r/PainManagement

My pain meds aren’t working today. Oxycodone/Acetaminophen 5/325 every 4 hours. i’ve been having to do 7.5 every 4/6 hours instead because 5 just doesn’t cut it. i usually take it with an ibuprofen 800, but today it’s not working at all. what do you do when your pain gets this way? i’m so so SICK AND TIRED OF THIS!!!! Edit: i am taking the Amneal Pharmaceuticals brand. i’ve noticed it doesn’t work nearly as well as alvogen or mallinckrodt. i’m so stressed out about this i feel like im taking the medication for no reason.

So, I'm starting at a new pain management clinic in 1-2 weeks. They only deal with pain management medication. I'm going to a new (and only my second) pain clinic because the other place kept talking to me about a pain pump and I'm just not ready for that or know if I ever will be, so they basically said they can no longer do my meds which felt very gross when I heard the words...almost like weaponizing it against me.

Just a quick little background on me - 49/m, chronic neck and back pain with several issues seen on 2 different MRI's that's been going on for the past 4 years. It has completely changed my life and my quality of life. It's a pretty miserable existence as I'm sure most of you know.

Here's where I need some advice/feedback - I am so sick of the "game" of all this. The walking the fine line of conveying you need help, but not wanting to look like a crack head. Do you guys typically lay it all out on the table or how do you navigate the "game" of it all with a pain dr? Have you ever walked in and said something like "I feel like crap and want to try "x""? I'm just so sick of all this and I feel like I've never really been heard! I want someone to truly want to help me and to actually follow through. I've tried several different medications with fairly low doses and nothing has helped. Have you guys had good luck with a combo of meds? I guess I just really don't know how to go into this new clinic and "state my case" and say that I need HELP without big red flags going up. I am so sick of this game of wanting to actually receive help and take something that actually helps, but not being to direct or saying the wrong thing etc......

I get so much anxiety with my pain and then double the anxiety about going to hope/maybe/possibly getting help. It's all such a workout!

Any advice, help, words etc would be so greatly appreciated!!! Feel free to ask me anything about what I've tried, doses, injections etc - I just didn't want to write a novel initially.

Thank you so much for reading

-Josh

Not sure if I wrote here already, but let me introduce myself

I wrote many good threads as im a pain for 15+ years, but in the wrong subreddit sadly. So I guess this is my new home.

I live with a Dr. (literally in my house and my cousine is a dr too). Ive read 15 years of med literature given by the doctors in my family about a-z, including chronic pain/withdrawal/lowering tolerance and many more topics.

Besst regards

Banned/muted me because of course against the rules:

"Did i ask for a life advice? U gonna tell "life is unfair" to people that were victim of a crime?"

I simply mirrored the messsage the mod told me, which was basically ~ "life is unfair deal with it".

Are the mods of chronicpain this bad?

I still an uncomfy around taking weed (grew up in a cult where nothing like this was allowed), but I have a huge level of pain, getting doctors to care is taking legit years, and I an nervous about opiods too. So i learned how, and my doctors know and don't care. I take enough to function mostly and just at night but sometimes I do take enough to get truly high. I dont take daily because my life cant handle that and it works for me currently, but probably up to 5x a week.

I have a lot of fear around weed using always leading to addiction or being wrong or whatever that i am working through on my own and in therapy. My pain is not minor, so.

The problem is, the second I remember I enjoy being high and I dont base my whole use only on not getting high I feel gross because it takes out the "its a medication to me" And also as soon as I mention it to anyone, I am an addict or potential addict. Im removing those people from my life but it scares me to admit it at all.

I know some of this is work I need to do. I am doing it. Has anyone dealt with it? Looking for your experience. If so, did anything else help?

Note: not currently looking for other suggestions on managing pain.

My doctor increased my prescription to oxycodone 20 mg four times a day, but I can’t find a pharmacy that can fill it. I’ve called around 25 pharmacies, and they either don’t have it or say it’s backordered.

One pharmacist told me something about a state or regional limit and pharmacies already having their available “spots” taken by existing patients. I might have misunderstood what they meant, so I’m wondering if anyone knows what that actually refers to.

Has anyone in Michigan dealt with this recently? Were you able to have your regular pharmacy order it, or did your doctor have to rewrite the prescription for a different available strength?

I’m frustrated and exhausted from calling everywhere. Any advice on navigating this through my doctor and a licensed pharmacy would be appreciated.

