Opiate meds and aftereffects

I have only been on 3 5 mg. of generic percocet per day for six days. I meet with pain specialist tomorrow and it will be a full week. I am also just starting gabapentin. I am a little confused about that drug. I take it at night as she suggested. My first week is 100 mgs. per night, then 200 mgs. for two night and then 300 mgs. going forward.

First, even though I have been on percocet before, this time I am having severe painful constipation. I have tried to drink more water, taken Konsyl fiber drinks in which you add the powder and water to the line in the cup and shake, but not mix (tastes awful). And still I was in such pain until last night. I was getting scared that I would have to go to ER. Finally, last night but it was a painful experience. Any ideas on what else I can take to battle that.

Also, I am wondering on the gabapentin (1st time ever), although I took it at night as she recommended, the next day I was highly anxious. I mean much much more than usual and it lasted for a few hours and I felt jittery. It may be my body acclimating to yet another medication. But although I take at night, the next day for most of the day, I feel agitated. Am a little nervous that I will now be doing 200 mgs. at night. I can't put my finger on it, but I feel a bit off.

Also (sorry jumping all over), these percocet (generic) 5mg. are made by a company called Amneal. They seem very very weak to me. I read that different companies used different fillers in generic and that sometimes you can actually have less than 10% or more of the actual oxycodone than the brand percocet. I even called my small family owned pharmacy bc in 2018 when I had that surgery, I was on percocet for a bit under three months every day and I had perfect bowel movements and felt them working. I asked him what brand that was but he just brushed me off saying they get whatever their distributor sends to them.

These are definitely weaker and feel like a placebo. I would like my pain specialist to write me an rx for 10 mg.of the generic percocet so I can cut in half and they should be stronger since they will have more oxycodone but do not want to press too much on this bc in US that could be misconstrued as "drug seeking behavior." She only wrote me a week of the percocets bc the new laws in US (constantly changing) said that if a patient has never had the drug or has not been prescribed it in three months, a doctor, even a pain specialist can only write an rx for one week for the first time. After that, she will be allowed to write it for more. (Weird).

Is there anything one takes to avoid the constipation pitfall? And has anybody felt a bit off when starting the gabapentin or that will resolve itself. I see her tomorrow since my first visit 7 days ago. I am noticed when the family pharmacy I go to delivered it to me, it said on it (first time I seen this), for Chronic cancer pain. I am glad that she wrote it that way and that they had to put it on the label bc I ALWAYS get comments from the son who is also a pharmacist when I am getting any kind of opiate, even knowing I have stage iv cancer. So I am hoping that now that she wrote this on the rx and its on the label, they will be less likely to make comments that they think I should not be taking or getting rxs for opiates after a month or so.

It is the closest pharmacy to me and they deliver and I don't drive so I stick with them.

[Barbteeth]

Hi

I’m answering your query about constipation

I’ve had a similar experience and it’s awful...I found on Amazon...some glycerine suppositories...made by ‘Care’

I didn’t expect them to work but they did help a lot....I also take senna tablets fairly regularly otherwise I can end up constipated again

Hope that helps

Barb xx

[Hidden in reply to Barbteeth]

LOL......I am dressed and ready to go to pharmacy to buy Senna and THEN seen your response. I had a bottle but it was empty (why I kept an empty bottle I have no idea LOL). I never had children but I felt like I had the experience of childbirth last night. The pain was really unbearable but when the relief came, I was in tears I was so happy. And this was not even a full week. So I am off to buy my senna and then see you recommended the same thing. I am going to look into what you suggested on Amazon.

Fun week. Tomorrow pain specialist, Wednesday, my primary doctor, Thursday, psychiatrist in the am and then regular injections, onco, blood work (all in same cancer center) and then Friday I go to a physical therapy center to get evaluated.

I am excited about going out and walking hopefully without feeling pain in my back and having to keep stopping and leaning on something. I was getting so depressed so today will be my first attempt to walk five blocks, hopefully, without the back giving out.

[Hidden in reply to Barbteeth]

Do you go to a pain specialist? Do they continue to write you the rxs every month or so? Do they test your urine? I was told, not a problem, that every time I go to see her, I will be expected to do a urine test. They do this bc they want to make sure I am taking it and not selling it LOL. I get it though, some people do it. I also have to bring the bottle (I should have two left). You feel like a criminal but I am so glad to get it, I will follow each and every rule.

