Well, I didn't make it until morning to get in to see my doctor.  I ended up driving 40 miles to the emergency room at  5 a.m. this morning.  I ended up going into the beginnings of withdrawal last night and I just didn't want to go in to work feeling the way that I did.  Of course, the ER doctors really do not deal with stuff like this all that often so they really didn't know what to do.  They made me wait for almost 2 hours as I squirmed and fidgeted all over the waiting room and felt like I was having seizures.  I am was a little frustrated to say the least.  When I finally got in to see the doctor, I think he was dumbfounded as to what he should do.  He said,

Yes, keep us updated with what happened at the dr.

thank you for your response.  First,  I want to say that my doctors have not prescribed more than 4000 of tylenol a day and I am aware of the damage that can be done to my liver.  I am prescribed 2 tabs every 4 hours which with being the 325's, I am under the 4000 mark.  My doctor wants me to try oxycodone extended release.  I have tried them in the past, but I truly feel that my mind plays tricks on me.  I will keep you posted as to how my appointment goes.  I truly need to do something.  As far as my shoulder is concerned, I had slipped on the ice over a year ago.  The hospital first misdiagnosed it which lead to further problems and then on top of that, as a result of the first surgery, I received staph infection in my shoulder joint which cause a lot of further complications.  The doctors have said that they will not do any more surgery unless it will be a complete shoulder replacement and they feel that I am pretty young for that (42 years old).  I think a big problem is that my doctors do not have a great deal of experience with addiction problems or pain management.  Being in an area that doesn't have a huge population doesn't help much with options either.  I am trying to force myself to get more proactive about this whole thing.  You had asked whether or not my wife was supportive....up to this point yes,  but everyone has a limit.  I don't want to get even close to that because I cannot imagine my life without my family.  That is the most important thing to me and I'm not sure I would do if all of a sudden they were gone.  I will post more later.  T

Sorry about that....

If you copy it and google it will come up...

www.medhelp.org/forums/addiction/messages/31002a.html  Hope this one opens.

Sorry, I didn't acknowledge all that chimed in.  Thank you to all!

I will tell you this from my own experience with oxycodone (percocet) that is really makes me have lots of ups and downs.  Brian4040 said the same thing.  I know someone who went through a horrible time with a botched surgery and had to endure horrible pain and got rid of the percocet because it made them so depressed.  I can't imagine the pain they had to endure. I saw the work that was done, oh, it makes me cringe.  Anyway, there are other medications out there that I think don't have quite the ups and downs that percocet and hydrocodone do.  Some of the extended released morphine products for instance.  They don't give any kind of a feeling of a "high" at all.  They just take the pain away.  That sounds crazy, I know but it is true.  I got of it extremely easily and it was controlled release so I only had to take it twice day and my pain didn't get out of control like it would with percocet because I would have to wait for my next dose and my pain would be out of control.  A couple of the different ones that come to mind are Avinza and Kadian.  I am not sure though if they are once a day or twice a day. And then, of course, you take the other stuff for break through pain.  But you don't get that mental haze with these products like you do with hydrocodone or percocet, in my opinion.  I am sure they are physically addictive but they weren't for me, some may have trouble with them though, so be careful.

Truly, it would be worth it to travel to a bigger city to get better medical care.  The top orthopedic doctors are typically not in the smaller towns.  It sounds like you really need to go to someone who specializes in shoulder surgery.  And I have never even heard of a shoulder replacement, they do those?  Sounds horrible.  Are you off work right now due to all of this?

You asked if it was need or denial.....I am not in your body but from what you have said it does sound like you need something to help take the edge off of your pain.  I personally went through this for several years and it took forever to get diagnosed.  I finally did get diagnosed and got it corrected this year, it was orthopedic in nature as well.  It was the worst pain I have ever experienced....ever.  For one thing it just never let up.  I have had children and I have to say 9 months of carrying a child and giving birth was much easier than what I had to endure during those years.  Had I not had pain meds I wouldn't have been able to function.

Here's the deal, you have a wife who you say is supportive.  Be truthful with her.  Have her keep your meds if need be.  Go through her and tell her about the pain you are experiencing and see if you really need it or if you can go another hour without or if you can take some anti-inflammatory mediction in between (do you take anything like motrin or aleve or a prescription anti-inflammatory?  You do have to be careful about your stomach on those).

The thing I have noticed is that there are people who do have legitimate pain (from reading on here to what I have noticed in person in life) and they truly need pain medication for a time, sometimes a long time.  The problem comes when  you abuse the medication or take it when you no longer need it.  You have to be honest with yourself and your wife.  Tell her you want her to keep you in check.  And as soon as this shoulder thing is resolved you want her to encourage you to get off the pain meds.  But make sure you do it under the guidance of a doctor, it will be a lot easier.  The problem I see from reading here is when people abuse the meds and they run out they have to detox on their own and they are in pure misery.   But if you don't increase your dosage on your own then you won't run into that.  If the meds they are giving you aren't strong enough then tell them.  There are many more out there.  Personally, I didn't think hydrocodone worked well for me.  Some say it works better for them than percocet.  But it didn't for me and percocet is a step higher in control status than hydrocodone so it is more addictive in nature, and stronger.  I would say if you are taking 20 a day, you definitely need to find a new med.

Keep us post on what the doctor says.

SB

I do hope you get some answers from your dr in the morning, and the posts here help you.
While doing a search online I came across this post from this site several years ago. Here it is  http://www.medhelp.org/forums/addiction/messages/31002a.html
I was doing a search because I have concerns about what the drs told you about detoxing and it can't kill you. I know with xanax and alcohol, it can kill you. I do agree with the other posters to do it slowly if that is what you and your dr choose to do.
Please keep us updated.

I really feel for you having such pain.  Is your doctor prescribing that amount of medication for you to take?  That is a huge amount of Tylenol and could really damage your liver.  There are other meds out there for chronic pain without tylenol that are a lot stronger than hydrocodone.  It sounds like you need to be in pain management.

As far as your thoughts of your brain "tricking" you, you are on the right track.  What happens is your body quits producing your own natural endorphins when you take pain medication.  And the more pain meds you take the more pain receptors your body produces.  It is a vicious cycle.  I think you are very smart to stay on top of the medications and try not to let them take over your life.  They really mess with your emotions and seem to make many people depressed.  You feel okay when you take them but then they work less and less and you need more and more to get the same amount of pain relief.  It sounds like you have some severe shoulder problems, did you injure yourself?  Are you in physical therapy?  Have they tried anything like ultrasound or other therapies.  I know that probably wouldn't even touch the surface of your pain.  It just seems like after 4 surgeries you are going to have quite a bit of scar tissue building up and that will cause more pain in the end as well.

Also, I am sure you do, but are you taking any kind of anti-inflammatory meds?  I would definitely call the doctor tomorrow and get the meds switched so you don't have to take so much Tylenol.  You should never take more than 4000 mg of Tylenol in one day.  And even if you are on the hydrocodone with the lower amount of tylenol you are ingesting at least 6500 mg of tylenol (if it 325mg per tablet) if it is the 500mg of tylenol per tablet you are ingesting 10,000 mg of tylenol.  You don't want to end up having liver problems on top of your shoulder problems in the end.

I really hope your doctor is receptive and will give you the help you need.  I just can't believe they said they would address the dependency issues later.  I would understand changing them so you can take less and have better effectiveness, maybe I am missing part of the story.  Keep us posted.

Is your wife supportive?