Scared

My wife and I had our quarterly pain follow up appointments with our PCP Wednesday afternoon. We always schedule two appointments ahead so that we don't have any problems getting in. When we reminded the receptionist that the appointment in three months wasn't adequate and she needed to schedule one in six months, she let slip the information that our doctor is leaving in four months. He has NO PLAN moving forward and hasn't even talked to any of the other providers in the office about taking on our cases. Every pain management office has refused our cases because they're medication management cases, which means that they can't make obscene money. The other doctors in the office have been extremely vocal about their objections regardless his management of our case. There are a few new providers that haven't chimed in, but two of them are PA-Cs (physician's assistants), which can't prescribe CIIs.

Steve

Updated "About Me"

If anyone is interested, I've updated the "About Me" section


-----Updated Text-----
I apologize for not updating this part of my site for a while, but I've been fighting with the incompetent, ignorant, rude imbeciles who run CYS (Children & Youth Services) for over six months concerning my wife's and my need for prescription opioids. I've been told that they've never gone after people as hard as they've been going after us, that includes heroin addicts and crack whores. They routinely lie on court paperwork, leak confidential records, commit perjury, and they're constantly change their story & accusations. We've had to prove that we are ill enough to require opioids, but not too ill that we can't care for our daughter. Thankfully, our family doctor has not abandoned us. He knows how much these medications help us and he knows that our daughter is well taken care of. Thankfully, my state has never had a law allowing children to be taken from disabled parents and there are federal laws (i.e. Americans with Disabilities Act) that protect us, slightly. Unfortunately, we still have to prove that our medical conditions don't prevent us from caring for our daughter. Aside from our doctor, we have our almost useless lawyer who can't schedule a meeting, and a great subcontracted (not a CYS employee) parent educator who isn't afraid to tell the truth, even if it isn't popular and even if it contradicts her conclusions. We've also been complying with their ridiculous WEEKLY urine drug testing (costs taxpayers $100/test per person). I really wish that they'd switch to saliva testing, or better yet hair testing, which covers the last 3 months (more, if you're willing to pay for it) instead of the 2-3 days that UDT (urine drug testing) covers. I did the math once and found out that you could buy a VERY nice car with the money that they've spent harrassing us and violating our rights. Privacy is a thing of the past.

Update

My wife and I had a hearing today and the judge sided with us. He told CYS that they had until August to close the case (or find some evidence).

Unfortunately, CYS going to continue with the extremely intrusive weekly urine testing (wasting $200 taxpayer dollars each). I feel so bad for the people who collect the smiled because it isn't their job and the guy wants to quit because if it. The stupidest part is that saliva testing would be just as useful and hair testing would be superior (hair testing goes back 2-4 months, but urine & saliva only go back 2-3 days). The worst part is that you have no choice. As a victim of sexual assault, being forced to allow someone to watch you urinate is not easy (thank God for Ativan & Xanax).

Anyway, back to the hearing, the judge was not happy about CYS's behavior and he wasn't buying any of their bullcrap. He could tell that we were not drug addicts and he could tell that we weren't invalids. Our "parent educator" really blew their bullshit out of the water, as did our doctor's testimony.

Anyway, thank you to everyone who prayed for us or kept us in your thoughts.

Steve

Pain-somnia (mini-post)

It's well past 5am & I have to get up at 7:25am, my pain induced insomnia (aka Pain-somnia) had kept me up all night, despite significant pharmacological treatment.  Unfortunately, with about two hours until I need to get up, there's nothing that I can take right now to help me sleep (even Zanaflex/tizanidine knocks me out  a bit longer than two hours). It is infuriating to feel so tired, but be unable to actually get any sleep.

I hope that you're all doing well, in minimal pain & getting plenty of sleep.

Steve

Insomnia

As I am sure most of you know, pain can interfere with sleep on a monumental scale. I had to get up pretty early this morning (actually, I've had to get up early for the past two weeks) and I have to get up early again tomorrow (or rather today), so I took my lorazepam 2mg (x2), tizanidine 4mg, and Rozerem (because I took the Rozerem, I had to skip the melatonin tonight per my PCP's orders). Unfortunately, the earlier of a morning, the worse my insomnia seems to be. I recently added two more tizanidine 4mg, which seems to be the most effective sleep aid in my extremely well stocked arsenal of insomnia remedies. In addition to the pain related insomnia, I have had insomnia since I was a toddler, AND the location of my tumor causes it to mess with my circadian rhythm.

