Are they going to work?

[Sandragene]

Ok, in a nutshell, I am a 55 yr old woman with chronic back and neck pain, Fibromyalgia, Lupus, Arthritis, "Mini" Fractures in severe areas of body, and very severe chronic insomnia. For the past 15 yrs for the most part my treatment has been manipulations and cortisone shots maybe 4-6 times a yr. along with Hydrocodone/APAP 10 mg/500mg 6 tabs daily and either Temazepam or Ambien at bedtime. Of course being that long of a time, the Hydrocodone works but I need more and more and then if I take more and run out the withdrawls are devastating to go thru. The sleeping pills are the same and 1 of highest dosage does not even make me drowsy, 2 and I can go to sleep within half an hr and sleep for 3-4 hrs at most. I have also been on Lyrica for the past yr. So now.....dr visit today to decide on better plan...he is "concerned" about the 180 Hydrocodone I am taking causes liver damage although he tested for liver function last month and it was fine. He says he knows I am in severe pain and need medication. We tried pain management center with physical therapy 6yr...what a joke!!! So today, he changed from Hydrocodone to Morphine Sulphate ER 60 mg 3X day, renewed the Ambien for 1 at bedtime, and changed the Lyrica to Savella Titration Pack(sample right now) with me taking 12.5 mg at bedtime for 5 nights, then 25 mg at bedtime after that, with the 50 mg tablets in the pack being split in half instead of gradually going to 50 mg.

I guess my biggest concern is how the new regiment of drugs compares to the old one? Are the new dosages high enough to at least compare somewhere with the old or are the dosages and drugs not even in the ballpark? I know I will not ever be pain free but sure don't want to be suffering needlessly. So I am willing to try this new plan but just wanted to know what others have to say about these new ones?

[Sandragene]

Thank you so much for your note. I definitely needed the encouragement from you this morning after another sleepless and painful long night. I have my new sleep refill coming...snail mail because of insurance....the new pain med CareMark pharmacy insurance says cannot be filled thru the mail and has to be filled at my local CVS and only 30 day scripts avail instead of the 90 day mail scripts that save me the most money. So, being that it is Jan, that means my retail deductible is due again up front....and this year it skyrocketed...so now I will not be able to get it filled until I have pay $75 AND $10 copay in order to pick up this first month. After that it will only costs me $10 per month. So I will have to wait until SSDI check comes later in the month to pick up. But at least I have some kind of hope within the next 2 weeks. Again, thanks. I will let you know how it proceeds. The drowsiness issue will be a welcoming one!! I could sure use some zzzzzzs. That alone would help with pain.

[Tuckamore]

You have asked some very good questions. In my opinion your physician has made a wise choice to prescribe a more potent opiate to control your pain.

It is a big step up to Morphine Sulfate ER , especially at three times a day. It should provide you with more pain relief.  Often finding the "right" opiate is a matter of trial and error. You may experience some initial side effects including drowsiness as your body adjusts to the medications. Usually they will subside in a few weeks.

Just changing the opiate may help greatly with your insomnia. I would not be overly concerned with that at this point. I would do a wait and see....trail and error.

I am on the same opaite as you were. When my physician changed me to Morphine ER the dose was only 20mg BID (twice a day). It gave me horrid headaches that I could not manage and I am back to my "old" schedule. I do know that others that did not have that issue.

Please keep in touch and let us know how the new medications are controlling your pain. I wish you the very best.

Take Care,
Tuck