It really shouldn't take time to adjust seeing how as it's all the same med just dosed differently. Perhaps a little adjusting but not much. You are sooooo responsible with your meds that maybe your expecting too much.

I've never had a 12 hours Rx last 12 hours! 8 hours max! And I'm told that's the reason for the break through meds, but I don't know now since i did fire my PM PA.

I have to say that I noticed that you were taking( 2 ) 30mg break throughs. And I remember from your MSContin post that you have thrown many extended release meds away because of a chip or something and afraid that it would go into your system all at once. I just want to point out that when you took your break throughs it was like taking a broken extended release. You would've been safe taking them as break through. Don't get me wrong, there is absolutely nothing wrong with being overly cautious when it comes to pain meds! Next time you have a concern like that, perhaps speak with your doctor or a pharmacist. I would hate for you to run low on pain re-leaving meds due to not knowing what to do.

I really hope this regimen works for you!!


Stay Gold!!

SSWarning-
Thanks! And I DID know that the MSIR was instant. My fear was that the broken MSContins in ADDITION to the MSIR that I had taken, would cause an overdose. And I always had extra MSContin b/c I took less of them in Summer than in winter. In fact JUST before my PMP died, I went through and tossed bottles of old MScontin. My doc always wrote for 3 a day and for 3 months a year I only needed 2 a day. Now I wish I had saved those meds, in case something happens and I'm w/o a doc, I guess having a doctor die on me was a wake-up call! And you're right, I should've returned the broken meds. Back then all my meds came from a pharmacy that was acting with our Insurance, and came to me FedEx. Now I go to an actual pharmacy and wait for my meds like everyone else. Luckily the new pills are small and coated and won't break or chip. (I know I sound ridiculous about the old pills, but I believed both doc and pharmacist about broken pills and erred on the side of caution.)

Right now I actually think that my body is just too used to the instant release. I like the idea of only have to take the meds a few times a day so am hoping this new system works.

As for the MSContin lasting 12 or 8 hours, I think maybe after years of use, my body just metabolizes them differently? I can't seem to get past 6 hours with the MScontin. With only 3 MSIR now, having the meds last exactly 8 hours is so important.

Having said that, I realize how extremely lucky I am to have had a doctor who knew exactly what I needed, and for my body to have agreed with the meds.

I'm keeping a very detailed pain diary so I can tell my new doc how it all went. And maybe I shouldn't complain, as so many people have nothing.

In 4 minutes I can take another MSContin, so hoping that will bring my PL down a bit!

Now 12 hours in and feeling a bit better. However, have taken 2 MSIR so hoping it won't be a difficult night. I don't understand the DEA's rule about not taking more breakthrough meds than long-term. Shouldn't it be a case-by-case situation? I REALLY don't want to have to take an even higher dose of MScontin, and hope the doctor can figure something else out. One more MSIR a day would make all the difference. But maybe it'll take another day to get used to the MSContin.

At least the fire's gone down a bit in my foot. And sleep is always a possibility. Guess we'll see.

Hope it will work out and you will get the sleep that you need tonight. I find that helps cope with the pain - without sleep it always seems so much worse.

It might take time to adjust - I have just been put on long acting (taken in the evening) plus some short acting for during the day and my body is adjusting to it now after 12 or so days.

Hope that yours will work for you soon.

Thanks Hathani. I'm now going through kind of a weird time, though my pain is really low. I just feel funny, like i did when I 1st started the meds. Tired, a bit dizzy, and a bit...not sure what to call it. It just began about a half hour ago.

I followed exact directions. And it's actually less morphine per day than I'm used to taking. I am just adjusting, I guess. I don't know why it's one extreme to the other, but this morning when I started I felt awful, in pain and just icky. Now, over 12 hours later I have a dry mouth, a bit dizzy, but no pain. I can't complain about the no pain part, I just didn't want to feel this weird feeling. But it's all part of the plan and I know it'll be fine.

I know from the 1st time that it is simply something one must put up with and will go away. The good news is that this DOES kill the pain. It's going to take getting used to, is all. This is also the way I SHOULD have been dosed, with less pills to take or worry about. I still have 1 MSContin to take if I need it in a few hours, but hoping that I'll fall asleep w/o needing it.

I'm SO glad I waited for the long weekend b/c the hubby is here for the baby, and told me to just rest and get used to the new med schedule. I might even need less of this than expected. THAT would be nice. :)

Odd how this changes by the hour, but my body is just getting adjusted. I know I may very well feel awful again in the am. I know this is not over.

It's nice to know so many people are with me through this change, and even nicer to know I can get on here and document my progress or lack thereof, and know that you all know what I'm going through.

I always wonder who makes the guidelines of how long a med should work because it always seems to me it is the extreme basis that the doctors go by and it should say the med will work from anywhere from 4-6 hours instead of just a straight 6 hours.

I know for me I just started taking this fentayl patch and it says it will give a even amount of medicine to 72 hours and after 48 hours I just find that it starts to wear off and I feel like crap not only from the pain but from it wearing off. Now my doctor is stuck on the part were it says it wears off at 72 hours and when it says that it is usually given with breakthrough meds probably because it is a problem for some she totally does not go by that. Selective reading I guess.

I do not know what MSIR is but it seems he upped the MS CONTIN a bit so it looks like you are covered there and if you are in pain I would question the switch at all, I say if the old was working why change it and if you do change it, it should be for the better and should be getting more relief then worse

I dont know if you do a pain journal during med change, well you haven't changed in a while so maybe not, so I suggest you do so you can give doctor acute information.

