2.) ASAP - Good dosing overlaps versus Poor dosing

From: Helen Dynda (olddad66@runestone.net)
Thu Sep 27 20:15:10 2001


** American Society for Action on Pain (ASAP) **

2.) Good dosing "overlaps"...vs...Poor dosing has "spaces" at dose time: Meds LEAVE the body

http://www.asappain.com/home-1.html

Again, anytime a doctor provides 4 hour pills, it MUST be at 6 doses per day or the patient is going to suffer. This is what made OxyContin such a God send when it first came out that had even the DEA saying what a miricle drug it was! By using one of the larger mg pills, a patient could have the same pain control using just 3 pills per day, as someone else would get using 40 pills per day! If they give you only 2 pills per day, then it's 16 hours of suffering each day that your doctors wants you to hurt and so on. And when they prescribe only 30 pills per month, that's only ONE pill per day, and 20 HOURS OF SUFFERING OUT OF 24 like this:

[ GO TO THE ABOVE WEBSITE (and scroll down) TO READ THIS INFORMATION. ]

Us "old timers" need far heavier doses and many times more powerful medicine than the "starting" pills many patients find themselves now on. Some of us take several GRAMS of morphine a day. Others must 'horde' medicine if they are ever to get a 'second' dose for a day so they can have 8 hours of relief in a row, or suffer for days on end with nothing if they need around the clock control one day to make a trip or or get out of bed to do something useful. But pain medication works much better if it's put into the system at "regular intervals" and kept there so it's "growing" to therapeutic levels in the system. If done that way for a week the patient really gets it into their system providing TOTAL CONTROL of the pain. Adjusting the medication this way is called "titrating" to fit the patient and the pain. Without that no pain patient can ever "catch up" to proper control. As one patient said in an email to me: "I have Fibromyalgia and migraines. I only get 30 tabs a month for the pain..." So having your doctor change your prescription to read what ever you need per day is what you'll need to do, or fire that doctor and move on. People in Kentucky have been victimized by the State Drug Police down there where a form of State Sponsored Terrorism is taking place in the name of the War On Drugs. Patients are being arrested for "Felony Doctor Shopping" because doctors are afraid to dose like I'm showing you here! So our Law Enforcement thugs have been "Lowering" the overall "medical dosing" over the years creating the "Pain Crisis" we have today.

Another thing to remember if you are going to get proper dosing is constipation. Opioids will block up your system so fast that many new to pain control have ended up in the hospital with an emergency operation because they didn't use laxatives and became impacted so bad it became an emergency. So use Ex-Lax or some other strong laxative if you are given proper pain control for the first time and keep close watch on your system early on. If you are taking "4 Hour Pills" then you will need 6 doses a day. Period. If it takes two of them to control it for four hours, then you need 12 pills per day and if it takes 3 pills to do it, you'll need 18 pills per day! That's a LONG way from "30 pills per month" that provide only 4 hours of pain control a day! Why make patients suffer 20 hours each day? Some doctors just lose all contact with math when it comes to prescribing medicine for pain, but they wouldn't think of under treating someone with insulin! Go to the Letter to The Patient (Click on "The Patient" at the above website) for links to the best documents for helping you talk your doctor into treating your pain right.

[ GO TO THE ABOVE WEBSITE (and scroll down) TO READ ABOUT THE ABOVE INFORMATION. ]

