Breakthrough Meds Change

[Inspektahdek]

For a long time I was Rxd partially oxycodone 5mgX2 at a time every 6 hours prn and I left a note with her nurse to be changed to either something like OXY-ir 5mg or LORTAB 10 to cut down on APAP and since I can only see this busy busy physician like maybe once every month if im lucky and usually once every month and a half u have to book WAYYYYY in advance and most of my refills are done through phone consultations with her NURSE PRAC or something of the sort. I called last time and asked (shes pretty cool about changing meds) if I could be off the perc 5mg (the pharm i get them from only has mallis and they are horrid! plus taste horrible) so I asked for OXY IR -5mg so it would be easier and without the apap plus in a capsule or to be put on lortab 10 so she gives me 90 count lortab 10 when I come to see the nurse.

The rx was there and I never even got to see the doctor. She has it written take 1-2 tabs every 6 hours of lortab 10/500 prn which makes the APAP 4g max and my refill is due this friday and im trying to sway her back to the oxy IR but I dont want to sound too suspicious. Also when I asked for the lortab 10 I was asking for something weaker to see if it could sustain my pain so it looked good in that aspect but im going to mention that it doesnt and perhaps mention that I dont want that much APAP in my liver or something of the sort, should I say this?

Shes pretty cool about changing meds and what not but most of the time these changes are done through me talking to a nurse prac and the nurse talking to her and then the doctor consults the new meds, etc and I rarely get to even see her. Shes the head of orthopedic surgery where im from and I know this sounds weird but this is how I get my meds. Anyhow, what should I do without sounding to swaying to get her to hook me up with OXYIR- I hate mallinkrodt and thats the only type of percocet 5s I can get here when OXYIR is not germany manufactured, and is way better IMO but I dont want to sound like im digging for this drug or look like a seeker, etc. so should I mention the apap?

In the past ive gone from oxys to fent 75mcg, back to oxys etc. Except all my fent is rxd for 72 hours, another thing I have a prob with but I never say anything about it because I dont want to look like a seeker because it only works for 48hrs because I do get 75s so anyhow, shes pretty cool about all this I just dont want to sound to convincing on my part about changing meds and really want the oxy IRs instead the lortab or percs I was on before, any advice?

Sorry for the mangled msg

[smojo]

I've been on every known BT med there is this past year.
I didn't care for the OXY IR with the OC
The best has been Actiq, but havn't been able to afford these because of insurance issues
The last BT med I had to try before my PM Doc was going to insist on me considering an Intrathecal Pain Pump was MS IR's, and what do you know, they have helped mask my pain issues.
The Opana was pretty good for BT.

What kind of Fent patch do you use...which one's stick and stay stuck?

The Nance

[Inspektahdek]

I get the Jannsen Duragesic gel types. They're either brand or I think a really good genreic, like ABGS or watsons are.

They're fantastic anyhow

I've been doing some research and I might have another disc problem :(

All the side effects im seeing seem to be another herniated disc, anyways that means more meds I guess


anyone have any advice for my scrambled post above? lol


thanks

[smojo]

Guess I misinterpreted your mangled post, ha, sorry.
Lortabs, Vic's, Norco's are NOT acceptable PM meds for BT pain, esp. when your on OC or Fent patches.
Yes, you look young to me, so emphasize that you do not want to chance liver problems at your age and I just don't see how requesting a mere 5mg. Oxy IR is asking too much.
I say go for it.

What new issues are you having? I had a L5-S1 "Central" Disc Herniation (thats the Cauda Equina Syndrome Crapola I had mentioned). I'll say one thing, If you (or Anyone here) EVER has ANY form of Incontinence, no matter how mild/minimal GO TO THE ER, LIKE PRONTO. I went 6 months without telling my Neurosurgeon...but heh, I was 17y.o, god that was 21 years ago. Enough memories.

Let me know if you need any info/advice...
The Nancester

[Inspektahdek]

thanks for the advice, I've always kept the incontinence in mind because that's been one prime question asked to me many times during appts, and other various visits. What type of problems dealing with incontinence were u having exactly? Were they just minimal if u werent telling your surgeon?

The lortab 10 was given by request and I kind of mentioned both oxyIR and lortab 10 to the nurse but you know the telly game, that shit might have been misinterpreted knowing how busy my physician is.

I'm definitely going to go for it now.

The new issues im having is upper back pain really bad like upper and almost on the shoulders and I know its not just muscles and if i move my spine in any direction there is a very distinct ripping sound of pops like a zipper of pops its insane. I'm thinking maybe a thoracic disc herniation with all the research ive been doing that would make alot of sense.

