Some clinics believe in therapies, are they offering any instead of the meds.

They give me 15 mg of ms contin 2xday.... i have been with them for 5 months.... My pain levels are going up .... They are really tight with the meds... They have no other options to offer me...

I can't speak for other clinics but my pm doc gives me breakthrough. It only makes since to me the long acting doesn't always take care of all the problems all day, I hug my breakthrough on bad days. I know on my pain contract I signed the doc promised to treat me with long acting and short acting for my pain issues. I would ask to read through that and then ask them for breakthrough and if there firm on saying no then maybe it's time to find a new pm doc. I am sorry you are going through all this

Sorry you are having problems with your meds. I see a great pm doctor that gives me ms contin 30 mg three a day and oxycodone 10 mg every 6 hours for b/t pain. (the oxycodone is without the tylenol-there are a bit less expensive). I agree that if you approach the subject again and at that point the dr still will not give any b/t , than you should find another doctor to treat you.
I wish you good luck as I know how hard it is dealing with pain.

I agree totally with healingandmovingon!! The long-acting meds are necessary, but not enough. If I didn't have breakthrough meds, I don't think I could ever get out of bed (or pain)!! It can't hurt to talk to them again but if they turn you down and refuse to give you adequate relief, there are other PM doctors who will. It's a shame so many people in pain have to fight so hard for quality of life. Keep us posted.

Maybe is time to find a new PM Doctor..... Break through medications help when our pain peaks beyond normal, and we need a quick pain relieving boost. If your Doc doesn't believe in BT meds, I would start to look for a new Doc that will treat you like a true pain patient.

Go to www.doctorsforpain.com or www.youdontlooksick.com, to find a new PM in your community.

So I guess it is not normal... I had been with this PM from the late 90s til 2005 then took a break and went it alone til Nov,,, Went back to them and now they will not perscribe any BT meds. Just long acting... It seems really difficuly to fimd the right Dr now...

Pam

I think it all depends on the injury and what meds you are currently on. If you are on long acting and they are not working so great sometimes doctors will either increase dosage long acting or RX break through meds and it sort of depends on the doctor it is like they have a cut off in their mind for all patients and they do not go by case by case management.

My PM Doctor has me on Morphine 4x a day and Lortab for breakthrough pain and sometimes that still isn't enough. I can't imagine not having the option of having something for breakthrough pain.

I had a saw PM today she increased MS Contin 45 mg a day... 3 15 mg doses... 100mg Topamax 2 times a day and flexril 3 times a day....
I feel fairly certain that is as much as I will ever get from them.... It is not enough... I take ( extra strength tylenol a day....


Pam

no, my doctor is wonderful like that, he gives me break through med, once a month and he knows that pain can be all over the place, and that i use bt for when the pain is high, even my pain dr thought it was great that my doctor done that.

I have only been prescribed with the fentanyl patch for pain with no mention of BT meds since I have been going there. I'm unsure of what to do or say as I have mentioned increased pain sites and I get silence. I am afraid to appear to be a drug mooch.
I'm wondering how to handle this just like you are faced with confusion. Is it because they only give them for patients with radiculopathy? I do have pain radiating down my thigh if I try to walk anywhere, and that is blown away.
I am going to pull out my pain contract. I wish you luck.

Pam, what is your pain from?

15 TMJ surgeries.... I have an appoinment with surgeon today... I have not seen since the late 90s.... I am terrified...... I saw an Oral surgeon last nov...He said just to remove a tooth he wanted me in pain mainagement.... Then proceded to tell me I might need total jaw replacement..... this is really scary....

Pam

I've NEVER heard of that! In fact, when I was 1st diagnosed and the docs were looking for the right dose for me, they explained breakthrough pain and said I needed to tell them when it happened. When I was 1st put on morphine, they were trying different things for the pain. The MSContin 60mg didn't keep the pain away so the gave me several different meds, then settled on MSIR 30mg. I took 2 every 4-6 hours as needed for breakthrough pain. Then they tried increasing my MSContin to 100mg and lower the breakthrough MSIR. It was the same AMOUNT of morphine in my system, but for some reason, it made me tired and dizzy and I couldn't work. I felt no pain, that's for sure, but I felt nothing! So my doctor back then just put me back on the 60mg MSContin and the 30 MSIR. In the winter (I know it sounds weird but my pain is worse when it is cold or for some reason, humid) I might take 2 MSIR as needed, up to 8 a day. In summer, I often would take LESS MSIR b/c the MSContin would be enough. In MY opinion, they worked out to be one main medication and I never really thought of the MSIR as breakthrough meds. I just took them on a schedule daily and IF pain ever got to be too much for THAT, I used to take Darvocet. It actually worked well for me. Now it is off the market and I take tylenol if I feel that the morphine combo isn't working, but it's rare. But I don't consider the MSIR as breakthrough any more. I just think of it as one medication in differing forms. If you need breakthrough meds and they won't give you any, you might ask if they can increase your long-acting meds. It didn't work for me but I do know people who live on a high dose of MScontin or Oxycontin w/o breakthrough meds. I've never heard of a clinic actually saying "we don't do breakthrough meds" but in the past few weeks I've heard some crazy things so nothing really shocks me anymore. Good luck- and keep advocating for yourself as much as possible. If the meds are not working, then you need them to fix it. It is just WRONG that CPs are made to suffer b/c of stupid, ignorant statements or stances. Sorry for the rant- this just makes me furious! Good luck!!!!