I agree, you have to tell him exactly what is going on - he can't read your mind! And he seems to be trying to help you - giving you something stronger and getting you off all that tylenol.
He may take you off it all and try a while different drug, but it will be based on you explaining what is working and what is not. When the pain is the highest, what helps, what doesn't etc. Once he has all the facts, he can hopefully get you on a plan that works for you!
Good luck at your appointment.