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what should i ask the dr for extreme pain.

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    what should i ask the dr for extreme pain.

    Ive got severe back pain and even worse nerve pain.the strongest pain meds ive taken is norcottt and even taking 4 at once dosnt help at all.what should i ask for?
    "Independent from the rest of the sheep"

    #2
    I've not heard of norcott - do you perhaps mean Norco?

    Generally doctors aren't terribly fond of patients asking for a particular narcotic. I'd suggest you ask for a referral to a pain management doctor, who may try a number of things, often in combination.

    Lyrica or Neurontin are a first-line treatment for neuropathic pain. Some people get great relief - and that's the only med they need. Others do not, or get intolerable side effects. It's something to try, and depends upon the person. I would expect that to be one of the first things that a doctor would try for you.

    Some kinds of antidepressants are used for neuropathic pain, for example amitryptaline and nortryptaline.

    Opioids are also used if the other medications do not control pain well enough - often a long-acting, time release version such as a fentanyl patch or other long-acting medication. A quick-acting medication is often used in addition, for pain that "breaks through" the long-acting medication level.

    A good pain management doctor will work with you, to hopefully find a combination that works best for you.

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      #3
      yes I meant norco.im on my 6th so called pain managment dr.IM sick of playing games witb them,They will start giving me hard core pain meds or they are done.IM the one that has to deal with the pain not them.IM thinking delodid or percocet,maybey somthing stronger!
      "Independent from the rest of the sheep"

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        #4
        Ive been on a 100mg fentenal patch.no help at all!
        "Independent from the rest of the sheep"

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          #5
          Fentanyl is probably considered "hard core"- it's pretty much the most potent opioid there is. Dilauded isn't used out of the hospital that much - and in fact, fentanyl is significantly stronger than dilauded. And fentanyl is WAY stronger than percocet.

          Of course, everything is dose dependant.

          But opioids (especially alone) aren't always effective on neuropathic pain, which is why I'm suggesting trying things like Lyrica etc.

          I hope you find a solution that works for you.

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            #6
            At various times I have taken morphine sulfate and am now on methadone for pain. Both are supposed to work about eight hours. I also have oxycodone for breakthrough pain that I can take every four hours if needed. Tramadol (Ultram) is a lower level pain med but was quite effective for me until my body got too use to it.

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              #7
              Been working on the same problem for about four years. I've tried Lyrica, too many side affects and did'nt work any better than gabapentin. Topamax might have worked but it was way too expensive to pursue.

              I finally broke down and found a physiatrist to go to and after refusing two new expensive drugs, she put me on a fentanyl patch 25mg every three days and 10-325 hydrocodone for the break thru pain. I think the fentanyl is helping some, but the third day is ugly for sure. It's only been my first month with the new doctor, so I'm sure there are ways to tweak the dosage/meds etc.

              I find it amusing (not) that I am now subject to random drug screening (pee test). Thanks so much to those who abuse the stronger drugs needed to kill the neuropathy pain. I understand why the doctors that prescribe the drugs need to do it and that's the reason they just can't ramp up your drug strength all at once. They have to go by the guide lines set up for them and not what their medical knowledge/experience is telling them you might need. Sure as hell does'nt make life easier for the ones stuck with the neuro pain.

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                #8
                For many people, the fentanyl patch only works for 48 hours. Perhaps ask your pain doc to write it so that you change the patch every 2 days - it is frequently prescribed that way.

                I'm sorry you are still having so much pain.

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                  #9
                  I'd heard that about the patch. I'm hoping that will be the next step. I hate having my life dictated by pain and what I have to treat it.

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                    #10
                    I am sorry - I'm sure that really sucks.

                    I guess they have to titrate doses up carefully, to be safe. But in the meantime - not fun.

                    Perhaps you could phone them, and tell them the patch isn't working on the third day? Hopefully they could authorize changing it every two days. If they do, I'd suggest reminding them to notify the pharmacy of the change.

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                      #11
                      I have an appt on the 4th, I have to drive to Knoxville to see her so I might as well wait. My doctor won't do any changes over the phone.

                      I need either stronger doses or more often on the time schedule. (I'm sick of taking medication. Took my last pain pill for the day. I hope the muscle spasms settle down.)

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                        #12
                        If you get stronger doses or not, it sounds like the fentanyl patch does not last 3 days for you. So whatever else she does, it sounds like that needs to be every 2 days.

                        As far as dose changes, there's plenty she can do if she likes.

                        I hope you get some relief soon.

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                          #13
                          Newpara, I am sorry about your pain. You are on your "6th" pain management doctor? And you state they either give you the the hard core pain meds or they're done? I really don't know of any reputable pain management system which will hand over narcotics on demand like that. You may be fishing for a long time. The reputable pain management clinics that I am aware of do not only look at the pharmaceutical perspective (handing out meds) but look at the pain from a multi-disciplinary perspective. I have found yoga, exercise, meditation, possibly physical therapy has helped with my pain management.
                          I think you may get a more comprehensive evaluation for your pain at a larger medical hospital specializing in pain. I found this (UCSF):
                          http://mountzion.ucsfmedicalcenter.o...t/patient.html
                          Last edited by med100; 2 Mar 2010, 7:45 AM.

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                            #14
                            Originally posted by smokymtn memories View Post
                            I have an appt on the 4th, I have to drive to Knoxville to see her so I might as well wait. My doctor won't do any changes over the phone.

                            I need either stronger doses or more often on the time schedule. (I'm sick of taking medication. Took my last pain pill for the day. I hope the muscle spasms settle down.)
                            Hey, I am over in the Tri-cities but I see a dr in Knoxville. Dr. Uzzle. He has been great. As for pain meds I take a Ultram 200 ER daily and then have Darvocet or Norco for breakthrough pain. Usually it is enough to take the edge off. For my neuro pain I take Baclofan and Trazedon. Reg pain meds dont touch the neuro stuff.

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                              #15
                              Originally posted by NEWPARA View Post
                              yes I meant norco.im on my 6th so called pain managment dr.IM sick of playing games witb them,They will start giving me hard core pain meds or they are done.IM the one that has to deal with the pain not them.IM thinking delodid or percocet,maybey somthing stronger!
                              are these pain doctors treating other sci patients? that is what I ask when looking for a pain doctor. if they have experience in spinal cord injury, you are likely to be more understood, as far as treatment of pain goes. it may take calling down a list of available pain doctors. sometimes a physiatrist doubles as a pain doctor. those are the best for understanding the type of pain you are having, and how to treat it.

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