Pain Meds?

Discussion in 'Fibromyalgia Main Forum' started by pam112361, Oct 31, 2005.

  1. pam112361

    pam112361 New Member

    I'm curious. Unfortunately, even though I work in the administrative area of an emergency department, I don't know the first thing about pain medications. Right now for pain I take: Mobic (2/day); Neurontin 300 (3/day); Zanaflex 10 (4/day); Skelaxin (2/day if needed); Darvocet N100 (1 every other day as needed). I seem to be doing OK (not good) on the meds except for the Darvocet. I usually don't need it except during the work day (I have a very stressful job). Normally, if I take one Darvocet and alter my other medications to work with it, I can get through until my night time medications. Would asking for Darvocet 1 every day as needed be asking too much?

    I said in an earlier post that there is a bone of contention between me and my doctor's office. If I call in a day or two before my prescription is up, the office staff nearly strokes out but it takes them that long to call anything in. Then they seem to wait longer to call it in. By the time they do, I'm out of meds and may have been out for several days. It makes me feel like they are punishing me for asking for the Darvocet. The last time I called, it took them nearly a week to call in the prescription for Darvocet and Mobic. When I picked up the prescriptions, the Darvocet was written for 1 tablet per day. It was a Friday and I was on my way home so I thought, "well maybe he thought about it and decided that 1 per day wouldn't hurt me" so I didn't call. About 7-10 days later, I called the pharmacy and asked how the prescription was written. They (the pharmacy) had screwed up and put the wrong instructions on it. I knew I should have called them earlier. I was just hoping! Well, nevertheless, I let the pharmacist know how unhappy I was and what my concern was when I called to get a refill. They contacted the doctor's office to let them know what happened and that I would probably be contacting them 7-10 days early and the nurse said she would mark my chart. Unfortunately, having dealt with this staff for some time now, I know what that means when I call to get a refill. I just wonder if I made an appointment to go in and talk with him (he is my PCP), if he would relent and change my dosage. The drug itself seems to work OK for me and I understand that it is one of the lowest forms of pain relief. I've read where many people take a much larger dosage on a daily basis.

    What are other pain meds in the order of potency and how are they taken?

    Thanks!
    Pam
  2. Bailey-smom

    Bailey-smom New Member

    I too take the Mobic - 15 mg X1 a day.

    I do not take Darvocet but instead I take Tramadol 50 MG. 1 every 4 hrs PRN. Or I can take 2 every 6 hrs PRN.

    They do not have fits because it is not a narcodic but it still helps me with my pain.

    Hope you feel better!

    Kelly
  3. pam112361

    pam112361 New Member

    ...then they would get to feel some of the pain that we feel on a daily basis!!!

    Anyway, I know you don't know how my doctor would react to such a request, but if your doctor had you on 1 Darvocet every other day and you requested to be changed to a non-narcotic such as Tramadol on a more frequent basis, what do you think his/her reaction would be?

    Pam
  4. JLH

    JLH New Member

    First of all, I don't know how you can take both Zanaflex 10 (4/day) and Skelaxin (2/day if needed). They are both muscle relaxers and are sedating--how can you stay awake at work?!!!! Also, why would your doc prescribe 2 of the same type meds? I would ask him--no need for you to take 2 of the same thing. (I take Zanaflex, 6 mg at bedtime only to help me sleep.)

    And ... Darvocet is a weak pain med. Asking for 1 Darvocet a day would DEFINITELY not be too much! In fact, asking for 2 a day on days that you work would not be too much. Or, if you want to try something different, you could ask to try Ultram (tramadol is the generic) because it is non-narcotic and may be better for you while you are working.

    Another thing ... about calling in for meds early. I know that all nurses and docs hate that!! It gives them the impression that you are not taking your meds properly, or you would not have to be calling early.

    In fact, they expect you to get the proper scripts with needed refills when you are at your doctor's office visit. When you get a script, always ask for refills, and for whatever your drug insurance covers -- like do you need a 30 days supply with refills, or a 3-month supply with refills? Then refill with your local pharmacy or your mail-in pharmacy when due. When your refills run out, make sure you make a doctor's appt in plenty of time to get new scripts and also allow the appropriate amount of time to get them filled or mailed in before you run out.

    If you are experiencing a lot of pain, you might want to discuss with your doc taking an anti-depressent. They normally help people who are in chronic pain. The new one out, Cymbalta, which I take--as do a lot of others on the board--helps fibro pain and depression.