[Barbteeth in reply to Hidden]

Hell no...I just request repeat prescriptions for whatever I need or fancy (!)...do it on my GP website

The drugs are at the local pharmacy to pick up usually within 2 days...I have to sign for the opiates that’s all

So easy over here...probably why opiate addiction is on the increase as people can just ‘borrow’ drugs from other people or family

Barb xx

[Hidden in reply to Barbteeth]

Not here in US. The only ones that can easily get opiates are the ones that are addicted to them. They are NOT allowed to give refills on opiates and you have to see the pain specialist doctor every time.

I am glad this time on it it had for Chronic Pain from Cancer bc my small dad and son pharmacy always have comments to make when I am getting opiates in the past. I had the operation where they put holes in my leg and then during the fifth week (the recovery was 4 months), they said you really need to be cutting down on the opiates. They look down if you get more than 2 refills from them but now they see Chronic Pain for cancer so I hope they won't be making any comments.

Here in Brooklyn, you know to hide your meds. I met a lady in the first hospital who had a double mastectomy. She said they gave her Oxycontin but that she never even got to take one because her sister stole them.

Another friend her mother died from cancer and she actually had a friend call her from CA and ask if her mother had any pain meds left and she could send them to her (and she DID).

My other girlfriend who had a reoccurence of stage iii was given opiate pain meds that she kept in her medicine cabinet. It is just her and her husband no kids. He was married before so his adult son came to visit and after he left, her two bottles of pain meds was gone and he swore he did not steal them.

I want to ask her if she prescribes something for opiod constipation since she manages med for people with cancer although she seems to think my lower back pain is not from the cancer. I am going to ask her why she said that the week before.

[PlumNice in reply to Hidden]

aamkearns, my palative pain specialists care team prescribed Docusate Sodium50mg/Sennosides 8.6mg. Its a generic and you can pick up OVER THE COUNTER. Please make sure you are not allergic to anything on the ingredients. I would feel so bad for suggesting something that would hurt you. The brand name is Colace 2 in 1. Its a stool softner plus a mild stimulate to help things moving. A 100 tablets for around 10 dollars (American).I am on pain meds (15 mg of oxycotin 3 to 4 times a day). You might have to break down and take MiraLAX if you are constipated. (They also recommended this as well). I take 2 Colace pills a day, but when things are a little smoother than usual, I take one pill a day. I suffered horribly with constipation when i started my oxycotins. I did not have a bowel movement for 14 days. That was horrific. I am surprised no one has mentioned a stool softner for you. Maybe at your appt they will. If not, just be pro active. Do not be afraid to let them know you are still in pain and need something stronger. Palative pain care understand better than the normal GP. They have a wonderful bedside manner(in my humble opinion). As far as the rude son at the pharmacy, smile sweetly and tell him , if you wanted his opinion, you would scrape it off the bottom of your shoe!! Okay, maybe not tell him, but you can at least think it and walk out with a smile lol. Sherry

[Hidden in reply to PlumNice]

I have an appt. today at 11:00 am with the pain specialist. It has been a week since my first initial visit. I was not keeping on top of the thought of constipation bc the last time at end of 2018 I was on percocets (10 mg.) for about three months and I had perfect bowel movements every day (which I never had even before cancer). No pain or anything. I even referenced to the pharmacist (small family owned one I go to) that it was the best laxative I ever had. This time it was not the same PLUS now I am also on gabapentin which I read also causes constipation.

Now the pharmacist got some generic ones by Amneal. They feel like placebos. OMG. The constipation was awful. Two nights ago, I was on bowl close to an hour in tears. I was drinking loads of water, taking tablespoons of olive oil, used about five senna (stool softener) plus I take Verzenio which I usually get diarrhea. I think I was too late. It was so hard I could not pass. I was in tears. I struggled for about 45 minutes. I was in tears. I finally went but it was so small I could not believe it. It was rock hard. It was scary and painful and I was getting agitated. I did not clean out my whole bowel so now this morning I am suffering also. I took so much stuff yesterday that I was sure I would wake up in the middle of the night but nope. Trying not to get agitated bc that makes things worse. As I get ready, I can only hope that everything kicks in at once. I drank so much water and basically drank my rx bottle of Lacutolse(?) plus four senna, plus olive oil, plus the Verzenio (which causes diarrhea) and still nothing.

Now this morning, I am still not clear and again started last night and nothing. I have to go before I get to cancer center. I am so uncomfortable and its so scary to push and nothing and you feel pain. I am going to ask what she recommends to people as she must have this problem with alot of her patients with the opiates and gabapentin. I need something major strong.

Here in US, you have to be careful. Especially at this cancer center. They are always looking for "drug-seeking" behavior. I am almost afraid to tell her that the 5 mg. did not do much so I had to take two at a time. I am hoping today she will increase it, even if I cut them in 1/2 bc then they will be stronger.

