GP pain management appointment

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I saw my GP this morning about my pain medications and dosages. I booked a long appointment so we could discuss everything.  He started off very hard line,  but quickly softened.  I looked like poo.  I had about two hours sleep last night. Tired. Very foggy.  And we could both hear all my joints crack whenever I moved anything.  I’m convinced he’s under pressure to lower my doses, and it’s not coming from him.  He was very understanding, in fact.

So the plan is:

  • Try to keep to only two 20mg targin (slow release oxycodone and naloxone) per day. I regularly take three per day, because they don’t last the full 12 hours.  More like eight hours.
  • Try to keep to three 10mg oxynorm (immediate release oxycodone) per day. I usually take four, and on knockdown days, up to six. He just asked me to try.  He wrote a script for four per day so he has covered me if I can’t stick to the lower dose.
  • I told him that Naprosyn really does help, especially with my spinal pain. He agreed that I can take Naprosyn 500mg up to twice a day, and
  • He has added in another blood pressure medication to get my blood pressure lower. It is a little high – he measured it at 145/95 this morning – but not dangerously so.  We would both be more comfortable with it lower, especially as before I started biologicals, my ‘normal’ BP was 110/60.  He said we could expect Naprosyn to raise it by ten points, so the second medication is needed to keep it better controlled. I’ll have it checked again next month and we’ll see.
  • He has prescribed Stillnox for sleep. I prefer Valium, because when I have horrible PMS Valium calms me down most effectively.  And I find it excellent for sleep, so it does double duty.  I only take it about for about a third of the month, but he won’t budge on not prescribing benzodiazepines and opioids together.  Fair enough, I’ve read enough about the dangers not to argue.

All in all, an excellent appointment.  I’m in a better frame of mind today (hard to believe after two days of crippling pain and no sleep) but there you go.  I’m happy with the plan, and he’s happy with the plan.

We also discussed prednisone, and he agreed I have adrenal insufficiency from long term prednisone use. While there are ‘better’ corticosteroids for adrenal insufficiency, he couldn’t see a huge benefit in switching. So I’m going to try tapering at a quarter of a milligram per month now.  He told me when the wheels start falling off, to come and see him and we’ll reassess from there.  He also reminded me that I need a bone density scan.

I also had paperwork that he needs to fill out every year to say that I am capable of driving, which he did.  So I am roadworthy for another year.

And he tried to get the results from my Lumbar Puncture.  All he could get was the high protein levels (High Albumin, high IgG) in the Cerebral Spinal Fluid.  There are more results, but they weren’t faxed through.  I’ll have to chase them myself, or wait until next week when I see my neurologist and get a copy from him.

It was a long appointment, very thorough.  We even discussed joint hypermobility, and my kids and their current medical issues.  He took all the time we needed, and didn’t rush.  I’m happy. He’s happy. The plan is workable for us both.  Win/win.

And now, a nap.

6 COMMENTS

  1. Good news! I”m happy! I have no idea why all of a sudden Drs are resistant scripting oxides . I swear it is a political thing or a pharmacy company thing. But I have heard this now from several countries. And it seemed to happen all at the same time. I had a dr who understands pain thank goodness. HEY, let’s all have a good 24 hours

  2. I am sorry about the prednisone issues. I can not take it because it wrecks my blood sugar. Unfortunately (or maybe fortunately) I have not used prolonged prednisone treatment. What I do think is that in a case like yours the stronger pain relievers are absolutely called for.

  3. I’m so glad that this apt went so well, I know how worried you were. Good to know that he took his time and went over everything and is still covering your ‘potential’ needs should you not be able to cope on the lower doses. I’ve had a really rough week myself and trying to make those doses stretch the full 6 hours (di-hydrocodeine) is a bitch on days like that. I did relent and ring my docs to get a short 2 week burst of pred as my costo has just been awful lately and I’m in desperate need of a break if only for a few weeks, so just waiting for that to kick in good now, maybe today fingers crossed!

  4. I have just been diagnosed recently and my first appointment is next week with the rheumatologist.. I’m in a lot of pain and I’m considering asking him to approve me for medical marijuana because I heard great things about the CBD oil to rub on your joints …I consider this much better than having to take Oxycontin for the pain. Also the chews which are supposed to help you sleep…. actually I’ve tried the chews (illegally) and they are amazing

    • I would love to try medical marijuana, but its not legal here yet. I’ve heard good things too, and given you have had a good result with the chews, I hope you can get some legally! Let me know how you go, I’m really interested in mmj, and haev a lot of hope for it! Good luck!

    • I have tried it for pain. And while it did not stop my pain, it DID relax me to the point that the pain was much reduced. So…win win! I say if you can get it, get it.

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