I have a central upper spine pain now that is radiating upwards and my initial L4-5 S-1 disc pain that hurt at the base of my spine (and still hurts) and radidates to my lower left thigh and a sharp stabbing pain when I take an odd step every now and then that almost rolls a shiver through my body because it hurts so fucking bad. The new pain in the thoracic region as im guessing is just as bad as my lower was before I found out that was herniated and prior to the fusion.

what do u guys think?

btw i am relatively young, 23 nearing 24

[Inspektahdek]

Ok I left the msg with the nurse a long letter actually describing my new pain and the pain that has been subsiding in the left thigh but worse pain in left buttock and numbness along with mid back and shoulder pain possibly from a thoracic disc herniation, I left the msg for change to oxy IR 5mg from perc5 or lortab 10 that I was on and since out of nowhere I was given 30 valiums today i dont think it would be a problem


we'll see though, my surgeon/physician is going on vacation soon and this is her last day and the nurse said that she will be doing all of her consults today hopefully, itd be nice to go this weekend with some oxy ir s and not just suboxone and valium, however they are nice :)

[Inspektahdek]

update: my surgeon/physician is on vacation starting today but came in to see a few patients, I left my note with the nurse talking about oxy IR and that I was experiencing "x" pain and that some pain in my thigh has subsided. Anyhow I left a nice long note being descriptive and mentioned at the end that I spoke to the apotheke (pharmacy) about equivalents of percocets (malli german shit lol) and she said they had OXY IRs available. I come back to the office later and I have a script for

120 oxy IRs! Fucking awesome, I've taken them in the past and oxy IRs are way more superior IMO to regular percocets, especially the Mallinkrodts I only get here.

Thing is I can't pick it up until Friday because my script isnt due until then. Oh well, that will give me 2 days to have this suboxone wear off so I can enjoy.

Anyways, yay! thanks for any advice given and I did get to pick up some diazepam today so that was kinda cool, mellows out the suboxone jitters

[the morphine the better]

For a long time I was Rxd partially oxycodone 5mgX2 at a time every 6 hours prn and I left a note with her nurse to be changed to either something like OXY-ir 5mg or LORTAB 10 to cut down on APAP and since I can only see this busy busy physician like maybe once every month if im lucky and usually once every month and a half u have to book WAYYYYY in advance and most of my refills are done through phone consultations with her NURSE PRAC or something of the sort. I called last time and asked (shes pretty cool about changing meds) if I could be off the perc 5mg (the pharm i get them from only has mallis and they are horrid! plus taste horrible) so I asked for OXY IR -5mg so it would be easier and without the apap plus in a capsule or to be put on lortab 10 so she gives me 90 count lortab 10 when I come to see the nurse.

The rx was there and I never even got to see the doctor. She has it written take 1-2 tabs every 6 hours of lortab 10/500 prn which makes the APAP 4g max and my refill is due this friday and im trying to sway her back to the oxy IR but I dont want to sound too suspicious. Also when I asked for the lortab 10 I was asking for something weaker to see if it could sustain my pain so it looked good in that aspect but im going to mention that it doesnt and perhaps mention that I dont want that much APAP in my liver or something of the sort, should I say this?

Shes pretty cool about changing meds and what not but most of the time these changes are done through me talking to a nurse prac and the nurse talking to her and then the doctor consults the new meds, etc and I rarely get to even see her. Shes the head of orthopedic surgery where im from and I know this sounds weird but this is how I get my meds. Anyhow, what should I do without sounding to swaying to get her to hook me up with OXYIR- I hate mallinkrodt and thats the only type of percocet 5s I can get here when OXYIR is not germany manufactured, and is way better IMO but I dont want to sound like im digging for this drug or look like a seeker, etc. so should I mention the apap?

In the past ive gone from oxys to fent 75mcg, back to oxys etc. Except all my fent is rxd for 72 hours, another thing I have a prob with but I never say anything about it because I dont want to look like a seeker because it only works for 48hrs because I do get 75s so anyhow, shes pretty cool about all this I just dont want to sound to convincing on my part about changing meds and really want the oxy IRs instead the lortab or percs I was on before, any advice?

Sorry for the mangled msg

I had the same issue with the Patches, what I did was downloaded some legitimate Medical documentation stating that for some people especially men the Patch metabolizes in 48 hours and the third day is usually an intense reduction in dose. If you PM me I will help you find that, its from a Journal of Pain Management. Apparently men metabolize Fent faster than women and it is not uncommon for the doctor to either RX 15 patches a month or for example 10 patches of your normal dose and then 5 patches of 25mcg to be put on on the 2nd day so that the dosage works out correctly and then you take it off when applying the larger dose for 48 hours (if that makes sense)

Also I have a excel spreadsheet written by my pain doc that explains what breakthrough meds work best in conjunction with your long lasting rx. Fent and Hydromorphone are a perfect combination, but Fent and Oxy IR really just builds tolerance and has little actually analgesic properties. Also he explains in the document that rotating opiods every 6 weeks is key to reducing tolerance... Just hit me up son.

[Inspektahdek]

im hitting you up right now

[Synack]

hitting you up as well, I'd like a copy of that xls if you don't mind.

