saw my doc. today,changed meds,i need opinions please???

Discussion in 'Fibromyalgia Main Forum' started by nje, Jun 27, 2003.

  1. nje

    nje New Member

    iwentto my for my yearly physical today;i woke in a bad flare-up,but went on anyway.while i was there,i told him just how rotten and aching and bad i felt,it must have showed in my face,because after the physical,he came in set down,and askedhow long since the ultram and lortab quit working?i told him for at least 2 months. so without any begging or anything,he said he would give me 2 choices, duragesic patch or oxycontin, i had read on here a few times where people had said the patch didn`t work that good,and i`d also read that oxycontin did work well. so i told him i`d try the oxycontin; then if that don`t work i`d try the patch,he also said to stop the ultram all together,just take the oxy, and lortab10 if i had any breakthrough pain. he started me on 20 mg. 2 daily, one every 12 hours.he`s got me coming back in 2 weeks. he said he might have to up the dosage on the oxycontin when i came back,because this is a low dose he started me out with,but i cantell a big difference already with just 1 pill. no pain11!!!!!!!!!!!!!!. i pray it stays that way. so ladies,gents, whomeever has been on 1 or both of these, oxycontin, or duragesic patch. which worked the best and the longest without much or any breakthrough pain? i`d really appreciate some feedback on this. nje
  2. nje

    nje New Member

  3. pearls

    pearls New Member

    I agree it is individual. That's what all the doctors have said in the various books and articles I've read on the subject. Some doctors have written that with fibromyalgia it is best to start with a very low dose of anything you try.

    I hope the fact that you've gone in for your "yearly physical" doesn't mean you haven't seen your doctor in a year. You really need to be monitored more often than that while you're on pain meds, especially narcotics. Also, expect to have to have them adjusted from time to time. Meds sometimes lose their effectiveness for us, or extra stress may up your requirements or visa-versa.

    Oxycontin has worked best for me so far, but only because I had an itching reaction to the patch after I had been on it for a few months. I've regularly had my pain meds adjusted, but expect to have to resort to Hydrocodone for breakthrough pain. Now that I've recently retired, I hope to be able to adjust my Oxycontin down. My doctor said that if I get down to zero to two Hydrocodone tablets per day he'll cut down my Oxy dosage. For pain, I also take Neurontin (also for sleep), and Celebrex. Other pain meds I've taken are Prednisone, Amitriptyline, Cyclobenszoprine, and Diltiazem. They've all required additional meds for breakthrough pain. I've only told you this to give you an idea of what one person has had to do. Meds are highly individual. My doctor's philosophy is that I should expect to experience pain. The idea is to keep it under control.

    Good for you and your success so far with Oxycontin!


  4. mstg

    mstg New Member

    I have been on both right now Im on the patch 50mg ahbd 10 lorcet. I was on 40 oxy they both work fairly well. with the patch you wont hav3 withdrawal from the lorcet if you run out. the only thing with the oxy for me was if I was in real bad pain I would break it in half and chew it which is bad but you get all the med at one time. and it did help me like that but the med didnt last as long. It can also be deadly since you can overdose and not realize it. so dont do that, if you have the lorcet to take in between you should be fine., at the time I didnt have anything for break-thru pain. but I changed doctors and he believes in treating chronic pain thank God.

    I had been seeing a PA but my ssd attorney said I needed a MD so I took her advice and Im glad I did. The PA was afraid to give meds even through he has a chronic back problem and sees a dr for his meds. He also would make me come in and see him every time I needed a refill, not only that his behavior was very inappropriate in that he more than one time made passes at me and would say things that made me uncomfortable. at the time I didnt know what to do I hated to start with a new dr and go through all that again. Im glad I did its a whole lot of stress off me and I dont need any more of that.
    I didnt mean to go into all that but I feel better now that I have I hadnt told anyone except for my new dr about what had been happening with him. I was always in tears when I would leave his office, Thanks for letting me vent.....
  5. Mar19

