vastchoirs
Enthusiast
Reged: 08/05/02
Posts: 287
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Hey all,
I have been on this particular medication called Kadian for about a year now. I am at the highest mg of 100mg tice daily. Problem is, it's just not helping me anymore.
How do I ask if the Dr can switch my medication? Do I say "Dr, can we go about and try a different kind of medication ? and explain why to him. I just don't know how to approach it.
Thanks in advance
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Doc, you're a pain in my pain
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Swirl
Journeyman
Reged: 04/17/04
Posts: 63
Loc: Hell's half acre
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I think that's exactly what you say. The med is no longer effective. So, there's got to be another one that will be. JMO. 
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trixxie
Member
Reged: 05/23/03
Posts: 122
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vastchoirs, you and your doctor should have a relationship built on trust. Let him/her know, just the way you said here. That the med doesn't work anymore. I know how you feel though, I have experienced the same thing when I changed from the duragesic to oxyc. I spoke up. Its strange, because of all the doctors that we have seen that if we tell them something works, the doctors then take any type of relief away. Thats been my experience anyway.
Now with my PMD, if I say something isn't working, she asks how and why, and when. Be prepared with timelines, they need to know that. Keep a pain journal showing the decrease in effectiveness.
You'll be fine!
trix
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The truth shall set you free!
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Eeyore27
Board Addict
Reged: 07/05/04
Posts: 375
Loc: Where Misery loves Company U...
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Just be careful when asking to be switched to different meds, because you might just wind up becoming a guinea pig if your doc is not on the up and up. I had horrible experiences with different medications from my old doctor. She switched me to 4 different medications that I had horrible side effects from before she finally caved in and prescribed me what I was originally on. Just be vocal about it, tell the doctor specifically what side effects you are experiencing and why you don't want to be on that medication anymore. If that doesn't work, find another doctor. I'm not suggesting you go "doctor shopping", but rather that you try to find one who has some compassion, I know it's hard these days, so good luck!!
~Eeyore
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~ R.I.P. Darrell Abbott 12/08/04
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Therion
Member
Reged: 06/14/04
Posts: 144
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Quote:
I have been on this particular medication called Kadian for about a year now. I am at the highest mg of 100mg tice daily. Problem is, it's just not helping me anymore.
Please consider, vastchoirs, that you may be asking the wrong question. Kadian is sustained release morphine. Although the highest SINGLE dose may be 100 mg, which you are taking twice daily, there is no dosage ceiling for morphine. In other words, one can be titrated upward in dosage indefinitely to compensate for the tolerance build-up inherent in any opiate/opioid use. Rather than asking for a different drug, perhaps MORE Kadian might be the answer. There are several other sustained release morphine products, but with each of those you would end up basically taking the same drug. If you are having adverse reactions to the drug itself (morphine), then your other options are pretty much limited to transdermal fentanyl (Duragesic patches), transmucosal fentanyl (the Actiq fentanyl 'lollipop'), sustained release oxycodone (OxyContin) and, although rarely prescribed for pain, methadone. Methadone has two advantages over the others; it has a very long half-life, so you don't dose as often, and it's MUCH less expensive. It also has two distinct disadvantages; it's highly addictive and difficult to withdraw from, and there is an unfortunate stigma attached to it. If break-through pain is your problem then perhaps your doctor can prescribe an ancillary drug such as one of the many forms of IR (instant release) morphine, or an instant release version of oxycodone, such as OxyFast. Therefore, the question you need to answer for yourself, before consulting with your physician, is: Are you having an adverse reaction to the morphine itself, or are you simply not receiving enough morphine to compensate for your current tolerance. Good luck in your quest for a pain-free life.
Edited by Therion (08/13/04 03:34 PM)
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PAIDFO
Member
Reged: 02/01/03
Posts: 149
Loc: southeast
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I agree with Therion and everyone else. Well said.Another very effective break thru med is Roxicodone liquid.The brand name is Intensol.Good Luck...P
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"The difference between Ordinary and Extraordinary is the Little Extra"
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vastchoirs
Enthusiast
Reged: 08/05/02
Posts: 287
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Thanks everyone for your great help. To let you know my injury and why I am on Kadian. I have a herniated disc at L5-S1, with Severe arthritis, and SEVERE disk narrowing. I also have a bulging disc at L4-L5 and getting worse. I have been through every anti-inflammatory, hydrocodone, and percocet. Now mind you, I have been to at least 4 other PM Dr's trying to find someone to send me for a MRI and just manage my pain. Everyone of those dr's, except my current one would tell me I just need PT, no MIR is needed. OR tell me, it was a slight injury nothing serious. OR tell me they don't believe in using narcotics, that they don't help, that they thing epidural injections will help. I can go on and on of them telling me I didn't need another MRI. I had one dr actually look at my older MRI report at the time, tell me to try and bend my toes. That was it, he said he will do PT and put you on Bextra....A nitemare everytime until now.
I went to my PM Dr. today and explained to him this way "Doc, I was wondering if may can try a different form of medication for me." I then explained how it used to be just breakthrough pain that was bothering me, which I have complained about in the past. At that time, he suggested not using another narcotic but try one of the OTC meds and see if it helps. Well, I explained to him that did not help, and I explained that I have been on Kadian for a year in three weeks and would really like to try something else.
He is a great dr. and we kid around with each other all the time..jokes, me taking his skeleton model and sitting it in his chair etc etc. Anyway, he said why don't we try the Duregesic patch (Fentenyl). He explained how it works for 72 hours, won't come off as I sweat etc etc.
So, I have had a new MRI with him and catscan, which was done the same day they did a discogram. I actually had to go to the ER that night I was in the worse pain of my life. The ER called him and he told them to give me a shot for the night and meds until Monday morn.
IN closing, he wants me to do the facet joint injections then PT. He was going to give me a script for the patches. I asked him to keep me on Kadian two more weeks so I can just read up on the patch, he was very cool about it and agreed. That's the short and skinny of it. I am going to do another post in regards to this one about another question.
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Doc, you're a pain in my pain
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ANNIEGIRL
Journeyman
Reged: 04/02/03
Posts: 60
Loc: New Jersey Best Beaches
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my pm doctor is retiring at the end of the month. i am on oxy 10 mg 3x a day. most of my friends are on hydro and he gave them 3 refills until they find another doctor or starts his practice up again.my question.... i get 90 oxys a month...are you allowed to get refills on oxys???? should i swith to the 20mgs. they kinda made me sick to my stomach though..any ideas on how to get enough meds for a while. maybe a post dated script for the next month. i know the pharmacy doesn't allow partial fills.(didn't have enough money) they said they can't partial fill a narcotic...i am going on friday. a week before i am due since he is closing or being run out of town..hope i even get to see him. i would like to be armed with info so i am not hanging. he might suggest going off them since i won't find a doctor that will give them to me!!!!!any ideas THANKS A BUNCH!!!
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CrazyAnn
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trixxie
Member
Reged: 05/23/03
Posts: 122
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Crazy Ann, get in to see him as soon as you can! Get your post dated scripts, and ask for a referral for a similar minded doc. He should know of someone. I wouldn't change from what you are taking now. What you are going through is everyone's worst fear, the doctor you find retiring, or being "forced" to retire.
Under these circumstances, perhaps the staff can get you in, or get the doctor to write the scripts written and signed for you.
Hang in there, PM if you want. I don't live in your area otherwise I would give you names...
trix
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The truth shall set you free!
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