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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 26. This is the beginning of the thread.
Posted by kerria on September 19, 2005, at 20:00:55
Hi Everyone, Hi Ed-
We're the one with the chronic pain that had the pain management Dr become angry with and start weaning me off all meds, reluctantly putting me on Kadian 100mg 2 x a day (morphine) with 15 mg morphine breakthrough. It's been a terrible experience with this pain Dr. He kept complaining that i don't have a dx. and i'm in terribly bad constant pain for almost two years now.
Last week i went to the Dr, a gyn oncologist, who offered to help me and stabilize my terrible chronic pain on meds if i would follow through on seeing another Dr- an expert on pelvic pain.
He was so understanding to my predictament- he asked and i told him what worked to take away the pain- 60mg oxycontin 3 x a day and 5mg breakthrough, 3-4 a day.In exchange i promised to go to a pelvic pain expert to help if he could do more. i cried in relief.
Then when i tried to switch from the Kadian to the oxycontin- it's only been a month or so since i was taken off the oxycontin- i had a terribly bad migraine - the worst - i couldn't hold anything down for Three days and became so violently sick and dehydrated. Today is #1 day out of bed. i had to go back to the morpihine- that i only have a few more days left.
Why would this happen?
i asked the new Dr- who gave the oxycontin, why i was so sick now and he said that changing shouldn't be a problem- just going from one med to another. i tried it one more time while still sick and it made the head pain so much worse. It's way better for the pelvic pain though.
But i couldn't hold it down- so sick.Does anyone have any trouble changing pain meds?
i'm afraid that i have parts that don't want me to have relief from the chronic pain for some reason- i remember hearing different negative things inside when i was violently sick. i wasn't able to see T all last week- became lost on Tuesday and too sick on Thursday.
It's so frustrating, finally i have the meds that worked for pain and i can't take them.
any ideas - anyone have similiar problems with changing meds? Does timed -released morphine and oxycontin not go ? i was waiting until the 12 hrs were up between. What's wrong?
What do i do now? The best thing i know would be to have a nerve block- especially for me but until then?
Thanks so much for reading,
kerria
Posted by ed_uk on September 19, 2005, at 20:00:55
In reply to Dr gave pain meds but now bad migraine, posted by kerria on September 10, 2005, at 13:57:44
Hi Kerria,
>Then when i tried to switch from the Kadian to the oxycontin- it's only been a month or so since i was taken off the oxycontin- i had a terribly bad migraine - the worst - i couldn't hold anything down for Three days and became so violently sick and dehydrated.
I think there's a simple explanation. Morphine and oxycodone are not interchangeable, you need to gradually increase your oxycodone dose while gradually decreasing your morphine. This way you will avoid the migraine.
>Does timed-released morphine and oxycontin not go?
They can be taken together. You will need to take them together for a couple of weeks while you gradually switch from morphine back to oxycodone. Ask your doc for advice on a suitable way to do this.
Ed
Posted by kerria on September 19, 2005, at 20:00:56
In reply to Re: Dr gave pain meds but now bad migraine » kerria, posted by ed_uk on September 10, 2005, at 14:32:50
Thanks so much Ed- you know everything. i can't believe the new dr didn't tell me that. He's really nice- he just didn't know.
The problem now is that the morphine is from the pain control Dr who i never want to see or call again, if i don't have to-
and the oxycontin was given mercifully by the new dr- i almost can't believe- he said he was just through patients charts and he wanted to help.
i don't want to be a pain to the new Dr.Already i'm taking the breakthrough oxycodone with the reg. morphine dose- all that i can hold down. i won't be able to titrate beyond that after i run out of Kadian but i have one week to do that.
It's so scary taking such high doses. After being sick so much, threatened with abrupt withdrawal - pain when meds wear off, i'm ready to hope for a some kind of other treatment.
i suppose i could keep going to the pain management dr and be weaned off but i'd better let the new Dr know first - he may not understand, he doesn't know me. He knows about the severe migraine but didn't think it was from the medicine. i do, like you said.
Maybe just keep taking the breakthrough oxycodone with the Kadian(i have seven days of the Kadian)and the last two days switch the morning dose- not take 60mg but 40 mg oxycontin if i can and seewhat happens?
(Ed-from now on could you stay around so i can check meds out with you first?)
