hydrocodone or morphine

[c7incomplete263]

i have a c-7 spinal cord injury and have been confined to a wheelchair for 26 yrs. my injury was incomplete which simply means my spinal cord was not completely cut. fortunately, because of this my injury was less severe then it could have been, nontheless i require a wheelchair to get around. i also have pretty good sensation, a blessing yet a curse because i have the pain that goes with it. my dr was recently fired at the pain management clinic i go and was recieving 4-5 lortab 10s a day. a new young dr has cut me down to 3-4 per day and wants me to consider morphine 2 times a day. the dosage i was taking helped but the reduction has really affected my comfort. im not sure what mg but i expect him to start me on 15 of morphine. will the morphine help me? should i talk to him about another option such as percocet? im scared that the low beginning dosage will affect my quality and comfort even more. what should i do

[marycarmel]

Pain management is tricky both for the patient and the doctor.  I know methadone is often used for pain, bnut I would only consider that if I knew I waan't going to come ofd it.  I was put on Fentanyl and it was not for me.  Again, I'd use it id I planned on staying on it for the rest of my life.  The withdrawal from it is pretty bad.  There is definitely a stigma towards patients who use narcotics for pain management.  Your pain manahement is only as good as your relationship with your pain managemwnt team.

[TheMadMan]

I have been to many pain management clinics. All they would do is refill my drugs without any other options. The last pm clinic I went to, the Dr. described one of my symptoms as piriformis syndrome. I went home and researched this and discussed this with the new pm doctor that was assigned to me. She continually said she had not read my case when I asked for shots. I didn't want the drugs.
I did my own research and found another pain management doctor locally who is giving me shots after reading the records I brought him. I am comfortable with the new doctor and am doing better because of the shots.
That has been my experience when they don't listen.

[NT77]

You were perfectly clear. It was me who left things unclear and I apologize. I figured it best not to talk too much about opiates as stigma about them is so deeply rooted, making any reasoning usually a waste of time. And that's also the reason you're getting such small doses from the doctor, while at the same time they have no problem whatsoever handing out NSAIDs like it's candy.

I'm not a chronic pain sufferer, but I've been with my father every minute for 8 months as he suffered excruciating bone cancer pain. He also, like many people, had an uneducated aversion towards morphine, so he tried everything else first. Diclofenac (another NSAID) was his favorite pill, which ultimately wiped out virtually all the platelets from his blood, and caused systematic internal bleeding.

Of all the conventional things, I'd say Fentanyl patch was most effective with least side-effects, but his pain was 24/7. By far the worst drugs were Tramadol and corticosteroids. Don't even wanna go into that...

After doing extensive research I realized, to my astonishment, that almost all drugs seriously interfere with natural body processes in one or multiple ways. Surprise was even bigger after dicovering that morphine interferes with - nothing. Anyone can research it for themselves. Morphine actually mimics the body's own pain-reducing mechanism. The only serious drawback is, obviously, addiction.

In the end we did manage to bring the pain down to a minimum... with cannabis oil. There you have it, loud and clear. It didn't work for first few days, but after a week we cut the Fentanyl patch from 50 mcg to 25, and another week later no patch was needed at all.

Best wishes

[marycarmel]

Everyone is different so what works for one, doesn't for another.  I was given Dilaudid  after a surgery and it was like a sugat pill, yet I know people who find it effective.  You can google a conversion drug chart and enter in what you're on and what the equivalent is for a different drug.  I take plain oxycodone because I do not like taking tylenol.  What'a really important is developing a relationship with this new doctor.  When he changes your meds he should be available to talk to you off hours if you're having trouble.  Best of luck,  and I hope you'll keep us posted.

[c7incomplete263]

MadMan, of course i plan to talk to him about it more then what i already have but he asked me to think about it and research it more so that is what i am doing. as i said previously he is a new dr so no he really doesnt know my history well. my previous pm doctor was easy to talk to but this one has no raport with me yet. its like your girlfriend breaking up with you and you just started seeing someone new. im just not sure what to expect and feel uncomfortable with him. im not sure if he is really concerned about my condition or he is just going through the motions. he strikes me as a bit unempathetic. its a difficult transition

[c7incomplete263]

i understand the health risks and i do not have a problem with changing to something else if i know it will help. i avoided going to pm for yrs because of health risks but as i got older the pain became unbareable. if i have to live with it i just as well be dead rather then suffer. at least the lortab make my pain tolerable. maybe i was not clear enough. my concern is that the low level of morphine i expect him to start me out with will not be affective. if i have to call to address this or even bear through the pain till my next appointment to tell him i will be looked at like i am just trying to get more to get high when that is not the case at all. if it controls my pain i will be fine with it. i also have the concern of tolerance to yet another pain medication. i hope to live a few more yrs and there is a ceiling so i want to avoid switching for as long as i can less i get to the point where nothing helps. if you dont mind me asking, are you a chronic pain sufferer NT77? Do you know what its like to not be able to sleep or to function well while you are awake due to pain you never imagined you would feel on a daily bases?

[TheMadMan]

The smarter thing would be to talk to your doctor. He can answer any questions you may have related to your injuries. He knows your history.
If you do not feel confident with his/her judgment, seek another doctor for advise.

[NT77]

Percocet is not for chronic pain. Neither is Lortab. Both have paracetamol in them, which, after months or years of everyday use, will most likely take it's toll on the liver, esophagus or stomach, or all three. Pure morphine is a much better choice.

Ask your doctor to do a liver function test (AST/ALT and ALP) while everyday on paracetamol and see for yourself. On the other hand, morphine, hydro/oxycodone (without paracetamol) in the doses you're taking, are highly unlikely to cause any liver toxicity.