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  #1  
Old 16-04-2010, 21:31
Sublimit Sublimit is offline
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What are doctors likely to prescribe

For moderate to sever pain? just a general kind of practice when it comes to chronic pain... specifically lower back pain and knee pain.

SWIM has be given 5mg oxycodone.... SWIM is just curious of what other medications that would be prescribed for similar circumstances

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Good question, how does a genuine pain patient obtain relief, as nowadays doctors are so aware of abuse issues, and as such, wary of prescribing opiates?
  #2  
Old 16-04-2010, 22:03
kasbeq kasbeq is offline
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Re: What are doctors likely to prescribe

Usually opiates are not first choice of prescription – It is usually anti –inflammatory painkillers that is the first course of action.

Opiates are prescribed as a last resort in swims opinion – when all other avenues are exhausted

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Excellent point about exploring all options before using opiates.
  #3  
Old 17-04-2010, 15:37
Sublimit Sublimit is offline
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Re: What are doctors likely to prescribe

SWIM is in a lot of pain and has already been prescribed 5mg oxycodone, but it's not effective for SWIM... he just wants to know of any other alternatives to suggest...

SWIM knows it's only going to be temporary, but would like to ask for something more effective without looking like he just wants better/stronger meds
  #4  
Old 18-04-2010, 11:56
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Re: What are doctors likely to prescribe

What SWIM would tell SWIY all depends on what exactly your true intent is here. If SWIY could stop taking all opiates (the oxy included) tomorrow, but had less back pain, would that be good? Or does SWIY really enjoy the feeling from his opiate prescriptions? And if so, does he really need more back pain relief or just more opiates?

If SWIY already has a doctor who is giving him 5mg oxy, the doctor must obviously believe in a real issue. How long has SWIY been given that RX, and for how many per day/month?

Under normal circumstances to relieve the pain, SWIM would just go into his office and be truthful that the 5mg helps greatly, but that it is still only taking SWIY from disabled to just comfortable enough to have some quality of life compared to before. The logical thing for any doctor to do in that situation, knowing the current drug works but just not enough, especially if the patient is on a low dose, would be to try increasing it. Don't ask- just see where he takes it. And, if SWIY is really concerned about pain and not just getting more of intoxicated, he would wait until the doctor hopefully increases your current dose- meaning RX already inked- then ask about second-line treatments like muscle relaxers and whether he thinks they might be an appropriate additional tool. For SWIM's chronic pain, any opiate will only take away perhaps ~75% of the problem without a second type of drug. For his back, a weak muscle relaxer was all the more it took.

Now, that's one idea. The second would literally be going in with the premise of NOT increasing the amount of oxy SWIY is taking. Say he would like to continue with his current dose, as it does help greatly as opposed to anything else SWIY has tried, but that he would like to try ________ he read about while researching his back pain. Anything from muscle relaxers to less common anti-inflammatory (Cataflam, for example) would be things to bring up. Obviously this makes it look like there is no desire to seek more recreational substances. If after a month of trying whatever is given in this scenerio, SWIY could decide if he was comfortable, or if he wanted to go back and let the doctor know there was zero improvement- at which time he'd be more likely to write a stronger oxy script, as it would be after you'd already asked for more conservative treatments.

SWIM is amazed people get even 5mg of oxy for "back and knee pain" without there being a chatostrophic trigger event like a severe car accident to prove it wasn't fabricated. SWIM has suffered from both for ages, and had to go through the typical stages of treatment, regardless of which doctor he saw. Same as with 95% of people with these injuries- first it's just a strong Ibuprofen script. When that fails, it's something like a muscle relaxer, or best case scenerio a weak opioid like Darvocet or Tramadol. when that doesn't work, already months into treatment, most doctors would then consider writing a low-dose of hydrocodone in some form (Vicodin, ect) with a 30 day follow-up. From there, some doctors wouldn't touch it- they'd send you to a specialist for what hurts. Some might give you a higher dose of hydro, such as two Norco (10mg) twice daily. It's not easy, especially for younger people, to get the treatment they need, even if it is an honestly unbearable situation.