I know that I'm not the only one who does it, but I frequently want to kick my own @$$ for repeatedly calculating how much time I would get to sleep if I fell asleep right now... or right now... or right, well you get the picture =P. This is one of the most self defeating habits of insomniacs, but, if you're anything like me, you simply can't help it!

Personally, I find this unpredictable sleep one of the most frustrating aspects of life with CP/IP because it makes it extremely difficult to schedule absolutely anything.

I feel like this post needs a conclusion, but I can't for the life of me figure out what that should be, so I'll simply wish you all happy slumber.

-Steve

Update- May 16, 2014

I haven't posted an update in a while and I haven't posted a link in three days, so I felt that this post couldn't wait any longer.

As some of you may know, my wife and I have been fighting CYS for a very long time. First, they called us drug addicts and said that we didn't need opioids or benzodiazepines. Once we disapproved that several dozen different ways, they decided that we're too ill to care for our daughter (disability is not legal grounds to take a child anyway). So, we've been disproving these most recent ridiculous allegations.

Honestly, they're pissed that we didn't cave and agree to discontinue our medically necessary medications. They don't like our young age or our knowledge of our medical conditions. They've wasted thousands of dollars on things like weekly GC/MS UDT (urine drug testing, ~$200/week).

Now, we are walking up to the school that our daughter will attend next year twice a day to prove that it will not be an issue. I honestly thought that it would be more difficult. We started Monday morning and haven't had any problems. We're almost halfway done with our two weeks of this ridiculousness and I've only noticed  a mild increase in my pain and no loss of function.

I am so thankful that our PCP has really had our backs. So many doctors would have jumped ship and abandoned us, but he refuses to allow himself or his patients to be bullied by these imbeciles.

I'm so thankful for such a caring family physician. Although he's received training in pain management (as well as Suboxone),  I find it impressive that he is willing to go through the hassles of being our doctor. At my most recent appointment, I thanked him for everything he's done, but instead of accepting any praise, he apologized for not being able to find a pain management doctor. He acknowledged my need for a higher level of care (specifically an intrathecal pain pump).

My pain hasn't improved since moving or since winter ended, but I'm functioning so much better than I was before we moved.

Steve

Update/Insomnia

It's 10am my time and I'm officially giving up on sleep. I miss the days when I could sleep for more than 2-3 hours at a time, not that I've ever been able to sleep when I want. My insomnia started when I was still in a crib, it's my first memory. Of course, my insomnia only got worse as my pain worsened. I developed childhood Fibromyalgia and then brain cancer. The brain cancer caused severe migraine-like headaches and worsening pain... all of which has worsened my insomnia (which worsens pain) to the point where 4mg of lorazepam AND 8mg of Rozerem don't help me get to sleep without the additional help of 2-3 4mg tizanidine/Zanaflex. It shouldn't take six pills to get to sleep! Worse yet, it only gets me  a few hours.

Steve

April 29 Update

As you may have noticed, I haven't been posting a lot of personal information lately. I've been stretched a little thin and my family comes first. Unfortunately, that means that my blog has been conning second. Aside from when I was sick, I've been extremely careful not to completely abandon this blog because many people have told me that they've benefited from my experience and knowledge. Unfortunately, the easiest posts are links to useful information, which I've been making heavy use of.

Since moving to a healthier home and experiencing a reduction in stress, my pain has been much easier to manage. Although my pain rarely drops below 5/10 (averaging 6-7/10 & still experiencing flares of 10/10), I've been much more active. In the past 48 hours, I've taken my daughter to two parks, played Frisbee, and played Wii Sports Golf, Bowling, & Baseball. I was exhausted by the time that I went to bed last night, but it was so worth it!

I'm still not able to go back to work or college yet, but I'm once again able to fully care for my daughter, including running around the park & playing Frisbee.

The pain in my legs last night made me miss the relief that methadone (not to mention Actiq/fentanyl lozenges & intrathecal morphine gave me. Thankfully, I've been able to recover amazingly with a single night sleep.

Steve

Mini-update

I felt bad for not updating much lately, so here we go. My doctor increased my clonidine patch to two clonidine 0.3mg/day patches (0.6mg/day). In short, it made me sleepy for two days, and extremely weak for a week. I'm recovering now, but I'm worried because my legs still hurt. On a positive note, it is helping with other symptoms, like my headaches.

Christmas was hard, but I'm surviving. I'm praying that Santa was a little late with my Christmas wish,  a pain doctor willing to manage my pain. Maybe, my future PM doctor is waiting for New Years and their New Years revolution to help more Medicare & Medicaid pain patients.

