Hello guys, this is my first post though I've read a few threads from this forum while researching my pain management schedule. What I basically want to get information on is the type of medication I should stick with, and strategies to maintain efficacy.
I'm relatively young but had a few sports injuries when I was in high school and shortly after. End sum is back pain: Protruding discs at each level of my spine (L, T, C), mild-medium scoliosis resulting from my right leg being short, and onset of arthritis in my lumbar spine and cervical spine. Then I have chronic headaches, possibly from Chiari Type 1 but more likely from the disc problem. Also have onset of arthritics in a couple of those spots.
Anyways, my doctor started me on a a medicine regiment in addition to other treatments. I want to focus on the opiods and see if I can glean some knowledge off the people here who know better. She started me on Oxycontin for long-term relief and that's basically not changed. For breakthrough pain she started me on 4 x Per (10/325) a day which I stayed on for about 6 months. When flare ups in my back and head weren't getting broke through by Perc anymore she switched me first to Tramadol for a couple weeks, then do Dilaudid 2 mg 4 x a day. TR just didn't work, and Dilaudid seemed a little better but died off too fast. So for the past few months we've been alternating between Dilaudid and Perc to try and maintain efficacy/reduce tolerance. Last visit I told her the Dilaudid didn't help much with the headaches, and that before going back to Perc I wanted to see if there's another more effective. Now I have Morphine Sulfate 30 which I don't like for a number of reasons (side effects, efficacy).
We've discussed my concern about finding one that works for me, and she always lists off the standard short-actings for me to choose from, i.e. Morphine, Hydromorphone, Hydrocodone, Vicodin, Percocet, etc. The one time I brought up potentially going from 2mg Dilaudid to 4 mg Dilaudid she simply said she didn't want to increase strength. We have good rapport and she knows I'm being honest with her.
Is there a better way to approach looking for something more effective? Is there a reason she'd be so hesitant to increasing strength/dose (i.e. legal, ethical, fear for me getting addicted, etc)?
Sorry for the superlong read! Hopefully I can get a good opinion or two on how to go about finding a better short-fuse opiod that will help my pain. My doctor seems open to any option medication wise, but it seems like she may have a red line she won't cross when it comes to doseage and we may have to cross it to find the right combo. Thanks again!!