BTW- if SWIY truly isn't getting relief from their current medication, they COULD ask to try switching from oxycodone to hydrocodone (say, percocet to norco) just to see if that helps. Most doctors would rather write two 10mg norco daily than 5mg percocet, simply because the percocet has more street demand and is scheduled higher on the DEA list.

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Answers the question, gives valuable advice, and backs it up with sound reasoning.
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  #5  
Old 19-04-2010, 00:32
MisterV MisterV is offline
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Re: What are doctors likely to prescribe

SWIM suffers from strong pain in knee area. Consulting several doctors and doing x-ray and scans in hospital. All SWIM got was some
diclofenac which causes stomach problems (SWIM told his doctor before, but he didnt come up with an alternative pain med) and actually ibuprofen which causes stomach problems, too and is quite in-effective for this strong pain.

Thats SWIMs actual situation in germany.
  #6  
Old 19-04-2010, 12:28
Sublimit Sublimit is offline
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Re: What are doctors likely to prescribe

Quote:
Originally Posted by TinfoilxTouch View Post
What SWIM would tell SWIY all depends on what exactly your true intent is here. If SWIY could stop taking all opiates (the oxy included) tomorrow, but had less back pain, would that be good? Or does SWIY really enjoy the feeling from his opiate prescriptions? And if so, does he really need more back pain relief or just more opiates?
Wow, firstly i just want to say that i really appreciate such an informative post, and for taking the time. Swim has been a heroin addict for 7 years, so his intent is to get sufficient pian relief without having to go back to buying heroin. SWim had a bloodtest that was negative a few months ago and since that time he has Used Heroin 2 times.... he's never shared a needle but was convinced he had hep c... SWIM is pessimistic, but has now realised he can turn his life around and be happy. Obviously he is still fond of the opiate and sees his knee injury an opportunity to do a little experimenting and creating a challenge to try and get different opiates. for the most part SWIM is taking the Oxycodone for the prescribed reason, but yes, SWIM will feel awful and go into withdrawal if stopped taking opiates


Quote:
Originally Posted by TinfoilxTouch View Post
If SWIY already has a doctor who is giving him 5mg oxy, the doctor must obviously believe in a real issue. How long has SWIY been given that RX, and for how many per day/month?
This is funny because Swim came across this doctor at the start of the year when he had a moderate benzo habit(self medicating diazepam for heroin WD) he was seeing multiple GP's and effectively doctor shopping. Swims first visit he told the gp that he had a 20drinks a day alcohol problem, and subsequently gave SWIM 50 5mg of valium. About a month ago SWIM went to a ER room with a 7 year old diagnostic imaging report from when SWIM injured his knee. took the referel to this doctor( had crutches ) and he gave SWIM 20 pack of Endone(5mg oxy) Another week, another pack of Endone, but he said it would be SWIMs last because SWIM had an addiction problem in the past.... so he prescribes SWIM 2 5mg Norsepan(buprenorphine)patches.... So after using the Oxycodone SWIM was reluctant to put the Bupe patch on because of the high affinity it has to the mu receptor.... It's strage that he'd prescribe in that order... Anyway Swim waited and waited and ended up eating the patch, which was effective for 24 hours... so shortly after the second bupe patch SWIM twisted his knee and was in serious pain, another trip to the ER room, and another referral and a dose of Oxycodone. This was on friday morning after SWIM got out of the ER he went to the wonder doctor and basically said "i know you're not comfortable about the Oxycodone, but SWIM takes it responsibly and is helping a lot" He then had absolutely no problem with the script mentioned in the OP.

SWIM thinks it was an 'authority script" because the gp had to make a phone call to get it approved and said SWIMS first name. SWIM was unsure about this process, but was surprised when the pharmacist handed all 3 boxes of 20x5mg oxycontin tablets... ironically thought it was irresponsible of him!