:) missed you so much.kerria
Posted by ed_uk on September 19, 2005, at 20:00:56
In reply to Dr gave pain meds but now bad migraine, posted by kerria on September 10, 2005, at 13:57:44
Hi K,
I'm trying to work out a suitable way of switching from morphine to oxycodone with the amount of morphine you've got left.
Am I right in thinking you were taking 100mg Kadian every 12 hours before you made the switch?
How many Kadian capsules do you have left and how much morphine does each capsule contain?
How many breakthrough doses of morphine do you have? Do they contain 15mg per capsule/tablet? What is their brand name?
Did your doc switch you straight over to 60mg OxyContin three times a day?
Which strength of OxyContin tablets has your new doctor prescribed? eg. 20mg, 40mg etc.
Has your new doc prescribed 5mg oxycodone doses for breakthrough pain? Which brand name has s/he prescribed?
~Ed
Posted by kerria on September 19, 2005, at 20:00:56
In reply to Re: Dr gave pain meds but now bad migraine » kerria, posted by ed_uk on September 11, 2005, at 6:34:30
Hi Ed,
Thank you so much for helping me.
i tried twice but wasn't able to post- trying again-
*Yes, you are correct, i was taking i capsule of Kadian 100mg every 12 hours (and still am).
*i have 15 kadian capsules left.
*i have 30 tablets of breakthrough morphine left. They do contain 15mg and are generic MSIR- brown tabs.
*Yes, the new Dr switched me to 60mg. oxycontin three times a day. The strength of the tablets are 20mg. - i have about one month supply.
*also he gave oxycodone breakthrough tablets, they're 5mg - the generic eq. of roxicodone. They're orange and have 'ETH' on one side and '315' on the other side. i have a little less than a months supply because i've been taking 4 a day with the Kadian.
Thanks again, Ed. It's so good of you to help.
Take care,
kerria
Posted by kerria on September 19, 2005, at 20:00:56
In reply to Re: Dr gave pain meds but now bad migraine » ed_uk, posted by kerria on September 11, 2005, at 19:17:37
Sorry, i typed fast- It's 1 capsule of Kadian 100mg every 12 hours- not 'i'.
kerria
Posted by ed_uk on September 19, 2005, at 20:00:56
In reply to Re: Dr gave pain meds but now bad migraine » ed_uk, posted by kerria on September 11, 2005, at 19:17:37
Hi K,
OK, here is my suggestion.......
First, put the Kadian pills in a cupboard, you won't be needing them :-)
1. Tuesday and Wednesday
Take 20mg OxyContin three times a day 30mg MSIR four times a day generic Roxicodone when required. Don't take any Kadian.
2. Thurday and Friday
Take 40mg OxyContin three times a day 15mg MSIR four times a day generic Roxicodone when required. Don't take any Kadian.
3. Saturday.........
Take 60mg OxyContin three time a day generic Roxicodone when required. Don't take any Kadian.
~ed
Posted by kerria on September 19, 2005, at 20:00:57
In reply to Re: Dr gave pain meds but now bad migraine » kerria, posted by ed_uk on September 12, 2005, at 14:59:21
Hi Ed,
Wow. That's amazing.
Thank you so much.Ed, it looks like such a good plan, so reasonable but are you sure i could not take the Kadian anymore and be ok?? i'm kind of afraid. i can't chance a bad migraine. Are you sure?
aw heck- if you weren't sure you wouldn't have told me to do it like this.
Ok, starting tomorrow, Tuesday, i'll go by your schedule.
i'll let you know how it's working, k?Thank you again, Ed for taking the time to help me with this.
Thanks sooooo much, Ed,
please take care and stay around,
kerria
Posted by kerria on September 19, 2005, at 20:00:57
In reply to Re: Dr gave pain meds but now bad migraine » kerria, posted by ed_uk on September 12, 2005, at 14:59:21
Does that mean Extended release ?
these pills are so different than before:(they're orange pills with 20 on one side and E703 on the other. i'm afraid to take them now:(
thank you, Ed,
kerria
Posted by ed_uk on September 19, 2005, at 20:00:57
In reply to Re: Dr gave pain meds but now bad migraine » ed_uk, posted by kerria on September 12, 2005, at 20:40:54
Hi K,
>are you sure i could not take the Kadian anymore and be ok??
You'll be taking the MSIR intead. The 15mg tabs are useful for tapering.
~ed
Posted by ed_uk on September 19, 2005, at 20:00:57
In reply to Re: Ed- oxycontin is generic oxycodone 20mg ER, posted by kerria on September 13, 2005, at 10:46:31
>Does that mean Extended release ?
