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Vicoprofen, Dilaudid & tapering
I have degenerative disc disease with four pretty much non-existent discs in the lumbar region and mild bulging beginning in my cervical spine.
I'm only 40 and yet I have a handicap placard for my car and I feel like I'm 80.
Surgery could be an option but I don't think it's the best at this point for fear of destabilization of other discs - and would I just be trading one type of pain for another.
A month ago, my spine doctor wanted to decrease the amount of vicoprofen I was taking a day (10-12 pills) and gave me a prescription for Dilaudid to combine with the vicoprofen. (Both were the same directions - 1-2 pills every 4-6 hours, with the Dilaudid having a total of 120 pills in the bottle.) I called for a refill of the Diaudid 25 days after the first fill - and my doctor promptly dumped me. I hadn't asked for a refill of the vicoprofen - just the Dilaudid and I was dumped and told I needed to see a pain mgmt doc.
Pain management was never brought up as an option during any appointments w/ the spine doc, never discussed - nothing. They said I called too early for a refill - which makes no sense if you do the math & follow the dosing directions. I'm actually embarrassed too ... like I did something wrong. And I'm more than a little pissed off as well for the way I was treated.
But, they dumped me at a time where I'm getting fed up with taking meds - I don't want to take these pills any longer ... but when I've tried cold turkey, I get sick. Really sick. I feel completely and hopelessly stuck.
I'm no longer taking the vicoprofen and I'm taking 6, 4mg tabs of the Dilaudid a day ... the plan (my own) is to taper and remove 1 pill every 5 days and hopefully that will curtail the withdrawl sickness. Is this a good plan?
I have an appointment with the pain management doc next week - apparently from what I've gathered they do epidural injections. (Epidurals - for childbirth - never worked on me so I don't have high hopes for this doc either.)
So ... questions for anyone out there ...
1. Why would my doc dump me? (I doubt anyway has the answer, but it really bothers me.)
2. Is my tapering a good plan?
3. What do pain management doctors do? Like I said, this is out of the blue and I have no idea what to expect at all.
Best of luck
this seems to be an older thread and you may have already made your choice but i wanted to give you my two cents.
My doctor dumped me from Percs one month after my surgery despite me being in great pain. I was told from others that surgeons and their assistants do not like to follow up with more pain meds due to lawsuits. This may be why he wanted you to see a pain doctor.
As to your other question, I think it would be in your best interest to see your pain management doctor and discuss tapering with him as it seems you do not have enough pills to taper just yet.
Pain doctors for the most part are just great places to get more pills. They tend to see tons of patients, ask vague questions then write a script for narcotics.
Last edited by Selfishself; 08-19-2011 at 01:16 PM.
Reason: More info
I actually just posted this a few days ago and had given up hope that someone would answer ... so thank you for your input! I really appreciate it!
Originally Posted by Selfishself
I have the appointment w/ Pain Mgmt this Wednesday - I'm definitely going.
I really want off the narcotics so I'm hoping that they can advise me on how to taper as well as have different pain relief alternatives - I've read a bit about Cymbalta and perhaps that would be a good possibility.
Everytime I think about my doc dumping me, I get irritated. I really liked him on a personal level, did what he told me to do and suddenly got cut loose. I believe that eventually I'll need surgery and I felt confident in his abilities ... now, there's no way I'll let him cut into me.
I am glad I can help a little. You might want to ask your doctor about Soma. It is a great muscle relaxer that has helped me with pain when I did not want to take Oxy/Morphine.
Originally Posted by girlygirlmom
Ask about Soma and or Tramadol. I have been on Cymbalta and it did not help in the least bit.
My advice tell your PM doctor you want to taper and get off the pills (If your pain is under control) and get a less addictive pain medication.
I hope all goes well. If you have any questions I am always available. I have been to more PM clinics then I can count.
Just dont quit the pills because you think they are bad. If you are in pain you have the right to get proper treatment.
My experience with tramadol is that it is MUCH more addicting and hard to get off of than opiates. Doctors will tell you it is non-addicting, but that's not true. Read around on the Forum--the tram stories are legion! I'd much rather CT opiates than trams.
Soma is ALSO addicting--just a frank tranquilizer. In the olden days it was call Miltown, and was the 50's valium. Robaxin is a better muscle relaxer, working directly on the muscles without giving a buzz or acting as a tranquilizer.
I've been where you are girlygirlmom--I've had three back surgeries and medical problems--don't we all! It's how we got here. So your pain management doctor can tell you all these things and help you manage you body without addicting drugs.
I've tried so many of them to be "normal". Ain't going to happen. Just got to live my life the way it is without messing it up any further.
You're on the right track--move forward.
I can see where you are coming from Shrimp. Tramadol and Soma have never had me like narcotics. I can see people getting very addicted to Soma but I have heard it is easier to get off than a narcotic.
Originally Posted by shrimpboat 1942
I have taken Tramadol numerous times as it is available OTC where I live and can not imagine getting addicted to the stuff. I know that some people find it addictive but from experience with both substances I find them MUCH less addictive than stronger narcotics.
This is all something to discuss with you PM doctor. Everyone is different so make sure you really have a heart to heart with your PM doctor.
Shrimp I was not trying to encourage the use of Soma or Tramadol, but in my many years of experience with both substances I believe they are the lesser of evils.