Even with stage iv, they give you a hard time. It's insane. I hope she increases it but they have the power and I am nervous and do not want her to take me off them. She is also saying I need to go for physical therapy. I have to go along with what she said otherwise she will not write anything.

[Hidden in reply to Hidden]

Restoralax is what I use as I get extremely constipated and things get compacted. My Pallitive nurse recommends it. It’s a powder you can mix in any drink and it’s doesn’t taste or make the drink thick. You can adjust the amount you take and it’s the only thing that helps me b

[Hidden in reply to Barbteeth]

Does the doctor who writes you the strong pain meds give you anything specific to take for constipation. I read that there are specific meds/liquids for that purpose. People that take opiates.

[Barbteeth in reply to Hidden]

She just told me to take senna

Barb xx

[Hidden in reply to Barbteeth]

I just looked on amazon but I cannot find the product you mentioned by Care. Only some brand called Fleet?

[Barbteeth in reply to Hidden]

I guess there are different brands out there

These contain glycerine but I looked again on amazon and there were some suppositories which contain castor oil so they all should do the trick

Barb xx

[Hidden in reply to Barbteeth]

Thanks, I am going to order then.

[Hidden in reply to Barbteeth]

I agree with Barb. Glycerin is the best thing for me and I hope you try it. I take it mixed with honey and lemon. 2 teaspoons is enough when there is total blockage. I sympathise with you so much. Good luck.

[Hidden]

Thanks stupid me. I was so desperate I drank three cups of the Konsyl fiber yesterday. I even took two teaspoons of olive oil. After I did that I then read that Konysyl fiber is NOT recommended for opiate constipation. DUH! No wonder. I am going out to buy Senna which is supposed to make it softer. I was in hell yesterday. I am a bit surprised because when I had my operation (2018) I was on percocet for almost three full month and the amazing thing was I had the best bowel movements every day. I even made a comment to my pharmacist that it worked excellent as a laxative.

Now they have a different generic one (Amneal). First, they feel so weak. My pain specialist gave me enough to take 3 5 mg. of generic percocet a day for a week. (Some new law that if I have never had percocet or have not been prescribed it in over three months, she can only write an rx for a week's supply for the first time.) She said afterwards that she can write more. I was in such pain I was going crazy. Will NOT be using the Konysl again. Going out to be Senna which is a stool softener now. I find that taking the pill once three times a day does not work that well. I feel pain with just taking the one in the am and I think its because it is a different brand name. They all use different fillers. It felt like a placebo so I find it I take two in the morning instead of one, it seems to work better and last longer. Yesterday I took two at once in the am and found I did not need to take the third one at night.

I go see her tomorrow. I am thinking its my body adjusting to this new med gabapentin. Others have taken it (my friend has been on 600 mg. for about five years for restless leg syndrome). My friend said (my pain specialist told me this) that she was not aware that you could not just stop taking it. You need to be weaned off. Since it is only a week, I need to give it more time. I am going to ask the pain specialist if I can stay another week on the 100 mgs. per night instead of jumping to 200 mg. per night.

I also go on Friday to a physical therapy center for an evaluation. Its my back, my lower back. I was unable to even walk 1/2 block without feeling intense pain and I would have to stop and lean on something for like five minutes. It was crazy. What would have taken me 10 minutes to walk was taking me almost 40 minutes. Today, will be my first day trying to walk several blocks to the pharmacist.

I will stay on the gabapentin and give my body more time to adapt. Just odd. My friend said she had no issues with it.

[Red71]

I will also echo Sandra and recommend Miralax. It’s what I use, but if it’s the first time you use it, it doesn’t kick in immediately. Just use their dosage daily. I am on opiates but for the most part only use it occasionally because I try to eat a fairly high fiber diet.

As far as your opiates go, I think you shouldn’t worry. You say you are having less pain so they are working. Maybe they are feeling like they are less strong because you are having a different kind of pain than you were having before, ie nerve pain as opposed to incisional pain. In this case I would follow the doctors directions for a while and see how it goes. There is always some feeling of weirdness at the beginning when you take something like that. You have to give your body a few weeks to get used to it. Just accept the blessing of reduced pain. Elaine

[Hidden in reply to Red71]

Thanks for the first time in about two months, I was able to walk 7 blocks to the pharmacy without pain. The back started throbbing a bit when I was a block away, but I forced myself anyway. Unfortunately, the back pain started when I started to try and walk home so I sat on a bench for about 10 minutes and then started walking home. At least that is better than before the pain meds. I actually had to take car service 7 blocks a week earlier to run in and get toilet paper (I can't believe I forgot in it my order from peapod). $4.00 for the TP. $15 for the car service (I don't drive and being in NY don't know my neighbors in my apt. building) so I had no choice.

