Changing Medications (Level of Trust Required)

[Darth Fluffy 302]

Glad it went well.

[mlooney 3,417]

CW: Poop

For reasons dealing mainly with lack of energy, I've been living on instant breakfast, milk, and tea with a bowl of cereal about every other day.  Why the hell do I have just this side of constipated bowel movements?  The iron supplements I've been taking are supposed to be "non constipating"  I'd really like to have a morning that after I do my morning constitutional my ass wouldn't hurt for several hours after.  I take Metamucil daily so it's not lack of fiber, or at least shouldn't be.

[ProfessorTomoe 1,308]

I've just been through a time span from hell. Seriously, I can't really remember the exact length of it. Let me think...let me reconstruct the whole mess.

I went to my pain management doctor's assistant and asked to be put on a stronger dose of my current pain medicine, which was Dilaudid (I was at 5mg every 4 hours). She didn't have the authority to increase my dose, but she did have the authority to rotate me to another pain medicine of the same strength. So, she put me on Morphine, 30mg every 6 hours. This appointment was on October 11th. We couldn't pick up the prescription until October 21st, 10 days later, due to problems with the pharmacy getting the pills in stock. So, I took my first dose on Saturday, October 11th.

The side effects set in slowly, and as a result we didn't know what they were. They were also mixed in with the onset of an upper respiratory infection, which further confused things. I was coughing up phlegm, I couldn't breathe through my nose, my equilibrium was off, I had hand jitters that made holding things difficult, and I couldn't sit still without my stomach clenching up on me. They didn't all set in at once, of course, but by Saturday, October 28th, things were bad enough that I needed to see a doctor. Since it was a Saturday, I first tried a TeleDoc service from my insurance company. Things were apparently bad enough that they didn't want to really deal with me, and they passed me off to Urgent Care. I went to an Urgent Care place, where they treated me just for the upper respiratory infection symptoms. I got a "Z-Pack" for that, plus pills and a syrup for the cough. For everything else, though, they told me to see my pain management doctor.

I called my pain management doctor's office the following Monday (the 30th) and explained the symptoms. Surprisingly enough, I got an appointment the very next day(!!!) with the doctor himself, not his assistant - something extremely rare in that practice. So, on Halloween Day (the 31st), I found myself sitting in the pain management doctor's appointment room. He was very receptive to my needs after hearing what I'd been through. He took me off of Morphine immediately and put me back on Dilaudid, albeit at an 8mg dose instead of the previous 5mg dose.

Now, I'm facing a different but similar problem. I'm waiting for the pharmacy to get in a supply of 8mg Dilaudid pills. Until then, I have my old Dilaudid supply, so I'm taking two of the 4mg pills they'd been giving me (I'd been getting 2mg and 4mg pills, and I'd have to cut one of the 2mg tablets in half and take it with the 4mg tablet to equal 5mg). I'll be taking the 2x4mg pills until the pharmacy gets the 8mg pills in stock. However, after just a day off of the Morphine, I already feel better, and that's a HUGE statement. I felt so bad on the Morphine it wasn't funny. My wife was on my case constantly over the past several days leading up to the Urgent Care appointment - she thought I had overdosed at one point (I hadn't). The difference is like night and day. I'm glad to be on the upswing.

[Darth Fluffy 302]

Morphine is closely tracked as a controlled substance, so the distribution bogs down.

Glad you figured it out and are feeling better.

[ProfessorTomoe 1,308]

You wouldn't believe how much better I believe, pharmaceutical-wise. Pain-wise, however, I'm hurting more. That's the sad thing. The morphine did more for me in terms of pain relief. Everything hurts now. Everything hurts.

[ProfessorTomoe 1,308]

I am still waiting for the 8mg Dilaudid pills to come into stock at the pharmacist's. I'm not fscking believing this. I've run out of my 4mg pills as of last night, and I'm going to run out of my 2mg Dilaudid pills today. I'm going to have to go back onto the Morphine From Hell until the 8mg arrives.

And no, I can't switch pharmacies. I've already tried that. Texas law prevents other pharmacies from even entering me into their system for opiates. Aaugh. And I don't know if it would do any good to try to get the doctor to give me 2x4mg pills instead of 1x8mg - the 4mg pills are in just as short of a supply.

Give me a fscking break.

