More Catching Up: The Great Med Switch

Of all the pieces of my life with pain I find that I am always tiptoeing around the topic of pain management. I advocate for patients’ rights to pain control, and I speak out against the stigma that only addicts use opiates. The word epidemic is being thrown around with abandon these days and opiate use is being sensationalized on all fronts.

It’s incredibly frustrating.

While most of the people in my life know how my pain meds contribute to my quality of life I believe only half of them actually understand it and even less than half truly accept it without a hint of disagreement. No matter how it’s brought up I always feel uncomfortable discussing it with most everyone I know. Truth be told there are maybe three people I will take my meds in front of, and even then if I can sneak it in while they are looking at their phone I’d prefer it that way. So as you can imagine, this post is very hard for me.

I have been on the same dosage of OxyContin for about a year and a half now, prior to that I was only taking immediate release Percocet. In total I have been on 65mg of Oxycodone for about four years now. For a long time it was working just fine to help manage my pain both daily and after the never ending string of surgeries.

The last 9 months or so have been pretty tough and I have finally found myself in the care of a Pain Specialist who is comfortable helping me get to a better place with my pain control. Back in March we discussed increasing my dosage but I wanted to wait out the recovery of my last procedure before we made that move. It took over five months for me to completely heal from that surgery so this plan has been on hold for a long while.

At my last appointment we decided to move away from the Oxycodone and move to something that stays in your system a bit longer. Where Oxycodone lasts 12-24 hours in your system Buprenorphine will stay up to 72 hours. Since my body burns off my long acting meds in 4-6 hours this is a much needed change. While I am super excited about the idea that my pain could be so much better controlled, I am terrified things will go sideways and I will be left without a plan to control my pain.

Another thing that is really urking me about this switch is the stigma Buprenorphine has for being the “addiction medication” since the brand name is Suboxone.

Heard of it? If you haven’t take a moment to Google it. You will see page after page talking about how Suboxone is a great tool for helping people who have an addiction to opiates. Suboxone is a combination of Buprenorphine and Naloxone in a film that is dissolved under your tongue.  The Buprenorphine is the opiate, just like Oxycodone, but the Naloxone is an additive that stops the “high” sensation that you get from taking extra which is the whole reason addicts like opiates.

This is fantastic if you are indeed an addict looking to get sober. Not so good if you’re me, trying to find the best way to control your pain. As soon as I started asking people about it in support groups they started asking if I was going off my meds completely. My pharmacists started looking at me differently and to some extent I think even my closest people doubt the true reason for the switch.

It could be just my anxiety making me worry so much about this, but I swear everyone is thinking “I knew it! She is an addict.”

Gross.

Dr. K has always been straight forward with me, and she told me verbatim “It’s really unfortunate, but you won’t find much information about this when it comes to pain management because it’s stigmatized as an addiction medication. To be clear; I do not think you have a problem. I believe this is going to help with your pain much more than your current plan.”

I mean, c’mon you guys, how much more could I ask of her? I’m just so in my head it’s crazy.

On the one hand I am so excited about the idea of having less pain spikes throughout the day. I love the idea of using a film in the morning and that’s that. No more swallowing tab after tab. Layering Advil and Tylenol and Oxycontin. Tracking the hours to be sure I don’t take things too soon or miss my next dose.

I find myself daydreaming about what it might be like to have consistent pain control. To be closer to a 4 than a 6 all day long on the pain scale. Would I finally get to go to the gym a few days a week? Will I sleep better? Would I need to sit down less?

It’s damn near euphoric you guys.

Know what else I love about it? The fact that there is less of a “high” associated with this med. My least favorite part of my pain management is the sleepy, foggy, warm flushy sensation I get sometimes when I take my meds.  While it is helpful when my pain is way up there, it’s not my favorite and it makes it hard to keep on with my life. I don’t have time for a Percocet nap when I am trying to make dinner. Good riddance.

Even with all of this though, I have fears.

What if I have a bad reaction to it and it doesn’t work out? What if the dose I’m set at on induction day isn’t enough and I go through withdrawal? What if we start it too soon and I end up in Precipitated Withdrawal?  What if I have issues with the films and it makes my mouth hurt? What if it isn’t as effective as we are hoping it is? It’s all enough to keep a girl up at night.

And it does.

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