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Tolerance to pain meds? Opana?
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finn2 posted:
I've finally built up a tolerance to my pain meds I think. Either that or my pain has increased, maybe both. Last week at pain management I discussed this with the assistant I had the appointment with. I've only been with her the last 3 months, they often change who I see due to transfers and such. She decided to change one of my meds. I was on oxycodone 15 mg, 4 or 5 a day as needed for breakthrough pain and 3 15 mg morphine sulfate ER per day. So she changed the morphine to Opana 10 mg, twice a day. I haven't really noticed a change, I still have the same amount of pain. I go back in two weeks since the meds have been changed and this time will see one of the docs. I never felt the morphine helped me with the pain, when they increased that to 3 a day, it only made me drowsy when I sit down for awhile, if I'm up and busy, I'm not so drowsy. I do not like feeling drowsy. I like to keep busy and have lots to do, I sell on Ebay and have a garden which I enjoy and make lots of craft things. But since the pain is increasing I am doing less and less and gaining some weight back, and my earnings are going down drastically because of pain, it hurts to stand, bend, stoop, walk, reach, I am staying home more and doing less. Oxycodone is the only thing that helps decrease the pain but my 4 or 5 a day aren't as effective and I am sleeping poorly now too. My question is has anyone tried Opana, did it work for you in 10mg amounts and if not what is a good alternative that helped anyone here? Or what is a good plan to change to something else and then go back to oxycodone again at a smaller amount? I have felt relatively good for 4 or 5 years, but this past spring it's going back wards and I want to be active again, I need to be active to stay healthy. I need to be able to walk with less pain. I have cervical spine and lumbar disk problems and overall joint and muscle pain unexplained, it changes and I basically hurt all over from head to toe. I may need surgery someday but my spine doc is not pressing me, he said I will know when I'm ready. Between him and my pain doc I have had some nice years lately.
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annette030 responded:
You sound great. Having more pain sucks though, some docs like to try different long acting pain meds, kind of rotate through the choices you have. Increasing the dose of the long acting med might help also. I personally use methadone, it is cheap and works well for me. Depending on what causes your pain, makes a difference in the best drug for you to try.

Sorry, that last sentence was awkward at best. What I meant to say was that the cause of your pain does make a difference in your drug choices. Methadone works best for neuropathic pain, it may not be best for you.

Take care, Annette
 
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finn2 replied to annette030's response:
Thanks Annette, I do have neuropathic pain, I was amazed when my doc explained how spinal issues can cause pain in your entire leg not just sciatica like I thought, plus it's in my arms too from my neck. And from walking strange because of pain, tendons and ligaments and muscles are working wrong and they go into spasm etc. Or my neck pain causes back stabs in my back muscles (TENS unit helps that so much! I had a place in my back so sore for years, it took it away!) I am a young 66 yrs old and refuse to give in to this pain and sit on my butt in misery the rest of my life. I have so many things to do and there aren't enough hours in the day, I get very despondent when I'm unable to do the things I like to do or need to do. Even reading, holding the book hurts my wrists so much I end up not reading very long. Oxycodone takes that sort of pain away for a time, whereas the worse pains are still there but not disabling. It's so hard to garden and I love doing that. Thanks for writing.
 
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77grace responded:
Hi finn2 ,
I can really relate to the issue of tolerance !I have had a problem with tolerance on and off for a very long time !!!I have had to be on pain med along time so I've tried dalot of things and of course done detox to lower my tolerance too !That really did help !But now I'm afraid that I am in too much pain to try that again !I got off everything and tried Suboxone ! It did not help the pain !
I can't type fast so I better make this in 2 !
77grace
 
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77grace replied to finn2's response:
Hi Again ,it's me 77grace !
I guess what I am saying is just don't give up ! How long have you been on these strong meds ???
I hope you can find something to help !
Like Annette I also am on Methadone and it works pretty well <It's been about 12 years !
Take care 77grace
 
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annette030 replied to finn2's response:
Best of luck to you, you sound like my kind of 66 year old, I am a very young 63 year old.

Take care, Annette
 
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finn2 replied to annette030's response:
Thanks Grace and Annette, just wanted to update quickly, I am heading out to work for a bit. I've gotten hives and intense itching even where there isn't a hive, told the doc's office this morning, they haven't called me back yet. Checked side effects for Opana and I have several things going on this past week on Opana that's on the list, irritability, abdominal pains, hives and sad feeling, so I am not taking it until I hear from the docs, went back to my MS Contin generic, I guess I will see if the symptoms go away. I've never not done what my doc said but am afraid ot keep taking the Opana due to the hives especially. I hope they don't get mad at me, I expected them to call me back with instructions. Have to go, will let you know what happens.
 