[Inspektahdek]

hitting you up as well, I'd like a copy of that xls if you don't mind.


some mighty nice info we'll be getting, this will prob def get me an extra 5 patches which I would love. an extra 75mcg fent patches, omg, Id love it

[youwonhundred]

Count me in on that, please. I would like a copy of the spreadsheet iff'n ya don't mind. Thanks

[BLOODY]

update: my surgeon/physician is on vacation starting today but came in to see a few patients, I left my note with the nurse talking about oxy IR and that I was experiencing "x" pain and that some pain in my thigh has subsided. Anyhow I left a nice long note being descriptive and mentioned at the end that I spoke to the apotheke (pharmacy) about equivalents of percocets (malli german shit lol) and she said they had OXY IRs available. I come back to the office later and I have a script for

120 oxy IRs! Fucking awesome, I've taken them in the past and oxy IRs are way more superior IMO to regular percocets, especially the Mallinkrodts I only get here.

Thing is I can't pick it up until Friday because my script isnt due until then. Oh well, that will give me 2 days to have this suboxone wear off so I can enjoy.

Anyways, yay! thanks for any advice given and I did get to pick up some diazepam today so that was kinda cool, mellows out the suboxone jitters
i live in ur country AND we have NO oxy's,maybe da drug but DEFINITELY not under dat brand name!wat are u?sumone gettin DHC an thinkin its da same?please clear dis up or u are just a liar.

[BLOODY]

i live in ur country AND we have NO oxy's,maybe da drug but DEFINITELY not under dat brand name!wat are u?sumone gettin DHC an thinkin its da same?please clear dis up or u are just a liar.
no percodan ,percocets,norco roxys etc. in naziland.i get morph but had to fight 10 years to find a way.doc's here shit their pants if u only mention opiates,even codeine or DHcodeine.an u ar sooo lucky?clear this up for all,cause i know terminally sick cancer patients who get 2!Temgesics a day,hell thats not even one shot.

[OxyContinuously]

i live in ur country AND we have NO oxy's,maybe da drug but DEFINITELY not under dat brand name!wat are u?sumone gettin DHC an thinkin its da same?please clear dis up or u are just a liar.

"chill out son"

and by the way, I *highly* doubt he's getting DHC and thinks it's oxycodone...be real.

[Inspektahdek]

Forscheim is where I'm from and they do have oxys, and what not. I have also lived in the US and I go from living in germany to back to the US quite often, I'm a demo engineer basically explosive ordnance coordinator and we demolish old artillery shells, bombs and the like that you might consider duds or landmines that are no longer able to be used (anti-personnel) because of the Geneva Conventions. I'm not in the military but I work for many and I have lived all over Europe in stints of months and the US is my biggest boss because they have alot of ordnance that needs disposal and because of the troops in IRAQ dealing with those homemade roadside bombs, I work as a contractor to eliminate these because th e shortages of troopers.

yea and "chill out son" and please don't call germany nazi-land, why are u living in the past!?


btw I'm am totally not opiate naaive and know what "stuff" looks like, I find that an insult for someone whos never really posted here before calling me out for no reason.

[smojo]

U can also have "referred pain" that mask and mimics the exact same s/s of your lumbar ruptures. I recall having some episodes of it. You actually think your having new ruptures in your thoracic area, when it is just referred pain from your injured sight. Radicular s/s from your knees up is from L4-L5 and up (what you have described), where as radicular s/s extending below the knees straight down to your toes is reserved for L5-S1.

The incontinence issue...guess I'll write it all out, just in-case godforbid it happen to anyone else
At 15 my L5-S1 disc was just bulging. I continued with Classically trained ballet and by 17 I had an enormous "Central" disc herniation which is referred to as a Cauda Equina Syndrome. Well, when we first new it had actually herniated (foot drop, radicular s/s) my neurosurgeon decided to hold off since I was so young. He would always say "if you FLOOD OUT or have loss of your bowels go to the ER immediately, you will have to have emergent surgery". THAT GOES FOR ANYONE READING THIS, IF YOU EVER HAVE ANY FORM OF INCONTINENCE PROCEED IMMEDIATELY TO THE ER, YOU may suffer permanent loss of bowel/bladder, and/or paralysis. It is an emergent surgical procedure.

So, I was 18 sitting in my first college English class and I "leaked" as I call it. Was like a quarter size. My heart and soul just fell, I knew what I should have done, but I was so young, all I could think was the DOC kept on saying "if you FLOOD out, not if you ever even have one tiny ass drop of urine" So, dumb ass me went 6 entire months before telling my internist who immediately notified my neurosurgeon and the next day I had a laminectomy.

2 weeks went by, I called my surgeon and said, heh, am I still supposed to be leaking? Well, long story short, they went back in 2 weeks after first surgery. Went back in on the right side, found nothing, did a lami on the left side, found nothing, then the fuckers really got me and did an "intrathecal" exploration of my dural sac, excising the dura/arachnoid/blah blah and still found nothing.

End of story, if any of you ever see the term 'intrathecal exploration' on your OP report...your going to be fucked for life, period. And yes, 6 months of incontinence, I've got permanent damage from it.

So, there is the incontinence update.

[jerets]

Some doctors think only junkies know about APAP levels, so a better line might have been, "The Lortabs don't kick in soon enough". Because Oxy does kick in well before Vikes. Some people don't know that. I don't know what it is exactly but I believe Oxy is like 15-20 minutes and vikes are 30min-1 hour.
Glad you got them anyways :)
Jerets

[Inspektahdek]

I told the doc I spoke with a pharmacist about it