What are others taking for break through pain

[freebird63]

I suppose my problem is really not break through pain, but constant pain.  My doctor  has me on 20mg opana ER, 15mg oxycodone for break through pain and 5mg valium for muscle spasms.  The problem is its not just break through pain, its pain all the time and heaven help me if I try to do anything around the house, a friend barrowed my lawn mower, and just lifting it out of her truck killed me, doing dishes kills me, mowing my own lawn kills me.  I am so tired of being in constant pain.  I see my pain doctors new PA on Monday so I am nervous on how thats going to go, because his old PA never would listen and the doctor really won't listen.  He switched me from 40mg oxycontin to 20mg opana ER, did it help????  he didn't ween me off the oxycontin, he just stopped me as he has done so many times before.  Another thing that has me worried is I have to pay for my meds out of my pocket and I am affraid next week I can't afford to get my meds, I have heard horror stories about opana and its withdrawls.  For me it seems like this cycle never ends.  What else could I suggest to the PA that might work better then the 15mg oxycodone????  not that I can afford it.  Thank you so much for listening
Chuck

[pmartin1664]

I'm so happy to see that your new P-PA helped you out. Because there are many MD's that are hesitant about prescribing Fentanyl, never mind a PA. Hip Hip Hooray, for you!!! Got my fingers crossed. Something tells me your feeling a great deal of relief today!  Just, don't run around like crazy, cause your feeling better, thing is, once you surpass the effective therapy level of Fentanyl, you will be looking to pop them break through pills, in mass quantities. Run at a cautious level, but enjoy your newly once again, found freedom ! Pmartin

[namnam46]

Good luck Chuck,

I hope that you have the same good luck with it that I have had!!! I also change mine every 48 hrs.

Hope that you have a Pain Free nite...Sherry

[Sarajmt]

Yeah!!  I really hope this does the trick for you.

Good luck

Sara

[freebird63]

Well my doc switched me over to the fentanyl 50mcg patch, he gave me enogh for 1 patch every 2 days, he said normally people get by with 1 pactch every days.  So it will be interesting.  I will keep everyone informed.
Chuck

[freebird63]

Thank you Pmartin, you hit it right on the nail.  Yesterday I went out in the desert shooting for a couple hours and paid dearly for it.  I was in bed the rest of the day and the pain was so intense I wanted to cry, have been there a few times.  My granddaughters were over and I couldn't even play with them and they love to play with papa, it really breaks my heart too that I can't play with them.  Tomorrow I see my pain doc's new PA and I really hope he listen better then the last PA, otherwise when I leave their office I will be taking my records with me and finding a new pain doc.  I hate the fact that this pain dictates what I can and can't do.  Thank you for all your help.....Chuck

[pmartin1664]

Hey there Chuck,
Too bad about the Dilaudid not working. That tells me exactly where you are at with your daily pain. If I'm guessing right, on any given day, your pain is at about a 6 while throughout the day you will spike to 8-9 when seated or atanding in any one position for more than a few minutes. Yeah, that freaken knawing ache of pain can be, and IS as close to, absolute torture, that any person can endure. If your spending $500 on pain meds alone, I would seriously ask the doctor about Fentanyl. I have 4 or 5 coupons from a maker, that's good for, I believe $50 off your Rx. I could'nt use them because of my coverage, but you may. I will dig them up and shoot a private message to ya as to arranging a mail out to you. Till then, I hope things stay at a pain level, you can manage! My heart goes out to you. Like they say, "been there, done that".

Oh, and don't I know how this pain of ours so effects out moods and outbursts with the people we love the most, outr families! As if they did something to give or bring the pain to the level we find ourselves in!!  Hang in there, Chuck!  YOU ARE NOT ALONE !   Pmartin

[TrayCee]

you shouldnt withdrawal switching from from 40mg oxycontin to 20mg opana ER.  They hit the same receptors.

[TrayCee]

I take hydrocodone 10mg for break through pain....  It seems to work fine

[freebird63]

Right now I pay out of my own pocket $500 a month for my meds.  I tried Dilaudid before and it was not effective for me, I am not sure if they make a stronger dose of oxycodone for break through pain, right now I am on 15mg 4x a day for break through pain.  I see that opana makes a short acting med also.  When I first talk to my pharmacist about opana she said the 40mg opana is $800 for 60 pills.  OUCH
Its hard to not let this pain effect me or my family, but slowly it is doing just that.  I have already for warned my wife if I can't afford my meds next week that I may not be a very nice person.  I know these pain management doctors are under alot of watchful eyes, but I have been going to my present pain doctor for a year and a half.  I think deep down they know they made a mistake and are just hoping I will get fed up and go to a different doctor, which may just happen after this next Monday.  I know with taking the oral pain meds there is a happy medium, either you take too much and can't function or don't take enough and are in severe pain all the time, thats where I am at, in severe pain all the time and its getting real old.
Thank you everyone for all your support and thank you Tuck for all that you do, especially in the difficult times your in right now.  I lost my parents a long time ago.  Take care everyone and have a wonderful weekend.
Chuck