Yes. They're just a generic.
Anyway, how are you doing?
~Ed
Posted by kerria on September 19, 2005, at 20:00:57
In reply to Re: Ed- oxycontin is generic oxycodone 20mg ER » kerria, posted by ed_uk on September 13, 2005, at 14:55:20
> >Does that mean Extended release ?
>
> Yes. They're just a generic.
>
> Anyway, how are you doing?
>
> ~EdHi Ed,
i'm doing ok physically. i'm not in pain or uncomfortable - the medicine exchange is going really well. i feel even less pain than usual after a lot of hiking yesterday. Oxycontin works better for pain.
There are so many things wrong i can't even begin to say but at least the medicine and pain isn't one of them.
Thanks so much, Ed. You're the Best.
take care,
kerria
Posted by kerria on September 19, 2005, at 20:02:54
In reply to Re: Ed- oxycontin is generic oxycodone 20mg ER » kerria, posted by ed_uk on September 13, 2005, at 14:55:20
Hi Ed,
This morning i'm having very bad pain, trying to get it under control . When i woke up at 7am after a very rough night - bad dreams and pain at 4am , when it was an hour late to take the 30 mg MSIR.
One thing i'm worried about, the ER oxycontin doesn't last as long as the 12-hr Kadian. It works better but i'm not always on top of the time. Time gets away from me and i miss doses but with this i can't and still keep control of pain.
It's so hard to remember doses, i'm losing time a lot now :(
Yesterday (Tuesday) was like this-
MSIR 30mg at 8am
oxycontin at 12noon
MSIR at 2pm
then i was away from home until 9:15pm and took MSIR 30mg and oxycontin 20mg then.
nightmare at 1:30am
Then i woke up in pain at 4am and took MSIR 30mgToday, Wednesday-
oxycontin 20mg and two breakthrough 5mg oxycodone for emergency pain at 7am.and i still hurt but it's getting better i think.
It's so hard for me, things are so difficult, holding pain at bay without any support from h and everything hurts. Trying to get ready for work and h is so angry .
Thank you for being there and trying to help.
kerria
Posted by ed_uk on September 19, 2005, at 20:02:54
In reply to Re: Ed- oxycontin is generic oxycodone 20mg ER » ed_uk, posted by kerria on September 14, 2005, at 7:51:48
Hi K,
>One thing i'm worried about, the ER oxycontin doesn't last as long as the 12-hr Kadian.
Are you taking the OxyContin every 8 hours? Perhaps you could set an alarm (on your watch) to remind you to take it.
~ed
Posted by kerria on September 19, 2005, at 20:02:54
In reply to Re: Ed- oxycontin is generic oxycodone 20mg ER » kerria, posted by ed_uk on September 14, 2005, at 15:39:43
> Hi K,
>
> >One thing i'm worried about, the ER oxycontin doesn't last as long as the 12-hr Kadian.
>
> Are you taking the OxyContin every 8 hours? Perhaps you could set an alarm (on your watch) to remind you to take it.
>
> ~edHi Ed,
Are you there? i'm in a lot of pain- the chronic pain and bad body aches- i don't think that there's enough pain medicine in this schedule.
It hurts and i feel like i'm withdrawing. i took everything exactly on schedule today but the pain started getting bad this evening despite that. Now it's after midnight and i woke up hurting badly after being asleep just an hour:(
i have work tomorrow morning also.i took the last single dose of 20mg oxycontin at 10pm with the 30mg MSIR, just two-and-a-half hours ago. Can i do more than just take two oxycodone now?
Thank you,
kerria
Posted by kerria on September 19, 2005, at 20:02:54
In reply to Re: Ed- urgent/pain/not enough medicine » ed_uk, posted by kerria on September 14, 2005, at 23:29:07
help please, Ed,
it hurts so much to even walk- the joint pain is so bad and i have chills/pain/sunburn feeling all over.
please write,
kerria
Posted by kerria on September 19, 2005, at 20:02:54
In reply to Re: Ed- urgent/pain/not enough medicine » ed_uk, posted by kerria on September 14, 2005, at 23:29:07
The problem is with the MSIR- it doesn't add anything to pain relief at all- it's not like the Kadian which didn't work at first until about a week . Once it built up i was not so bad. The MSIR doesn't work at all.
k
Posted by ed_uk on September 19, 2005, at 20:02:54
In reply to Re: Ed- urgent/pain/not enough medicine, posted by kerria on September 14, 2005, at 23:52:58
Hi K,
Time for a re-think.
