Thanks guys. I'm not sleeping but my pain is down to a 3, so I can't complain. Just feel jumpy in my own skin. The graph is a good idea- and you're right, this is only the end of the 2nd day so it'll take awhile.

I haven't heard of Tramadol but sounds like it works. Morphine worked for me all this time so I just have to wait it out. The label actually read that I could take 2 of the mscontins every 12 hours but I think it was a misprint as I recall the doctor's directions. And I can't imagine taking 2 at once- I'd be a zombie. Although they do make a 200mg, I know it would be too much for me.

I'm setting my alarm, so if I DO fall asleep, I can wake up to take the mscontin on time. That way I won't fall behind, and staying ahead of the pain is the best thing with RSD. At least with MY RSD.

Meanwhile, I'm watching tv. I finished the book I was reading and it was so good I can't find much to get into today. I read about 3 books a week, and more since this med change. I've gotta do a search and download some new books. I think when my mind is occupied I deal with the pain better.

Thanks again- it's nice to know you guys are out there. I don't know how I got through 14 years w/o this group!

I hope you get adjusted to the new med regime quickly... and that you continue to have your pain well controlled. I know RSD/CRPS is a dreadful condition for anyone to have to live with... so I understand that it would make you feel very anxious when changing from something that has been working.

I just wanted to comment on how important it is to take any controlled release meds at the time when they are due. I also think you are correct about the need to keep in front of the pain rather than chasing it. My pain specialists always stress that it is much easier to stop the pain from getting to the extreme levels (by taking breakthrough meds as soon as pain is noticeably increasing) than it is to get it back down to a reasonable level after it has been extreme.

It took me a long time in the beginning to learn that lesson. I didn't want to take any extra meds until I really was forced to by being in unbearable pain... then it would take a very long time for the pain to drop back down. Now I pop a b/thru as soon as I think it's on the rise. Perhaps there are times when it wasn't really going to get extreme, and therefore I could have managed without the extra meds... but my docs prefer that I err on the safe side, considering that there is no barometer available to let us know how high our pain will get on any given day.

I use the alarm on my mobile (cell) phone to remind me to take my meds. I use the phone alarm because it is always with me regardless of where I go. I also always carry water and a days worth of meds in the small backpack I take with me whenever I leave home. So that no matter where I am when the alarm goes off, I can just take what is due and immediately reset the alarm for the next dose.

The other thing I do is take a bottle of water, and my morning meds dose, to bed with me. I normally wake up at around 9am... but I set the alarm for 7am and take my morning meds then. Once I've done that I roll over and go straight back to sleep. Doing that ensures that it's very rare for me to be in pain when I first get up in the morning, because the meds have already started to work in my system... so I am on top of the pain right from the start of the day, and can then work on keeping on top of it as best I can.

Wishing you all the best... and sending hugs and smiles for your day... xxx

Gotcha...short acting and polypharmacy (mixing long and short acting) are problematic approaches for chronic pain. The superimposition of peaks and troughs can be unpredictable in terms of positive and negative effects. When the positives are inconsistent, this drives a person towards more medication unnecessarily (and increases the chance of dependence). Inconsistent peaks invites side effects (2 tiers, mild symptomatic, and serious/potentially harmful). Titrating to a single long acting agent per class is best imo

????????????????????

The reason that mixing long acting and short acting drugs within the same class is not a great idea for chronic pain in answer to the ?????

Mixing long acting and short acting drugs got me through 14 years of RSD. At a high activity level. Breakthrough meds are often necessary BECAUSE the long-acting drugs don't always last as long as they're supposed to. MSContin lasts about 6 hours for me, maybe 7. I'm very happy I have the short acting meds for breakthrough pain. As I lead a very busy life and have little time to rest my foot as often as I should, the combination of meds works well.

I thought they called those breaking through, or break through. I don't know too much about drugs and I certainly couldn't understand response #18. I guess I have a limited vocabulary. I didn't even understand the "Gotcha" part. Thanks for the response, but I'm sorry, still don't get it.

No need to elaborate, thanks.

D-Looks like we were replying at the same time, LOL! And you're right about breakthrough meds. THAT is the problem I'm having- increasing the long acting and decreasing the short acting w/o going too far in either direction.

Thank you. That I understand.

No problem. And thanks for all your support. It's been a long 3 days and I'm still not sure how this is going to work. But am keeping a positive attitude, in great part to the many kind people here who know what CP is b/c they've experienced it.

Tomorrow I'm on my own as hubby goes back to work, but I think it'll be okay. My body seems to have adjusted, though the pain level is a big higher than I'm used to. Still, it's well within tolerant levels.

Happy Memorial Day everyone!

I understand,That if you find a med. that works for you short acting.I've been on the same dose of vicodin for a while but my pain level was not controlled,all the time.I was Rx'd a new continous delivery system,and just started it this weekend,72 hours in to it I can say it's working with a small side effect of a mild headache.I still have my vicodin for break through pain,I used it 8 hour in to the 72hours. and not sense.I'm still not sleeping well either it's not really the pain it's just being nervous about the med change.

I have always heard (from my doc) that as soon as I notice a flare coming on, I need to take my BT (break thru) meds. When I ignore his advice, it takes twice as much or twice as long to recover from the BT pain.

Have to agree that changing meds is a bear.
Hope you get some stability soon.
Praying for you
Sunny

Dmsaprod,

I think he asked another question before!?!?! The GOTCHA may mean "I got it!"
Course I have been wrong before.

Sunny

Dmaspord,

So sorry for butchering your user id. That is classix dsylexia.

Please frogiev
Sunny