Pain Meds and How Much

[Laura C]

I would like to talk about how much medication I am taking and how it relates to everyone else. ALthough everyone's pain tolerance is different, I still think this could be an interesting topic.

I am currently taking 2 Vicodin ES every 4 hours - sometimes less if I have a good day and sometimes more if I decide to go shopping or cook where I am on my feet for a couple of hours.

I had gone to a pain management dr about 2 months ago and she originally put me on Palladone. It was very strong and I could not tolerate the side effects (nausea, extreme constipation). So I went back to the Vicodin - I was hoping to have my surgery by now - scheduled for October 11 - pending approval. I have an appointment this week with her to discuss how to proceed with my meds. I want to relieve my pain, but don't want to build up a tolerance.

I also want to note that those of us that are taking narcotics on a chronic basis, to make sure that you drink plenty of water and take a stool softener everyday - very important!!

[djscal]

Laura,

My doc said that 5 Vicodin ES (7.5/750) was the MAX per day! This is because of the high amounts of tylenol in it. 750 of tylenol per pill would make 3,750 mg per day of tylenol if you are on 5 pills per day. Liver toxicity can occur if you are on more than 4,000 mg per day of tylenol. You may want to check back with your doc ASAP! If you need that high level of narcotic I would go to Norco 10/325 which is the same as Vicodin but stronger and much less tylenol. Or Percoset 10/325 which is oxycodone (a little stronger than Vicodin).

Dan

[Laura C]

Dan,

That is exactly why I am going to the dr. this Thursday. I also have vicoprofen, but too much of ibuprofen is not good either. I am so concerned about my condition. I have a tentative surgery date of October 11th - 1 fusion and 2 adr. I am so worried about long term narcotic use. My discograms last friday proved to be what I expected.

I see that Dr. Regan is your Dr. as well - what insurance do you have? Mine is BC of CA thru the Directors guild. What meds are you taking?

Thanks.

[djscal]

Laura,

I don't want to freak you out, but I would be CONCERNED about exceeding 4,000 per day of tylenol. You may really damage your liver. If you can cut down to 5 or 5.5 pills per day until you see him, that might be wise.

Yes Dr. Regan is my surgeon - I'm only a week away! I have Regence Blue Cross/Blue Shield PPO out of the state of Washington. This is because I work for Boeing and even though I live and work in California its a Washington state administered policy.

I'm taking a 1/2 of a pill of Vicodin ES (7.5/750) 5 x per day. So about 2.5 pills per day. I also take Neurontin 300 mg once or twice a day for nerve related pain. Trazodone 50 mg to sleep. Occasionally I'll also take an anti inflammatory if its a real bad day. Dr. Regan told me that pain meds and anti inflammatories are a good combo. He said that after surgery he is able to give his patients a moderate dose (instead of a very high dose) of pain meds because of the combo of anti inflammatories and pain meds. Maybe you should consider that instead of such a high dose of narcotics..? Although since you have multi level issues, maybe you would still need to go to a time released morphine narcotic such as Oxycontin or Morphine IR.

Dan

[Patrick]

Boy, I hear you about the severe constipation problem with some of these meds. I recently saw a PM doc and he prescribed Avinza (time release morphine) for me. After about a month on it, I am very unhappy with it. It has turned my insides to GLUE! I take 2 stool softeners, 1 laxative, and a daily supply of a fiber drink every day and it hardly even gives me the slightest bm. On top of this problem, I don't think it has the powerful pain reliever blast that I need during my several flareups throughout the day. I think I am going to request to go back to the 10/325 Percocets all day, it also doesn't seem to bother the bm as much either.

[Laura C]

Hi Dan,

I should clarify that I switched to Vicodin just a week ago because I had the discogram this past Friday - so I was not taking that much for a long period - also the dr. did give me some Norco for after the disco. I am going back on the Vicoprofen tomorrow until I see the PM dr. I am going to post my films in about a half hour - check back for the link - I am interested in what you all think. Tell me about the Percocet? I don't want to feel drugged - the Vicodin/Vicoprofen actually keeps me awake. ALso I have a blood clotting disorder (clot too much so I have to take into consideration how much ibuprophen i should take) - check back for the link. Thanks.

[Laura C]

Ok, Here is the link to my "key" frames.

One shows the facet joint that is missing and the other speaks for itself.

www.lauracedar.com/XrayGallery

(Not sure if a hyperlink will be displayed - if not, just copy and paste the address in your browser window)

[djscal]

Laura,

Unfortunately yes, Percoset does make me a little sleepy. Vidodin doesn't do that, but it does give me headaches sometimes. So neither is great in my book.

I'd say try it and see, I think everyone has a little bit of a different reaction.

Dan

[Laura C]

Dan,

I can't wait to be off of all of these drugs. I feel so awful most of the time. The Palladone made me VERY sleepy. I don't like those time release drugs because they are in your system all the time. I drive very little now and I make sure that I don't take my meds before I get in the car. Since they wear off after 3 or 4 hours, then I can plan what I need to do. I have 3 kids so I need to be awake. They are not babies but I want to help them and be there for them. I will see what the dr. has to say. Also, I am feeling better from the disco - the test was not as bad as the 3 days afterwards. The bottom line is that there is no free ride.

Wow, your surgery is coming up soon. I just spoke to the office today and the soonest date that they can give me is October 11th and that is if I can fight with BC. Is your insurance covering it? How many levels are you having - you are so young.

Thanks for chatting with me.

[djscal]

Laura,

Only one level L5-S1 fortunately for me. Yes, I am young at 29. I will be more careful from now on after the surgery, because I think my discs are genetically weak (I have relatives with DDD). No more bike racing for me, and no more lifting 30 + lbs.

Regence BCBS has agreed to pay for the Cedars-Sinai hospital bill which is most of the cost of the surgery. We're not sure if they will pay Regan's and Wagner's (vascular surgeon) bill. To cover my bases, I worked out an arrangement with the doctors (should BCBS not pay) that is reasonable. Email me or PM me if you want more info.

Regards,
Dan