I wish everyone a happy, pain-free New Year

-Steve

P.S. Got a Canon EOS Rebel T3 digital SLR for Christmas. I haven't had a chance to play with it because it was just delivered yesterday thanks to FedEx taking THREE WEEKS to deliver it. I'm so excited! Remember, hobbies are great distraction techniques.

Clonidine patch

I received my first box of clonidine patches today. I opened the box to find 4 clonidine 0.3mg/24hr patches and 4 foam overlays (personally, I prefer occlusive dressings, but these work alright).

I placed roughly a third of a patch out of an abundance of caution and in seven days, I'll use the roughly 2/3 patch, then go to full patches.

When I started the pills, I had very little side effects, but I'm experiencing significantly more sedation than previously. Despite a reasonable amount of familiarity with this chemical, I'm a little freaked out.

Wish me luck...

Note: on clonidine for neuropathy & headaches

Friday Night Update

Once again, my wife and I volunteered at the local (well, 25 minute drive, ~15 miles each way) no-kill dog shelter this evening. Unfortunately, we had some rain, which caused my body to treat the 3 hours that we spent there feel like I was out and about for 30+ hours. Around two hours in, I was feeling extremely depressed and doing my very best to hide it. All of a sudden, the weirdest looking, and cutest, dog came over and jumped up on the table next to me. He sat as close to me as possible without touching me.

Maybe it was coincidence, but I truly believe that he knew exactly what was wrong and wanted to comfort me, but didn't touch me for fear of causing me additional pain.

While everyone else just thought that I was taking a break this dog knew not only that I was distressed, but that I was dealing with a lot of pain, even more so than usual.

-Steve

Update + Sex & CP/IP

I once again feel the need to apologize. My posting has been limited lately.

As winter draws nearer, the child weather worsens, and so does my pain. The opioids only do so much and distraction techniques must pick up the slack. Unfortunately, some of the most effective distraction techniques will exasperate my pain. My wife and I have been volunteering at the local no-kill dog shelter. This is both a great distraction and a great way to add meaning to a life of unemployment. The unfortunate part is the side effect, the SIGNIFICANT increase in SEVERE pain.

My wife wants to volunteer much more often than I am physically able, so this thing that should have brought us together has been corrupted by intractable pain into another topic of animosity.

Pain corrupts most things that make like worth living, from work and volunteer work to dating, marriage, and sex. There's nothing that we can do to stop it, but that doesn't mean that we shouldn't try to fight it.

I never would have believe that at age 24 I would need to take multiple pills (breakthrough opioids and sometimes a muscle relaxer) in order to have sex. I used to save my Actiq for the end of the day because they allowed me to perform closer to the way my wife remembered before IP took over my life. Was I still able to go for six to ten hours, hell no, but two hours was no longer out of the question. Having sex half of a dozen (occasionally up to a dozen) times a day is also a pre-CP/IP pursuit, but twice in one day and three or four days a week is possible with carefully timed opioids. *quick note: Sex is a great distraction technique when the pain gets really bad, although it can also exasperate pain flares*

I believe that the biggest reason that untreated CP/IP destroyed marriages is that it destroys the closeness that comes from sex. I'm not saying that cuddling up and watching a movie doesn't have a similar effect, but everyone needs their own ratios of each. It's a lot easier to deal with a spouse (or significant other) who is grouchy from unrelenting pain if they make you feel special.

When my doctors first cut my fentanyl patches in half and eliminated my Actiq and methadone, I gave up on life. Everything suffered, especially my wife's and my sex life. We both felt like I wasn't contributing and my wife grew to resent all of the little things that she does to make my life livable. As time went on, either of us felt very sexy or sexual and several times per day quickly dropped to 2-3 times in the first month and 4-6 times the next month. Thankfully, my doctor started to realize that he was killing me and increased my pain medication. It was at that same time that I realized that it wasn't just our sex life that we had abandoned, it was most of our relationship. When you're bedbound from pain and there are multiple known cures (to being bedbound from pain, they're only treatments to the pain itself), you get depressed and lose the will to live- not sexy.

I originally had a point beyond describing the hell that is CP/IP, but I've forgotten what that is. So, I'll end with these thoughts
1) CP/IP will corrupt everything good in your life, you can't stop it, but you can minimize it's effect
2) sex is an important part of relationships, try not to let pain eliminate it from your life
3) when sex isn't an option, there are other ways to maintain closeness- USE THEM
4) without intimacy (sex, cuddling, etcetera), relationships are doomed to fail
5) tell your doctor what CP/IP is taking away from you (even if it is as embarrassing as sex), it makes it real for them
6) All men AND WOMEN with CP/IP should have testosterone levels checked, especially if you're experiencing a loss of interest in sex

Steve

P.S. I hope that everyone is in minimal pain and handling the changes in weather and the holidays without too much excessive stress.

