At the end of my rope with failed pain management

[skmedlin27703]

I am on the highest dose of narcotics my pain management doctor is going to prescribe me.  I know this because he has told me this numerous times. My breakthrough medicine was increased by my ortho doctor after he did my ankle fusion surgery 12/2008.  Had he not doubled my dose of oxycodone I would be far worse than I am now... If I do anything that requires me to walk more than an hour all together I am left suffering from pain that just won't stop in my foot/ankle.  When I had my surgery I signed a paper to acknowledge that it would not provide pain relief only provide stability. My disability rating in the ankle is 35% as of 12/2008 after surgery.  And even with my fentanyl 100mcg patches and oxycodone 15mg tablets (x2 tablets three times a day) I am still in unbearable pain.  Any ideas?  I cannot step down without shooting, sharp, electric shock-like pain in my foot... it hurts... and I just want it to stop.... or let up enough to make it to the bedroom or bathroom....

[namnam46]

You are very welcome!!!

Thank you..Sherry

[sandee1818]

Thanks!
I have deleted hat one as well:)

[namnam46]

Thank you Sandee, that really bothered me!!!

You're always there when we need you!!!

Sandee, they had posted the same thing on another post. If you didn't see it could you find it and delete it also?  Thanks!!

We knew we could count on you....Sherry

[sandee1818]

The post was deleted as MH does not allow such post.

[Sarajmt]

Thanks.  I wish it were a good day.  It's raining - ouch and I just hurt all over.  After so many years of this, you'd think I'd be used to it.

[namnam46]

Thanks because I was SLIGHTLY (LOL) paranoid about that.

Thank you for the compliment!!

Hope you are having a "good" day today....Sherry

[Sarajmt]

No, it's fairly obvious to me that deanopet posted it.  I think he was complimenting your answers.  A well deserved compliment I might add.  But no, it doesn't look like you did it.  But I do see how you'd think that.

[namnam46]

I'm so glad that your appointment was such a success for you. How nice it is to have a Dr. that listens to your needs

I hope this gives you the much needed relief that you so desperately need and deserve to have. Be sure and let us know how the new meds work for you. Glad you are off to such a good start!  :)

Congratulations!!!...Sherry

[skmedlin27703]

Hello! Hello! Hello! Well my appointment went well.... He took me off the Fentayl Patch that I have been on for 5 years and changed me to MsContin.  He gave me the same Oxycodone Rx and I am feeling a little loopy but I feel alot less pain. I took one MsContin tabelts (60mg) and in 12hrs I am supposed to take another so I will let you know how it goes... I took my Oxycodone just a moment ago but only one versus the two I normally take...

[skmedlin27703]

Thank you for your input.  Until about 2 months ago the Fentanyl patches controlled my pain very welll at 100mcg until I went to the pharmacy and the patch I was accustomed to had changed.  The company changed the way they make the patch.  I was using the brand name Duragesic welled patch with the gel inside until it became to costly, then I found the Sandoz which was the generic made by basically the same company (J&J owns Sandoz) and it was much cheaper and worked great.  Until I get my normal rx and now the fentanyl is made into the adhesive like the Mylan patches.  I have experienced increasing pain since the change.  From what I understand the matrix technology works differently and my doctor thought I would be ok in the next month.  That was in Feb and now it's May.  Prior to the change he made it clear he would not increase my patch dose... but maybe he will be more open minded now.... I am going to ask that he do SOMETHING when I go to my appt this morning...

For breakthrough I am going to ask about the Actiq lollipop, awesome idea.  I asked about the fentanyl buccal tablet,  He would not prescribed the tablets b/c he said even though they are quick dissolve up to 800mcg each.  They are very fast acting they do not last long enough to take care of a breakthrough episode of a chronic pain patient.  It was designed more for cancer pain b/c of the length of breakthrough pain episodes.  

I wear a brace everyday.  It makes my ankle feel alot better and I do not go anywhere without it on.  It provides extra support even though my ankle is fused.

I am hoping for a change in something this morning whether it be the replacement of the patch with something new or the breakthough medicine... I have read of a new dual opiate meds that are hopefully going to be in the US market soon; much like Opana.

I will fill everyone in when I return to work this morning.... going to take a shower and get ready for my 7am appt! Keep your fingers crossed for me please!

[sandee1818]

A brace is an excellent idea. It will keep your ankle stable and may relieve some of your pain. It may be time to speak to your doctor about trying a new pain medication regimen.
We all have changed our medicines at one point because of tolerance issues and just changing to a different medication can help a great deal.
Since you have been on the regimen your on for some time now I would suggest asking your doctor about other options and see what he/she can offer.
There are other pain medications you can try and then you can eventually go back to the Fentanyl at a later date if you wish.
Let us know how it goes:)

[namnam46]

I'm so sorry that your meds aren't helping your pain anymore. I too am on the Fentanyl patches with the Percocet for BT. I'm only on the 50 Fentanyl patch and 10/325 percocet for BT3 times a day,  a much lower dose than you.What I'm wondering is whether he wiould consider increasing you Fentanyl as there are numerous CP patients that have more than 1 patch on. I've heard of some that actually go up to as high as 300 mcg of Fentany. If he doesn't want to do that because of your age, would he consider the Fentanyl Actiq (lollipop) for the BT med?

I'm really sorry that you are having to endure such debilitating pain.  I can't even imagine how excruciating the pain is when you take a step.

Say, that just gave me an ideal. Have you ever tried a brace for your ankle to help relieve the pain when you walk. I fell down some stairs 3 years ago on my knee and my Dr. gave me a brace to wear and it IMMEDIATELY relieved most of the pain when I stood up and walked.

Good luck tomorrow and let us know how it goes....Sherry

[skmedlin27703]

Thanks for the input... I will let you know how things go in the morning... I have 8 tablets left to make it through which is right on track... 6 for today and 2 in the morning... and the plus is today is half way over! Yippie!

[skmedlin27703]

Tell me about it... you know my pain doc was switching my breakthru from oxycodone to dilaudid about every 6 months or so... the dilaudid did not help at this last time.  My oxycodone dose is so high I don't know what or if i have any options left.  My appointment is in the morning... I hope my doc is in a good mood and ready to problem solve b/c he has got to do something!

[briashjess]

I was on 80mg oxycotin with break through 30mg oxycodone two years ago for about 1 and half. I started out frowing my doses as well. The daily meds just did not seem to help.
Fentanyl did NOT work for me at all. I know from what I am going through you can not stay on the same pain narcotics for long lengths of time with out building great tolerances to the level your continually on. I don't understand why Doctors can't switch medications on a yearly basis to help keep people like us  out of pain! My best to you , I feel your pain!

[Sarajmt]

Bless your heart.  You're having a time of it.  This is just a shot in the dark, but could you have nerve damage in your ankle?  If so, narcotics are not very effective for nerve pain.  I have no idea if that's what's going on but just a thought.

I really do hope you get feeling better.