Can I make a change in my meds?

[Barbj55]

I just saw my doc yesterday. I told her that I am having so many problems with the side effects of my meds. I take Lyrica 75 mg. 3 times a day, Ultram ER 100 mg. 3 times a day, and Norco a half a tablet about every 4 - 6 hours around the clock. The side effects I have from these meds are constipation, bladder retention, dizziness, poor sleep, and poor balance plus a constant dry mouth.

She said there is nothing else that is better. When I asked about the Duragesic patch, she said that insurance will only pay for that med. if you have cancer. My chronic pain is from my spine, the neck, the middle part of the spine and the lower back, all on the right side. It is due to over work by hyperextension of my neck and right arm for 10 hours each day for 4 days. First it was just neck pain, but now, 18 years later, it also includes the other areas.

I also asked about oxycontin. She said I would continue to have bad side effects. Is there any meds that would be better? Or would it be better to have a spinal surgical procedure? I recently had 3 epidural steroid injections to the neck, one to the thoracic region, and 2 to the lower back area of the spine.

Any help you can provide is greatly appreciated. I can't seem to come up with any more ideas. I trust your ideas as so many of you have been thru greater pain than I have. These meds do control my pain during the day, but leave me too tired to have any life in the evening. I am in bed from 7 pm to 7 am. I want to get my evening life back.

Thank you so much.

Barbara Johnson

[lobelsteve]

I think your doc is ignorant or lying to you.

Probably both.

Go to:

1. www.spineuniverse.com (Good info site)
2. www.spinalinjection.com (ISIS)

and find a listed doctor.

Just because a doc can put needles in the spine does not mean that they need to for your problems. But the folks listed there are usually better trained than the folks not listed.

[mazie456]

Barbara I have been on the Duragesic patch for 5 yrs for chronic spine related pain. Any opoid pain medication is likely to cause constipation but you can take a stool softener to help with that. Dry mouth is also pretty much a given, you need to drink more water. Poor sleep is often a by product of the pain itself. My pain management doctor usually asks me about most of these things when I see him every 6 weeks.

~You need a new doctor~

For a new doctor also try

http://www.spine-health.com/

Kathy

[lobelsteve]

My only problem with Spine-Health is that docs have to pay to get listed.
So it is more advertisement/bias than the other sites. I just looked to add my info on their list and I came across this:

This online signup will gather information required to create an individual physician web page which will be listed in the Spine-Health.com specialist directory (go to the specialist directory).

Annual subscription rate is $895 per spine specialist plus a one-time $100 set-up fee.

I'm not pain $1000 so I can get listed on another site. You can get good info on any doc just by googling their name.

[Tau]

Barbara, both have given you good advice, anything is going to give you constipation. I know no matter how long I've been on the same dose I have problems. I've been a chronic pain patient for about 8 years now and because I had not planned this being a lifetime thing I took my bad advice and tried not to use stool softeners or anything else because they told me that once I got off the meds my bowels would then be forever defendant on them. Now I have learned otherwise, but because I didn't for so long and spent a lot of time straining I had to have surgery once....never again it was such agony I literally screamed while having a bowel movement. Not only hard on me but my poor partner couldn't do anything she felt helpless listening to me. Not only do I have a problem down below but I think I've now strained so hard for so long a disc between my shoulder pushed into my spinal cord. When I go I get a sharp pain that radiates like an electrical shock through my arms, upper back all the way up my neck ending with a headache, the tingling takes awhile to disappear. Now I have to make an appointment with my Dr because it is happening a lot more and with more pain. Not to make you worry, just be aware that you need to do what it takes, no matter what you are on to keep your stool soft and easy to pass. Don't end up with my nightmare! Good luck!

[Mark N]

Barbara, you have had some good answers so far but I wanted to add that you can get Miralax OTC which is an effective laxative that had been prescription medication last year. Stool softeners are a good first step but if you need more help don't hesitate to get the Miralax. I am more concerned about your urinary retention. Your doctor is wrong that all meds will work the same. You may have to try different meds to get the right combination for you. Steve is right about seeing another doctor if your current doctor won't work with you. You can minimize the SEs with different meds. Many of us have found that it is better not to ask for a particular med as it throws up a red flag to many doctors. It is better to give them your symptoms and say you want to see if something will work better.

[lobelsteve]

Only your doc can figure out the right med for urinary retention.
For my folks with this uncommon, but not rare side effect from opioids and TCA's I use Flomax or Urecholine.

[Barbj55]

Thanks to all of you for your answers. The side effects are terrible but, I guess, something I will always have to live with. So far I've managed well, but would like to find a med that is stronger. I take Lyrica and Ultram 3 times a day and I'm still popping Norco in my mouth every 4 hours. Is that good control? Not to me. That's why I'm looking at the Duragesic patch or something equal to it.

I moved to my current community 4 years ago and started seeing my first doc soon afterwards. I stayed with him for 3 years. Nothing was working to my satisfaction so I asked for the Duragesic patch. He got all excited and said it would be worse than my current meds of Lyrica, Ultram and Norco. I felt there must be another answer and changed to this current doctor. His answer was steroid injections. When 6 of them didn't work, 3 in my neck, 1 in my thoracic and 2 in the sacral-lumbar area, he wanted me to stay on the same meds as my first doc. When I said I would like to try a stronger med because the side effects might be easier and my pain under better control, he said it's not worth it and besides the Duragesic is covered by insurance only for cancer patients.

I feel hopeless. This second doc would do nothing more for me than the first.

