Eva 33
Bluelighter
I'm prescribed opiates for pain management. My pain doc is very nice and understanding. My pain levels really can be excruciating, but the opiates do help a fair amount.
I got some great advice on this forum re: Exalgo, the new long-acting form of Dilaudid. I still am only on a low dose of Exalgo, so it will need to be titrated up when I next see my pain doc. At least Exalgo doesn't cause the terrible sweating that I was getting from oral morphine, so that's a huge plus!
I wanted to ask about the best and strongest opioids for breakthough pain. My current pain is so severe that on top of the long-acting Dilaudid (Exalgo) I need to take the following meds for breakthrough pain: Dilaudid suppositories----the 3 mg. ones. I also take phenergen suppositories for the migraine nausea. I take 3 of each every day. Taking suppositories is inconvenient and they need to be refrigerated, so I don't know what I'd do if I ever took a trip to the tropics. But Dilaudid and most every other oral pain med has such poor bioavailability that's it's no wonder I need the Dilaudid suppositories to get my pain under control.
My other breakthrough pain med (usually taken once daily) is Dilaudid injectible, given via IM injection. Again, my pain is so severe that I absolutely need this, and am very grateful to have found a pain doctor who is willing to prescribe it. However, I'd been taking morphine injections prescribed by my neurologist for several years before I began seeing my pain doc. Morphine IM and Dilaudid IM work equally well. There was a recent shortage on morphine injectible, so that's why I was switched to Dilaudid injectible.
The Dilaudid injections are my most powerful pain med, with the Dilaudid supps being my second most powerful pain med. I really wouldn't want to give either of these up by asking for something different, but I would at least like to know what's out there. I've already done a fair amount of research into opioids, so I do have a couple of ideas.
Actiq or Fentora (fentanyl lollipops) would presumably be an option, if my pain doc can get my insurance to cover them. My pain doc told me that they would be just about as powerful as my Dilaudid injectible, but I have some doubts about that. Perhaps Actiq could replace my Dilaudid supps, but I hate to give those up, too. I still have to take the Phenergen supps to control nausea.
I saw something called "Subsys", which is fentanyl sublingual spray. How effective are the transbuccal meds like Fentora or Actiq for pain? I know they give them to cancer patients, so presumably they are pretty effective.
I have a high tolerance for pain meds. Sometimes I think I'll never get this pain under control. I wish I could have the dilaudid injectible, the dilaudid supps, AND the Fentora, but perhaps my pain doc would think that's just too many powerful pain meds. I have no doubt that I could handle it, especially with my high tolerance.
I guess I just wonder if there is something that I can take for breakthrough pain besides the dilaudid suppositories? I wouldn't mind using those in my everyday life, then on the rare occasions when I venture out of the house for a prolonged period of time having something else to take in place of the suppsositories, like Actiq or Fentora.
My pain doc is pretty compassionate, but does this sound like too many pain meds for one patient? I've always complied to the letter with my pain doc and he absolutely trusts me. I think the DEA bureaucrats may scare him....I don't know.
Just wondered if anyone has any suggestions for STRONG oral pain meds that I might be able to take in place of the dilaudid suppositories. Thanks for any info or advice!
Eva
I got some great advice on this forum re: Exalgo, the new long-acting form of Dilaudid. I still am only on a low dose of Exalgo, so it will need to be titrated up when I next see my pain doc. At least Exalgo doesn't cause the terrible sweating that I was getting from oral morphine, so that's a huge plus!
I wanted to ask about the best and strongest opioids for breakthough pain. My current pain is so severe that on top of the long-acting Dilaudid (Exalgo) I need to take the following meds for breakthrough pain: Dilaudid suppositories----the 3 mg. ones. I also take phenergen suppositories for the migraine nausea. I take 3 of each every day. Taking suppositories is inconvenient and they need to be refrigerated, so I don't know what I'd do if I ever took a trip to the tropics. But Dilaudid and most every other oral pain med has such poor bioavailability that's it's no wonder I need the Dilaudid suppositories to get my pain under control.
My other breakthrough pain med (usually taken once daily) is Dilaudid injectible, given via IM injection. Again, my pain is so severe that I absolutely need this, and am very grateful to have found a pain doctor who is willing to prescribe it. However, I'd been taking morphine injections prescribed by my neurologist for several years before I began seeing my pain doc. Morphine IM and Dilaudid IM work equally well. There was a recent shortage on morphine injectible, so that's why I was switched to Dilaudid injectible.
The Dilaudid injections are my most powerful pain med, with the Dilaudid supps being my second most powerful pain med. I really wouldn't want to give either of these up by asking for something different, but I would at least like to know what's out there. I've already done a fair amount of research into opioids, so I do have a couple of ideas.
Actiq or Fentora (fentanyl lollipops) would presumably be an option, if my pain doc can get my insurance to cover them. My pain doc told me that they would be just about as powerful as my Dilaudid injectible, but I have some doubts about that. Perhaps Actiq could replace my Dilaudid supps, but I hate to give those up, too. I still have to take the Phenergen supps to control nausea.
I saw something called "Subsys", which is fentanyl sublingual spray. How effective are the transbuccal meds like Fentora or Actiq for pain? I know they give them to cancer patients, so presumably they are pretty effective.
I have a high tolerance for pain meds. Sometimes I think I'll never get this pain under control. I wish I could have the dilaudid injectible, the dilaudid supps, AND the Fentora, but perhaps my pain doc would think that's just too many powerful pain meds. I have no doubt that I could handle it, especially with my high tolerance.
I guess I just wonder if there is something that I can take for breakthrough pain besides the dilaudid suppositories? I wouldn't mind using those in my everyday life, then on the rare occasions when I venture out of the house for a prolonged period of time having something else to take in place of the suppsositories, like Actiq or Fentora.
My pain doc is pretty compassionate, but does this sound like too many pain meds for one patient? I've always complied to the letter with my pain doc and he absolutely trusts me. I think the DEA bureaucrats may scare him....I don't know.
Just wondered if anyone has any suggestions for STRONG oral pain meds that I might be able to take in place of the dilaudid suppositories. Thanks for any info or advice!
Eva
