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RE: FCE - Cycler - 09-05-2009

Damned with faint praise.....ty.


[quote=bronco54501]
While this is not a pissing contest or who can spit the farthest. I would think we all have made good point as well as cycler.


RE: FCE - Bad Boy Bad Boy - 09-05-2009

((((slowly get off them = Detox
Being able to perform very heavy duty work= super human strength.This is definition of what you said.))))


"To slow get off a Medication for the fact that certain medications stopped quickly can even cause a heart attack and such. This is not Detox, but being safe, not addiction."

"Very Heavy Duty Work, is a classification in the DOT book, it's not a definition."


But, then again, as smart as you are, we would have thought you would have known this.


RE: FCE - Bummer Knees - 09-05-2009

I believe most on this forum know I do not like to take meds.

And like AQA if I have to take meds I try and take them at night and when another family member is around that can drive.

Seldom do I take meds durning the day, I would rather be in pain but be safe if I have to drive.

Let me explain, I live in the country, about 15 miles from the closest hospital.
My 10 yr old son has seizures and asthma, both conditions have required emergency treatment in the past few months.


RE: FCE - jayne - 09-05-2009

Bummer I believe you and AGA said it best.....we do not want to be on meds 24/7 in order to do the job I did it would take that.....I would rather be home safe than take meds drive and put others at risk....to some that is not so...


RE: FCE - c0436 - 09-05-2009

Thanks for the info everyone you have been very helpful, I think I'm not gonna take them so they can get a more accurate discription as to whats going on with me me, so that its not masked, and I do not injure myself further. I did not mean to turn this into a very heated subject lol Big Grin I hope u all have a great day. God BlessSmile


RE: FCE - cnaz - 09-05-2009

I think you got a lot of opinions and experiences and can tell how much they differ, I think that speaks to the variations in medication responses.

My husband who is 6'2" and 255lbs has a much lower medication threshold than I do at 5'5" and &%$ ( like Im gonna tell everyone how much I weigh LOL but its way less than hubby). For his multiple injuries ( spinal compression fractures, brachial plexus nerve damage, broken ribs, broken femur) his pain was managed but he was dizzy and sleepy on 5/325 percocet, where I had torn ankle ligaments taking double the doseage with no dizziness, sleepiness etc. with not as good pain management.

- I was able to work while on medications, with Dr and employers ok, not all drs or employers have the same policies.
- All Drs wrote ok to drive even for hubby with reported side effects, but all have been supportive of his decision that he does not feel safe and thus does not drive, even NurseCM from WC ( which was a big suprise)

Response to meds is very individualized and that's why it often takes multiple trials to find a med cocktail that manages pain with least side effects as possible.

Best of uck at your FCE - take the info you recieved here and make the best individual decision you can.


RE: FCE - Cycler - 09-05-2009

Let me point out the the problem is not generally with the patient but with the Dr prescribing the wrong medication for the situation which results in the impairment and side effects.

Drugs such as Vicodin and Percocet, etc are reasonable for short term acute pain but are a very poor choice for patients who suffer from persistent pain meaning 24 hours a day that is expected to last for more than a week or so. This is because they are fast acting but short duration. The medication is quickly released as a total dose into the blood stream and then hits the brain where the full dose causes the impairment such as drowsiness, euphoria or High, slow reaction times, nausea etc etc. They wear off quickly though and so then does the impairment. This is precisely why these type of pain meds are absolutely the wrong and dangerous choice for chronic pain patients.

It makes no sense at all, by any measure, to prescribe a medication that lasts only 2-3 hours then have to wait 4-6 hours till time to take another, to a patient who has steady state moderate to severe pain 24 hours a day seven days a week. Chronic pain patients should be treated with an opiate, if needed, that meets the goals of reducing pain all day, therefore a long acting or sustained release opiate is indicated and there are many to choose from

The added benefit to the patient and society as a whole by extension, is that there is no appreciable impairment when the medication is released slowly, no high, no clumsiness, no slowness etc once the patient is acclimated to the medication. Since this type of pain treatment is then required for the patient the FCE should then only be done while taking the medication. Otherwise it's a false report.


RE: FCE - freebird - 09-05-2009

Cycler Wrote:Let me point out the the problem is not generally with the patient but with the Dr prescribing the wrong medication for the situation which results in the impairment and side effects.

Drugs such as Vicodin and Percocet, etc are reasonable for short term acute pain but are a very poor choice for patients who suffer from persistent pain meaning 24 hours a day that is expected to last for more than a week or so. This is because they are fast acting but short duration. The medication is quickly released as a total dose into the blood stream and then hits the brain where the full dose causes the impairment such as drowsiness, euphoria or High, slow reaction times, nausea etc etc. They wear off quickly though and so then does the impairment. This is precisely why these type of pain meds are absolutely the wrong and dangerous choice for chronic pain patients.

It makes no sense at all, by any measure, to prescribe a medication that lasts only 2-3 hours then have to wait 4-6 hours till time to take another, to a patient who has steady state moderate to severe pain 24 hours a day seven days a week. Chronic pain patients should be treated with an opiate, if needed, that meets the goals of reducing pain all day, therefore a long acting or sustained release opiate is indicated and there are many to choose from

The added benefit to the patient and society as a whole by extension, is that there is no appreciable impairment when the medication is released slowly, no high, no clumsiness, no slowness etc once the patient is acclimated to the medication. Since this type of pain treatment is then required for the patient the FCE should then only be done while taking the medication. Otherwise it's a false report.

Excellent post! I am treated with a Fentanyl patch which is a slow release narcotic. I do have Hydrocodone 10/500 for break through pain also.

I can drive without any issues. I do not believe that all who take controlled prescription narcotics for chronic pain are impaired and cannot drive. Someone must be on a "powerful narcotic cocktail" if they have this problem.

If someone feels they cannot drive on a narcotic,they should notify there treating Doctor of this. A driving restriction should be put on there Drivers License also.

All of the IW's who say they are impaired by a narcotic and cannot safely drive, Do you have a Drivers License?

If yes, does it have A Restriction on it?

Is your Treating Doctor aware you are having these type of issues with your pres. narcs?



RE: FCE - cnaz - 09-05-2009

I reported that my husband doesn't drive by choice, no there is no restriction on his driver's license,(we actually discussed this with both the PM and nueropsych and neither felt it was warranted at this time) his impairment is not solely from the narcotics its somewhere in the combination of a traumatic brain injury which causes episodic vertigo and then compounded by the narcotics. Much of the time he's not impaired for safe driving but its a risk he's chosen not to take.

His treating drs are aware and have done multiple trials to change meds but he has had serious but rare side effects to other medications which have prevented him from taking meds with fewer side effects.

Its a tightrope to control pain at a managable level ( not pain free) and managing the side effects. Luckily we have a good PM specialist who requires monthly face to face appts to monitor side effects and used adjunct non-narcotics to avoid increasing narcotics when possible.


RE: FCE - freebird - 09-05-2009

I see my PM Doctor monthly. I have to do this to get a Schedule II narcotic filles on a monthly basis. I am noy pain free but it is manageable with my narcs and other daily meds. I also watch what I am doing.