Daycamp72
Enthusiast
Reged: 06/29/02
Posts: 289
Loc: Tara
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Thought I'd pass this on. I had my first trip to a PM doc this week. He was the neatest doc! I took a friend's advice and brought with me an explanation of my pain symptoms, a brief history of surgeries/injuries and a list of meds that I've taken, some related to this issue and some not.
After a 30+ minute visit, he prescribed Bextra and Vicoden 7.5 (for breakthrough pain; I'm not really familiar with this term). So far, the Bextra does not work on its own.
I am wondering, though, am I supposed to TRY and get by on the Bextra by itself MOST of the time? He rx'ed me 90 Vicoden and I'm trying NOT to take many of them, but I'm wondering how many are TOO many. How many Vicoden would a NORMAL person take per day in my situation, with the Bextra? I'm scared to ask him.
I posted earlier this week that I have a tolerance, but I don't want him to know that for obvious reasons. The purpose of my going to a PM doc is to STOP buying these pain killers on the Internet$$$$$$$$$.
I'd appreciate advice from you guys.
Thanks for listening!
Chris
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painster
Stranger
Reged: 08/09/03
Posts: 12
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Daycamp,
That's a good post. I'm brand new to this board and I commend you on your fortitude in seeking one on one medical attention. You are ultimately going to save a ton of money by seeing your PCP and going to receive better treatment. Don't get me wrong, the OPs are a lifesavers for some, but a good percentage of the users are just plain hooked.
Anyway, when your doctor referred to "breakthrough pain", he was addressing that pain that exceeded the Bextra's efacacy. I'm sure you read the literature on the Bextra and saw that it is a NSAID, non-steroidal anti-inflamatory drug. If the Bextra is insufficient to relieve your pain, then take the Vicoden, however, give the Bextra a chance to work. Your blood serum levels of the Bextra is rising and so will the pain relief. I'm assuming you're taking it for neck, back or joint pain and it isn't initially doing the job. Unfortunately it doesn't provide that immediate relief like Vicoden. However, your doctor did prescribe #90 of the Vicoden ES and he probably expects you to take it as prescribed if needed. If you need the Vicoden because the pain is not suppressed sufficiently by the NSAID, then take the Vicoden, as per Dr,s instructions. I don't know how many narcotic pain meds you were taking before, but this is one way to "take that down a notch".
I hope you feel better!
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scissorhands
Member
Reged: 06/04/03
Posts: 168
Loc: Hell
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Quote:
Don't get me wrong, the OPs are a lifesavers for some, but a good percentage of the users are just plain hooked.
Don't take this wrong Painster but I don't agree with your statement, I don't think a good percentage are hooked, I think they are unmedicated by their drs and have to look to Ops in order to live a halfway decent life...So maybe you could edit your post to just what percentage you think "are just plain hooked".
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Baseball is wrong...Man with four balls cannot walk!
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Daycamp72
Enthusiast
Reged: 06/29/02
Posts: 289
Loc: Tara
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Thanks for the informative reply, Painster. The actual instructions on the Vicoden bottle says to take one tab 2 or 3 times each day as needed. The Bextra says take one tab twice daily.
Does that indicate that he expects me to have breakthrough pain? I told him all the meds I'd been prescribed for my coccyx pain and that I'd gotten no relief. He also wants me to keep a pain "diary", which I need to start doing!
I'm going to give the Bextra time to work. I did tell him that Vioxx and Celebrix didn't touch the pain, too. Guess Bextra is stronger??
I also agree with Scissor that the vast majority of people on this Board are NOT "hooked" and are sincere about their pain. I may continue to order from OPs, if needed. I really want to shoot straight with this doc, but I'm rather gun-shy about asking docs for pain meds. This is a very small town, if you know what I mean.
Any more advice is appreciated. I love this board!
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chevygal
Veteran
Reged: 04/28/03
Posts: 504
Loc: Way down south
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Hi daycamp
I have read some not so great things about bextra, just it affecting the stomach ect. YOu couldl look it up. My son broke his arm and collarbone and was given bextra and this is someone who has never taken opiates, he got no refief from the bextra, I was annoyed that they had prescribed this for him. He did give it a day or so, but I could tell by the look on his face how much pain he was in and demanded something else fo the kid. Bextra is still pretty new. I am not saying you won't get any refief, I hope i didn't come off sounding like that. I would give it a few days and then call your doc and just let him know that the bextra just isn't doing much and is it okay to just use the vicodin, and if you are having a really bad day can you take more than prescibed as 2-3 just isn't getting through the day. I do know how ya feel, I have been there and just been to chicken to say anything to my doctor for fear he will get the wrong impression, and boy some of them sure are quick to judge,
And painster, as far as beig hooked, you bet I am, I like to be able to function during the day so call me dependant, call me hooked call me what you will, but I will damned if I am going to live in a box because my doctor has decided how I feel or how much pain I am in and can endure, instead of letting me decided how I feel. So be it.  and I don't have a problem with it. Besides which if it takes me being dependant on something so my family doesn't suffer because of me, then so be it also.
