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Suggest Remedy For Severe Pain Despite Being On Oxycodone

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Posted on Mon, 29 Jun 2015
Question: I'm on pain med for arthritis and stenosis I've also had surgery for both knees 3 knee replacements 2 revisions and 2 orthrascopies. I've broken my foot and fibula some time ago. I have pain also in my right and left shoulder. I am a 52 yr old manic depressive m. My name is XXXXXXX My question is I'm on 10 mg of oxycodone a day 6 xs a day and I would like to take 30 mg 4 xs a day. What is that usually given out for? What would u recommend .? And how should I approach my clinic provider, what should I say . I should also add the 10 mgs is not covering my pain I still walk with difficulty and it is hard to sleep at night sometimes. Thank you

Hi dr. I also have stenosis of my back lower vertebrate and severe degeneration . I fractured my back about 6 yrs ago and didn't go to dr. I had to work. I have been told it didn't heal right. I refuse to get surgery on my back because I am too scared it won't work better. Also I have had injections ablation and epiderals. But they didn't help after 3 days I've had about 8 of them.

I've also had blunt force head trauma on the back of my head. The colors on the scan are red where the fall occurred and green blue and yellow everywhere else. This was 30 yrs ago. The report is recent. It doesn't affect my psych meds or pain meds. What could this report mean. I'm on an iPad and can't send them. My psych meds are geodon 60 mg. 3 xs a day, lamictal 200 mgs 2 a day , cymbalta 60 mgs once a day ,nadalol 40 mgs 3 xs a day and meloxicam 7.5 2 a day. I take oxy condone 10 mgs 6 xs a day and Benadryl to sleep at night

My grandmother was in a wheelchair due to osteoarthritis and my arthritis is very bad now. My fingers toes and elbows. My shoulders my back and legs and knees and ankles hurt. I have bruises on my ankles due to walking. I have gotten out of my car 20 yrs ago. There is a spot on my left leg after surgery it's about 6 in on the let leg I on the left side that hurts very badly the orthopedist says it's not the nerve but doesn't say much about it or that it can be fixed. My left knee swells permanently . I use ice and a tens unit. And am on a cane . What do you think this place on my let leg could be .? What could be wrong with it after surgery? Who can I talk to who will address this pain. .?

Thank you

Oh yeah I've also had a bowel resection and about 13 hernias rips ya know . Due to rape. My gallbladder , appendix is gone . In total I've had 14 surgeries. That's all.

This all happened in the course of 15 yrs. I've had a surgery every year. Since 1999
In the picture I'm 51 yrs

I was getting a compound from the pain clinic called Bacolod/ cyclo/ disclosed/ Galapagos/ tetracycline/ cascade2/2/3/2/10 percent cream . But tricare no longer pays for compounds it really helped can you suggest a already prepared script for topical anesthetic except for voltaren because the alcohol makes my legs itchy.?
doctor
Answered by Dr. Dr. Matt Wachsman (1 hour later)
Brief Answer:
Last one first...?

Detailed Answer:
First, check what the price actually is.. Epic/compounding pharmacy is not expensive. The ingredients are all readily available generics.

Then, several ingredients do not sound like real medications (Galapagos? cascade? Bacalod?) and tetracycline is a scarification agent. Good for pain, but only under very narrow conditions. Tetracycline is quite easy to make into a topical that should not be expensive at all.

Then, depends on what the creme is doing. I doubt it is being a non-steroidal aspirin like drug so voltaren is not very relevant. If it is a scarrification agent, then capcaicin is likley to be very similar to it as that is a topical that kills off pain nerves. It should not be much more expensive than the hot chili oil from which it is derived. Lidocaine .. an anaesthetic.. comes in a wide variety of topicals that vary tremendously in price.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Dr. Matt Wachsman (48 minutes later)
Thank you I'll try the pain relief liniment from jr Watkins that is kinda hot to burn off nerve pain. Will you answer my other questions? Thank you so much. I might also try hot chili pepper oil like you suggested
doctor
Answered by Dr. Dr. Matt Wachsman (16 minutes later)
Brief Answer:
ok... tricky.... since there seem to be seven paragraphs on display

