I have been on Norco (10/325mg) pretty much every day for the last two and a half years because of back pain. I am in the US Army and started having a lot of back problems after my first deployment in 2005-2006. I started out with 30 a month to take as needed and never really had a problem. As time went on, some months i would have some, some I wouldn't. It was never a big issue, but as time went by my condition became worse and worse. I went through chiropractic, and physical therapy but with no relieve. Finally, they sent me to pain management and I would get about 90 for a month. Still, never really had an issue, if I ran out I was out. While in pain management they also did injections, and did and RFA on a never that was suppose to be causing me problems. Though after the deaden the nerve, I began having hip, thigh, and knee pain on my right side. After switching pain management Dr.s My new doc told me it sounds like the had done the RFA on the wrong nerve and I would have permanent nerve damage. He still continued me on the Norco and did injections, and some diagnostic procedures before finally finding. I had two torn discs, a fractured vertebrae facet on top of significant degenerative disc disease for my age. They said i could continue with the injections and medication or have a three level spinal fusion done by a spinal surgeon.
In January of 2009 I had the surgery done, and after about 3 months of recovery, I was feeling a lot better with the original back problems, most pain was from bending or sudden movements such as sneezing or coughing. The unfortunet thing that happened after the surgery though was the hip, thigh and knee pain on my right side got almost 5x worse. The attributed this from relieving the pressure of the discs off of the nerve that had been damaged. So I continued going to pain management, still getting Norco, and never had any trouble.
I was still having the sever pain on the right side, so they decided to do one of those MedaTronics Neuro Stimulator trials. It worked alright, but I was told it would be a lot better after it was surgical implanted and it would get a lot better coverage. Well in April of 2010 I had the Stimulator implanted, and this seems to be when everything started getting worse and worse. I got some relief, but nothing near what I thought i would, and after about three months, the stimulation area had shifted and i felt it in my stomach a chest mostly, rather than my lower back, hips, and right leg. At this time, I was beginning to have issue with norco not work as well, and I didn't want to keep pushing up the dosage. I was obviously building up a tolerance at which but my Pain Management Doc took me off norco and put me on Methadone. That was alright, but it didn't work as well as the norco did, and it made it really hard for me to urinate when i was on it.
After being on methadone for about three months, I had to have a third surgery to get the electrical lead for the stimulator replaced to refocus the coverage where it was suppose to be. Now out of the other surgeries I had, this was the simplest and the most painful recovery by far. After that surgery, the surgeon gave me Percocet 10mg to take, and i took those for a couple of weeks, but wanted to come off them because they gave me headaches. So they put me back on the Norco till I could get back into Pain mangement. At this time I was on the max dose for the Norco at 2 every 4hrs. I finally was able to get back in to see my pain management doctor and he put me back on 5mg methadone three times a day, despite what I had told him about it the last time. I used the methadone, but found my self still using the Norco I got from my surgeon for the break through pain the methadone didn't cover. Three months after the lead replacement, I was still having a lot of hip, thigh, and knee pain. I discussed this with my surgeon and how the methadone wasn't help and the side effects made it much less desirable to take. He said that he hopes the area will calm down in time but he thinks I need to be on a extended relief type medication a little better than methadone. He suggested Extended Relief Oxycodon and he would send that recommendation to my Pain Mangement Dr. for my upcoming visit, but in the mean time he gave me another Script for Norco (10/325mg) 80 which was a ten day supply but for me I was lucky to make it 8 because of my tolerance I couldn't take it every six hours, it was more like 4-5 before i started hurting again. When I went to my Pain management doctor, I was rushed in, he already had the methadone script wrote up by the time he came in. He asked how I was doing and as I tried to explain the issues with the methadone, and the stimulator was just making my legs ache worse. He honestly didn't seem to care. He told me if the methadone wasn't working, than it was to bad and I would have to suffer because he didn't wanna put me on any thing else.
