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Avatar universal

Butrans, Percocet and Xanax for long term pain

New here and after looking around decided I might try to reach out for some advice. Chronic pain is the hardest thing to get someone to understand unless of course they have been through it.

Background: Began with a spine issue, assorted lower back pain and such years ago. I saw my gp, had an MRi turned out to have minor bulges, arthirtis and a bunch of other small things I can't remember. Those hadn't gotten better, eventually I was referred to an Ortho who thankfully put me on a low dose of percocet so I could sleep. The pain was beyond anything I could imagine (little did I know how much worse it would get).

I've been treated with Percocet for years...about 3 now with the 5/325 dosing. In there we've also tried a number of epidurals and other shots in various places (SI joints). I should probably know better everything that's been done to me but it's been SO MANY THINGS! Shots provide some relief sometimes. Sometimes not at all. Spoke to my Pain Management doctor about how percocet wasn't doing it and I could easily take my 4 pills a day by noon because I was that desperate for relief. He switched me to something called Nucynta (oh and btw I've been on all kinds of combinations over the years to include, cymbalta, elavil, neurontin.) Nucynta was like a godsend. For 2 months I was almost painfree. I felt like I had a life and even better I was ecstatic it was meant for the body to not get adjusted to. YAY!

And month three it stopped.  Bad luck I guess?  My doctor upped the dosage on Nucynta but it still didn't have any relief. He switched me back to a myriad of things, shots, neurontin and percocet 3 or 4x daily. Most days are unbearable. Most days I want to just stay in bed and not move. The pain is just demoralizing.

Moving along (oh and I should add that while I've been going to the same clinic, I've seen assorted doctors every year or so because they change locations or transfer or something. Its really annoying.)

I'd been complaining of HORRIBLE groin issues and my Pain Docs have largely ignored that says its likely not caused by my back 'I've never heard of that'. I've been prescribed skelaxin to help with the horrible cramped up groin issues and gluteus cramping and tightening. I personally think skelaxin is hit or miss. I do seem to notice some difference.

Finally sent for a surgical consult on my spine (man he was wonderful) but he took one look at my spine and said people can function with my back issues for years. That I'd eventually need repairs but not now. He suggested it was my hips. So. hip MRI and Hip x-rays and discover that my hips are completely gone. Apparently I was born with shallow hip sockets (not uncommon) but that it had never been discovered and over the years, weight, car accidents, arthritis had just destroyed my hips. I need a total bilateral hip replacement; there literally is nothing left. I almost passed out looking at the scans

Hip surgeon I saw was kind of a jerk (not kind of, was a big one). And because of my weight and body proportion he told me basically 'good luck' I have no problem having them replaced even though I'm only 39. Its finding a doctor to do them on someone obese and both at the same time. Oh and I need to save up a little more time off from work.

So thats my story.  Just after finding this out my pain doc switched me to butrans (I began at 5mg then went to 20mg) with percocet 7.5/325 for breakthrough pain. (60 pills a month so in theory 2 a day as necessary)

And once again I have a new doctor who admittedly (and I'm fine with) very drug restrictive. He found out I took morphine 2x last month (they had been previously presacribed before Butrans) and went through the roof and I don't want to OD or do anything stupid. I told him I took them out of absolutely desparation (morphine makes me vomit. A LOT...but it takes the pain to almost nothing).  Anyway I see him again later this week and that brings me to this post.

I've had a bad year (well, being 39 needing both hips replaced, mom nearly died after an extended illness, sister died a few months ago, so it's been rough). The worse my pain is the bigger chance of an anxiety attack. Sometimes I wake up in the middle of a panic attack or start my day off that way because I can't walk more than 2 feet. I have a lot of walking on my commute and I live alone so any kind of things that I need, I have to do for myself.   Last week my GP gave me a prescription for XANAX 1 mg for panic attacks and to help me sleep (I've always had sleep issues...if not for pain then for stress and anxiety). I've noticed that when my pain seems to swell up taking half a xanax seems to make it a little better. Not great and doesn't take away the pain but it does prevent my freaking out over it. (BTW my GP does know what pain meds I'm on and my pain doc knows my other prescribed meds although the xanax is new)

Butrans is hit or miss. I'm having issues with it staying on my skin (especially during the summer) but I do feel more relief than when I haven't. I know the stressors don't help my pain. I don't want to go off Butrans (omg its awful when I run out of patches because they fall off and I can't get them back on then I've got to wait a week or so before I can go back on, I had no idea I'd have withdrawal :/ ). Between those being hit or miss and largely having to rely on percocet to ease the pain that sometimes is overwhelming I'm just not sure what to do.

