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Is this an actual PM Doc? What is your prognosis? Are you expected to recover @ some point, or will you be chronic? The reason I'm asking is that @ some point, most PM docs usually move patients to some form of long acting (LA) med, unless the condition is deemed short term. When you take a short acting (SA), the med is released immediately into your blood stream and your blood plasma level (BPL) peaks very quickly.Then, it quickly declines. Most pain meds are 4-6 hours, but after tolerance sets in, it's not unusual for the same meds to last 2-3 hours. The transition to this lower time frame is usually slow in nature and gradually becomes shorter and shorter acting. Conversely, when you take a LA med, your BPL stays elevated over the entire day. This eliminates the "ups and downs" that invariably accompany SA meds. Once the "ups & downs" start to kick in, they become more intense and happen more frequently, as the time in between SA doses gets longer. For example purposes, if one reads the patient prescribing white paper that comes with Oxycontin, Purdue Pharma reports that their research shows that 10mg of Oxycontin every 12 hours results in a higher BPL than 5mg of Oxycodone IR taken every 6 hours. Same amt of Oxycodone over a 12 hour period, but the LA med results in a higher BPL. Once PM Docs move patients to LA meds, they often also keep some SA meds in the regimen for BT pain, or "flare ups." BT meds are needed most of the time because pain doesn't always cooperate and stay steady all day long. I'm not suggesting that you go in and tell your Doc that you want some form of an LA med.But you could probably "hint" to the fact. For example, you could tell him that your pain is still not being resolved and that you seem to be having more "flare ups" and lots of ups and downs. I'd tell him that when you take the med, it's works ok, but as soon as it wears off, you're in bad shape. This type of feedback should have LA med written all over it. I would think that increasing the current SA med you're on, or increasing the frequency (doses) would maybe result in some short term benefit, but very quickly, return to the same issue yo 1000 u have now. Hope this helps and best of luck to you. Regards, Ex.
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