The reason SWIM initially lied to this doctor about drug habit is because being honest has gotten SWim hit with the stigma of a junkie with virtually every doctor he has seen. it's dishonest, but SWIM has been discriminated against...SWIM has been told blatant lies like "it's illegal for me to prescribe SWIM any strong pain meds" etc.. SWIM knows that would be the case if he was on an opiate replacement therapy program, but he's not.... SWIMs wondering about the last script he got a lot, because he fears if he try's his regular GP (15year relationship) and gets an "authority script" off him he might notice that SWIM has gotten strong pain meds, or even worse get flagged by a healthcare moderator and say goodbye to any trust and decent med in the future... SWIM has Only doctor shopped for a small period in his life and has been paranoid about getting found out so will not be risking it with more controlled drugs

Quote:
Originally Posted by TinfoilxTouch View Post
Under normal circumstances to relieve the pain, SWIM would just go into his office and be truthful that the 5mg helps greatly, but that it is still only taking SWIY from disabled to just comfortable enough to have some quality of life compared to before. The logical thing for any doctor to do in that situation, knowing the current drug works but just not enough, especially if the patient is on a low dose, would be to try increasing it. Don't ask- just see where he takes it. And, if SWIY is really concerned about pain and not just getting more of intoxicated, he would wait until the doctor hopefully increases your current dose- meaning RX already inked- then ask about second-line treatments like muscle relaxers and whether he thinks they might be an appropriate additional tool. For SWIM's chronic pain, any opiate will only take away perhaps ~75% of the problem without a second type of drug. For his back, a weak muscle relaxer was all the more it took.
Thats sound advise and something worth considering... SWIM defiantly wants to play it cool and get the most while having a comfortable relationship with this new doctor. On one hand SWIM has a regular GP that knows everything about him, he seldom sees him, and when SWIM does its for mirtazipine and maybe some temazepam, SWIM could possibly get strong opiates because of SWIMs tolerance to opiates, but he could also compromise SWIMS current pain management too. Its a bit of a tricky one, but SWim doesn't want to push his luck. being 27 and being able to present well is a plus and have already built up a bit of trust with this doctor

SWIM's current RX was picked up on friday... the dose recommendation are "take one or two, swallowed whole twice a day. So at 4 a day that's a 2 week supply. SWIM is thinking about seeing him on friday and saying that it's really been helping but it's not effective until a 20mg dose. Swim will also say that he is aware of the tolerance and risks of addiction but the pain is making sWims life terrible. As Swim said before he is fond of opiates and wants to make the most of his current state and is seeing it helping his addiction to heroin a lot. once his knee is sorted he will likely dabble in prescribed opiates here and there, but realises it will be hard. Since SWIM knows that he has clean blood, thats SWIMS most motivation to not use Heroin, but he knows that some of that motivation has transferred to seeking some recreational amounts of opiates on top of pain management and it is a problem, but nowhere near as bad as putting something that has been cut with god knows what and changed dirty hands 5 times in ones arm!

Quote:
Originally Posted by TinfoilxTouch View Post
Now, that's one idea. The second would literally be going in with the premise of NOT increasing the amount of oxy SWIY is taking. Say he would like to continue with his current dose, as it does help greatly as opposed to anything else SWIY has tried, but that he would like to try ________ he read about while researching his back pain. Anything from muscle relaxers to less common anti-inflammatory (Cataflam, for example) would be things to bring up. Obviously this makes it look like there is no desire to seek more recreational substances. If after a month of trying whatever is given in this scenerio, SWIY could decide if he was comfortable, or if he wanted to go back and let the doctor know there was zero improvement- at which time he'd be more likely to write a stronger oxy script, as it would be after you'd already asked for more conservative treatments.
Thats also a very viable approach, and the more SWIM thinks of it the more it seems to be better for SWIM in the long run... with regards to tolerance and trust.