Another ER visit

I haven't been online much lately because I've been exhausted. On Friday, my wife and I volunteered at a local dog shelter for three hours and I WAY overdid it. I missed everything we had planned on Saturday. On Sunday, we volunteered for about eleven hours, but  I made sure that I sat most of the time (not easy for me). I washed and folded laundry, except when we took the dogs to Petco, which was really easy, almost therapeutic. I felt a lot better at the end of Sunday than the end of Friday, so we planned on volunteering on Monday (didn't happen).

Yesterday, we went to the dog shelter again, but unfortunately my wife got pretty sick. She's had  a headache/migraine for days and hasn't eaten much. She was pretty dehydrated and couldn't stop vomiting, so we went to the ER. We were taken back pretty quickly because of her cardiac history, but they left her in the room without the nurse or CRNP checking on here for over AN HOUR!!! Even once the doctor ordered the IV Zofran, Toradol, and saline it took over half an hour before they gave it to her (I had to page the buses station repeatedly). The ER want even busy! They're usually at 200% capacity (patients in hallways), but they were only at 50-70% capacity.

They discharged her without her having eaten anything

The b!tch nun that came in to discharge was extremely rude when we asked for the sandwich and ginger ale that the CRNP said she could have. She got a ginger ale. I had to give her my Zofran 8mg before we left the hospital because she was discharged so quickly.

How can you discharge a nausea and vomiting patient without making sure they can keep food down? Plus, it was 1am and we didn't have want food at home that was easy to keep down, so we had to stop and buy her something on the way home.

ERs need to stop rushing patients out the door before making sure they're okay, ESPECIALLY when they don't need the bed.

I wonder if they do it to everyone. My wife has a capitated Medicaid HMO and I have Medicare Parts A&B as primary and traditional Medicaid as secondary. Has anyone else experienced this? If so, what type of insurance do you have?

She's doing better now, thanks to my Zofran (her insurance refuses to cover it). She's been sleeping ever since, except when I wake her up to take her meds.

To be completely honest, if my ER hadn't helped her, I was ready to go out and find her some cannabis so that she could eat and drink and break the cyclical vomiting cycle. She's become acidotic from this before, so I was pretty worried. Thankfully, their 2mg of IV ondansetron and 990ml of 0.9% NaCl solution (saline) helped her enough that she could keep down 16mg (8mg*2) of oral ondansetron, then some real food.

Steve

Paying for it

I spent a few hours volunteering at the local animal shelter yesterday. I WAY over did it yesterday, and now the nerves in my legs are on fire. I can practically trace the nerves because they're so inflamed. I missed our weekly outing with our daughter (museums, historical society, hikes, parks, carnival, Army war college, etcetera) this morning. This afternoon, I didn't get to go to the animal shelter (my wife still went and helped for two hours). And now, I'm missing out on going out with some of the people at the shelter (my wife got both of us invited while  I slept and she volunteered).

I'm not sure which is more frustrating
1) constant, unrelenting pain
2) inconceivable BTP (breakthrough pain) flares
3) missing out on everything (family stuff, social stuff)
4) NO ONE gets it

I think the worst part of this is that none of this is necessary! I'm in pain for no legitimate reason. My pain was under control (bad, but under control) with low dose methadone, Actiq, Duragesic, and oxymorphone. My pain was virtually eliminated with 3mg/day intrathecal morphine. I feel like the one sane person in a world of crazy. I feel like I'm screaming and no one is listening. I'm in excruciating pain, there's medication that can fix it, I'm insured, my insurance will cover Duragesic, Actiq, methadone, oxymorphone, AND an intrathecal pump, I have NO risk factors (including NO family history) for abuse, I don't smoke, I don't drink, I've never abused my medication, I've never been high, I have cancer, I'm dying, I've never run out of meds or needed an early refill, I've tried EVERY non-drug treatment recommended, I've tried every non-opioid, I've tried every single weaker opioid, I'm beyond compliant, I keep myself informed (as instructed, although it's being used against me now)... and, STILL, I'm treated like shit and get inadequate treatment.

How does this make any sense to anyone?

Steve

Update- October 28, 2013

I realized that I've let some of you down by failing to post much more than links. For that I apologize, I owe you all some original content.

