So, yeah. I may have overreacted. I am in a fairly high level management position (am I allowed to say that?), and I guess I have grown accustomed to an entirely undeserved deference from people who don't know me. Having said that, I am also experiencing some crazy mood swings due to the stew of mediations I am currently taking -- the opiates are the least of it. I have been experiencing some entirely uncharacteristic meltdowns like this, but way more intense lately, which is causing problems with friends and family, and has precipitated a request for a medical leave of absence to try to get my health issues under control.
But ... your post above is right on. I commend you. I appreciate competence in any medium, and you really know your stuff. The bottom line is that I didn't know I had liver disease until recently. I suspected, but I was just diagnosed with NASH several days before I posted. So, very upset about that, on top of all the other chronic diseases I am dealing with, and I escalated rapidly and inappropriately to your comment. Sorry. I talked to my pharmacist of ten years, whom I trust implicitly, about my concerns. I realized that he couldn't possibly know about the NASH diagnosis, since I wasn't taking any meds for it. Once I told him, he strongly suggested that I tell my doctor I needed -- you guessed it -- roxicodone. I had to laugh. He said it made the most sense by far, given my liver, and other conditions. He talked a lot about the effect of APAP, even on a healthy liver. He is quite passionate about the subject. LOL. Who knew that my mild-mannered pharmacist is vehemently opposed to the practice of loading pain killers with filler like APAP that do nothing -- his words -- except cause liver problems in people who shouldn't have liver problems. He's quite the crusader on this subject. I had no idea.
Anyway, thank you. Excellent advice. I have an appointment with my doctor in June and I will be asking her about Roxicodone at that time. To date, she has been extremely accommodating whenever I ask for specific pain medications, so I am hopeful that this will not be an issue. She has suggested both morphine and methadone in the past, but I do not want to go down that path for various reasons.
Again, this board has been extremely helpful. I wouldn't even have realized that I apparently suffered from an APAP overdose last month if not for this board. I thought I just had a norovirus, but it went far beyond any flu I've ever had. After reading the warning signs of APAP toxicity here, I realized there was little doubt that I had ODed on APAP. I am so lucky that it did not progress past the first stage to the second or third, but I am far, far more careful about tracking my dosage now. Right now, I'm at or just above the 4000 recommended maximum grams of APAP per day, which is really not good with pre-existing liver disease, I know, but will have to work until I can talk to my doctor in June. My pharmacist seems to think that waiting until June will be fine, but he doesn't realize how much vic I'm taking (friends and family provide me with all the norcos I need, plus my script is for 240 a month). Given the dosage info I have provided, am I at greater risk than I realize? I can talk to my doctor's PA about switching to Roxicodone, but I'd prefer to wait and talk to my doctor FtF, unless I'm going to need a liver transplant if I keep this up. Any recommendations on whether to wait or not will be very much appreciated.
So, now I've gone completely O/T, sorry. Just wanted to acknowledge the wisdom of your advice, apologize for my temper tantrum, thank everyone here for their expertise, and, hopefully, find out if I need to request a change to roxi right now instead of leaving it until June. Again, thanks.