    Mar19 New Member

    I have used both oxycontin and the duragesic patch -- not at the same time, of course, LOL. They both worked well for awhile, but then my body got used to them. One problem with the patch was that it didn't alway stay on -- it's supposed to be changed every three days and sometimes it would start coming undone on the first day, sometimes it lasted all three. When it came loose I would used adhesive tape, but that didn't always help. With the oxycontin I tended to get very constipated and would have to use a laxative. I had breakthru pain on both. Ultram never did anything at all for my pain. Right now my pill regimen includes: Vicodin ES, Neurotonin, Paxil, Xanax, Celebrex, atenolol, Lidoderm patches, and Fioricet w/codeine when I get the headaches, which is fairly often.

    Don't you all get tired of being a walking pharmacy? Man! I sure do! But I being in pain is much worse. As to whether the oxycontin or the duragesic is better? For me, at least, I have to switch the pain med about every six months because my body builds a tolerance; do you find the same to be true?
  6. mstg

    mstg New Member

    you do form a dependance for them but there is a difference in dependance and addiction. all the other meds you mention are also addictive, so why not treat the pain with what helps the individual. For me I cant use anti-inflammatories Im allergic to them....I am grateful for narcotic pain meds and if I have to take them for the rest of my life thats okay too. Im concerned with the quality of my life, and the pain meds make it just alittle more tolerable.
  7. franners

    franners New Member

    It is my own personal opinion (not stepping on anyones toes cause we all are different) that a pain med regimine along with PRN (as needed) pain meds for break through pain is the way to go. Quality of life should be the number one thing. What works for an individual is what works for that individual. I can't wait to be pain free (working on titrating my neurontin) and if it does take a narc that is what I will take. Some times you will have a druggy feeling but that will go away when your body becomes accustomed to it. If and when your pain becomes in control you will be more active and have a better productive life. KUDOS to you when you do.
  8. Mikie

    Mikie Moderator

    I am so glad that you have a doc who is not afraid to prescribe opiods for unbearable pain. It is difficult for anyone to really give advice to another about what works best because we are all so different. We need to tailor our meds to our specific needs.

    I agree that there are other things, in addition to opiods, which can help with our pain and increase our sense of well-being. Less than one percent of those with chronic pain become psychologically addicted to opiods. We can become physically dependent on them as a Diabetic is dependent on insulin, but that doesn't make the Diabetic an addict. That said, however, I don't believe we should depend only on opiods for pain relief. Once our pain is relieved, we can try other things.

    Physical therapy which teaches flexing and stretching can help relieve our pain and stiffness and increase our strength and flexibility. Magnesium, especially in the ZMA sold here, will help with pain. The ZMA helps with sleep and works synergystically with whatever meds we use for sleep.

    Antiseizure meds help us get better sleep which also helps reduce pain. It is during restful sleep that our bodies produce growth hormone and repair muscles. Klonopin and Neurontin will help with sleep, decrease anxiety and sensory overload, and will stop RLS and muscle spasms and cramping. They also help protect the brain from damage from misfiring and overfiring of the neurons.

    The Guai treatment has worked well for many, including me. I was on Morphine for my pain. I now seldom take anything for it. It's not the easiest of treatments and it requires patience, but it's been a Godsend. I just celebrated my second anniversary on the Guai.

    Racwhite, please go to the library and read two of Dr. Cheney's articles, one on Klonopin and the other on SSRI's and stimulants. Klonopin and Neurontin are both antiseizure drugs from different families of drugs. Klonopin is in the same family as Vallium, but it is not a tranquilizer. These drugs can prevent brain damage from misfiring neurons. According to Dr. Cheney SSRI's will fry the brain because they increase this misfiring and will eventually burn out the neurons. I do not believe that SSRI's are good for us and should not be prescribed unless a person has mental or emotional conditions which would benefit from these drugs. Again, it's a personal decision, but I do think we should make informed decisions. Docs hand out SSRI's like candy and most of them are really not qualified to be prescribing these kinds of drugs.

    nje, I want to wish you the best of luck with your new meds. Please keep us informed of how you are doing.

