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Thread: Steve - tell me if I'm really taking too much Norco

  1. #11
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    Karri, Diandra is right about the limit on acet. but with the new lawsuits out due to liver damage or death from taking too much dr are trying to lower the amount. One very good thing about changing to MSContin or Oxy is there is no acet. in them so you aren't putting your liver at risk. The other problem with that much norco is if you ever have to tak cold medication you are often adding more acet. and can really get the numbers way above recommended levels. I hope this dr will work with you on getting a new med with no acet. in it to relieve your pain.
    1979 spinal issues, 1993 lumbar microdisectomy L3-4, 1996 360 3 level lumbar fusion L2-5, 1999 open thoractomy fusion T8-9,
    2002 C3-7 herniations and T4-7 herniations, 2004 total disability, a new limited life

  2. #12
    Distinguished Community Member Pharmacist.steve's Avatar
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    Kari... taking 3900 mg of APAP/tylenol is no longer considered a safe level... the FDA advisory committee wanted it down to 2500mg/day but ended up at 3000mg/day.. IMO.. the longer you take APAP.. I believe that the dose should be < 2000mg.. My drug of choice is Morphine SR.. Morphine and Hydrocodone are equal mg to mg as far as pain relief.. Your doc has been giving you a 4 hr duration medication for a 24 hr pain... doesn't make a lot of sense for chronic pain... Moving someone from 40mg of Hydrocodone (HCD) three times daily .. should get better pain management from 45 mg of Morphine SR every 8 hrs... I agree with your new doc about the amount of APAP that you are taking... it is dangerous level... I do not share his concern about the amount of opiates that you are taking per day... just that the frequency and amount per single dose.. seems to be a bit "off the norm"... IMO.. neither doc really knows what they are doing in regards to properly managing your pain.
    Pharmacist Steve
    www.pharmaciststeve.com

  3. #13

    Default An Option?

    Would it be an option to have your hydrocodone compounded. This way you can have the amount of Hydro you need yet lower the amount of acetaminophen. My first PM med was a compounded Hydro with 15mg hydro and only 85 of acetaminophen.
    Life isn't about waiting for the storm to pass, it's about learning how to dance in the rain.

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  4. #14
    Distinguished Community Member Pharmacist.steve's Avatar
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    Insurance companies are cracking down of paying for compounded meds.. that are very similar to what is commercially available.. There is suppose to be a new long acting Hydrocodone coming out with 40 mg of Hydrocodone and no APAP. It is called Zohydro.. I am not sure that it available yet... I suspect that it won't be cheap.. as any new drug are.
    Pharmacist Steve
    www.pharmaciststeve.com

  5. #15

    Default How to get the care you need and deserve and remain confident in your treatment plan

    Karri, many of us, myself included, blame physicians for their inability to help us overcome that what ails us, or potentially puts us in harm's way. We allow some doctors to intimidate us, or try to convince us we know less about ourselves than they do. As some posters have mentioned, some doctors are opiophobic. Nothing you have to offer vocally or present medically is likely to change their minds. They may be fantastic clinicians and have helped you with other medical situations in the past. When the subject of opioids comes up, they are not going to help you. They may even make you feel insecure and dishonest. I have had the misfortune of seeing such doctors. It was through this forum and Pharmacist Steve's plethora of postings that convinced me that I am responsible for my well-being and therefore it was my responsibility to find a physician who satisfied my medical needs.

    Reading posts from Pharmacist Steve, I was able to understand the issues I had with my original long-term doctor were not my fault. Fortunately, I located and became a patient of a no-nonsense pain management physician who gave me the confidence to be straightforward with him as to what does and what does not work. My physician keeps very detailed notes and is a firm believer in the "Trust, but verify," motto made popular by a former President. The particular pain clinic I visit maintains a limited patient load so the doctor can take time to examine affected areas, diagnosis my pain levels and keep track of any changes or new problems and analyze the symptoms and their likely causes. After the examination, the doctor spends time talking with me on matters some might mistakenly think are unrelated to the purpose of the visit. I was fortunate to find this doctor when I chanced on a advertisement for a seminar sponsored by the DEA (I worked in a network of children's hospitals). The doctor that was to speak at the seminar concerning the correct procedures for operating a pain clinic which prescribes controlled substances became my physician of choice. I have no regrets. Within months, though still permanently disabled, I could function better than I had in years.

    The doctor you will find will unlikely have any interest in destroying your liver with acetaminophen. Acetaminophen can be much more life-threatening than many opioids prescribed. Your new doctor will have no motivation to over medicate you with controlled (and uncontrolled) medications. Random testing will be part of the doctor-patient relationship, so trust won't become an overriding issue (as long as you are taking your prescribed medications exactly as prescribed). When you find said doctor and establish a professional doctor-client relationship with him or her, you should no longer suffer in pain needlessly and should feel confident and secure with the pharmacological plan and treatments your doctor provides you. If you still have reservations and are bothered by the stigma of opioid medications, don't hesitate to share your concerns. There is a world of difference between being opioid dependent and an opioid addict; just like although all living humans are food dependent; there will always be those that have an unhealthy and dangerous addiction to overeating!

    Good luck, Karri! Keep us posted and always try to stay positive you are among friends!

  6. #16
    Community Member Diandra's Avatar
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    Default Just wondering how you are....

    Hi Karri,
    I know these issues were a few months ago but, just wanted to know how you are doing? This was really an awful situation for you to be put in.
    I hope your regular doc came back and and all is well.
    You are in my thoughts,
    Diandra
    Last edited by Diandra; 08-12-2012 at 10:30 AM.

  7. #17
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    Kari - going thru much the same thing 180 morphine to 90ER and my ir from 45 to 21IR ( break the fifteens in half - I can truely sympathize - My advise , if possible, is to find another doctor, as this one sounds like a piece of work - or if you can stand it, wait until your REGULAR doc comes back and hope they understand. PM me for the whole story - Complain to the director if you are at a medicaid clinic, this is inhumane and also complain to your states medical board. Good luck and I will pray for you. And No, you are not a drug addict. You are simply a person who needs a commpasionate Pain Management Dr, Not this freak, Yes I am mad as heck too about your situation.
    Blessings
    Alex44

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