Heyo fam. I was wondering if there's anyone out here with any experience relating to having done or doing ketamine therapy for treatment resistant depression while also simultaneously enrolled in pain management?

I'm in SoFlo and my PM doc is actually a blessing. I've never had any issues in the almost 8 years I've been a patient with him, no failed UA's, no issues with scripts needing to be filled early or overrode, etc., did any and all injections recommended, repeatedly continued to go to and failed out of PT 8 times before insurance finally said hey, no more bc it's not working and we don't wanna pay for it. He is also one of the more (for lack of a better term) "chill" ones, and is one of the only pain doctors in my area that allows both opioid therapy AND your medical marijuana card.

I also, unfortunately, have an EXTREMELY extensive mental health history and have been on and off meds since I was 13, tried and completed almost every therapy out there, tried and tested almost every medication out there, and it seems as though nothing really works super well. At the most, it keeps my 24/7 suicidal ideation in a more passive phase, rather than being ragingly active and spiced with self-injurious intrusive thoughts every second of the day. I have gotten to the point where both myself and my psychiatrist are at our wits end and very much so creatively thinking of any, and all, potential positive treatments that we can do in order to give me a quality of life where I'm actually living, not just going through the motions bc I don't want to hurt those around me by peacing out.

I don't see my PM doctor for another 2 weeks, am doing some research on my end, but I figured it was worth asking here if anyone personally has done both of these things at the same time or if it's something that, in your personal opinion, isn't even worth asking bc there's not a chance in hell that they approve it?

I'm not worried about bringing this up to them and him or the office assuming "OMG SHES LOOKING FOR MORE DRUGS CUT HER OFF!!!", if anything I'm more worried they ask me questions about how I'm doing and I end up in a Baker Act hold, but yeah. IG that's it. If anyone has any info or suggestions, I'd greatly appreciate it.

Hope you all have as much of a pain tolerating day as you possibly can!!! 🫶🏼

I’ve been dealing with back issues for years now and every time I see pain management they recommend physical therapy or only injection I’ve had the injections it didn’t work the only relied I’ve felt was when I was on Percocet 10 or Carisopidol both 3 times a day and I was Louisiana getting prescribed these meds since I came out to California I’ve been suffering with finding an okay doctor to take over my meds I don’t know what I’m doing wrong I tried everything else even suboxone which helped but after it was over the pain would be even worse

Hi,

I had a recent appt with my GP who is prescribing my dilaudid. She abruptly discontinued a script she’s been providing for 6 years. The pain specialist I work with said he did not advise her to do that and that he just believes a change in dosing and pharmacy pick up schedule makes sense. She was prescribing only 1-2 weeks at time for the last year with only 1 refill and I was needing to run around all the time trying to either see her for a new script for get it filled. It caused a lot of frustration with the pharmacy and for me. And it made it look like I was “spending a lot of time trying to get opioids”. He wants her to switch to monthly scripts with at least 4 refills, so there are less issues. In Ontario, pain management advises GPs; so he can’t prescribe. He said he will speak to her but may not before my next appointment Tuesday.

In the meantime I’m struggling and really hoping to get the medication back Tuesday at my next appointment with my GP. I have very few leftover from my last prescription that I am really rationing for pain and withdrawal management.

How should I approach the appointment? She didn’t explain why she was making the decision except that the pharmacy was calling her recently asking questions and she was concerned. She told me I would see the pain specialist and “make a plan” but she doesn’t know I was able to get an appointment this week (it eas scheduled originally for Oct 23)

How to handle tuesdays appointment?

I am missing Enzyme # CYP2D6 which makes me immune to all opioid pain medications.

Anyone else have this issue?

Last Saturday I started the patch for the first time 7.5mcg/hr. I am starting day 6 of the very first patch, I have had insomnia sooooo bad! Exhausted and cloudy headed during the day that i have to take a nap to feel normal again. I take 7.5mg oxycodone 4x/day.

