Pain Management Community

Hi bamaman50, Beginning a new narcotic (or any new medication) right before you go on vacation or even when the weekend is coming up, is not a very good idea. There are too many things that can go wrong and your MD is not available to help you on the weekend. Trying a new narc and then going on vacation is even worse because you don't have access to your MD or PM that know you. I learned my lesson a few years back when I was switched from the Fentanyl patch to OpanaER 10 mg. QD and told to take the patch off after the 3rd day. Well, by the 3rd day, I was in full blown withdrawal (sweats, chills, nausea, diarrhea and body aches) and the PM was no where to be found. My internist had to approve me going back on the patch. The pharmacist was livid because he said that it takes weeks to get off the fentanyl and apparently the 10mg of Opana was no where near enough to keep me out of withdrawal. I would hate that to happen to you. It was horrible and it definitely is not something that you would want on your vacation. If it were me, I would go with the oxycontin since you know it worked before and you have just become tolerant to it. You are blessed to have a new (internist?) who is willing to write your pain meds. If I were you, I would go with him and ditch the PM doc since you said he is obnoxious anyway. Even if you find the oxycontin dose to be too strong, you can easily cut back on it, but if you choose the Opana and go on vacation, you might end up in a very bad situation without any help nearby. T.

Hi Bamaman,

I hate to hear about your PM doc and his attitude... mine has acted much like that recently and I would leave if I knew where to go. Anyway, about the Opana...

I take Opana ER, 30 mg twice a day. I was first put on 20 mg. twice a day but the pain was still bad. The past month I have taken 30 mg. 2/day and for the first time my pain seems to be what I call managed. I can't compare it to switching from oxycontin, because I haven't taken it. But, the amount seems pretty low to me.

If I were you I would ask my regular doctor to prescribe oxycontin 40mg. like you said he said he would have done. If he is willing to treat you on an ongoing basis, why put up with the PM guy? It would be pretty risky to start a new med right as you go on vacation. When I first started Opana ER, I was very nauseated for a couple of weeks. It finally went away, but I wouldn't have wanted to feel like that on a trip! I always seem to have drowsiness problems also when I switch meds. I just hate for a change to ruin your vacation.

I hope you figure out the best thing and go somewhere wonderful... have a great trip!

gail

I so feel you on the whole thing about Drs. being the way they are! I think it is a requirement for pain MGM Drs. I wanted to reply because I went from Opana to Oxy. To be honest with you, I would say the two 40mgs twice a day of oxy is what I am on. i was on three 30mgs oxys but found the 40s better. As for the Opana, it is a good med as I was on it for a year and a half. The problem is that when you are in so much pain, NOTHING really works. I would recommend staying on the oxy but that is also because I started on opana. You may find that since you haven't taken it, it actually works for you. I wish you so much luck with this! I know what your going through. if you want any more info and I could possibly help, swirl322@yahoo.com, just email me!

I was seeing a neurosurgeon who had me on MS-Contin for approximately 3 months; then advised me that my insurance would not cover that med. so he switched me to Opana ER 40 mg. twice a day. After he got me on the Opana, he dropped me like a hot pancake. I had to seek out a new doctor who would provide me with it and having great difficulty. I also take Vicodin ES 7.5-750 tabs 3 times a day and supposed to use the Opana for break-through pain. I found that in the past taking the 3 Vicodin and then taking the Opana at night helped me to sleep through the night and not wake up crying from the pain I have from peripheral neuropathy, back and neck pain. The doctors I currently see do not support that plan and I have had to fight hard to convince them (my primary care physician and pain mgmt. group) that that is what I have found works for me. In the interim, via my pain mgmt. group, I have received 3 epidural injections which have not made any difference in my pain levels. I was referred to another gen. practitioner who wasted my time after an hour to pronounce that she would only prescribe Opana for people who were dying of cancer and so I promptly requested back my paperwork and left the building. My pain mgmt. group hands out Ultram or Tramadol which does nothing for me and at this point will not prescribe Opana. My primary doctor made me sign a pain contract and keeps telling me that this is the last time she will prescribe me the Opana. I am so freaking tired of having to fight for what I have found works. They are so paranoid about drug addiction, but since I have been on pain meds for 4 years now, my pain mgmt. doctor says I probably already am addicted. And if I had the choice, I would rather be addicted than in pain. The pain impacts my entire life. 10 mg. of Opana is mild compared to what I have been provided and all I can tell you is that is the only med. that gives me any relief for all the pain issues I have. I try to take the Vicodin during the day and can't wait til 4-5 pm to take the Opana because it is so much more effective. I am not sure why the doctors are so hung up about not providing Opana to pain patients (who are not dying of cancer) because in my case, it is my salvation. There is information on the internet about the product and I don't see any reference to it being used primarly for cancer patients. It is a morphine-based medication but in my world it is my sanity. I hope this information will be helpful to you and please do not hesitate to respond if you have any further questions. Hope you feel better. Jamie