I decided to start out by updating you on hope I've been doing. Unlike most weekends, I didn't spend hours at the park, library, or historical society with my dad, wife, and daughter. Still, I'm in excruciating pain, as if I'd run a marathon. The clonidine isn't helping with the leg pain at all. Despite the fact that I can still walk sort distances and don't have paralysis, I know that I'll soon require a wheelchair because of the weakness and pain in my legs.

The opioids that my PCP (or anyone else) is willing to prescribe exclude three of the most efficacious medications, methadone, Actiq, & intrathecal morphine.

There's something that I've been considering that I am very much against overall. It has become extremely obvious that no one is going to come to my rescue. No one will prescribe what I need and no one is willing to manage an intrathecal pump on a patient like me. I am a high risk of litigation because when I die, there will be no way to prove that the tumor killed me, not the high dose opioids. Actually, the inadequate analgesia itself could cause my death (through stroke, heart attack, or even aneurysm) thanks to the constant overdose of cortisol and epinephrine/adrenaline.

I have many types of pain throughout my body. Most of it originates in my spine, brainstem, and/or brain. Most of the pain responds to mu-opioids. Unfortunately, my leg pain only responds to intrathecal mu-opioids and methadone.

Methadone is a mu-opioid, like morphine, codeine, fentanyl, sufentanil, alfentanil, oxymorphone, oxycodone, hydromorphone, hydrocodone, and others. Methadone is also a kappa-opioid and NMDA receptor antagonist. Both kappa-opioid and NMDA receptor antagonists are extremely effective in treating neuropathic pain. Contrary to popular belief, Neuropathic Pain DOES respond to mu-opioids, HOWEVER it requires significantly higher doses than other pain types. For patients, like myself, that were born with a high tolerance to opioids, all pain requires a higher dose of opioids, but neuropathic pain in patients who already require high doses requires higher doses than most doctors are willing to prescribe. Low dose methadone on its own doesn't help me with most of my pain and only partially reduces my neuropathic pain, but, when added to my fentanyl regimen, it almost eliminated my leg pain and somewhat improved my other pain.

For those of you that don't know, intrathecal pumps deliver medication into the spine (one layer deeper than an epidural). Unlike an epidural, they use opioids only or mostly opioids. They use little or no buprivicane, so you can still walk and feel your limbs. Morphine is the FDA approved opioid for intrathecal pumps (although fentanyl, sufentanil, alfentanil, hydromorphone, and methadone can also be used; hydromorphone and fentanyl are the most common off-label intrathecal opioids). ONE milligram per day of intrathecal morphine is ROUGHLY equivalent to
* 300mg/day oral morphine
* 180mg/day oxycodone
* 90mg/day oral oxymorphone
* 9mg/day IV/IM/SubQ oxymorphone
* 48mg/day oral hydromorphone
* 3-6mg/day fentanyl
* 125-250 mcg/hr fentanyl

While intrathecal morphine is 300x stronger than oral morphine, the side effects are not. I cannot tolerate 2mg of IV/IM morphine or 5mg oral morphine without my throat swelling up and a drastic increase in painful muscle spasms and my neurosurgeon knew this prior to my intrathecal morphine trial. He still decided to use morphine in my intrathecal trial. Even at 3mg/day (0.125mg/hr) intrathecal morphine (equivalent to 900mg/day oral morphine), I had ZERO side effects.

Back to my point, I'm considering making an appointment with the local interventional pain management doctor who treated me pretty well, despite his interventional only attitude.

I'm curious to know if any of you have any experience with injections for neuropathic leg pain. I'm afraid that it could make the pain even worse. I'm definitely against multiple longterm injections of steroids, but even a single injection of just the numbing agent (lidocaine or similar) carries risk. I'd love to read your feedback.

Speaking of feedback, I have been receiving reports of problems with Blogger's native commenting system, so I decided to switch to a third party system. The system that I chose is called Disqus. It does require login, but you don't have to sign up with them, you can login with your Facebook, Twitter, or Google account. You have to authorize Disqus to let you login with your social media account, but it's a onetime, quick, and easy. Please let me know what you guys think. Thanks.

If anyone would like to share their stories or ask any questions, please don't hesitate to email me or comment below.

Steve
IntractablePainKills@gmail.com

Clonidine, yet again

I took my clonidine again eight hours ago and I'm tolerating 0.05mg well. Even now, I'm noticing mild improvements in neuropathic pain and PTSD. Unsure about headaches, they fluctuate too much to be able to tell so soon.