Does the feeling of exhaustion, insomnia, cloudy feeling subside with longer use? I have 3 littles and a very busy schedule day to day. The lack of sleep alone is stressing my out 😴😴

Pain management says I violated my contract, but my dosing instructions don’t match

I’m dealing with a really confusing situation with my pain management clinic, and I’m worried they’re going to discharge me over what seems like conflicting instructions.
Before my most recent appointment, I was taking buprenorphine tablets 1–2 tablets twice a day as needed. My previous bottle/refills also said 1–2 tablets twice daily.
At my most recent appointment, I was verbally told I could take **1–2 tablets three times a day as needed**.
They then prescribed me **84 tablets for the month**. However, the new bottle says **1 tablet twice a day**. That’s one of the things that confused me, because 84 tablets doesn’t seem to match those directions for a one-month prescription. At 2 tablets per day, 84 tablets would last 42 days.
I’m also currently tapering off a high dose of pregabalin that I’ve been taking for about five years. Between pregabalin and my pain medication, I’ve been dealing with significant sexual side effects, brain fog, and memory/recall problems. Because I’m coming off the pregabalin and expected my pain to temporarily be harder to control, I called the clinic and asked whether they could prescribe enough for me to use the upper end of what I understood their instructions to be — 2 tablets, three times a day if needed.
Instead, I was told that I wasn’t taking my medication as prescribed and that this was a violation of my pain-management contract.
That completely caught me off guard. I explained that I wasn’t intentionally taking medication differently from their instructions. I was following what I understood I had been told during the appointment. I even drove to the clinic to show them the discrepancies between the instructions on my previous prescriptions, what I was told at the appointment, the quantity dispensed, and what the newest bottle actually says.
So right now I have:
Previous prescription: **1–2 tablets twice daily as needed**
Instructions I was given at the appointment: **1–2 tablets three times daily as needed**
Current bottle: **1 tablet twice daily**
Quantity dispensed: **84 tablets**

Any advice?

**Update**
So pain management has released me from their care stating my type of pain and flare ups does not fit within their guild lines, and they would like me to be referred elsewhere…

Refill too soon
Your prescriber instructed us not to fill this before a certain date. Need it soon? Contact your prescriber directly.

EDIT to clarify:

technically today would be 30 days since my last upped dosage refill was picked up on the 2nd of september.
my previous lower dose refill was the 4th

but since it was implied that i could start the 3 a day that day (the 2nd) i technically ran out of meds on the 3rd.

That’s why i was confused.

I understand the rest isn’t my pharmacy or drs problem. i was just explaining why i picked up the refill on the 2nd since it was available, even though i had some of the old prescriptions pills left.

————————————-

I go to my appointments at or around my refill dates, usually because I have to schedule it around my husband’s days off because I can’t drive and it falls around that time every month.

My dose was upped this last month on the 2nd, my usual refill date is the 4th. I picked up my new prescription on the 2nd and took my previous meds the way I was prescribed on my upped dosage. (no one told me not to, in fact he almost insinuated to start the 3 a day immediately) Which would put me being out of meds on the 3rd instead of having my last dose on the 4th since there’s only 30 days in September.

My husband works from before the pharmacy opens and we live an hour away from his job so he’s usually home right around the time the pharmacy is closing. So if my refill date is kept the same date. I’ll be out of meds a full day before being able to get my refill as it’s worked out right now.

I am just trying to find a reason why my dr would set a fill date for a “future date” when i’m technically supposed to be able to pick it up on the 2nd (today) or 3rd (tomorrow) anyways given the refill date resets when my meds are upped.

Hi everyone. I have a question or two that I’m hoping can be answered.

I herniated a disc in my lower back about a month ago. Around that time, I had to find a new primary care doctor because my previous doctor of seven years found a position elsewhere. I was able to find a new primary care doctor who wrote me a referral to pain management. The pain management doctor prescribed me 5 mg Percocet, once every 12 hours. An epidural steroid injection was scheduled and PT was ordered. I would say that the medication’s effectiveness lasts for a few hours and then I’m stuck waiting to take my medication at the 12 hour mark. I appreciate that the pain management doctor wrote me a prescription at my first visit, but the amount I’m able to take isn’t enough to get through the day semi comfortably. I’ve communicated this to him at my epidural injection, which took place a week ago. He’s not willing to increase the dosage. 8 days post injection, the sciatic pain has returned and the pain levels have reached a 6/10 in the middle of the night, waking me up. My Percocet prescription runs out at the end of this week. I have an appointment with my new primary care doctor this week and am wondering if they are able to write prescriptions for Norco even though I’ve been seen by pain management. Can this even legally happen? I understand that it looks suspicious, but I’m just trying to be able to make it through physical therapy, be a dad, a coach, a teacher, etc without the excruciating pain that comes with an extrusion herniated disc.