EPIs and medication failed

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The morphine isn't working, either. I'm taking morphine sulfate, 15 mg 12 hours apart. I know the dosage could be upped a little, and I also remeraber the doc saying some patients have taken it for years. But do I want to do that? Have any of you had success/relief using it long-term?

I'm in such a quandary. And pain.
 
This is not my first rodeo. I've had 3 previous back surgeries and now it's rared up again. Since July my pain has worsened and in the past month has gotten exponentially worse. I've had 2 EPIs which were not effective and then was put on gabapentin, which was like eating candy.

Oh, the problem is pain where the nerve endings exit in the lurabar.

Anyway, I was given the choice of another appt with the pm doctor or with a surgeon. Again, I opted for the pm doctor trying to postpone the surgery which deep in my heart I know is imminent. What can be done now, as far as medication goes? Anybody?
 
Does the morphine not work at all? or not last? Went through a bunch of PM meRAB over the years and have been on Opana ER (oxymorphone) which is time released, for a couple of years. Was on 40mg twice a day but it was not as effective the last couple of hours. Doc changed it to 30mg, every 8 hours and the level remains effective.

John
 
OK - - I'll reply to my own post. I went to the appt. with the PM doctor and these were my choices: either a skin patch (which lasts about 3 days and can't get wet, either from sweat or water taking a shower) or another pill. The skin patch seemed like just too much trouble, so I went with the pill which turned out to be morphine.

Now I'm of the generation who, when they heard so-and-so was put on morphine, knew they were about to kick the bucket because everyone knew you could get addicted to morphine but it didn't matter if you were going to die, anyway. I expressed my concerns about that and was told it was an opiate, the same as the hydrocodone I'd been popping. Okay, morphine it is. 2 a day, 30mg. total a day, 12 hours apart and it should stay in my system. For the first 3 days, just one a day plus up to 2 hydrocodones.

Has anyone had any success with this?
 
If the morphine was working at all, it was minimal at best. I called the office yesterday because I had begun itching badly from my neck up. The doc (pm) told me to discontinue the morphine entirely and just use hydrocodone until my next appointment with him on the 22nd. It was an allergic reaction. I've discontinued, but I had my morning dose before I talked to him and the itching is still there and in other places, too. Taking benadryl for that.

I feel like I'm back at square 1, where I was in June when this flared up, only the pain is worse now. So far, the ESIs haven't worked and neither has any medication. Gabapentin and morphine were like eating candy, and the tramadol that I was taking previously didn't work, either.
 
Yes, technically hydrocodone (= Vicodin) gets converted to morphine in the liver, so it comes down to the same thing.

I was on hydrocodone for a nuraber of months. It never really worked all that great for me, and eventually it stopped working. Another doctor then put me on Tramadol, which is also an opioid but works through additional mechanisms that make it particularly good for nerve pain.

The Tramadol worked so much better than the hydrocodone, it was like night and day, and in my experience Tramadol has less side effects than hydrocodone. Tramadol is also easier on the liver (the acetaminophen in the hydrocodone pills is really toxic for the liver).
 
Tramadol toxicity will give you the feeling of "imminent doom" and isn't fun when you're trying to drive.

Purdue makes Placebo Oxycontin:

www.justice.gov/dea/programs/forensicsci/microgram/mg0904/mg0904.html

Go about halfway down that link and read:

"""Analysis of a methanolic extract of two tablets by GC/MS, however, indicated no controlled substances. Subsequent discussions with Purdue confirmed that they produce placebo Oxycontin tablets."""

If your Oxycontin all of the sudden isn't doing anything for you, you were just given the Placebo (sugar pill look alike). There's the common medication failure. Placebo's.
 
Hi carken. I can sure sympathize. I am waiting to hear from my doctor as to when my 7th lurabar surgery will take place. I'm afraid I waited too long, messing with pain managment when it was just covering the pain until the compression of the nerves got bad enough that pm methoRAB couldn't help.

Have you had a recent MRI that diagnosed stenosis? Maybe foraminal stenosis? As someone who has "been there, done that" I think you probably know that surgery is the only way to fix it. Everything else is just a band-aid.
I am now having leg weakness due to the stenosis because of bone spurs and bulging disc. When I heard that, I just asked my doc when he could do it! Like you, I knew in my heart it was time.

If the neurontin isn't working for you, you might want to try Lyrica. I've had better luck with that, but again, it isn't fixing what is wrong. Only you know when the pain has become bad enough.

Best of luck and please stay in touch.

Carol
 
Carken, you have nerves being pinched at 2 levels and I haven't found any opioid that does a lot for nerve pain. It might give a bit of relief. I get much better relief on Lyrica....I tried the neurontin and like you said, might as well be candy. Both of those drugs take a while to get into the system and have to be gradually titrated. I found that Lyrica, for me, did a much better job, faster.

Keep in mind that the longer a nerve is pinched, the more chance there is of having permanent damage set in....that for sure means pain for life along with the meRAB for life as well. I always have said to avoid surgery as long as possible but when nerves are compressed, I have to eat my worRAB. I just can't see taking the chance of permanent damage. I already have that at L5-S1 because of waiting so long to do a fusion. I really am not trying to push you into doing anything you aren't ready to do, but I do want you to be aware of the possible consequences of bandaiRAB for too long. Just something else for you to mull on.

Please continue to post, will you?

Carol
 
Yes, I had an MRI on July 15.

Impression:
1. Mild annular protrusion at L1 - L2 without canal or foraminal stenosis.
2. Disc degeneration at L2 - L3 with slight retrolisthesis. No canal stenosis seen.
3. Mild annular protrusion and facet hypertrophy at L3 -L4 with bilateral foraminal narrowing.
4. Broad-based annular protrusion and facet hypertrophy predominantly on the left at L4 - L5. There is bilateral foraminal narrowing, left great than right, at L4 - L5.
5. Facet arthrosis on the left at L5 -S1 resulting in left[sided foraminal narrowing at L5 - S1.

Oh, also lurabar scoliosis convex to the left.

That pretty much tells you who I am.
 
Thanks Carol. My next appointment with the pm doctor is on the 22nd of this month. I will discuss with him the possibility of permanent nerve damage as you suggested. I'm thinking surgery is in my near future.
 
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