Carly’s prescription.

My experience with controlled meds, i’ve never had any refills on any of them, if I ran out early, I was screwed.  insurance would NOT let you flil a prescription early.  The doctor always had to call in the prescription.  the nurse could not do it.

Years ago I worked with a girl who was taking Fiornol for headaches.  We worked an 8 hour shift and she would take one at the beginning of the shift, and 3 more during the shift.  Finally the pharmacy talked to her doc and she ended up in a psych ward for withdrawl.  Turns out one of the effects of too much Fironol was rebound headaches so she was taking them to get rid of the headache they were causing.  When the doc prescribed Fironol with Codeine for migraines (before Imitrex and the rest) I would take them once or twice a month but sometines 2 at a tme or 1 every 2-3 hours to get the edge off the migraine so I could at least sleep.  I did this for 15-20 years until I had my gallbladder removed.  Suddenly if I took one I had severe pain just below my ribs where the pain had been from my gallbladder.  One night I was doubled up on the bathroom floor. I lived alone and told when I saw the surgeon at work the next day I told him I don’t know what he did to me but this is the problem.  Turns out codeine can cause spasms of the sphincter muscles.  I had the same problem when I had knee surgery and they gave me Vicodin.  I spoke with a pharmacist friend of mine because I know Vicodin doesn’t have codeine.  No, but they’re both opiates and it was the opiate in general that was causing the problem.  When Before I was diagnosed with Rheumatoid Arthritis I would take a bottle of 200 ibuprofen a month, taking 4-6 at a time because the pain in my knees, hands and back would sometimes get so bad.  My husband had a script for Lortabs (hydrocodone) and I took one with the same results as the codeine so the next time I took 1/2 and was OK.  I talked to my doc who gave me a script for that but he writes it for a smaller amount per bottle because it’s really double for me.  As I said a bottle of 60 will last me close to a year.   Don is allergic to ibuprofen and acetemaniphin (breaks out in hives, even Aleive does it to him) and he had a bleeding ulcer and gastric bypass so he can’t take aspirin.   He has arthritis and can’t take anything so doc gave him tramadal which he said was like eating candy as it did nothing.  He gave him the script for Lortabs and he doesn’t like taking it so he’s got to be in severe pain before he will and even then he tells me when he does and it’s maybe 2 in one day at most.  As I’d said a bottle of 120 lasted him 2 years. 

My SIL has Lupus and Fibromyalgia.  She’s always taking pain pills and was taking Lortabs and Tramadal many times a day. It got to the point the docs office started limiting her on refills and she felt they were calling her a drug addict.  They sent her to pain clinics and finally the doc gave her a script for a patch that’s got a morphine derrivitive in it and you only apply it once a day but she still wants her pain pills so they only give her tramadal.  In my and my husbands opinions she is psychologically addicted because she complains if she gets a hangnail and is in the ER constantly for knee pain from osteoarthritis.  Of course we can’t tell her that.  Then her daughter who is an addict to anything she can get her hands on is always complaining of some ache or pain and taking her mother’s pain meds.  She won’t even try an OTC she jumps directly to the narcotics even for menustral cramps.  

With all the abuse I’ve seen around me I can understand the tighter controls on narcotocs.

Doctors and hospital personnel never believe Don when he tells them he’s allergic to ibuprofen AND acetaminophen.  They think he’s lying and I have to back him up telling them about the hives he gets.  We didn’t realize it was all NSAIDS until we decided to try Aleive.  He took one and I had the Benadryl handy.  20 minutes later he said he felt good but 10 minutes after that and his face and back were covered in hives.  So much for that little experiment.  He’s afraid to take any medication because it might have one or the other in and I’m surprised he can take hydrocodone because it does have one of them in it but it must be such a small amount or released so slowly it doesn’t bother him.  

Either the amount the drops contained or the fact that they didn’t go through the system the same.  Don used Voltran which is an NSAID in a gel for topical application.  He had no problems with that but it still carries the same warings as ibuprofen which is stomach problems and bleeding.  

When I worked in Respiratory we’d put people on inhaled steroids and they were afraid to use them because they didnt’ want all the effects of prednisone.  I’d have to explain to them that by inhaling it you’re able to use less and still get the full effects on the lungs and since there’s less getting into the blood stream you’re not going to have the same side effects such as moon face and brittle bones.  I have diabetes and glaucoma (had surgery to decrease the pressure) and was on high doses of prednisone a year ago (started at 117mg) and it took about 4-5 months to taper off and it raised my glucose to over 200 and increased the pressure in my eyes to where I needed drops.  It took about 4 months of being off of it for things to go back to normal and I could stop the eye drops.  When I use an inhaled steroid for sinus problems I have no problem with the glucose or eye pressure and if I do it’s minimal even though the docs say to watch it closely.  Same with topical, the eye doc said it could cause an increase in the eye pressure but so far not so much.  

Did it seem to anyone else that Carly regained control of herself far TOO SOON for it to be the results of the pills she took?  She was a shakey mess; took some pills, and ZIP, she stops shaking and is talking and making excuses.  I just did not realize that she would get calm so quickly; shouldn’t it take a while to get from her stomach into her system!!  Oh well, what do I know???

Goody

I do believe if you’re psycholigically addicted to anything just the act of taking or having it near will calm that anxiety. 

As far as meds under the tongue, yes that is one way to get the fastest effect to meds but you’re only to do it with a med that’s meant to be done that way.  Nitro is meant to be used under the tongue.  I take Vitamin B12 and some are meant to be swallowed but they do have a sublingual available which is what I buy.  Some meds need to go through your system through the GI tract and can cause problems if not so don’t do that until you talk to the pharmacist to make sure it’s OK. Its the same way some meds can be cut in half for 1/2 the dose but other’s can’t and only your pharmacist and doctor can tell you if you can take it that way.  Some meds you can take 2 at once for a double dose but other’s are time released and taking 2 will put too much in your system at one time so if taking doubling the dose you need to take them farther apart.  I found that out with a blood pressure med.  I was taking like 5 mg of something and the doc increased the dosage and wrote a script for 10mg once a day so I took 2 of the 5mg.  BIG mistake as my BP dropped too low very fast.  Taking it the way I did caused too much to be released in my system at one time where the 10mg tablet is slower releasing and would have caused no problems.  I was told if I wanted to double up the 5mg I needed to take 1 am and 1 pm.  Now I always call the pharmacist to see if it’s OK to double them when the doc increases the dosage.  

In Minnesota it’s not like that. We can get refills on controlled substances unless it’s from the ER. If we need a refill, we just call the pharmacy and they fax the doctor for a refill and then the doc decides if we get it or not, but if we get it, then it’s just faxed back to the pharmacy and they will refill it.