How much is too much pain medication?

[ljlu]

After having blood in urine for 5 years my GYN sent me to a urologist who DXed acute Interstitial cystitis, then she did Hydro-dystention and found half capacity small bladder with scarring, before the Dystention I had little pain, just blood in urine and some frequency, post Dx dystention I had agonizing pain, she Rxed 10/325, take 2 every 4 hours, then she changed to after 2 years, Oxycontin, first low dose then she kept increasing due to retention of urine caused by the Oxycontin, to 60 mg three times daily, I stopped taking it myself, she was away on vacation..I got ill terribl pain but got threw it..One month later I went to see her, she still insisted , "You have to take something for the pain, or your blood pressure will just go up and you go into shock"...Insisted I take Oxycontin anyway even w/ retention?? I stopped seeing her and stayed on 10/325 w/other MD.In time I see more blood in urine and go see her again, she Dxed 'Take one 50mg Duragesic patch each day..Pharmacist says 'She made huge mistake and she changed RX to one 50mg patch every other day. I over dosed. I went back to 10/325's.
One year later I had a flare and she Rxed this "take one 50mg patch every two days again..I did, it helped but I felt extreme exhaustion. Things were fine, two years later pain is back, so is blood in urine badly visible, she Dxed 75, 6 months later she insisted on increase to 100mg, within two months more blood in urine she increased to 150mg. I stopped seeing her when it got to be 175mg Duragesic every other day".Now 10 years later even more blood in urine, Dxed w/Osteoporosis and have back injury, MD wanted to increase patches due to pain levels and I refused..My question. How much Duragesic can any person take and what is too much? 55 year old female, small bones white, no other medical issues, post menopasal, not HRT, thoughts? What is the most any one ever took dosage wise of this drug and what is safe?


This discussion is related to pain.

[katarina777]

I think the real problem here is that your doctor is 'nuts'. Sometimes, it is really important to be able to know for yourself that something is really wrong, and not right with your doctor, or any other person or advice for that matter.

Do mot see her any longer and get a new doctor and another opinion.

This doctor is just way off and I think it's good you don't trust her. i.e. you do not increase oxicontin due to pain that is caused by retention of urine as a result of the oxicontin.

Glad she has not killed you yet. maybe you should also looj her up on the medical board of your state although that doesn't always mean much if it says nothing. Sometimes it's better to do a federal search and the best ones cost a little money, like $10 or a little more.

KATRIN

[katarina777]

Actually, I really admire you, ljlu, for not listening to her, and don't start now.

[Tuckamore]

Hello Ljlu,

I am sorry that you are having such horrid pain. You have multiple reasons for pain and it just never seems fair. I admire your courage and common sense that is so obvious in your post.

I've read your post several times. You stated you stopped seeing her. Good call. It is my understanding that you are now seeing another physician as you state, "Dxed w/Osteoporosis and have back injury, MD wanted to increase patches due to pain levels...." I assume that this is not the urologist that made this type of a DX nor the physician that has suggested an increase in your pain patch. Please clarify.

Your question is how much is too much? In my humble opinion you are taking a lot of fentanyl (duragesic). I would not be comfortable if a physician suggested the dosage be increased. However have you considered changing opiates. After all these years you may have built a high tolerance to this drug. Sometimes a drug holiday or change in the opiate can be effective. If you pain level is high it may be worth consideration after discussing this with you physician.

Are you on break through medication? This may also add to the pain releif. In my opinion another consideration. And last but not least are you seeing a PMP? They are the experts in pain management. Possibly a mixture of other medications can be more beneficial than the 175mcg of fentanyl.

Best of luck to you. I hope you will keep in touch. I will look forward to your updates. And as always...Take Care.

Tuck

[seano]

I was on 150 mcg. patches at one time. It is the largest patch they make. I know of someone who was on 2 of those at a time though.