I tried to discuss this with my surgeon, but it was like playing phone tag which ended with me talking to one of his PA's They told me that I should be more direct with my Dr. and that if i am not happy to get a second opinion. I did not want to have to go find another pain doc and get my insurance switched over because being an active duty soldier its a time consuming pain in the a**. Plus with in the next 6 months I will be getting a medical discharge from the Army for my back and leg problems and will be moving home to Indiana at which point I will have to re transfer everything again and start with a new doc. I just asked if she could keep me on the Norco for the time being and or at least till I went back to see my pain doc and tried to be more "Direct" What ended up happening was she gave enough for another week and I was going to be back where I was. So I finally asked them to put in the referral for the new pain management doctor, and told them I would no longer be going to the other one so they didn't have issues with giving me the norco, the only medicine that still works. Well during this time, the forgot to tell me a crucial step and now I have to go see my primary care dr. for the referral to be approved by my insurance(But i can not get in to see them till 13 DEC). Mean while I am getting ready to run out of Norco, Today is my last dose and I tried to see if the Surgeouns office would refill it again till I get in with the new pain dr. which is estimated at being around 30 Nov. Well the last time they refilled the norco they told me it would be the last and that i should make it stretch. Well I was trying to make it stretch, but i though it wasn't going to be that long of wait because they said normally I could get in with in a week. Which, turns out is not the case. On top of everything else I have come down with a bad stomach virus to where i have hardly eaten and been vomiting a lot, unfortunetly taking my pain meds or any meds even for nausea seemed make the nausea worse till the point I expelled the medication I just took and well, it doesn't exactly have the same effect in the toilet. So I would try to wait a while before taking some more, but I could feel my body start protesting at around 5hrs after last dose. So now my ten day supply once again lasted me seven and its november 3 and best case cenario I get to see new pain doc at the end of the month. So I am now scarred of going through with drawl, I have been through it for a couple of days before, and it was a miserable, sleepless time. I am worried they are going to tell me no again and think I am just trying to get the meds. I know I have a high tolerance and I will admit I have taken more than the ten day a limit i think the most was 14, but i stay with in the recommendations on the bottle. I sometimes hate taking these meds, but right now it is a necessary evil that I hope in time will reside to a more tolerable level. So anyway, It looks like I am going to start detoxing tomorrow whether I like it or not. I just wanted some advice on the best way for me to get through this, for me being in the military, I can not exactly call in sick so I need to be able to remain functional enough to go to work, but I am worried that being on that high a dose for so long is going to be extremely uncomfortable. So any advice you can give me would be greatly appreciated.
Thank you for your time,
I am sorry no one answered your post. It is the dinner hour and it is usually slow at this time. there will be more members on later tonight.
In the meantime I have to be honest. I could not read all of that and retain it. I have burnt a few brain cells over the years.
So, bear with me. Your prescription ran out early and you will be starting withdrawal tomorrow? You need help getting through until your next refill? Let us know and we can help you with some home remedies and such. Just my opinion but I think you may be a little uncomfortable at work tomorrow so if there is any way to call off, you may want to plan on that.
Hello and Welcome to the Pain Management Forum. I am so very sorry to hear about the your painful condition and the difficulty you have had getting your PMP to listen to you. Unfortunately this happens.
You are caught between a rock and a hard spot. I wish I had a magic answer but I simply don't. I understand your hesitancy to change PMP with so little time left in the military....but I think you have chosen the right option. Your current PMP is most likely prescribing the methadone because it is considered a "safe" opiate with little addictive qualities. It's been prescribed for me also and I experienced severe headaches too. My body just wouldn't adjust to the medication. It sounds like you may be experiencing the same side effects. I am not willing to change one pain for a debilitating headache and vomiting....especially when it wasn't all that effective in relieving my chronic pain.
It doesn't sound to me as if your pain has been properly addressed or managed. Once it is you will feel so much better. A long acting/slow release opiate may be the key here as suggested by your surgeon. Something that keeps the pain tolerable 24/7 with Norco or a similar opiate for break through pain.
It's my guess that you are using more of the Norco than prescribed because it is not sufficient in controlling your pain. It doesn't sound like an abuse situation but only you know that.
At this point you might want to call your PCP. I hope you have a good relationship with him. He is obviously aware of the situation and may be more understanding than you think. If not, make another call to the surgeon and explain the situation. As you suspect, he may not help you but then again he may. You have few options at this point. A trip to ER would probably not be productive but again your choices are limited and you may want to consider it.
Please keep in touch and let us know how you are doing. I am so very sorry that you are dealing with chronic pain and having difficultly finding the right treatment. We will look forward to your updates. I wish you the very best.
I appreciate the advice, but most is to no avail. No matter how hard I try to talk to my surgeon, he never calls me back, I always have to deal with PA's They say he but no more refills in my chart and go to pain management, though i feel that was before the situation arisen being between pain management Docs. So, I do not know if he knows what is going, but it seems that I never will. Once again, I get if the withdrawal gets to bad to go to the ER, Sigh. As for my PCP, they know nothing about me other than whats in my computer file. The Military care system is a lot different and a hudge pain to get into see the Doc, Like I scheduled an appt last Monday, first available wasn't till 13 Dec, so yeah.
Anyway Its been about 21hrs since my last dose. I slept like crap, maybe a total of 2 hours. I am depressed as all hell, nauseated, and can't seem to sit still. I know this is just the beginning and i know its only going to get worse. Its not easy for me to get out of work, we can not exactly call in. We actually have to have a medical note saying we need time off, and getting some one to give you one is, well like pulling teeth.
Thank you all for your time, and if there is anything you can suggest to help with withdrawal, I would greatly appreciate. It seems like sleeping meds can not even keep me a sleep so I don't know.
Once again thanks for your time.
I've been through Norco (10/325) W/D's before, and the first 2-3 days are the worst, with day 2 being the absolute worst.
It's different for everyone, but from how you described your usage, 2-3 days should be about right (all things considered). The lethargy will dissipate in time. Stay as hydrated as you can, as the seats tend to sap you of bodily fluid (and you don't want to have dehydration ON TOP of w/d's).
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