Jamie,I am just curious if you have any idea why your neurologist dropped you after prescibing the opana? That doesn't make sense. he's the one that prescibed it.

Have you ever tried the fentanyl patches? They are a Godsend for me with a BT med. You might ask about those.

Lori

Hi It's really difficult to find a pain manager who believes in you. It sounds to me like you have one that does not believe in you. I realize they have to be careful about how they dole out pain meds. but most of them are so afraid of getting their hand slapped, they won't even try to know where you are coming from. If your regular Doctor says he will manage it, then go for it. At least this way he will know everything that you are experiencing. I really wish you luck.

Leenie50

Thanks for all the replies. I met with my new family doctor earlier this week and decided to let him take over my pain meds. He put me on 40mg Oxycontin twice a day. He also prescribed percocet for times the Oxycontin was not working. Break through pain meds I guess you could call it. He even called my pharmacy for me and informed them he would be taking over my pain management meds. I have only seen this doc twice but so far I am extremely impressed. He also put me on a diet and exercise plan and suggested I take a number of nutrients that would help wit the pain and improve my overall health. Been taking them for a week now and feel better already. He spends a minimum of 30 minutes with each patient, but does not except insurance. I pay $150 per month and can see him as often as is needed. He is also on call 24/7 via his cell phone. Maybe my l20 year search for a doctor that actually cares is over.

Sorry about your problems with your meds and your PM dr. It does take quite a while to find one that is compassionate, and caring and that goes for ALL doctors! Sorry I cannot help you with the Opana question since I have never heard of it. But I can tell you that I was on Oxycontin (name brand) and I hated it! I felt like it did not touch my pain at all. So the dr. put me on oxycodone 30 mg. which works perfect for me. But, way back in March-May when there was a shortage of oxycodone (roxi) b/c of the manufacturer's recall on the roxicodone. Boy, that was a big mess! He switched me back to Oxycontin and then percacet 10 mg for BTP. It was not the same! But it was my only option unless I wanted to go through w/d!! I am just grateful that I have Oxycodone (Roxi) 30 mg. and have a muscle relaxer that does not put me to sleep! LOL! There are so many muscle relaxers out there that just put you to sleep....

Oh, I also want to say that my first PM dr that I went to, he put me on Fentanyl patches and I hated them b/c I live in Florida and I sweat and the patches kept coming off. It also reminded my husband that I was taking medication. (I am the person that emailed a while ago about my husband not being very compassionate or sympathetic towards me and my pain). He thinks that "mind over matter" and that pain is all in "my head" and I can live w/o meds. Sorry, but I would not be able to do alot of things (and take care of him, mind you) if I did not have my meds!

Good luck to you and I hope you get the relief that you need. Have a LPD and a great day!