If you find that your family believes the "Propaganda" against opioid pain medicine, be sure and download or print out "The Patient's Letter" (Click on "The Patient's Letter" at the above website) of links and letters to help you show them how your life would return to normal if you had your own pain controlled. And send your "Pain Form" to one of the Pain Placement Reps (Click on "Pain Placement Reps" at the above website) in your state. The "Joint Commission on Accreditation" in passing their new rules may help better pain relief to some extent, and the news of that was on the Peter Jennings Newscast on January 2, 2001, bringing the news of this new rule to the public for the first time! State PainLaws and "Guidelines" like we hammered out at the Federation of State Medical Boards (Click on "Federation of State Medical Boards" at the above website) in 1998, will make it so patients can have their Medical Boards remove the license of any doctor who failed to treat their pain, or refused to send the patient to a nearby doctor who would. These new rules will force Medical Boards to do a 180 degree turn and begin to support pain relief, rather than work against it as they are again here in Virginia with their inquiry into Dr. Solomon. Right now Medical Boards are a great threat to doctors who treat pain right so you need to know all this as you search for relief. For now YOUR life may be on the line if your pain is under treated or treated with NSAIDS or anti depressants and it's going to be your job to talk your doctor into treating it better with opioids or finding one who will. Again, as you can see on this brochure by one of the drug companies, "pain medicine" that lasts 4 hours "should be given every four hours." Simple.

To get help for yourself, first ask your present doctor to provide you with this kind of pain relief that we all get. If they don't have the courage to do that, ask that they at least provide you with a referral letter and that they send your medical records to one of the doctors that we recommend you see on our Panic Page or the Rep sends you. Click our PANIC Button at right (Click on PANIC Button at the above website.) and write to one of our "State Pain Reps" (Click on "State Pain Reps" at the above website) after you have read ALL of the Panic Page. On that page see how to join our discussion group (Click on "discussion group" at the above website) on the Internet so you can learn more from other pain patients who went through what you are going through now. Don't despair even if a doctor THINKS you are an "addict" or YOU think you're "addicted" because if you've got pain you are NOT an addict, so demand relief! Your pain may simply be undiagnosed for now. As a layman I have diagnosed countless cases of Ankylosing Spondylitis that doctors have missed and proved later that some who were called "drug seekers" or "addicts" were in fact REAL pain patients! You MUST BE a drug seeker if you're in severe pain and you're going to live! So many doctors forget to take the HLA-B27 antigen blood test for Ankylosing Spondylitis, if they don't see anything on your films. And that disease isn't going to show up on film until 12-14 years AFTER the pain starts! It must be diagnosed based on the symptoms, not on the films!

If your doctor is going to put you on the patches later this chart might be helpful. They are a lot stronger than the regular pain medicine so they aren't measured in miligrams. Most doctors leave the patient ON their regular pain medicine while they are getting used to the patches and then "back off" the pills slowly till the patches are taking most of the load. That way you should only need to take a few pain pills each day to get your control just right.

Let's just take OUT that word "cancer" from our look at pain control, because "pain is pain" no matter what is causing it. Many think that because we're going to live that our pain is somehow less than those who have cancer but many people who have failed operations from ruptured disks have far greater pain than many cancer patients do. So this brochure (not shown) has good clinical tips on getting the dosage right. It's by the U.S. Department of Health and Human Services, Public Health Service, Agency for Health Care Policy and Research Quick Reference Guide for Clinicians Number 9. Let's look a little closer at what it says doctors should do when evaluating pain: In Figure 1, it says under "Recommended Clinical Approach": A. "ASK about pain regularly." (Can you just see that?) Next is B, "BELIEVE the patient and family in their reports of pain and what relieves it." Then C, "CHOOSE pain control options appropriate for the patient, family, and setting." While D is "DELIVER interventions in a timely, logical, coordinated fashion." And E is "EMPOWER patients and their families" and "ENABLE patients to control their course to the greatest extent possible." So altogether here's what all pain patients should be provided by their doctors about pain:

ASK - ASSESS - BELIEVE - CHOOSE - DELIVER - EMPOWER & ENABLE the patient to control their pain! Isn't that simple? Yet it's just not being done; but working together we CAN make it happen for every pain patient in America. This is the goal for us all; and when you are "new" to this round the clock pain control, you must be very careful at first so you don't overdose. By keeping a careful eye on your breathing if it ever becomes labored, you'll know you are getting too much pain medicine in your system - so back off on your dosing a little until your body can adjust. As the days go by and the medicine gets into your system, it should balance out. Some doctors may give you something to help you stay awake and some other medicine to keep you from getting sick till you're used to the medicine.


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