SWim will have to come down with no opiates regardless, he's gone through most of the 60 oxy's. SWIM has done this cold turkey more times than he cares to remember. After getting a first full benzo tolerance from October to late February(resorting to doctor shopping) Swim realised they're worse to come off than opiates, so no tolerance and no benzo's.... when SWIY says "muscle relaxants" can SWIY suggest any non benzo? Magnesium is one that know. So that leaves SWIM with NSIADS. not aware of Cataflam. SWIM already has heard of Naproxen, and has an unused rx for Diclofenac EC 50mg tablets... are all of these better than ibuprofen? SWIM was also doing 300mg of codeine for 2 weeks prior to last friday so that with the oxycodone should make for a decent WD. SWIM has a rx of 20x50mg of tramadol handy which should help get through to a 14 day period between SWIMs visit to theGP.... if SWIM does it!

Quote:
Originally Posted by TinfoilxTouch View Post
SWIM is amazed people get even 5mg of oxy for "back and knee pain" without there being a chatostrophic trigger event like a severe car accident to prove it wasn't fabricated. SWIM has suffered from both for ages, and had to go through the typical stages of treatment, regardless of which doctor he saw. Same as with 95% of people with these injuries- first it's just a strong Ibuprofen script. When that fails, it's something like a muscle relaxer, or best case scenerio a weak opioid like Darvocet or Tramadol. when that doesn't work, already months into treatment, most doctors would then consider writing a low-dose of hydrocodone in some form (Vicodin, ect) with a 30 day follow-up. From there, some doctors wouldn't touch it- they'd send you to a specialist for what hurts. Some might give you a higher dose of hydro, such as two Norco (10mg) twice daily. It's not easy, especially for younger people, to get the treatment they need, even if it is an honestly unbearable situation.
LOL SWIM thought it was a goldmine for opiates in the States! There is a lot of stuff Australians don't get Hydrocodone and Oxymorphone are 2 that aren't possible to get. Its easier to get codeine and tramadol than it is to get benzo's. 5mg Endone(oxycodone) is the next thing up and it is hard to get. SWIM got lucky, like he said he has seen a lot of doctors and only one has came through and that was with a referral from hospital ER, SWIM on crutches, Diagnosis report of MRI from 7 years ago. now that it's been given for chronic pain, he's more likely to give more if SWIM plays it cool

Quote:
Originally Posted by TinfoilxTouch View Post
BTW- if SWIY truly isn't getting relief from their current medication, they COULD ask to try switching from oxycodone to hydrocodone (say, percocet to norco) just to see if that helps. Most doctors would rather write two 10mg norco daily than 5mg percocet, simply because the percocet has more street demand and is scheduled higher on the DEA list.
That would be nice but yeah unfortunately Australia dosent' deem it worthy... oxycodone is the most used for strong pain. Our drug board recently approved Hydromorphone -under a name by Jurnista ER, but that would be really hard to get as well as Fentanyl and Morphine. Buprenorphine is used for pain here too. SWIM would love to try Hydromorphone one day..... maybe SWIM will bring it up after the operation saying that the surgeon recommended it

Well SWIM has 4 and a half weeks until SWIMS MRI and hopefully will be responsible and not be reckless, but at the same time hope to be comfortable as possible. 10mg of Oxycodone twice a day is simply not enough, and there are so many ways to compromise this good and bad, its going to be a delicate balance indeed. saying goodbye to H is hard but SWIM knows he has his whole life ahead of him and deserves to be finally happy, pain free and eventually opiate free and healthy and working.

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Wow, great job taking the time to respond, only had time to read half, but great job!
  #7  
Old 19-04-2010, 12:53
rocksmokinmachine Gold member rocksmokinmachine is offline
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Re: What are doctors likely to prescribe

Quote:
Originally Posted by Sublimit View Post
For moderate to sever pain? just a general kind of practice when it comes to chronic pain... specifically lower back pain and knee pain.

