... chronic nerve-I fell and shattered my hip in Feb.2016 and did more nerve damage-I also take neurotin since 2003. My Dr. PCP suggested Cymbalta for my depression and pain- what advise can you give me?
You have either developed a tolerance or the disease has progressed.
I'm surprised you haven't had this problem in the past. Have you been on the same dose?
Is he talking about discontinuing the Oxycodone completely?
If you have depression (which is common with chronic pain) by all means, an anti-depressant is appropriate.
I'm concerned if he is trying to switch you rather than increase the Oxycodone.
If he's intending to switch you, it will require going through withdrawal because the actions between the two are entirely different.
Does the Neurontin help you? The reason I'm asking is because it is more like Cymbalta. Both of these only work on nerve pain. The OxyContin is for the bone pain. It's very common to be on all three for different reasons.
I hate to bring this up but it's a common problem with the government pressuring the doctors to get their patients off opioids.
If this is the case, you need to put #1 (yourself) up front and object to this reason.
You could do it this way :
-Point out the OxyContin has controlled the pain until recently. It's been the med that has gotten you through. Apparently you have pain other than nerve pain.
-Point out that tolerance is an expected problem. Tell him you have been a compliant patient... no asking for extra meds or taking more than you need.
-Ask him why he wants you off the OxyContin and see what he says. Why not just increase the dose?
-Point out that you have had no reason for the pain to decrease. You haven't had surgery or other treatments so why would it get better? If you don't get a straight answer than ask why he put you on it in the first place.
-Point out that he now will cause you to go into withdrawal during a time when you are having other problems (depression). If he was the one that prescribed it, he has to own up to his part in your current situation. You could come out and ask him if this change is because of the governmental rules. Tell him you belong to pain forums and it's become a big issue.
-He will try to tell you not to worry because he will put you on a tapering dose. The point is, it's still withdrawal and once he commits to this plan, it will be difficult to change his mind.
-If he really is committed to changing you, tell him you researched your condition. You have done step1,2,3 etc with no response. The book states if no response, opioids may be necessary. You want to follow the plan of care recommended by these multiple sources. It's absolutely true. The rules cannot just change because the government is protecting others from over-dosing! Tell him you don't want to be on meds! You didn't ask for this but now your more interested in having quality of life.
-I would take someone with me to witness the conversation. I'm sure you have noticed that pain and depression affect your memory. Doctors also like to have someone there who knows you to compare what your going through and how others see you.
Hopefully, he is just suggesting you take Cymbalta in addition for the depression. If a person becomes tolerant, pain guidelines state an increase in the same med is appropriate.
Best wishes. Please give us follow up if you have time.
If the pain is coming from damaged nerves that does take at least 10 yrs to calm down. Certain pain specialists are experts in explaining nerve pain. It happened to to me in 1996 and the specialist said what I'm telling you. It did calm down slowly by 2006 but I still feel it. But it does calm down with time. I'm confused, why are you taking OxyContin since 2003 if you hurt your hip in 2016? After 14 yrs you're immune to the OxyContin. You're also either addicted or physically dependent. Switching to Morphine or a Morphine - like drug may kill the pain but they feel completely different and you may not like them. I doubt he will increase the OxyContin first because of the DEA and secondly bc unless he's dumb he knows you're hooked on the OxyContin.
Lyrica might work better than Neurontin. Give Cymbalta a long chance but don't go over 60 mg a day. About 12 yrs ago I was given Cymbalta for depression. All I took was 20 mg a day. I felt less depressed in 7 days so I kept taking it. I also have a bad back and I can't stay bent over the way you need to when you work in a car engine compartment. About 6 months after being on Cymbalta I had to work on my car. To my surprise and delight my back didn't hurt at all. I almost couldn't believe it. So give the Cymbalta at least 3 months to kill the pain. My doc was shocked bc all I took was 20 mg. I believe in the less the better bc all drugs have negative effects in the long run. Cymbalta makes most people warm when they first start it. But stick with it bc if it works for you like it did for me you'll be glad you did.
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