I have an appt. on March 4th with a cancer nutritionist. The cancer center just hired her and my onco told me she tried to make an appt. at end of January but she was so booked that March 4 was the first day she could get me an appt.

I have horrible eating habits. I have lived on my own since I was 18. Not only do I hate cooking, I am very bad at it. I have gotten sick from my own cooking LOL. I never eat vegetables except for lettuce and even then rarely.

I remember being younger and not being able to leave the table until I finished my vegetables which I hated and remember thinking as soon as I am on my own, I will never eat vegetables again.

Even the gabapentin said a side effect is weight gain. Geez, is there any meds that make you lose weight. I start physical therapy evaluation on Friday. I am so so out of shape I cannot imagine what they will expect me to do.

It's only my first week (I go back tomorrow to pain specialist) so I guess I have to give it time. They give urine tests every time to ensure that you are taking the meds and not selling them (as if I would sell them LOL) but apparently people do.

I would love to get a medicinal marijuana card. I think its way better than these opiates and nerve medications but although legal in NY, Medicare/Medicare and private insurance will only pay for the doctor visit to get the card, but not for the actual medicinal marijuana itself which can run from $200 to $500 a month so a no go.

I told her I do it at night. She thanked me for telling her (I figured they would do a urine test). She said many of the cancer patients do the same as me but since it is so expensive they get on their own.

On news the other night, New Jersey said going forward people on workman's comp (only workman's comp) will be able to get their medicinal marijuana paid for by worker's comp but not for cancer. What the heck?

New York has a large one that opened on fifth avenue. But until they are willing to pay for the cost of it, not many people can afford.

At least for the first time I was able to walk there. It was so bad that I could barely walk 1/2 block without stopping and leaning on something every 7 minutes. I had tears in my eyes. So I guess I just have to take my time.

[Red71 in reply to Hidden]

I’m glad you could make the walk. That’s much better than before. Sometimes we just have to take each day as it comes. I find fresh fruit helps a lot with the constipation...and you don’t have to cook it! Just wash and eat!

[Hidden in reply to Red71]

LOL...if you knew me, you would laugh at the suggestion that I would even know how to cook fruit. I burn frozen pizza, I burn tomato Campbells soup. None of my friends would ever eat anything I made. Plus, I hate cooking. I find it boring and I always get hurt. My favorite time was I had something hot cooking in the oven for like an hour. I got my oven glove on to take it out. I used the hand with the glove on to open the darn oven door and then stupidly used my hand to take out the steaming hot glass bowl. That was painful.

[Southside25]

I've been on Ibrance/letrozole for 2 years. After a couple of months, I started getting several GI issues - all over the map - sometimes constipation, sometimes the runs, sometimes awful intestinal pains which I guess were gas. Not nearly as severe as you describe you're going through. I started taking extra magnesium over what is already in my daily vitamin. 250mg a day (one pill) has made a world of difference. It's cheap and easily available. I have a couple of friends who have drug-related constipation and also take magnesium and have found it helpful. If I remember correctly, it only took a couple of days for me to see the difference. Wouldn't hurt to try it.

[Hidden in reply to Southside25]

SInce she is a pain specialist for cancer patients, I am going to see maybe if she can give me something stronger. They work a bit but I am afraid if I mention it, she will take away the 3 5 mg. of percocet. She said something about trying out an antidepressant for the pain, but I dont want that but in NY they rule.

[SoCalLady]

There will be light at the end of the tunnel. Couple of months ago, I had severe sharp back pain and could not get out of bed. My bed's high, so once I boosted myself out, had to sleep on my low couch for 3 weeks in order to roll myself out with my arm strength to get up. I really thought this was near the end for me and I would be bedridden. I buprofen read somewhere that bone mets do not cause pain until the "end." LOL. Anyway, Doc put me on 5mg Oxycodone w/Tylenol. It did absolutely nothing. Told her I needed something stronger (by this time, I was two weeks into the pain) She gave me 5mg Oxy straight. I only took it at night and just suffered during the day. She also put me on 100 mg of Gabapentin, one to three caps twice a day. It was the only thing that took the edge off. I did not experience any side effects. Gabapentin was originally prescribed for seizures, then they found it worked well for neurological pain. The theory being I had inflammation in my back and bone mets were pressing on my nerve endings causing my pain. I could not take Ibuprofen for inflammation because of possible damage to kidneys and my Creatinine levels are high. The pain finally went away. Now only when I'm standing over kitchen sink or folding clothes, etc. am I getting a dull lower back pain. Walking does help. I think we have to be careful about not lifting heavy stuff and taking care of our backs as much as possible.

