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    Need advice concerning pain mgnt options
    An_254428 posted:
    Been on pain management for 15+ years due to chronic joint issues RE cancer and hernia and cardiac issues. My doctor changed my schedule from a 14 day to a 28 day refill schedule. The oxy-codon that I take is alot and yet it takes more to just function. I am trying to get by but will run out prior to my refill. What are my options, contacted the dr but due to a pain mgnt contract I have another 10 days to go. I am willing to try something different or to be medically detoxed but have not found any options. I do not want to have another cardiac episode due to lack of pain control. Suggestions?

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    blessedladyptl responded:
    Call your cardiologist. I doubt your PM dr would take a chance on you have a heart attack, maybe he consulted with your cardiologist first.
    cweinbl responded:
    That's the problem with pain management programs. You're more like a widget on a factory line than a person. Contracts, rules, rules and more rules. Sometimes its better to find a GP, family doc or internist willing to prescribe all of your medications, including those for chronic pain.

    One will always become tolerant to a medication over time. That means you'll need higher dosages to achieve the same result that you originally achieved with the starting dosage. You climb this ladder until you reach the maximum safe dosage. When tolerant to that, you must rotate to a chemically different pain medication for at least several weeks. After that, you can return to the original medication with improved efficacy.

    The solution is honesty. Call your PM doc and explain that the existing dosage is no longer effective. Ask if a higher dosage or a different medication would help. All doctors understand that tolerance is the inevitable result of using the same medication for a long time.

    I'm hoping that you won't have to wait out the contract period without a change. Typically, a family doctor that knows and trusts you will give you the higher dosage or different drug without forcing you to wait. But a PM doctor with a contract could be reticent to assist you.

    Good luck!
    meaningfulc1952 responded:
    Hi An_254428:
    Why did your pain mgt. dr. change your schedule on your
    medicine? That does not make a lot of sense to me to allow you to run out of your medicine too early and maybe go thru
    a detox at home. If your dr. does not give you an answer that
    makes sense, then I would contact one of your other drs. and see what they can do to help you out.

    Some of these pain mgt. drs. are just not very understanding and some are. I have had experiences with both kinds. I currently have a very understanding pain mgt. dr. that really does seem to "get it" and I am very pleased with her.

    Surely, your dr. would not want you to have a cardiac episode because you don't have the right type of meds for pain control. At least that is what I think.

    Good Luck and let us know what happens.
    jsilva99 replied to meaningfulc1952's response:
    Had a few days in the cardiac ward, seems the withdrawals have calmed down. But it is a fine line due to the pain issues. Appreciate all the input, it has been really helpful.
    annette030 responded:
    Did the doctor you have a contract with change just the refill schedule or did he change the number of doses you can get? If he changed the refill schedule he should have also changed the number of doses you get to go along with it. Twice as many days should equal twice as many doses. If he did not, ask him why?

    Take care, Annette
    annette030 replied to jsilva99's response:
    Are you the same person who originally posted as an anonymous poster?

    Take care, Annette
    ctbeth responded:
    I don't understand: are you being prescribed the same scheduled amount of pain medicine, but just pick up your Rx evert four, rather than two, weeks?

    If you take your meds as per contract, you shouldn't be running out.

    Actually, it's probably my mis-understanding. I cannot figure out what you're trying to say

    I hope that things are working out for you

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