High Risk Patient

[larbec7]

I will try to make a long story short.  I have been going to pain management for several years and on the same medication.  My doctor is a personal friend and my spouse worked for him.  She was getting tired and stressed out from all the BS going on in the office and he was not willing to change his ways and allowed certain people to just play around 50% of there day on computer playing games, face book, myspace, stc...

Well, I told her to quit and she did about 7 months ago.  Ever since then he has given me one drug test after another and changed my medication amounts as well.  I became disabled about 18 months ago.  When I went to see him this week, I confronted him and was very blunt as to why he keeps messing with me.  He claims that I am considered a "high risk" and I should not be on the dosages I am on since I am disabled now and I do not have to function in a work environment.  He also claims that because I am tan and have muscle tone I must not be in the pain that he thinks I am in and in the same breath he says "you seem to be in more pain the past few months than I have ever seen you.  I'm sorry but WTF????  He also says that since we are friends I may want to consider seeing another PM doctor.  Everything he said to me I called him on it and told him he can't baffle me with his BS and what is the deal.  He just said, well, you are considered a "high risk" patient and should not be on as much of medication as you are on since you are disabled.  Is this not discrimination or what.  Let me tell you, I am only on 40mgs Oxycotin a day ...10 mgs every 6 hours, 3 Darvacet for break through pain and soma/zanaflex for spasms.

What are your thoughts?  have you ever been told or heard of being a high risk patient?  Just seems strange to me to be treating me for 7 years and now all of the sudden since my spouse quits to be doing this to me.

[bmdad]

You said you are taking 10 3 times a day....Is that one 10mg oxycontin 3 times a day? I am no longer taking them as my pain subside so I dropped back down to the 10mg hydrocodone. I was on the oxy's for about 8 months or so. I was taking two of the 60mg every 12 hours. They normally wouldn't last the whole 12 hours though.
I agree on not wanting to have to keep increasing your dose. It is a pretty strong med so you the lower you take the better. But you want to make sure you are able to control your pain for quality of life. Have you talked to your doctor about a immediate release pain med for break through pain? When I was on a lower dose to start I was also prescribed 10mg oxycodone for break through pain as needed. I would usually (but not always) have to take one around the 8 hour mark until I could take another oxycontin. I wonder if you talked to your doctor about trying the 20 mg and then maybe you wouldn't need anything for break through pain? There are so many different options out there that you could try. Just talk it over with your doctor until you both agree on a regime that will work for you. It sometimes takes trial and error but eventually you will get to where you need to be.
I hope you find the right dose that works well for you.

[larbec7]

Thanks for your comment.  I am having to take the hydrocodone about 4 hours after I take the Oxy.  I can tell the Oxycotin is helping a little but we are not there yet.  I will keep everyone informed but the 15mg does not effect me mentally at all and I like that because I do not like being "out of it"

[opus88]

HI Brian...glad ur stabilized now on 60mg...can I ask you HOW LONG have you been stabilized??
I am currently on 30mg and not stabilized I am taking 10 3x a day because the moderated pain control only lasts abt 6hrs...so when i take it every 8 hrs...I still get pretty sore before I can take my next dose, but I hate to keep increasing this med.

I guess what I am looking for is some reassurance that at some point there will be a therapeutic dose where us CP  people will stabilize for LONG TERM.

THX

[bmdad]

Oxycontin and percocet are the same that they both have oxycodone in them. The oxycontin is time released as you said. Like Opus said, percocet has acetaminophen  in it and is not time released. I was prescribed oxycontin in the past and one thing I like about it is that it lasted for quite awhile. I was prescribed 1 every 12 hours but usually around the 10 hour mark I could feel my pain creeping back up on me. But there were also times to where I didn't have to take the one at night and could make it 20 hours or so without one. My doctor started me off on 20mgs and we worked my way up from there. Eventually you will get to a mg that is effective. Once I got to the dose I needed I didn't have to take anything for break through pain. I think I finally stabilized on 60mg. I think the reason I required that high of a dose is that I was opiate tolerant from being on pain meds for a extended period of time. Just do your best to stay at the lowest dose possible yet at a dose that is still able to control your pain effectively.
It sounds like things are finally coming around for you and your pain is being treated the way it should be. I personally feel if someone requires narcotic pain meds due to chronic pain the extended release are the way to go. When I was on norco's I got so sick of having to make sure I had my meds even if I was only leaving the house for 6 hours!
Keep us informed on how well your new meds are working for you.

Best of luck!
Brian

[opus88]

percocet also has the tylenol combination   thats what the /325 is...325mg tylenol...10mg oxycontin

[larbec7]

My doctor put me on 15 mgs Oxycotin for two weeks with 10/325 Hydro for break through pain and he said when I come back in two weeks he will up the dosage to 30mgs if needed

I thought Oxycotin was the same as percocet except for the time relief?  I hope this helps