[Hidden in reply to SoCalLady]

Was this a pain specialist or your onco? My onco won't prescribe meds, they made an appt. with me with part of the palliative team which is so far the pain specialist and I have to meet with the psychiatrist. She gave me 3 5mg. generic percocet to take 3 times per day and 100 mgs. of gabapentin once a night for a week, then 200 mgs. for two weeks, then 300 mgs. ongoing. I also have to get evaluated on Friday for physical therapy. I don't know what they expect I can do. What do you mean oxy straight?

In US (Brooklyn, NY), they are so paranoid even with stage iv cancer of giving opiates. I had mets to the lungs and two CT scans ago they saw two holes in my spine from the breast cancer. I Had a ct scan of my back and they just see the two holes and disc disintegration(?) which she said may just be from arthritis. Just odd to me that the dull pain started before my CT scan when they found the holes.

What did you do for constipation. I am only on day 5 of my weeks supply and am severely constipated. How the heck do people get addicted to these and take stronger amounts every day and not have this issue?

I was on percocets (10 mg.) for almost two full months after an operation and I immediately felt relief from the pain but I also had the best bowel movements every day while taking them. Better than before the cancer.

Does she give you a certain amount and tell you to take as is? Do you have to take a urine test? They want to make sure you are taking them as is and not selling them.

I see her tomorrow (my 2nd time). I am almost scared to tell her how constipated I am bc I am afraid she will take away the percocets. I dont expect to be on them forever but I want to for now with the gabapentin.

What do you to avoid constipation (sorry LOL)?

I was on the phone with a friend last night who takes 600 mgs. of gabapentin for almost four years for restless legs. Then we got into a 1.2 hour discussion about severe constipation. I said to her when did we stop talking about men and clothing and fashion design to talking about constipation LOL....

I dont know how people can get addicted to these and not have severe bowel issues. the generic I got was pretty weak.

[SoCalLady in reply to Hidden]

The oxy was just oxy (without Tylenol). My Primary Doctor prescribed the meds, who specializes in internal medicine. She did refer me to Palliative Care, but by the time I got the appointment (3 weeks later) my pain had gone and I was off pain meds. Did not have a problem w/constipation.

[Hidden]

How the heck do people get addicted to these and take them in large amounts for long periods of time and not suffer constipation???

[hdhonda]

I take a generic over the counter stool softener and it works. I have more of a problem with loose bowels though. Blessings Hannah

[Barbteeth]

Mr again

I know you hate fruit and veg but what about nuts and dried fruit?... high fibre and no cooking involved...lol

Barb xx

[Hidden in reply to Barbteeth]

Oh, no dried fruit is even worse than real fruit. I am going to have to buy prune juice (UGH) and hold my nose and force it down. Getting a bit scared. This is my third day and I cannot for the life of me go. I have downed sennas, take gulps of lacultose(?), drank olive oil, drinking water non-stop and still nothing. I will NOT take another percocet until this is cleared up. It is uncomfortable and I am getting agitated. I cant believe only a few days of taking 5mg. of percocet and this.

[PlumNice in reply to Hidden]

You should try miraLAX. Its gentle and you can do 2 doses if needed within a 24 hr period. You can use it once a day after that until you have a bowel movement.

[Hidden in reply to PlumNice]

Bought miralax yesterday. Primary doc who I seen yesterday advised it.

[Hidden]

I am going to ask her today. Since she is the pain specialist for people with cancer, she must have come across this before and probably has suggestions. I guess bc I told her (true) the last time I was on percocet for almost two months and had perfect bowel movements that she assumed I would have no issues. but this time she also prescribed me gabapentin which I now read also gives constipation issues. And now with that darn Verzenio which the major side effect is diarrhea is NOT helping at all. I was like a nut case yesterday taking anything I could find and still no go. It was a bit scary. I never had children so never went through childbirth, but I imagined this was what it was like only I didn't wind up with a cute baby at the end of the order. I was shocked that it took me close to three hours on and off (I would get agitated so I would stop and then try again) that all that came out was so so small.

I am scared to ask her for a higher amount (10 mgs of the percocet). This generic brand is garbage and I am bringing with me to show her I still have three left (when I should have two left).