[pmartin1664]

As noted, Fentanyl is quite expensive. I take 150 mcgs every 48hrs. The cost for the 6 boxes to my insurance company is $780, my co-pay, thank goodness is only $5.20.  I'm pretty sure even with a "Mylan" type brand, which is an generic, a 50mcg patch for the normal 72 hour change-over will cost you approx. $ 200.  I think if cost is the factor that it is for us all, Dilaudid would be the least expensive, and hopefully have a better effect than the med's you are on. Oh, and YES, get yourself another Doctor, if this "new guy" dosn't work out. We should never EVER,  feel that we have to fight someone, to get pain relief... Take Care Pmartin

[Tuckamore]

Hello Chuck,

You have certainly had more than you share of issues with pain management. I am sorry for that and your stubborn pain that seems to be so difficult to control.

Opana is a potent opiate, considered stronger than OxyContin you were being prescribed. The Opana dose may not be high enough. He switched you from 40mg of OxyContin to 20mg of Opana, which according to my understanding is basically equal in strength. You might want to keep that in mind. If the Opana was increased your break through medication may be adequate.

The other school of thought is that increasing the break through meds may reduce your need for an increase of the long acting medication. It's six of one and half a dozen of the other. A mere 5mg increase of the oxycodone may suffice in pain control. It's all trial and error. What works for you may not work as well for someone else.

The Fentanyl Patch may also be another alternative as suggested above. However if you are paying out of pocket for your meds be aware that it is very expensive. When I tried it my co-pay alone was almost sixty dollars and I don't think that was a month's supply. So beware of the cost.

Obviously these are just my opinions. Please discuss this with a trusted pharmacist and your physician. We often neglect the expertise that is available at no charge from our pharmacists.  

Please let us know what you and your physician decide and how effective it is for you. I will look forward to your updates.

Take Care,
~Tuck

[Sarajmt]

Hi Freebird:  Have you considered getting a second opinion from another pain management physician?  I had a pmp who wouldn't listen either.  I found another one who had been recommended to me.  My primary care doc gave me a referral to her.  And I couldn't be happier.

This may not be an option for you.  But you have hired these people to manage your pain and they are not doing this.  A 2nd opinion might not hurt.

Good luck.

Sara

[namnam46]

Hi Chuck,

Let me say that the reason I  mentioned the Patch is because I read your other posts about your unsuccessful Pain Pump implant. I'm  so very sorry that it didn't work and can't believe that it crimped up and they didn't tell you!!! Anyway that's why I knew that the Patch would NOT be too strong for you. As there is NOTHING stronger that the pain pump. Just wanted you to know that I didn't mention it arbitrarily I checked your other posts first.

Take Care and Good Luck....Sherry

[BP88]

Fentanyl will boost your opiate tolerance high really quick; it did for me at least.  The withdrawals were AWFUL.  I was wearing one 25mcg/h every other day and quit cold turkey because they stopped working for me after a few months.  I would try to stay on the weakest opiates possible because eventually you're going to need that room to increase your meds due to tolerance.

[namnam46]

Hi Chuck,

Have you ever thought about switching to the Fentanyl Patch?

I had my first hip implant when I was 35 years old and I'm 63 years old now, so I DEFINITELY am familiar with severe CP. I switched to the Fentanyl Patch in January when I went to my FIRST PM Dr. Also, I have had the RFA on both sides of my lower back in 3 places on each side and I was very fortunate as it gave me terrific relief. Unfortunately those weren't the ONLY places in my back. I have DDD the entire length of my spine. Ain't life grand....LOL. Anyway, It might be a solution that you might try. I use the MYLAN patch (generic brand of Mylan) it's the type that has the meds in the adhesive and have NO PROBLEM at all with it adhering to my skin. I put it on my upper back and it works fantastic. I noticed today how much easier it is to get in and out of the car. (Not perfect but easier.) I take 10/325 Percocet for BT pain. I actually cut them in half and space the 1/2's out in a 2 hour period, instead of taking an entire pill at once. I've found that it works better for me that way. (My PM Dr. has  OK'd this for me.) (I ALWAYS run EVERYTHING past him. I don't try anything by chance.)

Good Luck...Sherry