Aa
P)lease help with understaned my meds
I need help, I m new to pain clinicn and i think that for one the are pregargbe, I have a liphomo in spinal cord cause pain and no doctor will remove it. short story i beggeed them to take be taken of the patch Fentanyl, so i could go swimming my only true therphty i have in life. I was on a 50 mg patch and they stated me on a 15 mg morphine sulfate instead, i ened up in the hopsital a week laer becasue the pain level was to much for me to take. they. i just left the pain clinc angin doday and knwo they doulbel the dose 30 mg 3x a day, ohh and i also take 10/325 norco for yrs to help, i go back in a week what do i ask them if this dose of morhine dont work, Im at a lose i dont now what to do
Hi - I re-read her post and 30mg/ 3 X day doesn't sound like long acting to me. To Kindred - I read that your doctor started the conversion from 50mg fentenyl to 15 mg morphine sulfate - that's an immediate release drug, which obviously wasn't enough for you, so your doctor doubled it to 30 mg. Could you clarify for us whether your dose is ER - extended release, or IR - immediate release. This would be very important and relevant to how we respond to your question.
And, I know how hard it is to convert - it seemed like at one point in my journey, every drug my PM doctor put me on was discontinued. One, Palladone, was taken off the market due to causing heart attacks. Then another one I can't remember was also removed - but I finally settled on one that works and I've not had it yanked from me for years now. But, it can be a hard time, so hang in there.
And, I know how hard it is to convert - it seemed like at one point in my journey, every drug my PM doctor put me on was discontinued. One, Palladone, was taken off the market due to causing heart attacks. Then another one I can't remember was also removed - but I finally settled on one that works and I've not had it yanked from me for years now. But, it can be a hard time, so hang in there.
It looks like we posted at the same time! LOL
But I'm pretty sure, even though I had trouble understanding the post as well, that they were moved to MSContin 30mg at 3 times a day (every 8 hours) so that is another long acting medication.
And I agree...conversions can be very tricky and just wanted to add that I only posted what I did based loosely on a chart that some Drs. use.
(To the OP)....The key is not paying attention to the exact miligram number or an exact conversion amount but giving it time to work in your system which it will build up over time...
An example of why Drs. always start lower is because I switched from OxyContin when the patent ran out for the generic, to MSContin and the actual "conversion" should have been from 120mg of Oxy to at least 135mg of MSContin...But we started at 75mg up to 90mg....but many days I only do the 75mg....So we didn't pay attention to the numbers...just what was working for me.
As I mentioned...having a realistic view of how much one medication is supposed to help is very important..it is just one small piece of the puzzle to help with one's pain.
But I'm pretty sure, even though I had trouble understanding the post as well, that they were moved to MSContin 30mg at 3 times a day (every 8 hours) so that is another long acting medication.
And I agree...conversions can be very tricky and just wanted to add that I only posted what I did based loosely on a chart that some Drs. use.
(To the OP)....The key is not paying attention to the exact miligram number or an exact conversion amount but giving it time to work in your system which it will build up over time...
An example of why Drs. always start lower is because I switched from OxyContin when the patent ran out for the generic, to MSContin and the actual "conversion" should have been from 120mg of Oxy to at least 135mg of MSContin...But we started at 75mg up to 90mg....but many days I only do the 75mg....So we didn't pay attention to the numbers...just what was working for me.
As I mentioned...having a realistic view of how much one medication is supposed to help is very important..it is just one small piece of the puzzle to help with one's pain.
Hi there...
It's a little hard to understand your post....Are you diagnosed with cancer in the spine? I couldn't tell what you were writing that is your diagnosis..
If that is the case...I would think getting with a good Oncologist is important.
As well as with a Board Certified Neurosurgeon to see what they can do.
In regards to your medications...A prudent Dr. will always start low on any new medication and tirate up as needed and it seems this is what they did so that is good as they are looking out for you.
The conversion, with around a 25% cross tolerance which is normal for most people, is about 75mg to 90mg of Morphine which is right where you are now.
You need to give the new dosage/medication a chance to work which is usually a few weeks to a month.
It seems like you are already projecting into the future and not giving it a chance to work. How many of the Norco do you take a day? The key to good chronic pain management is to where an opiate is not your only means to lower pain levels to a 5 or so...(This is where most Drs. shoot for with CP)....I live with a 5-7 each day.
The breakthrough pain med is meant to be used sparingly when you have a bad flare..So they usually don't want someone taking it daily or else then it's really a maintenance med and you have nothing to take when the pain gets a bit higher.
As you said now that you will be able to start swimming again...hopefully that will help your pain levels go down a bit as well as it sounds like you haven't been doing that for some time now. That is why I would try to be hopeful about the Morphine and give this some time.
And then there are things like acupuncture, massage, ice, heat, biofeedback, yoga, daily exercise, eating healthy, physical therapy, and even counseling to help deal with chronic pain.
Good luck..
It's a little hard to understand your post....Are you diagnosed with cancer in the spine? I couldn't tell what you were writing that is your diagnosis..
If that is the case...I would think getting with a good Oncologist is important.
As well as with a Board Certified Neurosurgeon to see what they can do.
In regards to your medications...A prudent Dr. will always start low on any new medication and tirate up as needed and it seems this is what they did so that is good as they are looking out for you.
The conversion, with around a 25% cross tolerance which is normal for most people, is about 75mg to 90mg of Morphine which is right where you are now.
You need to give the new dosage/medication a chance to work which is usually a few weeks to a month.
It seems like you are already projecting into the future and not giving it a chance to work. How many of the Norco do you take a day? The key to good chronic pain management is to where an opiate is not your only means to lower pain levels to a 5 or so...(This is where most Drs. shoot for with CP)....I live with a 5-7 each day.
The breakthrough pain med is meant to be used sparingly when you have a bad flare..So they usually don't want someone taking it daily or else then it's really a maintenance med and you have nothing to take when the pain gets a bit higher.
As you said now that you will be able to start swimming again...hopefully that will help your pain levels go down a bit as well as it sounds like you haven't been doing that for some time now. That is why I would try to be hopeful about the Morphine and give this some time.
And then there are things like acupuncture, massage, ice, heat, biofeedback, yoga, daily exercise, eating healthy, physical therapy, and even counseling to help deal with chronic pain.
Good luck..
I'm trying to understand what you are asking - did you want off the patch so you could swim?
I do not understand why the doctor didn't switch you to another long acting opiate. You're already on 10/325 Norco - does your doctor know that? Now you're on another immediate release narcotic. For good chronic pain control, you need to be on a long acting drug, and if needed, a short acting one for break through pain. Your exact dosages are between you and your doctor, but I don't think you should be on two short acting narcotics - I don't know a PM specialist who would recommend that regimen.
If I've misunderstood, or if you have additional information, let me know. I wish you the best. I was a competitive swimmer for ten years - would love to be able to do that too.
Blessings, Jan
I do not understand why the doctor didn't switch you to another long acting opiate. You're already on 10/325 Norco - does your doctor know that? Now you're on another immediate release narcotic. For good chronic pain control, you need to be on a long acting drug, and if needed, a short acting one for break through pain. Your exact dosages are between you and your doctor, but I don't think you should be on two short acting narcotics - I don't know a PM specialist who would recommend that regimen.
If I've misunderstood, or if you have additional information, let me know. I wish you the best. I was a competitive swimmer for ten years - would love to be able to do that too.
Blessings, Jan
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