Doing alright overall, sick of the cold and ready for Spring already! I can feel the depression from SAD already =(

My wife was finally able to get her prescription for oxymorphone filled. She seems to be doing a little better. Unfortunately, I passed her sore throat back to her before I got rid of it.

Thanks

Steve

Clonidine, again

So, thanks to the killer headache after my first dose of clonidine 0.1mg (100mcg), I decided to only take 0.05mg (50mcg) last night. No headache and it did help me sleep, but didn't hit me like a brick wall. Also, I noticed since I woke up today that my neuropathic leg pain is less severe than usual. Of course, this could be part of the natural fluctuation of pain, but I'm hoping that the medication is helping.

I'm about to take my third dose and I'm worried that I'll have another bad reaction. So, fingers crossed.

I hope everyone is doing well and in minimal pain.

-Steve

You've got to be kidding me

So, today is my 24th birthday, but instead of doing something fun, as I had planned, I'm spending my birthday in bed (not in the good way).

My throat is killing me!

I wanted to update you guys with something lighthearted and fun to lift the mood of this blog, but I can't think of anything at the moment because of this stupid sore throat. For that, I apologize.

I hope that all of you are doing well and having minimal pain.

-Steve

Sleep, or lack thereof

Recently, I have experienced a SEVERE increase in insomnia, despite multiple sleep aids. This inspired me to write a post on insomnia.

First, anyone experiencing insomnia should mention it to their doctor because undertreated pain can cause insomnia and insomnia worsens pain.

Talking to your doctor about your insomnia doesn't mean that you need to take medication, but they need to know. Plus, if you do need medication, they'll know that you've tried other things and that it's not a brief bout of insomnia. The doctor can discuss non-drug treatments with you including better sleep habits and

I don't believe in using dangerous psychiatric drugs, like antidepressants (especially trazadone) or antipsychotics (risperidone/Risperdal, Seroquel) for sleep. It's every patient's personal choice, but I developed permanent tardive dyskinesia from it low dose, short-term risperidone/Risperdal as a child. Seroquel caused night terrors

There are many treatments for insomnia that should be considered.

Melatonin
* Melatonin supplements
* Rozerem

Barbiturates- rarely used anymore

Benzodiazepines
* lorazepam/Ativan
* alprazolam/Xanax
* Valium/diazepam
* and countless others

OTC Medications
* diphenhydramine/Benadryl/Unisom- the generic Benadryl is IDENTICAL to Unisom, don't waste your money
* Tylenol PM- DO NOT TAKE FOR INSOMNIA, take diphenhydramine; this medication is intended for occasional treatment of pain & insomnia, but leads to the overuse of acetaminophen/paracetamol/Tylenol
* Advil PM- DO NOT TAKE FOR INSOMNIA, take diphenhydramine; this medication is intended for occasional treatment of pain & insomnia, but leads to the overuse of ibuprofen

Z-drugs
* Lunesta/eszopiclone - this is an overpriced waste of money and should only be used as a last resort, after cheaper, equally or more effective drugs have been tried; this is the left hands isomer of zopiclone (clinically the same drug)
* Ambien/zolpidem - this is a very useful medication, but some idiots took Ambien CR and drove less than six hours later, which caused the FDA to recommend limiting the dose to 5mg, especially in women; many doctors are unwilling to go to the more effective 10mg dose, even if you don't drive and the 5mg was worthless
* zopiclone/Imovane/Zimovane/Imrest
* zaleplon/Sonata

Steve

Update

My wife and I had our quarterly checkup with our PCP Wednesday night. As some of you know, my wife and I are under-medicated because of a number of factors, including Opiophobia, the semi-recent increase in the War on Drugs, and the fact that our PCP also does Suboxone (treats addicts).

Our PCP still refuses to increase our Duragesic. My wife was switched from OxyIR to oxymorphone, after months of requiring that multiple doses of OxyIR 30mg. He wasn't as stingy as when he put me on oxymorphone, but her pain is finally diagnosed (EDS, type 1 & 2), but he still a bit stingy.

After 7-9 months of begging for an increase, he finally increased my oxymorphone again. It's still nothing collapsedl compared to the Actiq that he refuses to prescribe since he's started doing buprenorphine/naloxone treatments (generic Suboxone and Suboxone film, mainly the film according top the literature the drug reps litter the office with). That is also why he refuses to use methadone for pain management.

Wow, off-topic, sorry. Still waiting on insurance approval, fingers crossed that we get approved and that these help.