Yes, I have to change doctors again. It's difficult to change doctors because the docs don't trust a patient who keeps changing docs when you're on these narcotic-type meds and don't like to increase any meds when they don't know what kind of a person you are.

I hate going from doctor to doctor. This doctor has a large practice so I thought he would find something to keep me more pain free so I can have an enjoyable life. Right now I'm in bed from 6 pm to 7 am. There must be a better treatment out there?

I just have intractable pain from my spine. Other than the pain I'm healthy.
I'm doing all I can for to try to reduce the pain. I keep my weight normal. I go to a gym class, under the direction of my physical therapist, 3 times a week and see the phys. therapist twice a week. Why won't the docs help me?

Barbara

[lobelsteve]

Dont give up. There are good docs out there. And not just pill pushers. And not just needle monkeys. Do you have a definitive diagnosis as to why you are in pain? Not what the MRI says, but how your pain pattern matches the imaging with concordant aggravating and relieving factors? Any labs or imaging?
Start with what state you are in so folks can chime in on docs in that area that may be useful.

I've got docs not too far away that still just bend patients over and stick in a large bore Tuohy needle and call it an epidural. They always do series of $3. THen there are other docs that just take cash and write Rx's all day.
Like HM: mix it all together and then you got the best of both worlds....I have a 6 y/o.

[hoops2u]

Hi Barb,

I sure do feel for ya sweety. Are you or your significant other employed? Do you go to church? Is there a medical school in your area? Do you know any nurses? I have found the best way to find a GOOD Dr. is by way of other people with similar issues.

If you could, ask around. Find out who your friends, peers, associates, religious affiliates etc., anyone you respect, use for their physician and why. When changing Dr.'s it is easier to say to the "new" Dr. that the reason for change is "so & so, my friend, sees you and really respects/likes (whatever) you." And go from there about your inability to find relief for a particular condition, etc.

I would absoultely find a new Dr. When a Dr. says there is nothing else that I can do, you are being told "I" can do nothing more for you. That does not mean NOTHING can be done, just that that particular Dr. is inadequate or uncomfortable or even biased with regard to your physical condition.

Each epidural block creates more scar tissue, which in turn, contributes to additional referred pain. If the block works, GREAT, but if not, you probably do not want any more. They are dangerous, ya know.

I wish you the best. I take Kadian. It is a 24 hour release morphine based pain med. Some refer ti it as the cadillac of pain med. It has helped me tremendously, but I had to really work at getting my PM Dr. to RX it. Now he uses it most frequently for those who have insurance, otherwise it is extremely costly. And it has not caused too bad constipation. The worst side effect is I do not think it really lasts 24 hours so I break my dosage into 2 a day, AM and PM.

I have heard there is some major litigation going on with regard to the deurogesic patch. Some deaths have evidently occured? Apparently it was something to do with quality control and the amounts of medication in each patch?

God Bless you and I pray for your relief ASAP!!!!
hoops

[Barbj55]

Thank you, lobelsteve and hoops2u.

For the past 2 days I've tried to reduce the Lyrica and Ultram from 3 times a day to twice a day. That wasn't a smart move. I've been in so much pain that today I went back on 3 times a day. But I don't know if the increase in pain is due to less medication to the real pain or if I'm having imaginary pain due to addiction to the meds. Whatever, it's too much for me to bear.

Yes I will begin to search for another doctor and no more epidurals for me. So that's why my doc said that the buccal duragesic is better than the patch. I know I need something stronger than what I'm taking. I'm popping too many Norcos day and nite. There is a community email group in my community. I will ask them if they can help.

Thanks so much. There is no group that helps me as much as this group. I guess it's because you all know what it's like to suffer with pain. Sometimes I wonder why I continue to hang on, but those feelings are fleeting. I've never acted on them.

Thanks again,
Barbara

[Nana4&cntn]

Barb, Buccal Fentanyl is used as a break through med. It acts fast however it only lasts maybe 2 hours. I take it when I have the worst pain, typically from doing too much and forgetting my reg. meds. I can use it and it gives relief until my meds kick in. I had to fight my ins company as it is usually only prescribed to end stage cancer patients. My appeal did go thru thanks to my PM and his nurse, and a group of studies stating it is useful as a break through med for intractable pain. It is not for daily pain management.

I hope this helped, please do find a new doc, preferably one who is not a needle jockey(anestesiologist)

Take care,
Kathy

[Breeze]

I too was a victim of a MVA rear ended, in my signature you will see what I have been through and it is ongoing. I have been to 3 different PMS and the one I am with now is the best!
Do not let anyone tell you that Duragesic is only given to people with cancer or paid by insurances only for cancer! That is only a bunch of Huey!!! I had been on the patches since 2004 and my insurance was a national one who paid for them. I have been on copious amounts of meds from all of what has happened from MVA and other things that have sprung from it and insurance did cover all!
Now I don't have "insurance", I was awarded SSDI disability, but they screwed up my Medicare! I am supposed to get both Part A & B but some idiot data input put in the wrong information and now I have to fight for B. I did get to sign up for Part D but can't afford to go to the specialists needed to get meds.

So please check out Spine Universe, my PMS is listed on there and I know a lot of people who have gone to docs from there. My PMS was located with my surgeon that is where I found him and then later found out from him that he was a member of that site.

By the way where are you? You can do this privately if you want.

Does your spine doctor think your retention maybe from your spinal issues? Usually you lose control but the nerves can get damaged and do a lot of different things as my doc had said. I took meds for my heart to help with retetion both docs, cardiac and neuro, said it could be a combo of both dx. so please keep asking or fighting for answers, never give up!!!