SWIM has be given 5mg oxycodone.... SWIM is just curious of what other medications that would be prescribed for similar circumstances
Dihydrocodeine, hydrocodone, fentanyl
  #8  
Old 19-04-2010, 21:11
Paradox Paradox is offline
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Re: What are doctors likely to prescribe

Quite honestly, if SWIY has had problems with heroin in the past, any opiate based treatment protocol is unlikely to provide SWIY with either significant relief or with any significant "buzz" unless SWIY found a doctor who is comfortable providing high doses. Multi-modal pain relief is much more likely to benefit SWIY, if this is about legitimate pain.

What are SWIY's symptoms, and what injuries/issues are causing them? This will help in providing good advice on pain relief.

For instance, if SWIY is having muscle spasm issues, some sort of muscle relaxant will likely benefit SWIY considerably. SWIM has tried cyclobenzaprine and metaxalone; both non-benzo muscle relaxants. The cyclobenzaprine was significantly more effective, but SWIM quickly built a tolerance to it which hasn't gone away. The metaxalone is less effective, but so far SWIM has had no side effects or mental effects from it, but it does do a good job in reducing his muscle spasms and in reducing the amount of opiates he has to take. He doesn't notice it at all, until he simply notices "Hey! I'm in less pain and my muscles are looser!"

Also, since SWIY likely has inflammation issues, if this is from a previous injury either NSAIDs or corticosteroids might be a beneficial therapy. SWIY should ask his doctor about a stronger NSAID than is available over the counter. If it helps some, but not hugely, SWIY might talk to his doctor about a corticosteroid such as prednisone. Prednisone has more side effects than most NSAIDs, so SWIY should try that as a second line treatment after the NSAIDS, but it is very effective in reducing swelling. It doesn't play nicely with alcohol though, so SWIY would need to limit himself to only a few drinks.

If there is any kind of nerve damage, drugs like gabapentin could be beneficial for SWIY. It increases the firing threshold of nerves, reducing the number of pain signals that are sent. SWIM was a poor responder to these medications, so he can't provide too much advice on them.

Finally, if SWIY would have withdrawals if SWIY stopped taking opiate pain medication, simply taking a week or two off of the pain meds and making it through the withdrawals will likely firstly reduce the baseline level of pain, and secondly increase the effectiveness of the pain medications SWIY is scripted. SWIM at first took his opiate based medications daily, but he found that over time it increased the pain and decreased the effectiveness, so now he takes them once or twice a week for breakthrough pain, or when he needs to do something that otherwise would be seriously painful.

Honestly, if SWIY has chronic pain problems that are interfering in his life, SWIY really needs to be responsible with the opiates. If they turn out to be the only thing that reduces the pain to a manageable level, SWIY needs to be careful about only taking them to the level that reduces the pain, not to a level that provides a buzz. SWIM knows that this sucks - he would love to abuse his pain meds but he knows that if he developed a tolerance he would be screwed.

If SWIY goes to his doctor, and tries these alternate treatments, as well as trying to re-establish SWIY's tolerance with no success, then SWIY should talk to the doctor about increasing the level of opiate-based analgesia. There are a few reasons for this. Firstly, if SWIY's past abuse is discovered, and SWIY has NOT been asking for opiates, SWIY's doctor is more likely to believe that SWIY has a real pain problem and is looking for genuine relief, rather than looking to get high. Also, SWIY might actually find that an alternate treatment is more beneficial for the pain than the opiates. SWIM is sure that for a past addict that the attraction of being able to use his favorite drugs legitimately must be an incredible temptation, but in truth SWIY's stakes are actually higher now than in the past - if SWIY ends up being seen as a drug seeker, or develops a tolerance, instead of just not being able to use, SWIY will be stuck unable to use, and in serious pain - or back to using street opiates.

SWIM has been a chronic pain patient for a while now for fibromyalgia (By the way, for any SWIMmers who suffer from fibromyalgia, please PM SWIM, he has found a FANTASTIC doctor who believes he has found the source of fibromyalgia, and has had enormous benefit from the treatment. SWIM is talking about a CURE, not a maintenance treatment. Sorry for the OT.)