    Hugs,
    Janet
  5. mermaid01

    mermaid01 New Member

    Pam, please find a doctor that understands FM, please correct me everyone, but I believe the proper Dr. is a Rheumatologist. I notice that many of you go to Pain clinics or Doctors, it might be a good idea if you asked around the clinic/hospital you work for who (in those two categories) is a good doctor. One that specializes in Fibromyalgia. I hope you live in a big city, it is much easier to get some help. Good luck to you Pam.
    Carol
  6. jake123

    jake123 New Member

    My friend's name is Pam and my sister's name is Pam!! I would be upfront about it and say Dr. Podunk, I've called for refills for my medicine and it takes seven to ten days after I call for me to actually get the medicine.
    I really need it every day so may I have a 90 day supply or can I call ahead without it being a problem for (anyone, nurse, you, etc.).
    I have pretty good results with Ultracet which is not an opiod (sp?) but have been experimenting with taking my migraine medicine for body pain for the last week. It has worked for one day. I'm probably going to go to a pain doctor. I don't really want to take anything stronger than a Vicodin but I need at least that.
  7. pam112361

    pam112361 New Member

    Janet, Carol, and Jake123 (not necessarily in that order): My rheumy prescribed the Zanaflex (the only med he has prescribed; everything else comes through my PCP) long after I had been taking Skelaxin. I take 1 Zanaflex in the morning, 1 mid-day if I need it, and 2 at bedtime. My PCP has been prescribing the Skelaxin for a long time and I've continued to ask for it to use mid-day with my Darvocet instead of the Zanaflex since the Zanaflex is sedating. The Skelaxin may as well be a sugar pill taken alone but with the Darvocet, it helps some. I tried Cymbalta. One pill put me into what could almost be described as an "overdose state." When I talked to my PCP's office about the side effects, they told me it wasn't contraindicating with any of my other meds and to not take it again. It just wasn't something that I could take.

    As far as 90 day supplies of the Darvocet, it's not allowed since it's a narcotic; nor will they write it with refills.

    I've thought a lot about this overnight and I think I'm going to make an appointment with my PCP and see what we can do about the pain med situation. If he's willing to write me something non-narcotic that will work and will give me refills and feel more comfortable with that scenario, I'm more than willing to try it.

    I don't want to change doctors. I've been with this group for nearly 20 years. It's just that a new doctor stepped in and then took over the practice from the original physicians that opened it. They know me. The problem is that only two of the staff that were with the original doctors are still there; the new staff just isn't as friendly or understanding so I try to make my calls on days when I know who will be working. Pretty sad! Also, my PCP and Rheumy have worked together to get me on meds that seem to work. The only problem I am having is with my pain med and it is something that has to be resolved. If not, I may go over the edge.

    Thanks for listening and caring.

    Pam




  8. suzetal

    suzetal New Member

    She is awesome. I take oxcycotin 20 ...2 times a day.

    Need to have the script written every month.
    Doc told me make sure to call in 5 days before its due because the pharmacy may be out and it takes 24 hrs to get it in.

    When staff that does not know me ( this is a clinic my doc decided to go to work when she closed her practice and I followed her)Gives me a hard time because I'm early. I tell them docs orders so just give her the note.She knows that sometimes I may only do 1 a day so I will even go a month and a 1/2 so I do not abuse my pain meds .

    If your doctor knows you well you should ask him to talk to his staff and inform them to treat you with respect.

    I do not accept anyone treating me rudely and I would speak to my doc. about it.

    I am sick and I am not a drugy. I need them to live a little bit more comfy.

    Sue
  9. deedeej

    deedeej New Member

    I see a lot of people who use cymbalta. What is that for.
    I take 1.5 tazidone before bed to sleep and tylenol 3s and anti-inflamitory for pain. No it doesn't work.
    I am desprate to get something that does,
    So anyone with some good pain meds.
    ?
    Thanks
    Deedee
  10. deeders

    deeders New Member

    pam i cannot believe that you have not gone to another Doc. any doc that says a Darvocet every other day is enough is crazy. I take oxycontin every 6 hours and i must say your doc does not understand the pain that you are going through(i feel for u i had a doc like that once).i also take cymbalta, mirapex, prednisone, and neurontin for my combination of symptoms sometimes with not much relief but at least my rheumie is trying to find something that works instead of limiting my options and making me feel worse. i really think that maybe you should see someone else. What's the harm in a second opinion?????????
    i truly am feeling your pain. Best of luck i hope that you find something that works for you and that you find a doc that understands.
    [This Message was Edited on 11/01/2005]
  11. etoyl

    etoyl New Member

    I take from my Psychiatrist Mobic, Wellbutrin, Geodon (which helps me stay asleep once I am asleep), Zoloft, Nexium,Zanax, and Klonipin. My PM Doc gives me Morphine 30 mg 2xday, Lortab 10s. I'm fortunate that my doctors have worked together to come up with this combination of drugs which has litterally put me on my feet. I hope you find that there are competent docs out there who will take the time to help you. It took me two years to get to this point. But I do feel better.
    Good luck and hugs to you.
    Mitzi
  12. jake123

    jake123 New Member

    We could go through umpteen hundred doctors and tell them I am in pain each and every day of my life. My life is not normal. I can't function like a wife, mother, granny should. I need help. Where is a doctor that will help?
    We don't all have help with pain yet. Some of us are still limping along with Aleve. I have some Ultracet left over from an old prescription.
  13. JLH

    JLH New Member

    Maybe it's the difference in states or something, but my PCP gives me Lortab 7.5 for my back pain, and he gives me refills on it, and I refill it at my local pharmacy with no problems. I think I can only get 3 refills on it, though.

