfortable ground.

I agree with the others here, be honest with new PM Dr and seek a ER option. I am sure many here struggle with being in some amount of discomfort every day. It's very frustrating but the less medication you take the better off you are. It's not good to be in chronic pain all the time but these meds are harmful and all have side effects. Be careful and try to take as little as possible.

I don't even know why they kept you on ONE ir med for so long and just kept increasing the pill count.

Just switching IR meds along the way would have helped a lot.

But at this point, yeah, I think your best bet is going to be getting onto an extended release med, and then using another ir med (other than norco) for any break through pain you have.

I think you're done with Norco for a good while. At this point it's like beating a dead horse.

Did your new pain dr have a copy of your medical records ?

Wow, yes, definitely get a second opinion.

Wait, are you in a doctor shopping state? There are different best practices for getting multiple consultations though someone else will hopefully chime in...

1st, yes the new PM Dr had a copy of my records. No PM Dr in KY will see you unless they have a copy of your records to review first.
2nd, yes I can't take flexural or naproxen.
3rd, where did Dr shopping come in on this topic?
4th,my case is work comp and the insurance company will pay for name brand meds.
5th,When I told the new PM Dr about the symptoms I was having, which I believed to be WD, he said those weren't WD symptoms. Personally, I think he was lying to me. I know what the symptoms are, I have experienced them before. When does all the BS end?
And last, I don't know why they have kept me on these meds for so long, as I said before no Dr has ever mentioned the ER meds you all have talked about.

Well DK you explained it all when you threw (KY) in the mix!! It ranks in the top 5 worst states for pain management. I was born and raised there,spent 52 years there and all my extended family still resides there,I started this journey there and I have to be honest and say I was put through basically the same thing. Years of hydro and eventually so many KY Dr's alternative methadone and that battle has a historical nightmare here in archives if you ever wish to read a good horror story. We also have another Mod who is a long-term CPer and moved to KY a few years ago to be closer to family and he also has a horror story to tell about no Dr to treat him,having to leave the state every month to return to his previous Dr,eventually having the only recourse of having a pain pump implanted.

If you can't tell I'm not a fan of the PM Drs there!! Note as well I spent 30 years working at one of the areas largest hospitals so my experience is not just from a personal angle. I am sorry to see you in such a need in a place that's not likely to be much help. The few good Drs of PM there in Central KY have now retired and I don't think I have heard good things about any new one's from home.

Also unfortunately understand better the need not to rely on disability benefits there.

I have a few friends who are in PM there and the struggle is ongoing but I can say they're faring better than you seem to be. My email addy is in my profile if you want to share your area of the state I will see if either of their Drs are close enough to be feasible.

I don't think M&G was suggesting that any kind of Dr shopping was indicated just stating a fact that its not violating any contract or laws to get other opinions as long as you don't accept meds until your current prescribing Dr relationship has been concluded formally.

Hey Doesntknow.Welcome aboard the Pain Tran.

My Pain Management Doctor doesn't prescribe anything with Tylenol in it.

She prescribes an Extended Release(12 hour med) every 12 hrs.

She also prescribes Breakthrough,or Rescue Meds,every 6 hrs or as needed.

She's my 3rd in 10 years.She's the only one that's been worth staying with.She said she was going to get me out of pain and she has.

I've never known any one to get more than 4 Norco 10 mg a day.120 seems to be the number here in Alabama.

I think you would benefit from an Extended Release Med.

Take care and God Bless,

Rick

NP. Mercy

A little late on this conversation. For what purpose you are taking the meds?

Do you have any nerve related pain? If so has any dr ever tried you on Gabapentin, Cymbalta, or even Lyrica? A lot of surgical folks like you have nerve pain afterwards is why I am asking.

Like Vickie mentioned, with you living in Ky that is probably why no one has tied you on a long acting pain medication. When one of mods moved there every dr he saw said we only offer physical therapy, injections & that sort of thing, no narcotics & now knowing were youl ive that explains why no dr has put you on a long acting medication.

I sure hope that someone will come up with something that helps you.