[Darth Fluffy 302]

2 hours ago, ProfessorTomoe said:

And no, I can't switch pharmacies. I've already tried that. Texas law prevents other pharmacies from even entering me into their system for opiates. Aaugh. And I don't know if it would do any good to try to get the doctor to give me 2x4mg pills instead of 1x8mg - the 4mg pills are in just as short of a supply.

I've switched pharmacies for less aggravation than that, but I never had opiates prescribed. I thought Texas was a step more Libertarian than most states, but apparently not in that. Might have to do with Federal compliance.

[mlooney 3,417]

Texas is big on The War on Some Drugs.  Pain pills, in general, are Some Drugs.

[Darth Fluffy 302]

On 11/16/2023 at 1:20 PM, mlooney said:

Texas is big on The War on Some Drugs.  Pain pills, in general, are Some Drugs.

As in : "This is your war. This is your war on drugs. Any questions?"

[ProfessorTomoe 1,308]

I have pills now. As it turns out, the pharmacy was not totally without Dilaudid 8mg tablets. They simply didn't have enough to fill my entire prescription. Rat bastards had 100 of the 150 I needed, and didn't bother to tell me until I was completely out of my 4mg pills and practically on my hands and knees begging them for a solution. They finally saw fit to give me the 100 pills and short me the 50 they didn't have. I'll have to see the doctor early for a new prescription, but AT LEAST I HAVE MOTHERFSCKING PILLS NOW, YOU CORKSOCKERS.

Jebus Christos, I hate pharmacies.

[Darth Fluffy 302]

Glad you have some relief.

[mlooney 3,417]

3 hours ago, ProfessorTomoe said:

I hate pharmacies.

Hear you there, and I don't have to get pain pills, just drugs to keep me stable.  I hate running close to out as I'm never sure what they will not have in stock.

[ProfessorTomoe 1,308]

The ball is now rolling on the surgery to fix the torn right rotator cuff in my right shoulder. I finally found a shoulder surgeon who is willing to take me on, and who is willing to work with me on sending me to an inpatient rehab center after the surgery. He seems like a very good doctor upon research and first meeting - great bedside manner, very cooperative, very willing to do his own research into the patient's background. I'm encouraged.

As it stands right now, I've got a couple of pre-op appointments with my primary care doctor and my cardiologist prior to December 8th, and then the surgery is scheduled for 1pm December 15th. It was scheduled for the 27th, but they managed to wheedle an earlier date out of the hospital. Then my right arm will be in a sling from 4 to 6 weeks while it heels (I'm not looking forward to that part). I can only hope that the immediate post-op pain will soon be replaced by post-op relief.

Watch this space for updates.

[Darth Fluffy 302]

Sounds like a breath of fresh air for you.

[ProfessorTomoe 1,308]

3 hours ago, Darth Fluffy said:

Sounds like a breath of fresh air for you.

I don't know what it's going to be, but I can guarantee my anxiety level will be out the chimney and through the roof until the moment I go under anesthesia. I've had BAD post-op experiences with medical staffs not knowing how to handle my pain levels, thanks to the pain medication I'm already on. I hit a 10 on the 0-to-10 scale post-op on my knee replacement surgery and passed out from the pain on a couple of occasions because they were giving me hydrocodone instead of hydromorphone, which is what I was on. This doctor says he's going to put in a block, so I won't feel a thing until it wears off. I'm afraid he's going to do that and forget all about the 8mg 5x a day that I take in pill form, either that or just do what some other doctors have done and give me the token 0.5mg of IV hydromorphone (Dilaudid) and call it a day. I can't let that happen to me,  not for a moment's time.

Uggh, there are so many things to take care of in this mess. I wish it were simpler.

[ijuin 572]

Just to make sure we are on the same page here, to me a 10 on pain means “wishing for unconsciousness just so that I can escape from feeling it”. Is that about what it means for you?

[ProfessorTomoe 1,308]

24 minutes ago, ijuin said:

Just to make sure we are on the same page here, to me a 10 on pain means “wishing for unconsciousness just so that I can escape from feeling it”. Is that about what it means for you?

Pretty much. I've actually passed out from the intensity of the pain when I've hit a 10 before.