SWIM hopes he didn't come across too harshly. He is glad to help someone who has legitimate pain, but is not comfortable helping someone scam a doctor if the goal is to get high, and he sees SWIY toeing the line between the two. There is a reason SWIY got off of the opiates, and SWIY should be careful and honest with himself about the line between use and abuse. Having experienced chronic pain, SWIM would never deny anyone the full extent of pain relief, but he also knows how hard he has had to fight to not be seen as a drug abuser to obtain that relief himself, even though he had never used anything other than occasionally alcohol prior to getting sick.

Best of luck to SWIY.

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Great alternatives to approaching pain management
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Old 20-04-2010, 04:51
Lady Codone Lady Codone is offline
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Re: What are doctors likely to prescribe

In SWIM's experience, it depends more on the doctor than the condition in question (which is really unfortunate). SWIM suffers from excruciating menstrual cramps, and the best she's ever gotten was 30 tylenol 3's. More commonly, doctors will go the NSAID/COX-2 inhibitor route. Other options they may suggest before opiates include anti-seizure meds and antidepressants, which are completely useless for pain IMO.

When they do prescribe opiates, the most common choice is hydrocodone, followed by oxycodone and codeine. Tramadol is also an option. SWIM has never heard the words "oxymorphone", "fentanyl" or "morphine" uttered by a physician, but has heard tale of patients getting these with no problems whatsoever. It all goes back to the doctor and his/her comfort level prescribing controlled substances.

A pain clinic might be a more reliable route if SWIY's pain is chronic or severe. SWIM has given up on seeking relief directly and just tries to obtain pain meds whenever she can, such as at the dentist or eye doctor. She then uses them for the actual condition that causes the pain (cramps) and rations them out so they don't run out, though she hasn't had much luck (except the 12 vicodin 5s she got for having a tooth pulled). Here's hoping SWIY's luck is better.
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Old 20-04-2010, 17:31
Sublimit Sublimit is offline
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Re: What are doctors likely to prescribe

@ Paradox, hey thanks for all your knowledge of your experience with dealing with chronic pain. SWIM had horizontal and oblique tears of the lateral meniscus of my right knee 7 years ago, had an mri but never got the operation, has got better over time and was busy with work. he recently reinjuerd his right knee and is in a lot of pain, on crutches unable to retract the leg and put hardly any weight on it, the swelling has gone down a fair bit. SWIM hasn't had a lot of prescription NSAiDS experience, but found Ibuprofen to just take the edge off slightly, but opiates are very effective, its just getting an efficient dose and not being irresponsible with it.... SWIM would like to work towards a higher dose of Ocycontin and then eventually try for Hydromorphone. As a recovering addict swim is more than satisfied to be prescribed opiates. 1. because he's in pain, and there's no doubt they work. 2. it's been satisfying swims opiate addiction and have only used H 3 times this year.

regarding newish oxy prescribing doc, there's no way SWIM will be honest about his past addiction, that would be detrimental, and there is no reason why he could possibly find out that SWIM have an addiction to H, Unless SWIM have other authority scripts prescribed by another doctor...don't see how he could possibly accuse SWIM of ever lying about alcohol addiction... the only way would be for him to check if SWIM had any authority scripts written, or somehow find out who my local GP is and talk to him. Theres also a chance he could find out (not sure about discretion with information) that i've seen multible doctors. And the only way thats going to happen is if he gets suspicious of SWIMs behaviour when being consulted, and that why SWIM is doing a lot of research, asking a lot of advise, and being appreciative and completely honest with you guys here on DF. SWIM wants to see him with a complete understanding of the medication he is taking learning about other alternatives, reassuring him of there being no risk to opiate addiction in the future, and absolutely no drug seeking behaviour... SWIM was going to go back and say i needed to take more than prescribed for relief and breakthrough pain, but SWIM was advised thats a No No. any thoughts?

one of SWIMs good qualities is being honest and H has made him dishonest in the past and feels ashamed for the lies that he's made due to this drug, but lying to this doctor was necessary IMO. Another reason to quite H is that it degrades one's integrity