chevygal
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LumbarSpasm
Silent Chaos
Reged: 05/07/02
Posts: 1538
Loc: USA
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Daycamp, keep good notes in your pain diary! Bextra takes 1-2 weeks to work to reduce inflammation and it may or may not help your pain. Your PM doc is being conservative and that is not a bad thing. The doc is assessing the minimum amount of meds you can get by on.
Vicodin ES is 7.5/750 so beware of the APAP.
Keep the diary and if the Vicodin ES is not enough, do let him know. He/she sounds willing to work with you.
Congrats on finding a willing doc. 
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LumbarSpasm
Or just a pain in the butt?!
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PrivateRealm
Threadhead
Reged: 03/18/03
Posts: 927
Loc: usa
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Quote:
Don't get me wrong, the OPs are a lifesavers for some, but a good percentage of the users are just plain hooked.
I find this remark VERY offensive. I do not agree with this at all. Although we do use OP's for pain reasons, there is a HUGE difference between being DEPENDANT upon a prescribed medication and ADDICTED to a drug!!
Back on topic--though Bextra did nothing for me, as neither did Celebrex, give it a shot, as your doc is probably just starting at the bottom working up trying to see what the minimum level is that will work for you, which is the best way to keep tolerance down. And don't feel bad about using your Vicodin as prescribed, as those levels are not high doses at all.
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KeriAnne~~~
"Life is not measured by the number of breaths we take - but by the moments that take our breath away."
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prettyday
Pooh-Bah
Reged: 02/09/03
Posts: 1134
Loc: Coastal Sage Scrub
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Everyone is here is right! The best ally you have with this new doctor is THE PAIN DIARY! It doesn't have to lengthy; detail, detail is the key. I know you wouldn't, but it's not the sort of thing one wants to 'create' the day before or the morning of the next visit...just jot down the time and one word describing how you feel at different times of the day! I use the big calendar in my bathroom- I jot down my moods, what i got done that day, pain levels, etc. That way, if the Bextra doesn't work and you do need more pain meds, the dr will be gratified to see that you are at least working on the progress with him....if the Bextra does start kicking in here and there, hooray! You will be able to spot the trend yourself and that might make you feel so good you can cut back on the Vicodin.
Either way, the diary dignifies your experiences and dr. visit, usually. Now if it doesn't, that's another problem...
not one to worry about now, though!
Hey, Congratulations, on having the courage to go to a new Dr. It's not easy after a while! But you are smart to do it for the $$$$$ and many other reasons! 
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First they ignore you, then they laugh at you, then they fight you, then you win.
- Mahatma Gandhi
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Letherebrock
Newbie
Reged: 06/01/03
Posts: 39
Loc: South East US
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I would call the doc & tell him that the Bextra is giving you no relief at all, however the Vicodin is giving you adequate relief, so what should you do? He or she will probably take you off of the Bextra & give you the vicodin, and perhaps change the streangth or the amt. taken per day. Too much might be hard on your stomach, which I'm sure he or she will have in mind, so they might switch you to something like Vicoprophen, less APAP, the same (or more) hydro.
Good luck!
J
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It's the valley of sadness and despair that allows us to appreciate so much more the mountain of happiness and joy.
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Daycamp72
Enthusiast
Reged: 06/29/02
Posts: 289
Loc: Tara
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Thanks ever so much for all the wonderful advice from you all! I am going to call the PM doc, probably next week, but I'm still going to give the Bextra another several days.
You all have been SO much help!
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midnight
Enthusiast
Reged: 12/09/01
Posts: 279
Loc: u s
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Daycamp72, i have tried bextra , and unfortunately didn't get any relief. But i have tried alot of different meds , because of endometriosis, migranes and rheumatoid arthritis.My experience has been that doc's prescribe drugs that cause less side effects first. ( less addicting etc.) Make sense, but unfortunately alot of us have to go thru alot of different meds to finally find something that will work! Trial & Error . So if this bextra doesn't work for you don't hesitate to call or go in and let him know that it isn't working.
midnight
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