How much pain medication is reasonable?

[kprad]

I have osteopenia, almost 6 months ago broke both arms (screws, plates, and cadaver bones), tore both rotator cuffs (very severly) and gave myself 3 compression fractures. I had a seizure caused by medication, that is what cause the injuries. At this point almost all of the pain I have is back pain, I can live with the pain from rotator cuffs at this point without meds, not 100%, but good enough. Just wanted to give you guys some background.
       I am on 2 20mg oxycontin and 5 5mg oxycodone IR per day. Pain is worst in the morning and at night. I need 2 5mgs to get out of bed (at 5:00AM) then sit and wait for them to kick in, and for my 2 year old to get up. I need another 5mg to get off to work @ 8AM, leaving me with 2  5mg for the rest of the day. Just not enough for me, I've been on pain meds for 6 months, and have a tolerance. What I think I need is 2  30mg Oxycontin, and 3  15mg roxicodone, that I can break in half, or take whole
      I saw my 1st pain management doc for the 1st time last week, and had my 1st MRI done Thursday, have a follow-up scheduled for Monday to discuss MRI, and treatment options (my X-Ray showed compression fractures, there may be other stuff too MRI will say). I am not comfortable with the idea of any surgery or injections in my spinal area, unless is an absolute last resort. I am comfortable taking the Oxys. How do I have a frank discussion with him without the risk of getting red flagged? Does it sound like what I am on from my PCP (who has reffered me to the PM Dr., and will see me in 3 months, so PM Dr. will be prescribiong meds I guess), or what I would like to be on is alot of medication for my injuries, and the fact that it has been almost 6 months? Can it be that I am comfortable with pain meds without him thinking I am drug seeking?

[kprad]

Osteopenia is rare for soemone my age, it was appearently cause by being on Phenobarbital for about 2 years when I was like 12 years old, and no does not cause pain. Of course I want to be treated. My pain is not as sever as many people on this board I am sure. It is severe enough that it does limit my activities, and my ability to be the father I want to be to my 2 year old daughter, but is largely controlled by medication.
   More background, my wife was diagnosed with stage 4 colin cancer almost 2 years ago, I have to work full time, do things for her, and for our daughter. If I were to end up on the wrong side of say a .5% risk of being paralized of ending up worse off in any then I am now (I can largely do what I need to, and I can generally stand the pain, just don't want to be in pain all the time), it would be absolutely catastrofic, my wife would be taking care of me while undergoing chemo and other treatments, and our daughter.
   I would like to look at maybe a TENS along with pain meds (I will of course listen to all options). Also, my mother-in-law's job is to do administartive stuff with JENCO (sp?) stuff (basically botched surgeries) and has a million nightmare stories. So I have some rational as well as irrational I suppose reasons why I don't want to look at my spine being messed with unless absolute last resort (maybe all irrational, but regardless it is what I am confortable with if it makes sense or not).
    Really what I was looking for was tips for having this conversation with my PM Dr., and opinions as to if the amount of meds I discussed sounds exorbident.

[Tuckamore]

Hi Kprad,

Welcome to the Pain Management Forum of MedHelp. I am sorry you are in so much pain. Osteopenia does not commonly cause pain, but the fractures certainly do. You are young to have osteopenia. I am sorry that you have this condition. I am sure you are aware that this is a precursor to osteoporosis.

I do not understand why you would not want to be treated. There are options available that may decrease your pain level. It may be that you will still require pain medications but with treatment your pain may be better controlled. I understand why you may not want spine surgery but I think you should listen to all the options before you conclude that you will not consider any of them. If it were possible that a surgical procedure would provide me even a 75% chance of improvement I would jump at that chance. I am very tired of the pain and the narcotics.

However once your fractures are healed and the right treatment has begun for your osteopenia narcotics may not even be necessary, unless there is something I am not understanding. I would be concerned the PMP may not understand why you would not want to treat your painful injuries caused by the osteopenia.

I wish you well and hope that the PMP will be able to offer you solutions that will be acceptable to you and reduce your pain. Keep us posted and let us know how you are doing. Take Care, Tuck