SWIM was thinking about going back to this doc on friday(exactly one week when saw him last) and saying the oxy is working, but less effective than before and ask him if he could recommend a NSAID and how he would feel about increasing the dose from 1-2 5mg twice daily to 2-3 twice daily, SWIM will also say he's aware of the tolerance and can't stand the pain and need quality of life, but also mention that SWIMS aware of the risks of addiction, but put it to him in a way where SWIM mentions a second cousin died of a 10 year heroin addiction and there's no way SWIM would ever go there(true, apart from not going there). SIWIM would imagine that would make him comfortable in agreeing with increasing the dose slightly with an NSAID.

SWim will see him Probably early next week for more Oxycontin and ask for a different NSaid if not effective. Depending on pain and if SWIMs still on crutches, SWIM might ask to up the dose after a week of 30mg oxy a day + a NSAID, and say it's not sufficient, Getting my MRI on 17th of may SWIM needs to up the dose significantly as the last week has been unbearable(hypothetical ATM) SWIM has gotten a total of 500mg of oxycodone from him and 2 5mg bupe patches, 2 packs of Endone(oxycodone 5 mg IR) in mid march, the bupe patches late march and now the 60 5mg ocycontin script last friday... so doc knows that he's built SWIMS tolerance up and he's responsible to realise that the right thing to do is to increase the dose until it is sufficient and wait for SWIM MRI to come through and go from there... SWIM will want an operation this time around and think it would be necessary.

Do you recommend any NSIADS i could talk to my doctor about?

No SWIY didn't come across hash at all. SWIM is on these forums for information and advise and to be helpful if possible. SWIM chooses to be completely honest here and if he cops a bit of criticism then so be it. Some people have different point of views and just because SWIM has made some bad choices doesn't make him a bad person, he openly admits to experimenting with ocycodone as he has never experienced it before and has a fondness for being opiated. that is a problem, but it's keeping him away from street drugs and quality of life is getting better, learning to manage his addiction doesn't happen overnight and it's a challenge for SWIM to overcome. SWIM just want's sufficient pain relief without being discriminated against, and he had to lie/doctor shop until he found a doctor that has no problem with prescribing. Yes SWIM wants to strive to get a stronger Oxycontin pill... Would settle for a pack of 20mg ocycontin.... that way he would have sufficient pain relief and would be able to have to option of a recreational dose if the urge to do H came along. Using a Wheel filter with 2 20mg oxycontins an IVing it would be nice to do while in this condition and a lot safer than iviong street herroin, but as soon as my knee is fixed SWIM will hopefully get jurnista er and then slowly taper of once the pain subsides, and then it's back to work, completely drug free and then SWIMs off to live in the UK to get away and grow as a person.

Right now SWIM wants his cake and eat it too.... And no matter what, there won't be any heroin, the will power is there now and even turned down a free hit offered by SWIMs cousin... well SWIM did have oxycontin at the time, but that would of be wonderful to combine, but i'm making an effort for the first time in my life, an honest effort to not use, after all i've my health.

@Lady codone, Thanks for wishing Sublimit luck, sorry to here that it's a hassle for SWIY but don't give up, SWIY should see a GP until SWIY gets sufficient meds, they're out there, and it's not doctor shopping at all, unless you're getting multiple scripts from multiple gp's. SWIMs been told bluntly to go see another doctor for stronger medication.If you dont mind SWIM asking... how old are SWIY? maybe SWIY having trouble getting anything because you are young? Well Sublimit wishes you all the best too
  #11  
Old 20-04-2010, 20:07
Paradox Paradox is offline
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Re: What are doctors likely to prescribe

SWIM was scripted indomethacin at one point. He can't speak as to how well it worked for him, because his problem wasn't inflammatory. As SWIM said, talk to him about corticosteroids, SWIM knows people who have inflammatory pain problems who get cortisone shots and say that it helps their pain immensely.