I saw a thread the other day about people being addicted to Excedrine so anything is possible.
Last edited by Selfishself; 08-21-2011 at 01:08 PM.
Why the Doctor dumped you
You asked why the doctor dumped you, well thats easy. You said you called for a refill after 25 days even though according to your math and mine you wouldve ran out in 25 days. However Doctors Dont follow the rules as us they make up their own. In the Doctors eyes when he gave you the prescription it was for a 30 day month. This is usually how its done. 30 days that way they can charge your insurance for another Doctors visit. I guess insurance companys only will pay for 1 visit a month. so when you called for a refill 5 days early he thought you ate em all. So theres your answer and wow, dilaudid, thats a freekin horse tranquilizer. Just remember you have to pay the piper eventually and the Dilaudid Piper is a beaaatch. gl
Last edited by uhgmongrall; 08-22-2011 at 06:04 PM.
How you doing? Some posts here but I don't see a recent update from you. You got some good info from knowledgable folks here. The Forum will always have more than one person who is either walking in your shoes or has at some time. I just wanted to add my 2 cents even though what I'm about to say has been said hundreds of times on other threads but here goes. Dependency and addiction are two different animals. Both the same result, however when stopping opiates abruptly. I am an addict (in recovery...YAY). It's easy for me to see the difference because an addict will abuse ANYTHING including Excedrin. That's the truth. Addiction is an obsessive habit and it doesn't easily go away even after you've removed the substance from your body. For me, I to this day after over 19 months clean from a 20+ yr hefty habit find myself reaching for that Excedrin for the most minor ache, pain, or stressful situation. I am still fighting the fight with needing to pop some kind of pill! At least it's not an opiate and at least I recognize it. So, when I'm reaching for that bottle of Excedrin that I carried with me always and have since decided to leave it at home, I will always reconsider and I'm learning to put it back in the cabinet more often than not. The process continues.
I am starting to find myself reaching for the Excedrin bottle more and more lately and it has been freaking me out. It is simply amazing how something like Excedrin can become a habit.
Originally Posted by Catrina
girlygirlmom - How are you doing? Have not heard from you lately.
Actually, I didn't have another appointment with him til October ... and the way his office works refills, is that you can only call Mon & Tuesdays for refills. I called on a Tuesday.
Originally Posted by uhgmongrall
Maybe you're right and that's what he thought ... I'll never really know though. When it comes down to it, what does it matter anyway?
Hiya. And thanks for asking about me. (You too, Selfishself!)
Originally Posted by Catrina
So ... I saw the pain mgmt doc today ... and I told her pretty much exactly what I said here - how I was confused why the doc sent me, how I want off the narcotics, yada yada yada. Anyhow, the only thing in my referral letter from the other doc was that epidural injections may help as well as a long acting pain med.
I also said it a nutshell that I wanted off the narcotics and I had stopped taking the Vicoprofren and the Tizanadine (not a narcotic, but I stopped.) The doc said that it most likely wasn't realistic for me to be off of pain meds because of the seriousness of my issues. How depressing is that?
Anyhow, I'm to taper down to a couple of dilaudids a day then start taking Opana every 12 hrs. She actually gave me a prescription for klonodine in case I experience any withdrawls from the taper.
I did get some free Cymbalta samples. Woo hoo! I guess it'll help with the depression from being in my early 40s and being in chronic pain all the time. Son of a beeyotch.
Thats great to hear that you are doing well. I think you will find the clonodine very helpful if you do experience any W/D symptoms. It is a shame you do have to stay on your medications even though you want to be off of them. As much as I wish I never started on pain medication it would have been unrealistic considering the injury I had.
The good news is your working towards getting off of them which is excellent. You seem to have also found a pain management doctor who is actually interested in your well being and not on pushing pain meds.
I see that you recieved some samples of Cymbalta and they are working for you. That is great. I had thought I had been given Cymbalta by my surgeon after he denied me percs but I am not remembering it was Celexa.
"Cymbalta can help" I have heard that one to many times on television but I am glad you are finding it helpful.
I wish you the best with your taper. Please keep us all posted on how you are doing!
We are Sisters of the Absent Lumber Discs, I see. I've had three back surgeries, back fusion, yada, yada. There are days I can't stand up straight the pain in my leg and low back is so intense. Even lying flat on my back can be painful.
That said--When I got off opiates, I was surprised that my pain went WAY down. I still couldn't jump rope and play sports (you know what I mean), and I have to walk a little like a little old lady, but the pain is so much better OFF opiates.
I think your instinct to get off narcotics is a good one and I'll encourage you in this. The opiate-causing-increased-pain-sensitivity is a real phenomenon, and worth your while checking to see if you can benefit from an opiate free interval.
My plan is to avoid any more surgeries (resisting MDs here) and avoid opiates. I'm trusting that Nature will heal or at least improve me in time.
So much for Cymbalta. I took the first dose before bed last night and woke up a couple of hours later sicker than a dog ... nauseous as all get out. Ugh.
As for pain actually DECREASING when you are off pain pills, I have a sinking feeling that that will be the case with me - or I can hope!
I've resisted having surgery for the last few years - I believe that I'll be trading one kind of pain for another once I cross the final surgical frontier.