July 10, 2008 - 8:57pm
Hello all. My questions are for those who have been on any pain medication for an extended period of time. How long before you went to your doctor to explain that the dosage of medicine you were prescribed no longer provided the same relief as it did when originally prescribed? In other words, how long to a tolerance built up to your dosage? If so, how much did your dosage increase by?
I have been on Oxycontin 20mg three times a day and 60 Percocet 5/325 a month as needed for breakthrough pain for a year and three months. I believe that I have probably built up a tolerance because the incidents of breakthrough pain and overall pain have increased. I am seeing my doctor next week to discuss this with him.
Thanks for any insight.
July 10, 2008 - 9:11pm
#2
If you have been on the same
If you have been on the same dose for a year and three months it is probably about time to ask for an increase. tolerance starts building when you first start taking it and everyone develops tolerance differently some faster some slower. In my opinion the average time that a doctor would be willing to up the dose is at least 6 months so 15 months would deffinitely warrant an increase. Explain to him that you are using all the breakthrough meds and it still isn't helping.
July 10, 2008 - 11:58pm
#3
My old doc used to say that
My old doc used to say that you usually build a tolerance to meds within 6 months. The thing is, you are the one who has to inform your doc and let them know whats going on. They don't know how any med is working, whether it is meds for pain, depression, or even blood pressure, unless you tell them.
You need to treat this just as you would with any other med- explain to the doc exactly what is going on and what you are feeling. This is obviously something that did not JUST start happening, so make sure you explain how long it has been happening too. Tell the doc about any other things you have had to do for pain relief since your meds aren't working well enough- such as ice/heating pads, doing less activities, extra ibuprofen/tylenol (as long as its not more than 4000mg/day), or anything else you have had to do.
Don't tell the doc you need a med increase though, just explain yourself and allow your doc to come to that conclusion on his own. You don't have to act ignorant about your meds, or act like you don't know anything about them, but also don't act like you know more than your doc.
I'm a social worker, not a medical professional. All comments and thoughts are simply my opinion and experience.
July 19, 2008 - 6:59pm
#4
Read my post: What is the general consensus on the best...meds?
I talk a bit about that in my opening post to the forum. In my experience, tolerance builds fast. But different people have different metabolisms. You might consider asking your doc, and explaining the situation in doing so, to switch you to a new baseline med and a new breakthrough med. That way you will be on meds you have no tolerance to. You might try titrating up from where you are now, too, whether you stay on the current meds or change. That's just my opinion though, I'm not a doc. I just have had experience like yours off and on over the years.
July 19, 2008 - 7:54pm
#5
Speaking of tolerance,
Speaking of tolerance, I had just seen my new PM doc (who is a total quack, by the way) and explained to him that the Duragesic 50's aren't working as well as they use to (I have been on that dose for about a year) and he had the nerve to tell me that I had what is called "Opioid Induced Analgesia." He said I need to get off all pain meds, see a shrink and do Biofeedback (whatever that is.) I went back to my Primary doc and told him all of this and brought along my MRI that shows that I have 2 bulging disks and DDD and my regular doc increased my Patches to the 100's. I'll tell ya that new PM doc reallly had me fuming mad when I left his office. No bedside manner whatsoever. Now It looks like I'm on the hunt for another PM doc b/c my regular doc said that he can't Rx these Patches like a PM doc can b/c it would look bad to the DEA which I can understand. Some Dr's should'nt be Dr's!!
KK
If you have been on such medications for over a year and its the same dosage and type, its perfectly reasonable for you to gain a tolerance. Very probable. Plus everyone is different. A reasonable tolerance develops differently in each person. As far as knowing what to say... Saying exactly what you said to us here seems very good too. Let us know how it went.
Ya dont need insight man. You got it already!!!