Help w/ increasing pain med dosage or breakthrew addons

[Mikeysbrat]

Hi all. I have herniated discs,bulging discs as well as degenerative disc disease. I have been on pain meds steady since 2001. I am now on Norco 10 mg 4 x a day. I have had another child and just with age since its been 16 yrs since my first serious MVA my pain has gotten much worse with time and I can honestly say without my meds I wouldnt be able to do my evryday chores such as the house and keeping up with my 3 yr old and my husband. Its very frustrating. Ive had epidural injections as well as facet joint blocks with no help infact my pain increased in the long run after each treatment so Im done with those.  On my next visit on 4/22 to my pain management DR. I want to talk to him. I have to take 1.5 or sometimes even 2 pills at at a time to get any pain relief so I can function. Then it also will wear off in about 2.5 hrs and then here we go again. Ive heard alot of dr's give another med that they prescribe for break through pain. Can someone tell me how this works? I would like to bring this up at my next appt but I'd like to educate myself first. Or is it more feasable to just ask that he increase my dosage from (1)  4 x aday to 1.5 or 2 at 4 x a day? Which is better for releieving my pain and which do doctors usually do? Thank you for your input guys. I apprecaite it, Annmarie from CT

[Mikeysbrat]

Hi. Ive been on vic 7.5 for like 3 yrs and  I changed dr's. About 6 mths ago I bumped up to Norco 10mg. The Es's werent doing anything for the pain. The 10's are now not as effective at all either. Ive been much more sore ever since I had the facet joint blocks a month ago and even before that. So, they usually prescribe oxy's for breakthru pain or would they switch me to oxy's and then give me the norcos for breakthru pain? Im just a little confused. Typically how much longer would a oxy 15 last for pin help compared to a norco 10? My 10's wear off in about 2.5 hrs and that with taking 2 at a time. I just tend to build up a tolerance so quickly. Thank you again, Ann

[Red931]

It's not a problem. Been there....Done that!  LOL

[MontanaGurl]

Oops!  I meant everything that I said but, got the names turned around.  I guess I get on an agenda and get discombooberated.   :-)

[Mollyrae]

To Montana.....Mikeysbrat is the one who is asking the question. I think you have mis-understood who was doing the asking.

It's ok though, I think we have all done things like that before. :-)

[MontanaGurl]

I agree with Mickeysbrat, the type of meds you are on have tylenol in them - as you already know.  When taking that type of med over a long period of time the tylenol might be harmful to your system.  Be honest above all with your pain management doctor and tell him just what you have told us.  When dealing with pain meds, always tell your doctor everything, even if you don't understand or are seeking education.  That is what they are there for - to educate you and prescribe what is best for your situation.  There are alot of other meds out there that don't have tylenol or an added "filler" to them but, it is best to let your doc tell you what is what, so that way you can make a better informed decision based on what he / she tells you.  I hope that you get some good relief from your doc at your next appt.  If you have any other questions - post away. But, like mickeysbrat said - it is really nice to just take 1 or 2 pills and have them cover the entire day, instead of having to take a pill every couple of hours....................til next time - montanagurl

[Red931]

I can relate to your pain as I have the same type of injury to my back and then some. Let me address your medication concerns as best I can.

You are already taking the type of medication that would be prescribed for breakthrough pain as it delivers the entire dose into your system soon after you take it with a duration of 4 to 6 hours. However you have built up a tolerence to the medication because you have been on it for a long time. That is why you need to take more to get the same pain relief and it does not last as long.

I had this problem myself with Vicodin which is the same as Norco except it has more Tylenol in it.

My doctor took me off the Vicodin and put me on Oxycontin and also prescribed Percocet for breakthrough pain. Oxycontin releases Oxycodone into your system over the course of a 12 hour period because it is time released. This is the type of medication you need for your pain as it is moderate to severe all the time. While Oxycontin has gotten a bad rap because of people that abuse it by crushing it up and sticking it up their nose it is a great drug for people like us if taken as directed.

Talk to your doctor about it and tell him your concerns. There are other time released pain medications also but I have found that Oxycontin works well for me. It is nice to only have to take one or two pills a day then have to take a pill every two hours. When you have to control your pain in that manner for an extended amount of time it can lead to other health problems.

I hope this helps you. If you have any questions please don't hesitate to ask.

[Mollyrae]

Hi Mickeysbrat:

Nice to hear from you. How long have you been on the 10mg Norco?? When was the last time he increased your meds?? I would suggest that you go to a long acting pain med and use the norco for breakthrough pain. There are many different kinds out on the market.

You need to be honest with your PM Doc and tell him exactly what you have said here. . I'm guessing that you have a long standing relationship with him. If so, he should understand. Some of the long acting meds are: Oxycontin, Morphine, Fentanyl and Methadone. In my opinion, I would start with the Oxycontin. It is easier to wean off of if you ever find yourself in a situation where you don't need it anymore.

Remember, just be honest and tell him that you're not getting the relief from your meds at this point.

Please take care and good luck with your appt.

Mollyrae