[ProfessorTomoe 1,308]

Got up from my recliner a little while ago and almost fell over to my left when I tried to put pressure on my left leg. My left knee - the one with the replacement joint - damn near gave out and hurt like a motherfarker. Walking from the recliner to the bathroom was a new experience in pain. Fortunately, by the time I'd finished by business in the bathroom, my knee had finished whatever it was up to and had stopped complaining when I walked on it. I hate it when that happens.

[ProfessorTomoe 1,308]

As the date for my shoulder surgery approaches, I am being more and more pleasantly surprised by my doctor. He has personally called me concerning important matters related to the surgery not once, not twice, but three times now, as of today. The latest phone call was in response to a direct message I left for him over the patient portal system. In the message, I had asked him to kindly be extra careful when it comes to the management of my post-op pain (I've had some nightmares, as I've reported here, including the aforementioned passing-out from Level 10 pain after my knee replacement surgery). He called to reassure me that he would indeed coordinate my pain management with hospital staff and would be extra careful in the process. He also asked for my pain management doctor's name, so that he could contact him and consult with him on the best way to handle my case, since I have pains coming at me from every direction.

Never before have I had a doctor personally call me more than a single time regarding anything, and that was usually as a last resort after his medical assistants were unable to solve a problem. This doctor never let any of the situations get that far - he contacted me first, without trying to go through the M.A.s beforehand. I commend him for that, and recommend him so far for his professionalism and pre-op manner. I can only hope that his operating skills are somewhere in the same neighborhood. If they are, this surgery is going to be a worthwhile experience.

[mlooney 3,417]

This sounds good.  Hope the surgery goes well.

[ProfessorTomoe 1,308]

Saw my pain management doctor today. He's keeping me on the 8mg dose of the Dilaudid for now. The exact dosage is one to two 8mg tablets three times a day. I told him that I'm having to take the 2x dose often, especially yesterday morning when (I'll man up and admit it) I found myself in silent tears from the pain.

Mrs. Prof and I went home afterward, grabbing some fast food on the way. It made me sick to my stomach, necessitating the use of a Zofran anti-nausea pill.

I also had a small visit from the Shart Monster. Nothing messy, just embarrassing, and a harbinger of an attack of diarrhea.

I've been needing Zofran all too often lately. Every meal seems to make me queasy, and it seems like every other day or so I'm taking a Zofran. I don't know what the deal is.

[mlooney 3,417]

Shrink day. Some what major changes to my meds. Off Invega and on Latuda. See her again in 2 weeks.

[Darth Fluffy 302]

1 hour ago, mlooney said:

Shrink day.

Fits with the NP comic theme.

[ProfessorTomoe 1,308]

I'm not going to surround this with spoiler tags, because Bob Gammage, this needs to be out in the open.

I've been gathering stuff in preparation for next week's rotator cuff repair surgery (it's got me so nervous I can't even spell it properly). So far, I've got a lifting recliner chair, a left-handed ergonomic mouse (to mirror the right-handed one I have now), and one or two other things. I'm nowhere near ready.

One of the things that I do need, and which I just ordered from Amazon, is something euphemistically titled a "Toilet Aid." It's an 18-inch-long wand of sorts with a handle at one end and a gripping flap at the other end that locks. You insert your toilet paper into the flap, grip it and lock it into place, then make use of it. When done, there's a button on the handle that unlocks the flap and releases the paper into the water, completing the cycle. Repeat as necessary.

This *is* necessary, because I will only have one working arm (my left one) after the operation, and I'll only have very slight use of my right hand to either grasp the wand or insert the paper, one or the other (haven't figured that out yet). The post-use hygienics are still in question as well, but will probably involve a small bucket of bleach-treated water and another dry bucket.

I've got to think about this stuff, man! I'm going to have to live with it for a good six weeks while my right arm is in a sling. I don't like it one bit, but I prefer putting up with this crap to putting up with the pain in my shoulder that I have now. I mean, today I've had to max out and take the two-pill dose of my Dilaudid. That's 16 milligrams a dose, and I'm still feeling pain!!! If someone tells me I can permanently get rid of this pain by having to wipe my butt with a wand for six weeks, I'm making that deal. Case closed. 

[ProfessorTomoe 1,308]

I have run out of Cymbalta (a.k.a. Duloxetine), and I am suffering from withdrawal symptoms. Electric shocks to the head, jitters, coldness, and others. I'm not enjoying this, especially since Mrs. Prof didn't tell me I was completely out (she does my pills every week).