I've been on percocet for so long I really want to try something else but don't know what else I can even try; especially considering my use of Butrans and now having added xanax. I'm not sure if bumping me up slightly on prcocet will help. It's at the point now where taking 1 does nothing to touch the pain so I end up with 1.5 or 2 at a time, then have to really scrimp and save and hope I don't run out.

This went on too long. Any advice any thoughts? Thank you all for any insight or advice you can lend.
3 Responses
1855076 tn?1337115303
Just to point out, it would likely be OxyContin (which is long-acting) along with percocet or oxycodone or some other immediate release narcotic.

I feel for you.  I had joint replacement in my thumb, which failed five years ago.  I wound up with complications and also wound up overmedicated through trying to control my pain. (I also have other pain issues; fibromyalgia, RSD, nerve pain, a herniated disk in my back and very bad arthritis in my hips and one knee and back.)

First, to keep YOU safe, only one doctor should be prescribing the Xanax and pain meds.  Did you sign a pain contract?  If so (and even if you didn't,) you need to follow your doctor's directions to the letter.  Running out of medications can cause you to get dropped immediately, no second chances.  Same with when you took the morphine.  Even though it was previously prescribed, they could have dropped you.

I don't know anything about the Butrans patch for pain.  I was on the Fentanyl patch and I had trouble with it sticking, especially in the summer and then as I went into menopause.

I've weaned myself off my meds for a number of reasons.  Insurance companies and the DEA are making and going too continue to make it difficult for CP patients to be treated with narcotics.

You are clearly either under medicated and/or are on the wrong meds.  Is there another pain clinic you can call and check out?

Your second issue is finding a surgeon who will do your hip replacements.  When I went for the joint in my thumb, I was stunned.  For years I had terrible pain but the ortho I was seeing kept giving me cortisone shots.  I finally went for a second opinion who told me there was nothing left of the joint and the bones were all broken.  That's when I went to hand surgeon who told me he never saw anything like it in someone my age.

Unfortunately, my implant failed (in just about everyone.)  Since then I've had 9 further surgeries and countless procedures and medications.

You need two things:  a surgeon.  Start calling around.  Check with any teaching hospitals that may have some names for you.  Also, ask friends, relatives, etc., especially if they have any connection to the medical field.

Then you need a doctor or pain management clinic that you can develop an open, honest relationship with.  They should be the ones prescribing narcotics and/or anxiety meds, sleep meds, etc.  Leave the  GP for your regular medical care.  Your relationship with the pain clinic should be such that if your meds aren't covering your pain, you call them and they figure out what to do.

Also, by taking more percocet than prescribed you are at risk of taking too much acetaminophen as percocet contains Tylenol.  If you then take other things with acetaminophen, you can easily go over the daily recommended safe dose.

I hope you can find some doctors that can give you the treatment you need.  Staying with these ones will bring you more misery I believe.
1326416 tn?1370927001
From what I see and think is that you are terribly undermedicated. Simple as that. if you were on Oxycodone, with percocet for your breakthru moments, I think you'd be amazed at the difference in pain levels. it scares me to know you are already at a pain clinic. One would think that they would know what is indicated to help you. I understand that some doctors are weary of prescribing opiates, but come on now! Good Luck.
Avatar universal
I can't really help with med advice, but i too have groin pain and the NP at my pain clinic said that yes it very well could be from my back, i believe she said it could be because of the problems I'm having at l4, the nerves in L4 reach around to the groin area. I hope that helps and best of luck to you.
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