Detailed Answer:
not sure which question other than the last to which you refer.
"My grandmother was in a wheelchair due to osteoarthritis and my arthritis is very bad now. My fingers toes and elbows. My shoulders my back and legs and knees and ankles hurt. I have bruises on my ankles due to walking. I have gotten out of my car 20 yrs ago. There is a spot on my left leg after surgery it's about 6 in on the let leg I on the left side that hurts very badly the orthopedist says it's not the nerve but doesn't say much about it or that it can be fixed. My left knee swells permanently . I use ice and a tens unit. And am on a cane . What do you think this place on my let leg could be .? What could be wrong with it after surgery? Who can I talk to who will address this pain. .? "
Perhaps this one

But first, some clarification. I cannot diagnose, treat, nor recommend any particular modality/creme/surgery/activity for someone on the service. I can answer general information. There was a large list of places (Galapagos, Bacolod, Cascade) mentioned as a creme. Rather than try to come up with an exact match I listed all the topical medications that are useful as topicals for pain. Capcaicin comes as a medication. It can be prescribed. I am not recommending taking a cooking ingredient instead of a medication on someone I have not seen.

The second one is rather a good illustration of why one would not diagnose or give specific information without seeing someone. The description is not clear. Is the discussion about the knee, surgical complications, or generalized osteoarthritis? Is someone stuck in a car or left the car never to return? The characteristics of generalized osteoarthritis is that it is analogous to "wear and tear". It is in areas of use, It is asymetric, it is degenerative. Can involved joints and tendons. If it is joints, and inflammatory, swelling usually occurs in the joint. Anti-inflammatories can be helpful. This may involve injecting them directly into the joint. Surgery cannot bring back areas, but can make areas... smoother. This is about as mediocre in outcome as one would expect. And mechanical replacement generally gives better short term outcomes.

This covers virtually all modalities one can use for pain. Anti-inflammatories .. direct and indirectly applied; surgery, replacement, nerve removal either surgical or chemical. Other modalites that should also be included would be physical therapy to include also massage, range of motion, tens, and building up surrounding muscles for support.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Dr. Matt Wachsman (19 minutes later)
The question about pain medication could you answer that one and give me words to use to describe my pain and advice on how to approach the dr at the pain clinic about giving me 30 mg of oxycodone 4 xs a day instead of 10 mg 6 xs a day. I should mention I am going to have another knee replacement soon on my left leg.
doctor
Answered by Dr. Dr. Matt Wachsman (1 hour later)
Brief Answer:
There just isn't any answer to this that will not get me in trouble somewhe

Detailed Answer:
The question is "how do I wheedle/cajole/persuade a doctor to double my narcotics".
Do you see where there might be a problem with this question?
First point. Do you think the pain is going to be more or less immediately after huge surgery? And, if someone is already on basically a huge increase in narcotics and then has more pain, might there be a problem in that situation?
Then, are you aware there's potentially addiction issues with narcotics? This might be an issue someone might consider when being asked to double the amount.
Are you aware that narcotics in high doses, like tylenol and aspirin, can be fatal?

If someone were to have a cold that isn't better, and they say, "I want hospitalization and intravenous antibiotics", I wouldn't necessarily do that.
And, when I go to the mechanics with a flat, they don't necessarily replace the whole tire (would have cut the cost down by about half last time if they did...).

Reasonable would be to explain the clinical situation and have the physician try to treat the clinical situation.
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Dr. Matt Wachsman

Addiction Medicine Specialist

Practicing since :1985

Answered : 4214 Questions

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Suggest Remedy For Severe Pain Despite Being On Oxycodone

Brief Answer: Last one first...? Detailed Answer: First, check what the price actually is.. Epic/compounding pharmacy is not expensive. The ingredients are all readily available generics. Then, several ingredients do not sound like real medications (Galapagos? cascade? Bacalod?) and tetracycline is a scarification agent. Good for pain, but only under very narrow conditions. Tetracycline is quite easy to make into a topical that should not be expensive at all. Then, depends on what the creme is doing. I doubt it is being a non-steroidal aspirin like drug so voltaren is not very relevant. If it is a scarrification agent, then capcaicin is likley to be very similar to it as that is a topical that kills off pain nerves. It should not be much more expensive than the hot chili oil from which it is derived. Lidocaine .. an anaesthetic.. comes in a wide variety of topicals that vary tremendously in price.