Aa
do meds take time to work.
I had my first pain management appointment yesterday, and so far the meds have had little or no noticeable effect. My back feels the exact same as it did and has. I'm 27 years old and a firefighter, and I'm told as a result of my mri. I have arthritis, which has in turn created some stenosis. Ok now that that's out of the way I was prescribed 10mg neurotonin once a day and 7.5mg Norco once a day. I've been taking 10mg Norco every 4-6 hours for almost 2 years. I have not taken the Norco today as I'm at work until 8am. Would it be totally out of line of me to ask for more or somthing stronger? I'm also scheduled to have injections on the 10 th should I wait until then to say anything?
Just wanted to add that 100mg of Neurontin is almost a joke. Many doctors start their patients out on 300mg 3x a day. It is safely prescribed much higher than that. I personally have been prescribed 4,800mg a day, divided, and for very severe cases it can even go higher. Otherwise great advice from everybody here. :) Were you able to find a new PM doctor?
Maybe time to find a new pain doctor. He already set off a red flag for me by warning you about hypogonadism and not drawing a serum testosterone level.
He's a quack.
He's a quack.
Well I just got a phone call back, and I'm beyond frustrated beyond belief. I basically just got told by some nurse that it can't be that bad, and I will be getting nothing else for now. How is 1 pill that last for 4 hours supposed to do anything? I guess I just won't worry about the other 20 hours of the day.
Dependence is the nervous system's response to a regular supply of opioid pain medication.
Tolerance is the nervous system's response to dependence, and with tolerance, your body requires a larger dose of opioid to achieve the same analgesic effect.
Addiction is a psychological response some (about 10% of the population) have to behaviors that alter the mood. Addiction to substances -- opioids, benzodiazepines, barbituates, amphetamines, alcohol, tobacco, etc. all alter the mood and have the potential to cause addiction. Behaviors like sexual adventurism and gambling also have this potential.
Pseudo-addiction is a behavior that may have some signs of addiction, but results from under treatment of pain, and a person’s desire to find additional pain relief. Prescribers must be very careful not to confuse pseudo-addiction with addiction.
In general, chronic pain patients who use their medications as directed, for the treatment of pain, do not develop addictive behaviors, but may show signs of pseudo-addiction when their pain is not controlled.
Tolerance is the nervous system's response to dependence, and with tolerance, your body requires a larger dose of opioid to achieve the same analgesic effect.
Addiction is a psychological response some (about 10% of the population) have to behaviors that alter the mood. Addiction to substances -- opioids, benzodiazepines, barbituates, amphetamines, alcohol, tobacco, etc. all alter the mood and have the potential to cause addiction. Behaviors like sexual adventurism and gambling also have this potential.
Pseudo-addiction is a behavior that may have some signs of addiction, but results from under treatment of pain, and a person’s desire to find additional pain relief. Prescribers must be very careful not to confuse pseudo-addiction with addiction.
In general, chronic pain patients who use their medications as directed, for the treatment of pain, do not develop addictive behaviors, but may show signs of pseudo-addiction when their pain is not controlled.
Alright I called, and told them it was not effective, now I guess I'll wait and see about a call back.
As far as addiction goes I have been off opiods meds for 2 months, because my gp suspected I was addicted to them and it just took this long to get the appointment. I have already been through w/d and I am fine on that end. I adimmititly was taking more than I was prescribed to get relief. I was just trying to do it right this time to avoid all of that headache.
Nah that's solid advice, nah its not all kosher with the 7.5s I can hardly get out of bed. My shifts at work are pure agony. I just didn't want to seem too needy.
Your post is the type of post I read, and then I think to myself, "I hope the Pain Management Doctor treats this guy with respect." You're a firefighter (very physical and demanding job), and on top of that, you have arthritis and stenosis.
A bunch of things puzzle me, though. I'll go ahead and mention them, they're mostly rhetorical, you don't have to answer, but something to think about.
First, on 10mg hydrocodone every 4 - 6 hours for TWO years? And now you've been reduced to ONE pill a day (and a 7.5mg pill, at that), and you're not totally flipping out? Your post seems so calm. If it were me going from 60mg a day for 2 years, down to 7.5mg a day, I doubt I'd have the energy to press the power button on my computer!
Second, the 7.5 a day, to me, is ridiculous. (Not 'YOU' ridiculous, I mean ridiculous for a PM to prescribe that!). One 7.5mg of hydrocodone is not worth the Opiate-Prescription-Pad-Risk! Stubbing your toe will give you more pain relief (via distraction) than a 7.5mg pil LOL. So, I'm sensing your PM is telegraphing some sort of message to you (e.g. "Okay, sir, so you're one of those Norco-Takers, I'll patronize you with one pill so you can't say I never prescribed you anything").
(These are all just my opinions, of course, so please take them with a grain of salt, I could be totally off base.... but I'm writing them down here so you have some things to consider).
Third, if you were taking 60mg hydrocodone a day for 2 years, and now are taking 7.5mg, and as you said, "My back feels the exact same as it did ," then if it were me, I'd probably cease the opiate therapy (after discussing with doc). You're clearly not addicted or dependent (thank goodness), and if you feel the same on 7.5 as you did on 60, then not worth the risk!