[ljlu]

I did go to a Pain Managemnt person because I have a "healthy fear of tolerance and addiction".. PM MD said. "What do you have to prove by suffering"? He's the one who upped the RX of Oxycontin from 12mg daily to 60mg 3 X daily..and caused the urinary retention but then once the urol knew it caused retention, she Dxed the patches...but she admitted, she "didn't really know what she was doing with these"..( clearly). The thing is, she is the best Urol surgeon in CT but when her husband died she seemed to have gone off of the deep end. I have excellent records of all my history..When I saw her Tuesday she didn't even know what dose of Patches I was on??? OMG..Now she wrote "gross Hematuria"..means a lot of blood in the urine and she's sending me for Urol. CT Scan to see if I have another kidney stone ( I doubt it), or another bladder cyst)..could be, feels like that again.
Here I have to trust my own guts, given her past behavior///( almost over dosing me with too high dosages and increasing pain meds, "because she doesn't know what else to do for me"?? ( a quote from her)
Most of the good MD's seem to have left CT and I'm thinking of John Hopkins or Boston..I also have acute Osteoporosis and spinal stenosis..( sorry can't spell today lol)..I'm hurting in a lot of places, injuries,  from when someone hurt me long ago..( not here for that kind of help however)..I never saw 150 mcg of Duragesic patches.I use only brand name..the generics especially Sandoz caused rashes and all kinds of issues with how it went into my body..etc..I've had blood in urine since she met me.. before her MANY surgeries and after, it's always there, I have no idea why she is so freaked out that there is "more then usual now"?? But I do know more pain meds only MASK my symptoms and I have a healthy fear of addiction and although she sent me to Pain Management to "get over this fear"..To me it's a wise fear to have. With all of my pain issues and injuries...if I take this dose now..what will they RX when I am old? if I live that long.I hope to. lol Thank you all for your input..I read all I can about my situtations and try to not 'just leave everything up to these Md's, they're only human, and we have to know our bodies and learn to stand up to what our common sense says..I had hoped one of the MD's in here would tell me "How much is too much..This began over 16 years ago..and No, I don't want to suffer and weigh 99 pounds again from just 'dealing w/pain..I want my life back..today. I'd just settle for some sleep beyond 1-2 hours. Loss of sleep makes my pain ( anywhere) much worse..I have Norco 10/325 for break through pain..Nothing is helping today, Bladder pain is localized,, this is the ONLY reason I even went to her again..She is a great sureon, just a ding bat when it comes to 'what she Rxed and what it is or how much is safe"..and I recent being drugged just to shut me up, that's how it feels with her at times..Thanks again all of you.

[ljlu]

I forgot to say.. I stopped seeing the Pain Manager when he DXed 60mg 3 times daily and when Urol told him it caused retention, he "couldn't see me for a month so I'd have to deal with it"?? I stopped taking the Oxycontin he DXed that day and bladder soon began to 'work OK again within 12 hours"..I just suffered for days in agony and my poor bladder and then my body didn't know it at the time, but MD said when I saw her two weeks later, ..I must have gone through withdrawals from the level he had me on those two months..but I don't know about the withdrawl thing, all I knew was."This caused retention and I had to stop to save my bladder' ..." and so I did..I could have taken the Oxycontin anytime instead but I am stubborn..I jokingly claim this is how I keep my girlish figure..lol  kidding. Pain makes appetite gone...Have to have a sense of humor, it helps.I've been on the same dosage of patches 175 and 10/325 now for going on three years. That's why I asked the question,, "How much is too much"..The answer of two 150 patches answers some of that..The MD that did injections into spine once told me when I asked him.."Oh don't worry, I have Pt's w/cancer on 300mcg of patches"....but no one seems to ever know, does it have a limit in anyone, not even him? Even after some 16 years? Thanks again.

[Tuckamore]

I noted that you said," I had hoped one of the MD's in here would tell me "How much is too much.."  There are not any MD"s on the Pain Mangement Forum. You may have thought you posted on a MH Forum that monitored and lead by an MD.

Just click on the word Forum at the top of the page and that will take you to an alphabetical listing. Physician Forums are on the right of Forum listings. You can re-post your question.

I wish you the best.
Tuck