I wasn't sure. I feel so uncomfortable going in and asking for a higher dose when he just raised it to 120mg/day two weeks ago. MS-Contin and the family of generics come in15, 30, 60, 100 and 200 mg.

I think there are two things going on, One is that this dose simply isn't strong enough. Because of the doses it comes in, everytime it is raised, it is effectively doubled. And I feel great for a couple of days because I have *half* as much pain but my tolerance seems to build rather quickly. I would say about 50 percent of the time, I am still hurting, sometimes so badly I dread having to get up from a chair or from the bed. And there is always a dull ache in my lumbar and upper thoracic. The knee problem is almost certainly arthrtic--yesterday it Impossible to get relief from it, I even tried putting my tens unit on my knees, to no avail.

The other problem is that the slow release morphine doesn't last long enough. It simply doesn't last 12 hours.

So it sounds like I need both a raise in the mg and in the dosage. How can I go int there and tell the doctor that I think I need to take this 3 times a day and mydosage needs to be raised again?

Maybe I can ask him to have me take it three times a day, but I'm still not sure what kind of "breakthrough" med I should ask for. Farmer says 5mg of oxy for a person on 80mg a day, others say 30-40% of your daily dosage. But I'd rather take something else other than morphine for that.

Frankly I just want to get on methadone so I don't have to worry about the price so much, but my doctor doesn't know that methadone is prescribed for pain, so I can hardly see him knowing the bioequivalance between these drugs.

I can certainly tell him that the dosage doesn't last 12 hours. . . that's quite common and the length of relief is inversely proportionate to the the length of timeon opiate therapy. I've said myself that on good days the minimal relief I get from it is fine, but on bad days that relief is pretty useless. So a fast acting med to take in addition to my scheduled meds.

But what should it be? If I will be taking 180 mg MS Contin ('n 120 now) What would be the best, most efficent med to take on the days when my body refuses to be content with the meds it's on now. I don't have alot of options: it *has* to be something cheap. Right now 60 60mg tablets of generic MS Contin costs almost 200 dollars and I have to pay 10 percent of that. For a brand name, of would be %20. I have a medical card for 115 dollars a month and maybe 300 dollars of my university prescription insurance left.

I know the company that makes MSContin has a program for the "indigent." I'm going tolook it upm but for now, I have an appoitment with my doctor in 2 days. I want to ask him to give me the 60mg 3 per day and ask for a "breakthrough"med. Please give me your suggestions on what I should ask for. My tolerance is high, high, high and I wish there was something other than morphine I could add on the really bad days.

Please help. For once, by jeeves, I am without an answer. 5mg oxycodone IR wouldn't do a thing for me. I tell the doctor that I get my information from a chronic pain board pn the web, and he listens to (you).