Hope you start to feel better soon, will be thinking of you during your hard time.

Med changes sure can be the pits... but apart from the usual "body adjusting to the med/dose" type of thing it sounds like perhaps this is going to be a positive change for you. I hope that your body adjusts quickly to it, and that it continues to give you relief... hopefully for extended periods of time.
Sending gentle hugs and positive thoughts for you. Take care... xxx

Thanks all. Am now on Day 2 and can say that I didn't sleep much but when I did, it was the pain that woke me. I'm so used to just grabbing a breakthrough med when I'm in pain that it's difficult to remember that I have much less of them to take. But then when I get about 12 hours in, the MScontin works too well, if I dare say that. Last night I had a few hours of dizziness and dry mouth, etc. But compare that to RSD pain? I'd rather let my body settle and get used to the new doses. I never want to go back to the RSD pain I had at the start. I just need to learn when to take the MScontin so it allows for a good night's sleep, and to not forget to take them on time. Stay ahead of the pain is my new motto. So last night when I wasn't feeling much pain, I should've taken the MScontin anyway so it would get into my system and cover the pain that was about to break through. All in all I'm fine, though am glad I have tomorrow to continue with this as hubby is home from work for the holiday. I have a month before I leave for Scotland, and I just want it to be better by then. Can't imagine going all that way having to use my cane again. (Actually I left it years ago in an airplane overhead compartment & haven't needed it since.) Thanks for all the kindness- I love having a place where I KNOW people care.

I missed this part...why switch from long acting in the first place?

I support you and your doctors decisions. You may just have to hang in until your body adjusts. If you don't feel good, contact your doctor.

Again, I support you and I am here if you need someone to talk to.

David.

I am switching TO higher long-acting. I was taking lower doses of long -acting with higher doses of breakthrough meds. It worked well for 14 years but my doctor feels that a higher long-acting and less breakthrough would work as well, and I wouldn't have to worry about breakthrough meds so often. As I lead a very busy and active life, I agree. I just need to get used to the difference.

David- thanks for the support. And I may take you up on that offer to chat. It's nice to have supportive people around who know what this is like. :)

I think that where our meds and what doses we are to take should up to our doctors as they know us and our conditions.
I know we talk about the drugs we take, the side effects and whether they work for us or not.

I hope that this will work for you Thalia soon as well as mine is for me now.
Found that it takes time but once it is working it will be great.
But any change from one sort of med to another does take adjustments.

Yes, I just didn't think so much adjusting would come from changing the doses on the same medication. My body knows this drug well, it just doesn't deal well with the new doses. (More of the long-acting, less of the quick-acting.) It sounded good in theory, as it is less pills to take, but it's hard to catch up with the pain, let alone get ahead of it, which is how I always handled my RSD pain.

What's scaring me is the fact that the RSD pain was always mostly in my foot and lower leg. Now my knee is starting in pretty bad. Not the 1st time and it could be something else. I know RSD spreads, but my knee pain seems to be different. Maybe I should get an xray. It's a different kind of pain, at least, in a way. It hurts more when I go down the stairs, especially carrying my son.

Oh well, no reason to get upset till I know something. If it is something else, it'll be good.

Leg cramping awfully bad today. We had storms and a tornado warning so that's pretty normal. No sleeping well so THAT could be a cause. But honestly, I just think the long-term only works for 6 hours on me and there's not enough breakthrough meds to take. Still, it's better than a hospital stay to get me off all meds and onto a new one, as was 1 doctor's suggestion. And better than amputation, which was MY suggestion. I thought if we'd done it while it was still only in the foot, we could've disposed of the RSD for good. But that is NOT how RSD works.

I'm watching the clock, and had the hubby sleep in the guest room. The idea of anyone getting near my foot right now is sickening. So lucky to have him. He brought me crackers and soda on ice, took care of our son all day and yesterday, and got the pool opened in the meantime. All while under a tornado warning, LOL!

I'll be okay. It's this time of night that I feel lonely b/c I cannot sleep like normal people. Time for a movie. That'll take my mind off stuff.

Thanks again for the kindnesses- I need them today.

Well my body didn't know Tramadol all that well, I had been on it for a couple of weeks and the doctor changed it from only short acting to a mix of both and boy did I go through some adjustment to that! I spent nearly a week feeling like I was drunk, walking into things and really feeling awful (no hangover thankfully) LOL. Gradually on about day 5 of this it started to lessen and in a couple of days it was gone and I was back to normal. But if that is the feeling of being "high" thanks but no thanks.....not for me. Though I can understand how some people might like it and as your body gets used to the dose you would need to keep increasing it. Man, that is scary!

Hope that you will be better able to cope in a few days once your body has got over the shock of this change........... Hang in - things are going to get better - I just know they will.

BTW THIS is what this board is for........... to exchange our experiences, support and help each other.

I hope tonight you are getting some rest. I find med changes can take up to two weeks to settle in. Even though it's the same med you are taking it in a different way. It's used to the highs and lows in the old system so it just might be expecting it's time to be going up the arc of relief not coming down. Not sure I am explaining this well,

If you draw a timeline by hours, draw an arc between a 4 hour period in blue with the start at 0 and the end at 0. Now take a black pen and draw the arc over the longer period with ) at start and finish. the highs and lows are at different points and I think your body just has to get the idea of the new extended time line.

Anyway, the bottom line is I hope you feel better soon. Hugs, Barbara