Stop taking the MSIR. Increase your OxyContin to 40mg three times day. Open a 100mg Kadian capsule - you will find some pellets inside. Tip the pellets out of the capsule and divide the pellets into two approximately equal piles. Take one pile immediately (50mg) and the other pile (50mg) 12 hours later. DO NOT CRUSH OR CHEW THE PELLETS, THEY MUST BE SWALLOWED WHOLE. The pellets can be swallowed with a bit of yoghurt or apple sauce.
Your new schedule:
40mg OxyContin three times a day - every 8 hours
50mg Kadian every 12 hours
No 'regular' MSIR. 30mg can be taken 'when required' for withdrawal symtoms eg. chills, join pain.
No 'regular' oxycodone immediate release. Up to 30mg can be taken when required for breakthrough pain.
Kind regards
Ed
Posted by ed_uk on September 19, 2005, at 20:02:54
In reply to Re: Ed- urgent/pain/not enough medicine » kerria, posted by ed_uk on September 15, 2005, at 14:36:33
>No 'regular' MSIR. 30mg can be taken 'when required' for withdrawal symtoms eg. chills, join pain.
>No 'regular' oxycodone immediate release. Up to 30mg can be taken when required for breakthrough pain.If you decide to take OxyIR and MSIR together, don't take more than 15mg of each.
~ed
Posted by kerria on September 19, 2005, at 20:02:54
In reply to PS, posted by ed_uk on September 15, 2005, at 15:04:35
Hi Ed,
I've been so sick. i didn't get your posts. Last night i took 2 immediate release oxycontin for the pain that was getting bad. Then i woke up at 5:30am and the pain was the worst i've ever had in my life- it was incapacitating- it was so bad. It was exactly like i was having surgery without any anesthesia:(
Made tea so it would work fast and took the 40mg oxycontin with two breakthrough oxycodone and stayed still in bed, with some applesauce so i wouldn't get sick. It hurt so much i couldn't even cry, probably i dissociated. After an hour it started to work but it was so bad all that time. The worst.
Then at 7am i started getting violently sick and wasn't able to keep anything down and couldn't go to work. My h called the dr and i was trying to get admitted because i was afraid my stomach wouldn't let me take pain medicine and the pain was so bad. Then i just stayed in bed, the pain meds must have been in long enough to stay down despite losing everything else. i stayed in bed all day because a migraine had started.
It's a little better now. i was able to take the 40 mg oxycontin and one oxycodone breakthrough at 12:30, right after noon- i didn't wait 8 hrs-until the pain became terribly bad again. It was becoming bad at 7 hours. i stayed still in bed and was able to sleep a little.
This is so terrible to be stuck having to deal with severe pain every couple of hours:(
i feel so helpless, getting sick when i take med.Anyways, i wish that i'd read your post and did something with the long-acting pain medicine(Kadian) before going to bed.
The next 40 mg oxycontin dose is due at 8:30pm or at 7:30- seven hours and i'm having pain starting now at 6:30pm.
*** Should i take some Kadian with the 40mg oxycontin? i'm so afraid to get sick again- still trying to eat a little now.Thank you,
k
Posted by ed_uk on September 19, 2005, at 20:02:54
In reply to Re: PS » ed_uk, posted by kerria on September 15, 2005, at 17:25:45
Dear K,
I really think you need to be admitted to hospital in order to stabilise your pain and allow you to be transferred from morphine to oxycodone more easily. What do you think?
~Ed
Posted by kerria on September 19, 2005, at 20:02:55
In reply to Re: PS » kerria, posted by ed_uk on September 16, 2005, at 15:29:34
There is no dr to admit me to a hospital. i don't have a dr :(
The dr who prescribed the pain medicine - i only saw him once. He just asked what helped me before and gave it to me because he knew i was in real pain and wanted to help. In the meantime i have time to see a pelvic pain specialist to see if anything more can be done.
The pain management dr that's been treating me for a year with pain medicine and the nerve block was refusing to treat me anymore and put me on Kadian because he wants to just wean me off medicine. he made statements like 'you don't have a dx' and 'doesn't want to lose his license'.
