Pain Medication question

[mc4580]

I have been prescribed 6-norco 10/325 a day for a couple years, have fractured back with multiple levels of ddd. Cant do surgurey to many levels damaged, would have to fuse half my back L1-S1 shot.

Can doctor prescribe oxycodone or oxycontin in the 15-30mg range to take 1 or 2 times a day for really bad days along with the norco?

Prefer to stay with the norco as long as possible just looking for help during flare-ups. Due for some epidurals but thats about two months away.

[mc4580]

Well had the two ESI injections on L5, no help at all. Doc increased the Norco to 8 per day and wants to try Neurontin with steady increases for the next 3 weeks. Will go back in 3 weeks for visit and see how the Neurontin is working and then adjust from there. Options as of now try the Neurontin for a few months, consult with one of the other docs to discuss Percutaneous fusion at L5, talk to one of the other docs about a conventional fusion at L5, wait few months as they or in clinical trials for a new Percutaneous Discectomy that would be small cut with a larger tool to remove more disc material or live with it. Already had a Percutaneous Discectomy on L4 in 2008 that did help MRI shows reduction in bulge and the leg pain is better. New MRI showing bulge at L5 touching nerve. This is a full fledged Neurological clinic with some of the best Spine Surgeons in this area. Doc said regular Discectomy does nothing for back pain so thats ruled out.

Hoe bad are the side effects from Neurontin? I'm very high up in managment in our company and my boss pulled me aside and said he sees a differnce in my attention to detail and he doesnt want this to become an issue suggsted i talk to my doctors to try somethin that doesnt affect my alertness at work.

Problem is nacrotics soma and other meds do effect you. Anybody takes Neurontin? How does it affect you?

Tks
MC

[Mopar440]

I dont know if this is gonna help you, but let me give you a start on what I went thru hopefully briefly. Hydo, 5/500 7.5/500 10/500..then straight to duragisic patch when they realized it was real and the MRIs results came back and 6 or so months post op back surgery was in an MVA.I've been a pain patient for many yrs, but chronic pain treatment was just beginning. Skipping the PM quacks 3 of them really made life miserable, I had a different specialist handle my care. The invention of Avinza was great. Its what others where telling you about for long term pain, then follow up with a breakthrough med, Roxicodone, helped me, its fast, works, and doesn't have the aspirin additives..pure oxycodone..Oxycontin is like Avinza, I've tried it also, high cost stopped me from both now, BCBS decided that once a person is sick, they better find a way to get rid of them..raise the premiums so high and pay only for generic meds, well, generic time release meds for me don't work near as good as the real ones. Anyway, back to the point, I don't know anyway to avoid side effects of pain meds. I have to Ativan and resterill at times to unwire the brain so I can rest. I would say that if you were a chronic pain patient, you should be able to get a time release med, plus a breakthrough at the least just to give you a chance of having a decent day. No days are the same to me, you can start out good, end bad, start out miserable, end miserable..start out bad and hours later make it a decent day..me and my Dr just communicate as best as possible, and he calls the meds Tools..He gives me the tools, and I works with them as best as possible. Only word of caution is rebound headaches from the oxycodone type meds.. I don't know if you ever get that. It can happen.
Wish You Well
Mopar-man

[mc4580]

Thanks to all of you, you all  know that most people dont understand what chronic pain is all about and its difficult to talk about this even with my wife. The short acting medication is just not getting me through the day. Do you believe that the long acting medications work better to deal with the pain and what happens when you really have one or more of those really bad days? Does the er medication work that much better?

[sandee1818]

I had a PMP explain to me just exactly how pain medicines work and it is very easy to understand. It is like a puzzle. The pill is the puzzle piece and the brain the place where the puzzle would fit exact. When you take one pain medicine it fits into that part of the brain just like a puzzle piece would and when you have one piece of puzzle in then you can not insert another piece of puzzle as it will not work. The same goes for med, if you take one medication and it fits in to the brain in its place the next med will not work as the one you have already taken has fitted into place.
I hope I am explaining it as it was to me. It really made alot of sense to me.
I was taking two different meds at he time and was explaining that once I took the one the other one would be ineffective as the one I have took has already been taken.
I would do as Jaded sweetheart suggest and ask the Docotr about an extended release medication. It is not advisable to go in asking for a specific medicine.
When someone is on pain meds for an extended period of time they are usually given an extended release formula as the short acting begin to lose their effect due to tolerance.
I hope all goes well:)

[JadedSweetheart]

The best thing to do is talk to your doctor about your pain levels and how it's affecting your life.  Then ask if you are a candidate for a long-acting medication and go from there.  That way you're not asking for a specific medication, just for the doctor's expertise in providing you with pain relief.  
When I was put on oxycodone 30mg it was 3x a day with 1 norco for bedtime.  The reason being that oxycodone can give some people trouble with sleeping.  I found that I didn't have a problem sleeping taking the oxycodone at night as opposed to the norco.  I was equally insomiatic and took something for sleep anyway.  So he put me on only the oxycodone.  Really if your doctor would put you oxycodone, you wouldn't need the norco.  My doctor also told me that taking the two together would cancel one or the other out.  (Not that I would anyway)
I hope that you can talk to your doctor and get the relief you need soon.

[toolmaker]

Yes the Norco is still effective with an extended release narcotic.

[mc4580]

I am not opposed to taking an er type mediction, in fact it seems to be the better way to go.

Will the norco still be efective for immediate releif while taking a longer duration pain med?

My doctor is very reponsive to my suggestions for pain managment, is it allowablw to take the norco with a long acting med. I dont want to ask for somthing thats out of right field an damge the relationsip I have with my doc.

[Tuckamore]

Hello MC,

I am sorry that you have so much damage to your spine. Your pain must be significant.

If your question is can a long acting opiate be prescribed together in addition to the Norco regime you are on, the answer is yes. Physicians can prescribe OxyContin and Norco (hydrocodone) together.

I don't think it is common to prescribe two short acting opiates and allow you to chose which one you will take on any given day. I am sure it happens. This must be a decision between you and your physician.

In my experience most physicians do not prescribe OxyContin to be taken PRN (as needed).  If your physician will prescribe them in that manner remains to be seen. I encourage you to discuss this with him.

I understand your concern to step up to more potent narcotics. I agree that the longer you can stay at lower doses the better, especially if you are looking at a life time of pain management. However I also know the huge differance it can make to have good pain control. I recently went to a long acting opiate after six years of managing...or trying to manage my pain with short acting medications. It made a major differance in my pain levels and control. There is no good reason to suffer needlessly with unmanaged chronic pain. I think it is counter productive.

Our members will have additional comments. Our experience is all different. I wish you the very best and hope that you will let us know what you and your physician decide. I'll look forward to hearing from you.

Take care,
~Tuck