New meds

brewmonkey · 12-01-2004, 16:37

Well after 2 years of haing to take hydrocodone, darvocet, flexeril and some others I finally got with my doc and we sat down and came up with the start of a long term pain management plan.

We had 2 simple goals to start with and they were to 1- get me off all meds with acetaminophen and 2- provide a level of pain management that would allow me to resume some activities.

We ditched the old pain meds and started 20mg of oxycontin as needed up to 2X a day. This was a med that I looked at seriously as well as the duragesic patches but a call to my insurance helped me decide this one. The patches are expensive!!! The oxycontin is time released so I no longer have to pop pain meds every 4 hours or so.

We switched the muscle relaxers from flexeril and then skelaxin over to robaxin and then we switched from a SSRI (lexapro) to a tricyclic (elavil) antidepressant to aid in the pain management. And we added naprosyn for the NSAID.

I see the doc in two weeks to see how things are going and to make any needed changes in dosage or brands.

Thanks to all the gret advice I recieved from many of you. Without it I would not have known were or what to look for. I gathered information and even printed out some to bring with me as I expected some issues over the request for long term oxycontin use. Some studies suggest that the addiction factor for oxy is minimal when used in a pain management role, even when it is long term.

Again, thanks for the info and I will keep you all posted as to progress.

In the meantime I do keep a blog if you want to follow my daily ramblings.

http://ihavearachnoiditis.info
http://ihavespondylolisthesis.info
http://opforsoldier.blogspot.com

The blogspot address is the host and the 1st 2 are just re-directs to the site. I am hoping to get my software soon and then I will be hosting it on my own domain.

**Kyobanim** · 12-01-2004, 17:05

Hope this works out for you. My wife uses the Duragesic (sp) fentanyl patches and yes, they are expensive. She did get some coupons from her doc that gave her 3 months of patches for free. I understand that those companies will do that occasionally for long term pain treatment PTs.

**Roguish Lawyer** · 12-01-2004, 17:49

Brew:

I had no idea! Wow.

Anyway, you may want to take a look at the links currently on your blog.

**Eagle5US** · 12-02-2004, 11:00

Keep your wits about you while switching your meds. DUI doesn't only apply to alcohol.
Oxycontin is tremendous stuff and packs a great anesthetic punch. Long term pan management is a dance that requires patience, skill, and smarts. I pray that you are your PCM have all three.

All my best brother-

Eagle

SwedeGlocker · 12-03-2004, 02:38

Why did you want to remove acetaminophen? Elevated liver ensymes?

brewmonkey · 12-03-2004, 22:59

Quote:

Originally Posted by SwedeGlocker

Why did you want to remove acetaminophen? Elevated liver ensymes?

To avoid liver and kidney problems. I spent 5 years as a professional brewer, I am sure my kidney was not in the best shape to begin with. I am also going to be on pain meds for the rest of my life unless they develop a method to deal with the arachnoiditis. If I can avoid the extended use of acetaminophen then I am happier as I was on it for almost 2 years. Prior to the arachnoiditis I had spondylolisthesis and did 6 months pain management before having surgery and then another several months of pain management following. There was a few months break in there where I had some pain but tylenol was enough to cut through it, then the arachnoiditis developed.

Right now the oxy is working like a charm and I have done more in the last 2 days then I probably did in the last 2 weeks. I feel almost like the old me sans a few activities like driving a car. I spent most of the last 2 months in a recliner with a bottle of lortab and skelaxin popping pills every 4 hours or so. Now I am up and about and even re-arranged my office today and then did all the laundry.

I did have a bout of breakthrough pain last night so I spoke to the nurse practitioner today and she wants me to keep track until I see her again on the 15th. If it is something that is frequent and predictable then she will prescribe something for that as well (probably a low dose of oxycodone) but I am guessing if we time the meds right I should be asleep when it happens and to tired to care. The pain was not as severe as it was without the meds, about a 4 (I was a good 8 without the meds) and was towards the end of the dose.

If I understand what I have read about the oxycontin is that the time release comes about twice in the 12 hours. Right away and then again at about 6-7 hours. Maybe one of you docs can shed some light on this for me.