    I have also sent a new script off to my mail-in pharmacy for a 90 day supply with no problems.

    Hope you get the situation worked out to your satisfaction!

    Hugs,
    Janet
  14. tngirl

    tngirl New Member

    Pam I don't think asking for one darvocet every day is asking too much. In fact, I think that is a low dose.

    I have taken both ultracet and ultram (generic is tramadol and is very inexpensive)Of course I didn't take them both at the same time. Ultracet is ultram plus tylenol.They are both non narcotic. I was allowed to take one or two ultracet every 6 hours. I can take one or two ultram every 4 to 6 hours as needed. Sometimes I take some tylenol with the ultram to boost it.

    I also have Lorcet (same as vicodin) and/or Lortab for times when the pain is terrible. When it is really bad the ultram doesn't help. Those are taken twice a day, one every 12 hours.

    I also have a muscle relaxer robaxin or skelaxin to take every 6 hours if needed. I don't take them both at once. Sometimes switching to the other every now and then seems to help with the effectiveness. I think my body gets too used to one and the switch makes it work again.

    I also have degenerative discs and facets and arthritis spurs. I am allowed to take 200 mg.celebrex daily. I am off that right now because it is bothering my stomach. I have also tried mobic 7.5 mg. one or two daily. It is an anti-inflamatory like the celebrex.

    My doctor gives me enough refills to last until my next visit.

    I also use a tens unit which helps with pain.
  15. suzetal

    suzetal New Member

    A narcotic is controlled by our Federal Gov. Our doctors need to answer to them.The forms are revues by the feds.that we sign to get narcotics.Thats why you can not have a doctor on call fill them or try to get another of your doctors to write a script for them.

    The DRUGGIES THE FEDS CANT GET HAVE CAUSED OUR PROBLEMS> Not most of our doctors .Cant blame them for being afraid .If we take too much and get sicker or there stolen and the cops get the bottle its the doctor that is Questioned.And could be in some big trouble.
    My 2 cents don't know just had to.

    Hugs
    Sue
    [This Message was Edited on 11/02/2005]
  16. Bambi

    Bambi New Member

    are "allowed" to take, go to the American Association of Pain Medicine site and they have certified doctors who have trained in pain medication.
    Also the Purdue sponsored website of
    Partners Against Pain has doctors listed. Pain goes in cycles, it spikes at certain times of the day and night. To have real pain control you need to have a steady amount of the medicines in your blood stream as close as possible 24/7. If you do not do it that way, your pain spikes and you are always playing catchup which is very hard on your body.

    As far as just local doctors try the
    Yellow Pages under; Anesthesiologits,
    Pain Control, Pain, Sports Medicine and anything else you might think of.
    Rheumys help "some" people but don't have a very good track record with pain control, nor do PCPs. There are
    exceptions to every rule. If you have a local support group for FM/CFS (call the Arthritis Foundation for a
    list) go or call the leader and ask who in the group has a pain control doctor. Then call the person, explain yourself and ask if they would mind
    recommending you to their doctor or visa versa. Most people don't mind. I don't recommend mine because I haven't asked his permission yet..I will though. I know in the Phoenix area a good doctor is Steve Fanto and he has a clinic for pain and FM/CFS. in Scottsdale. He has articles on this site.

    It can take some detective work but put an ad on the Craig's list free ads even. Don't leave your name and they mail you any responses. You could just put "Want to contact any
    FM/CFS patients in the area who are doing well. Need doctor referral". You might get a reply, might not.

    There would be nothing wrong with asking what their doctor does for them to eleviate their pain or reduce it, but I wouldn't say I was looking for a doctor that prescribes anything in particular. You really aren't from what I get, just looking for a doctor that may be able to help you with the
    pain levels, and there's no sin in that though sometimes some make is sound like there is. Normal people's bodies produce pain relievers, ours just don't work properly (bodies that
    is).

    But, I'd probaby go with the Yellow Book and the local support groups. Good luck..noone should suffer needlessly in this day and age and there are many things that can help and not all are medications, just depends on what works for YOU.