As someone else here said, opiates will get you 75% of the way to being pain-free. SWIM just knows from his experiences with doctors that asking for higher doses/stronger meds deteriorates trust quickly. SWIM truly doesn't want SWIY to get "tagged" so to speak and lose the availability, and that is why he is urging such caution on asking for higher doses. SWIM doesn't know how the doctors in Australia work, but he assumes they are likely similar to doctors in the US.

Plus, if SWIY can find something else that takes away most of the pain, it'll allow SWIY more freedom in his dosing schedule for the opiates.

With the anti-inflammatories, SWIY does need to give it a little while to work.

Also, do SWIY's oxy pills contain APAP/paracetamol? If not, taking a reasonable (Less than 4000mg/day) dose of APAP will work wth the NSAIDs and the opiates to reduce the pain.

SWIM thinks that SWIY's plan of talking to his doctor about how it helps immensely but is afraid of addiction, ect is a fairly good plan, but SWIY should also talk to him and ask if he has any other non-opiate supplements for pain relief. SWIM doesn't know what medicines are available in Australia. SWIM truly understands that opiates are a very attractive option for pain relief, and in a perfect world, SWIY would have no issues getting them for the pain, but unfortunately that is not the world that us SWIMmers live in.

ETA: SWIY should also consider talking to a professional therapeutic massage therapist or physical therapist. SWIM doesn't know if SWIY is in a situation where he can do this, but if SWIY can, it might provide serious relief and help SWIY get off of crutches and back into a normal life. SWIM knows how discouraging chronic pain can be. SWIM truly wants to see SWIY regain a normal, pain-free life and is trying to suggest things that will truly help the source of the pain, instead of just medicating it.

Also, a topic like this is sort of toeing the line between source discussion and legitimate discussion. SWIM understands that this is about pain relief, not about scamming doctors for drugs, but he just wanted to warn SWIY because he doesn't want to see this topic closed or deleted and SWIY left high and dry looking for relief.

Finally, I didn't tell SWIY anything. Call SWIM SWIY please.

Keep DF updated on how the appointment on Friday goes! SWIM will be rooting for SWIY.

Last edited by Paradox; 20-04-2010 at 20:34. Reason: Thought of other things to add.
  #12  
Old 20-04-2010, 23:33
Sublimit Sublimit is offline
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Re: What are doctors likely to prescribe

^^^^No worries SWIY, yeah SWIM sees the point about drawing the line with regards to sourcing and how to ask doctors about obtaining medication. SWIM feels he is often discriminated agaist for being honest (not here) but understands the rules and know that they're there for the integrity of this site, and yes SWIM doesn't want this to be closed and SWIMs intention is not to source a particular drug as SWIM is already prescribed it for pain relief, But SWIM realises to be maybe a bit more subtle in future. SWIM Just was initially curious about what opiates are prescribed from fist hand information to get a better understanding about what to expect and what not to expect, what to suggest and what not to suggest, it's a delicate balance thats for sure. I would like to make a summary before next visit to gp and would like to thank everyone thats contributed to this thread

To be honest APAP does nothing for SWIM he's better off taking Ibuprofen. No Oxycodone pill contains APAP thank god, SWIM doesn't like the fact that it's basically a poison if taken over 2 grams at once, and even less if taken for a extended amount of time. not for chronic pain, which is why SWIM need opiates, as well as that stuff is absolute rubbish for your liver and kidneys. MRI gets done in 4 weeks then assume there will be an operation.... taking the right amount of opiates is fine and SWIM is able to move around without crutches but will inquire about the cortisone shot SWIY mentioned most defiantly..... NSaids are not for chronic pain either and although SWIM will propose to his doctor about using them SWIM has the fact that His doctor thinks SWIM is an alcoholic and will bring up all the problems that come with having an unhealthy liver and opiates being the healthiest option, which rings true, no doctor can deny that, especially when the pain is going to last for an extended amount of time.

Still, have a lot a research to do about raising alternatives, and about keeping SWIMs doctors full confidence

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