Then when he found out about my mental disorder he said 'why should i have to pay for botched therapy.' It became horrific to go to him and i can't be weaned off medicine without a procedure that works because i'm in way too much pain.There isn't a way that it's possible to live in the pain. Now i just had a fresh reminder how much it hurts without medicine and it's so so bad.
i'm scared to death about living in the pain again and i'd love to have a doctor right now who could admit me to help adjust the pain medicine but i don't. i called the new dr's office and talked to the nurse practioner there- they wouldn't let me talk to the dr- and she said that if i get migraines that i should go to another dr- not a gyn , that it was out of their scope of treatment.
and i don't want to bug this dr that wanted to help. i have nobody to help with medicine , the nurse said that the dr said going from Kadian to oxycontin was not a problem. It really is and i don't know why he doesn't know and i don't know why no one can find the cause of my pain but i pray that these drs will believe me.Why i can't go to a hospital-
When the pain dr first put me on Kadian six weeks ago or so, i went to an ER because the Kadian didn't help my sharp pain. It took weeks to work well enough- but the ER dr was so so negative towards me- calling the pain managemt dr and getting his negative view of me- that he wouldn't even treat me. They wouldn't even call a gyn or help at all and my pain then was an 8 on a 1-10 score. i left crying in pain. Other people there, nurses and patients were stunned also, that the dr didn't treat me. My BP was so high and i was in so much pain that the triage nurse bumped me to the top of the list to be seen and then the dr refused to help. All ERs will treat me like this because they share information. i have a mental disorder, an OD once, psych hospital history. i can't just go to a hospital. i'll probably end up in horrific pain screaming in a psych hospital with no one listening.There's never anyone to help me. i always get these disorders that are so rare and undiagnosed or can't treat:(
same with psych dx.Having a hard time today, especially after seeing T.
Feeling so abandoned by everyone.i'm so afraid to be in pain again, so afraid of doing the medicine wrong. i wish that i had a doctor for the physical pain, a T that will help, supportive family, everything . i'm in so much need for everything now. Why does everyone have these things except me?
i'm sorry- everything is so hard for me here. Everything is so hard. It's impossibly difficult.
k :(
Posted by kerria on September 19, 2005, at 20:02:55
In reply to Re: PS » kerria, posted by ed_uk on September 16, 2005, at 15:29:34
> Dear K,
>
> I really think you need to be admitted to hospital in order to stabilise your pain and allow you to be transferred from morphine to oxycodone more easily. What do you think?
>
> ~Edhi, Ed, since i don't have that option i'm just switching to oxycontin totally . This time it makes me feel bad- side effects, maybe the generic doesn't work as well as what i had before.
i took 2- 20g (40mg oxycontin) three times today. i try to make it every seven hours- eight is too long. i want to switch to 60 mg three times a day but the side effects are so bad already so i'm afraid to. The pain is mostly controlled, not at all gone and it makes me much more dizzy and sick than before when i took it.
Why do you think that is?
Maybe the Kadian leaves a residue- does it have a long half-life?- and it interacts with the oxycontin or else it's a bad generic (if one in a million bottles would be wrong i would get it).Thank you for being there,
k
Posted by ed_uk on September 19, 2005, at 20:02:55
In reply to Re: PS » ed_uk, posted by kerria on September 16, 2005, at 23:06:53
Hi K,
>Dizzy and sick.......
You could try an anti-nausea medication, you can get a prescription from your GP. You could try cyclizine, 50mg three times a day, prochlorperazine 5mg three times a day or metoclopramide 10mg three times a day. The nausea should decrease soon, with or without medication ....but I still think you should get an anti-nausea med from your GP. Nausea is common with opioids.
~ed
Posted by kerria on September 19, 2005, at 20:02:55
In reply to Re: PS » kerria, posted by ed_uk on September 18, 2005, at 12:46:22
Hi Ed,
i have companzine to use. Things are a little better now, a lot better than before.
Migraines are bad.Still i'm on the 40mg oxycontin three x a day but today i started taking a 20mg inbetween- so i didn't have to add another 60mg a day all at once.
i was taking too much breakthrough before , it's better to be maintained on mostly long-acting. It makes me feel terrible though. it's the generic and i think isn't releasing equally as the name brand. i have to fill out forms to see a pelvic pain dr.anyways, i think that i'm home free for now (i haven't won the ballgame but at least finished for now with the transition of medicine mostly). i wish that i had 10mg tabs.
Take care,
k.
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