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Avatar universal

My next step

I have been on Percocet 10/325 for about 5 yrs now and it just no longer is helping my pain. What is the next step up I should ask for without looking like a drug seeker? I am in talks with a surgeon, but that could takes months to even schedule something because I have a DVT and am eloquis.
5 Responses
547368 tn?1440541785
Hello Kr5552016,

Welcome to our Pain Management Forum. I'm delighted to took the time to post but sorry to hear that your medications are no longer as effective.

I've found the best way to "ask" about an increase - or change in opiates - is just to be honest with your PMP. Tell him/her that your pain is no longer well managed. Often just saying, "I need your help" will engage a conversation of better pain management. As you suspect, asking for a specific drug can trigger alarms bells or raise a red flag. Asking foe "help" and allowing your PMP to make suggestions is usually the best approach.

Often the next "opiate up" is Dilaudid (hydromorphone). All PMP have their own preferences. One PMP will never order Dilaudid while the next on will. Another possibility is going to a LA opiate (like MsContin or OxyContin) than PMPs often prescribe fewer SA tablets.  

I hope you'll find better pain relief. Please let us know how you are doing.

Take Care,
~Tuck
Avatar universal
Update:
Tuck, I took your advise and everything worked out great. My doctor took me off the ineffective Percocet and at first switched me to a new medication called Embeda. I took it to the pharmacy and they had the medication, but my insurance wouldn't cover it because I have Medicare/Medicaid and the cash price was $600!!! So I rushed back to my doctors office before they closed and he rewrote it for generic MSCOTIN. I took my first dose last night, and stayed up until like 11pm just to gage the effect it had on me. Let me say that it worked BEAUTIFULLY. I had one little twinge of pain at first, but was then blissfully pain free until I went to bed and even all night long. I didn't even have pain when I woke up. The only side affect it had on me was it made me a little chatty and I have a VERY mild headache. But shots of morphine like in the hospital has always given me a bit of a headache. And I know I cannot drive while on it. The only thing now is to calibrate the hours I take it. I am allowed two per day. One every 12 hours. I am normally up by 3:30 and 4:00 am, so I am thinking about taking it at 5:30am and 5:30pm. What do you think?  Also, something that shows how much my doctor cares about me, he wants to see me back in 26 days/4weeks and he wants me to bring in the bottle of meds with me to be able to count and hold me accountable for how much I am taking and keep me on track and see how it's working. I have the nicest, most caring, most invested pain management Doctor in the whole world. And he is going to help light a fire under the surgeon 's butt to get me in to get the ball rolling on a possible surgical fix on my back. God is so good!!! Thank you so much Tuck, for your advise and calming me down about my appointment yesterday.
547368 tn?1440541785
I can't tell you how delighted I am that everything worked out so well. It does sound like you have an excellent PMP. They are often hard to come by - thanks for sharing with us!

"Counting" your tablets - along with UDT (Urinary Drug Test) are common in PM. They are held accountable for their RXs - and therefore must hold us accountable.

MsContin is long acting Morphine. It can be very effective. I hope you'll be in touch and let us know how you are doing. We're here to help!

I'm so happy things went so well.

My Best,
~Tuck

Avatar universal
I BEG YOU PLEASE DONT HAVE SURGERY!
I am speaking from my own experience of almost 40 YEARS. Yes, 40 years. I was 26 didn't want to take meds. Just wanted the pain gone. Was uneducated and alone n it has not been good. Please. If ur pain is managed THAT WELL don't let someone go in there n stir things up by surgery honey. I am only one person, but my life has been hell n I'm now 60. Talk to a lot of ppl that have had surgery n please talk to several surgeons first. I messed up by having that first surgery n if u can take meds n have relief, please think long n hard. God bless you ❤️
17764482 tn?1459876567
I was in the same boat 3 years ago.  I had been on 3 Percocet a day for several years and it just wasn't working as well.  Tuck's advice was right on the money.  So glad your doctor listened to you and acted.

I have been on MS Contin 30mg every 12 hours for the last three years and it works wonders for me.  My PM did add a few Percs a year ago because I started to need BT once in awhile but I keep them to a minimum and the pain relief is the best I have ever had.

Yeah, the pill counts and UA's are just part of what the Doctors are now forced to do in order to keep their license and treat us with narcotics.  While it feels invasive at times, I sure don't want my wonderful PM to ever go anywhere, let alone lose his license!  I am willing to do what it takes.

I sure hope the morphine keeps you pain free!

Cindy
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