    Love, Mikie
  9. shazz

    shazz New Member

    "We need SSRI treatment" is a pretty broad statement. Some of us may benefit from these, but I would say that actually a minority of us probably suffer from true clinical depression. Being sad, or feeling depressed because of our illness or limitations does not equal true medical depression.
    Some people with FM do have depression in the medical sense of the word, but not all of us.
    I took SSRI's for very long term, and decided in the last year to get off of them. I can tell you, I feel no better for having done so , but no worse either. Just poorer financially. I have done the gamut of them because of docs who swear they will help me, we just need to "find the right one". For me, there IS no right one. Not yet at least.
    The use of these drugs is out of control in my opinion.
    They are handed out for everything from PMS to midlife crisis. Hence the big issue of renaming prozac to sarafem.
    I don't know who to believe, I have seen articles swearing that all FM patients need them to articles saying they will actually harm us. My thought is if you actually suffer physical depression you may need them, and IF they help you, take them. If they don't why risk it? I don't take sleeping medication lightly either but I do NEED it.
    Ok once again, stepping down from my soapbox.
    I hope one of our medical professionals from this board will jump in here and add their two cents, we have a PA here who treats FM patients all the time who will (most likely, LOL) agree with me. No names mentioned. God Bless him.


  10. Achy-shaky

    Achy-shaky New Member

    I have no experience with oxycontin & patches but my SIL who has had FM for over 20 yrs swears by Oxy 40mg - 2/day. She also uses Lidoderm patches after getting her trigger point shots (don't recall what kind). She also uses Neurontin, Elavil, plus Baclofen for spasms. She just had her Neurontin increased to 1200mg 3xday because her doc said he doesn't want to increase oxy in case she needs more later. She needs increases in meds/dosages about every year or two & has her blood tested often to watch liver/kidneys - has tried many other drugs and alternatives that didn't work for long.

    My daughter who also has FM also needed stronger meds to help pain after she had back surgery. She started out with Ultram, Percocet and don't recall what else but was finally given oxy 10mg 2/day but then had a car accident causing more pain and her doc increased it to 20mg for a short period of time and then slowly weened her off it. I know for a period of time she was using some type of patch along with the oxy but doesn't use them anymore. Her doc also got her on a lot of other drugs including Neurontin, Klonopin, Celexa, Flexeril and Strattera (for ADD) which seems to help as well as Oxy. However, I know that her pain level went down when she got rid of some stresses in her life.

    You didn't mention what other meds you take. Have you tried Neurontin and/or Klonopin? They have been a lifesaver for me even at a low dosage.

    I had my doubts about antidepressants but I've now been on Celexa for 5 months & I know it helps with my pain because a few times I forgot to take it and I couldn't believe how much more pain I had. I was in denial about the depression for years until my ortho recommended I see a psych for exam - I was shocked to be dx with major depression/anxiety - I thought I was holding up pretty good considering my pain & other FM problems but apparently I wasn't. Celexa helps my mood, I sleep better and it helps with pain...I don't know of any other medicine that does that! Before I started the Celexa I was on Neurontin and Klonopin but I couldn't take Klonopin at night because I have mild sleep apnea and heart irregularities which seemed to get worse when taking it so I only take it in the day now. Neurontin has been a Godsend for the nerve pain and is the only other drug I need now for pain since the pain got better when I added Celexa to the mix. I also have breakthrough pain but since I don't work anymore and have no kids to raise, it's easier for me to do alternative things like meditation, relation breathing, heat/massage, etc. until the Neurontin kicks in. I also take Prilosec and supplements to help with stomach problems and joint pain.

    All this goes to show that we are all so different so do whatever works best for you working with you doctor to get the right mix without too many side effects.
    Good luck.