Forthly, by not saying anything, by waiting until the 10th (your injection date), you are signalling to your doc that you are not in that much pain, and probably don't need the Norco (otherwise you'd be on the phone "Hey doc I'm dyin' here, my back's killing me, hellllp").
And, Fifth, well, I don't know... pills, steroid shots, etc., you have to weigh the risk of all of those with how much pain you are actually in. In fact, you don't mention pain at all, anywhere, in your post. If I were to guess (I'm usually wrong, even when guessing heads or tails on a coin who buys lunch), I would say you probably have some 'regular aches and pains' that most people have with demanding jobs, and maybe a little bit of ice and some safe OTC meds would be good enough? And you wouldn't have to go thru' ALL the nonsense/rigamorole of Pain Management, worrying about urine, about 'what doc thinks,' about having to do this, and that every month...
Of course, if you are in crazy severe pain, then by golly say something. The squeeky wheel gets the greasin! Someone in *real* pain doesn't care how much noise they make with their doc! (At first, at least! Then when you are an 'old timer' pain management patient, you learn to make sure to not upset your doc... you know what I mean?).
I hope all goes well for you, and I'd really like to see if anything I said resonates with you (or rubs you the wrong way, too!, I apologize in advance :-)
A bunch of things puzzle me, though. I'll go ahead and mention them, they're mostly rhetorical, you don't have to answer, but something to think about.
First, on 10mg hydrocodone every 4 - 6 hours for TWO years? And now you've been reduced to ONE pill a day (and a 7.5mg pill, at that), and you're not totally flipping out? Your post seems so calm. If it were me going from 60mg a day for 2 years, down to 7.5mg a day, I doubt I'd have the energy to press the power button on my computer!
Second, the 7.5 a day, to me, is ridiculous. (Not 'YOU' ridiculous, I mean ridiculous for a PM to prescribe that!). One 7.5mg of hydrocodone is not worth the Opiate-Prescription-Pad-Risk! Stubbing your toe will give you more pain relief (via distraction) than a 7.5mg pil LOL. So, I'm sensing your PM is telegraphing some sort of message to you (e.g. "Okay, sir, so you're one of those Norco-Takers, I'll patronize you with one pill so you can't say I never prescribed you anything").
(These are all just my opinions, of course, so please take them with a grain of salt, I could be totally off base.... but I'm writing them down here so you have some things to consider).
Third, if you were taking 60mg hydrocodone a day for 2 years, and now are taking 7.5mg, and as you said, "My back feels the exact same as it did ," then if it were me, I'd probably cease the opiate therapy (after discussing with doc). You're clearly not addicted or dependent (thank goodness), and if you feel the same on 7.5 as you did on 60, then not worth the risk!
Forthly, by not saying anything, by waiting until the 10th (your injection date), you are signalling to your doc that you are not in that much pain, and probably don't need the Norco (otherwise you'd be on the phone "Hey doc I'm dyin' here, my back's killing me, hellllp").
And, Fifth, well, I don't know... pills, steroid shots, etc., you have to weigh the risk of all of those with how much pain you are actually in. In fact, you don't mention pain at all, anywhere, in your post. If I were to guess (I'm usually wrong, even when guessing heads or tails on a coin who buys lunch), I would say you probably have some 'regular aches and pains' that most people have with demanding jobs, and maybe a little bit of ice and some safe OTC meds would be good enough? And you wouldn't have to go thru' ALL the nonsense/rigamorole of Pain Management, worrying about urine, about 'what doc thinks,' about having to do this, and that every month...
Of course, if you are in crazy severe pain, then by golly say something. The squeeky wheel gets the greasin! Someone in *real* pain doesn't care how much noise they make with their doc! (At first, at least! Then when you are an 'old timer' pain management patient, you learn to make sure to not upset your doc... you know what I mean?).
I hope all goes well for you, and I'd really like to see if anything I said resonates with you (or rubs you the wrong way, too!, I apologize in advance :-)
Ok then I'll give the neurotonin a few more days to hopefully start working, and if not I'll put in the call.
I don't think he tested my testosterone, I gave a urine sample but that was all. I don't know if they can test from that?
Did he check your testosterone level?
It is true - long term opioid use suppresses testosterone production (progesterone in women), but supplements can be used.
If your pain is real, then you should seek adequate treatment -- this means lowering the pain to a level that you can tolerate.
There are other means to lower pain, and you should get together with a pain psychologist to discuss them.
But the consequences of untreated pain are much greater than any consequence of hypogonadism.
It is true - long term opioid use suppresses testosterone production (progesterone in women), but supplements can be used.
If your pain is real, then you should seek adequate treatment -- this means lowering the pain to a level that you can tolerate.
There are other means to lower pain, and you should get together with a pain psychologist to discuss them.
But the consequences of untreated pain are much greater than any consequence of hypogonadism.
Yeah i did, he was worried about it messing with my testosterone, was what he kept saying. I don't feel like I was arbitrarily dismissed, but I do think I may have down played the pain a little bit, because I worry about coming off as a drug seeker.
Didn't you tell the pain doctor you've been taking 10mg Norco QID?
Neurontin takes a few days build up to a therapeutic dose, and 100mg is a very small dose anyway. Some people take 1600 mg / day.
Neurontin takes a few days build up to a therapeutic dose, and 100mg is a very small dose anyway. Some people take 1600 mg / day.
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