Bamaman,

That sounds great! I'm so glad this doctor is helping you. He sounds perfect- I wish I lived where you do. Around here a doc charges that much for 5 minutes. I really am amazed. That's how they all should do it... the way it use to be. And, I didn't know you were 120! lol

I do have a question. Are there actually supplements that might help with pain? I would love to know. My overall health has really declined during the past two years. I see my PCP for a "well" check in a couple of weeks and if you have something that you're doing that I could talk to her about it would be great. I'm glad you're feeling better. Keep it up! Take care,

gail

the plane your Dr. has going on sounds like a good way to operate. i like that you can pay a monthly fee and your able to see him as you need! thats REAL healthCARE! where is your Dr. located? im looking for somthing along those lines! thanks

$150 a month sounds pretty steep to me. Especially with no insurance.

In the old days, my husband had a car repair shop next door to the local hospital, and he provided free care repair and maintenance to doctors in exchange for free medical care for him and his employees. It worked out great for doctors' care, he had primary care and all the specialties covered. He only had to buy insurance for major medical hospital care for his employees.

My insurance company pays my doctor $70 per visit and I pay $30 per visit as a co-pay. I only see her once every 2-3 months. She spends whatever amount of time I need for that visit, no rushing.

I rarely need to see my doctor more than once every 2-3 months, I would hate to pay $150 every month, even when I don't see her. It is true that we pay more than that in insurance premiums, but my insurance also pays for meds, labs, xrays, hospitalization, etc.

I vote for single payer, universal coverage for everyone, get rid of all the blood sucking insurance companies, but I doubt I will see that in my lifetime.

More doctors are doing the concierge type care that you are talking about, they limit the number of patients to what they can handle alone. Then figure out what they must charge them per month to pay their own upkeep. The doctor's family life would suffer though, especially if they are on-call 24/7.

Take care, Annette

I usually agree with you Annette but not this time. My $150 covers as many visits as I need, many steroid and supplemental vitamin shots and flu shots. He is also on call 24/7 anytime I need him and after a bad bout with my back a couple of weeks ago he even called to check on me to see how I was doing and make sure my pain was under control. How many docs do that today? If I were to go see a regular doctor it would cost me $35 for a rushed 5 minute visit and a script. he allows a minimum of 30 minuts per patient. What doctor can you call at 10pm if you are having a real problem. When my back went out I went to him, got a steroid injection and left not owing anything. Lets see. If i went to a PM specialist that would be $50 and probably another $50 for the shot for the co-pay. I still have my insurance so if blood work is needed or CAT scans or whatever I am still covered. After being him for a month I would never go back to the way it was. Plus I was able to get rid of my heartless, obnoxious, PM doc. My present doc handles everything. If this sigle payer universal coverage is run by the government we are going to be in big trouble. Look at th other government run agencies and ask yourself if you would want your health care handled the same way.

This is one of those times when it just depends on what you need. I don't need the same kind of care that you do and I am happy with my current doctor. She doesn't rush me and she has always been available for me.

Our current system of health care is fine for those with money, but not for those without. The US is far behind other Western countries in all the markers of health care success, things like accessibilty to care, infant mortality, age at time of death, etc. If other countries' governments can run health care so can ours. I have no complaint about the police dept., fire dept and many other entities run by the government. (Of course, they might be better if they ran them my way, lol.) The current system is broken and does not work, and gets more expensive every year.

Take care, Annette

I agree our health care system is broken. As a Christian my heart goes out to those without adequate heath care. I would gladly contribute as much as I could afford to cover the uncovered. It seems to me if the government does want reform then why don't they pass regulations on the existing health care providers to make it easier and cheaper for everyone. For instance letting association such as the one I am in get a quote on the entire association of about 10,000 members instead of the 50 or so employees I have. Also they should make the providers give breaks in premiums for preventative medicine such as quitting smoking, exercise, etc. There are some good government agencies but very few. Look at what just happened to the U.S. Census bureau. Corruption is rampant. If each state would take just 1/10th of the government incentive money given them and put it into healthcare for all the money would be there. I think we could all put up with a bumpy road to care for the needy that have no health care at all. Where has the compassion for our neighbor gone in this country? Has our love grown cold as the good book says it would? Are we fulfilling our own destiny. God blesses those who bless his own, and we are all His own.