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finn2 replied to finn2's response:
Well, that's it for Opana, the doctor's office called me on my way to work, they said hives were from the Opana and to stop taking it immediately. I go back to the MS Contin until my appt. next week. I'm glad I figured it out, at first I thought I had poison ivy as I pulled some weeds Sunday, although I took great effort to stay away from that. It just kept getting worse all week, still itches but I think it's less than before.
 
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annette030 replied to finn2's response:
Hives are a sign of an allergy, along with difficulty breathing, the rest are adverse effects. Best of luck to you.

Take care, Annette
 
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finn2 replied to annette030's response:
Well, I never noticed difficulty in breathing. I'm allergic to fire ants, those bites do cause hives and effect my breathing. The hives are drying up, but still itch. I see my doc again Thursday.
 
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annette030 replied to finn2's response:
I stepped in a fire ant nest barefoot they stung bad on the tops of my feet. I had lots of small blisters filled with pus, my feet were all scarred up for years, from that adventure, lol.

Opana like all opiates will cause itching, that is considered an adverse reaction without hives, but an allergic reaction with hives, like you had. It is all very confusing.

Take care, Annette
 
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finn2 replied to annette030's response:
Oh yes, fire ant stings hurt and burn, that's why they call them fire ants I guess. The red dots with white centers that get worse before they get better. If I get stung on the foot, my leg swells up to my knee and I can't wear a shoe. Lived in Florida then and it was work to avoid them, they are everywhere. . I hear they are up thru the Carolinas now.
 
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cweinbl responded:
You are experiencing tolerance; but you are not on the most potent pain medication. Fentanyl is 80 times more powerful than morphine and more powerful than Oxycodone. Typically, when a patient becomes tolerant to the highest safe dosage of a pain medication, the physician will rotate the drugs.


Second, your oxycodone is not a long-acting pain medication. Research clearly shows that chronic pain patients respond much better to a long-acting pain medication (Kadian, Oxycontin, Fentanyl Transdermal, etc.). You can then use the oxycodone for breakthrough pain. This has been standard practice for a long time.


Perhaps you should ask your doctor about using a long-acting pain medication. When I first tried Fentanyl Transdermal, it wiped out at least 80% of my pain. One caveat though, the patches never last more than 48 hours. In fact, I've never heard of anyone who obtained benefit from a Fentanyl patch after 48 hours. But it is by far the most powerful pain medication available.


Try to keep the "nice years" rolling along by rotating your pain medications to long-acting and more powerful options. Your doctor should be able to help you with this. Good luck.


P.S. The success rate for spine surgery today is still about 60%. That's very low, especially compared with other types of surgery. Be certain that you have tried all of the dozens of various treatment options available with a comprehensive pain management program before going under the knife.
cweinbl
csw2@bex.net
 
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annette030 replied to finn2's response:
I stepped in their nest in Texas over 20 years ago. They were very large ants, my friend in FL pointed out fire ants, the were very small ants. I would have been glad to have red dots with white centers. I started out with big, white, pus filled spots. They were about 1/8-1/4 of an inch in diameter.

Take care, Annette
 
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finn2 replied to cweinbl's response:
Hi! I've tried the Fentanyl patch a few years ago, was up to only 25mg? patch and was so sad and felt like crying all the time and didn't feel any pain relief. So we won't do that one again. I've also tried Exalgo or something like that, it was some years ago and did not help. The morphine I was taking was the long acting med for me. I never liked it but no one seemed to hear me. The doc I saw last Thursday was a new one for me, I liked him a lot. He told me about a long acting Oxycontin I could try. He also said to stop the morphine if I felt it wasn't helping and was only making me sleepy. I wanted to wait until next month to begin any new meds because I am working for a family member the next 3 weeks and don't want hives or any side effects or allergies bothering me. He was in agreement with that. So next month I will try the long acting Oxycontin. I stopped the morphine immediately that day. I have had some extra sweating at times, no real increase in pain, just that the short acting Oxycodone seems to wear off much faster, and then I feel kind of icky, not more pain but more like withdrawal feelings, aching, teary eyes, so I guess the morphine did help a bit with that but I am not getting as drowsy and I like that. Maybe I should have started the Oxycontin now, it should be ok if I'm used to oxycodone perhaps.
My orthopedic doc isn't pushing for surgery at all and I appreciate that, I really don't want any surgery. (My brother has had some spinal surgeries, some with not good results). He also told me there were many alternatives. Thanks for writing!


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