I've gotten a few questions about this thread and I'll answer here instead of PM.
Obviously, all med issues are between you and your doc... you should not be based on internet info. It's all just info into the hopper and should be treated as internet info which should always be suspect.
Having said that, if you seek out technical information on your meds... half life... graphs of serum levels, you'll begin to understand how the retarded (that what they call time-release in Europe) meds give you smoother coverage. If you graph the use of immediate release meds, you'll see you get faster peak serum levels and faster elimination from your system. You'll get higher peaks and lower valleys of 'coverage'.
If you map your pain, you should get a graph that you'd like to overlap with the graph of your serum levels. If you don't need any meds between your peaks of pain, then short acting meds may be most appropriate. If you have pain all the time, a baseline of time-relase meds, dosed to give you the smoothest possible coverage may be more appropriate.
I've been frustrated when I hear clients tell me, "I take 60mg oxycontin 2 times a day." From my experience, I was able to get by on much less medication if I spread it out to get smoother coverage. I would do much better on 20mg 3x than I did on 40mg 2x. It's 25% less medication, but smoother coverage.... without the low valleys you get with 2x dosing. This is just my experience... you'll work with your doc to figure out what works best for you. When I could get by with less meds, I went to 10mg 4x... again, less meds, smoother coverage.
Cindy, sorry to hijack your threads, but a couple of PM's referenced your thread.
BTW, with my lumbar problems years ago, tramadol was completely ineffective. With my lower pain levels, but more constant pain I experience now with my cervical problems, I'm finding tramadol working well. I'm taking the IR stuff, (only a couple/three days a week and never more than 1 or 2 a day), but based on this conversation I may ask for ER (extended release vs. immediate release). For some reason I undermedicate now and have to get pretty bad before I take something. Things have cranked up a notch and I may be taking meds more regularly.... spine problems suck!
All the best,
Mark
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