Bait and Switch

OK, I'm adding this to this post, so I don't forget tomorrow, but the EGD procedure next week has been cancelled until further notice. If I remember, I'll add it tomomorrow as well. To repeat, no more EGDs scheduled!

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In addition to mowing the lawn, I finally took matters in hand and, for the first time in two – three years, washed the outside windows yesterday. So guess what happened last night and today. If you guessed rain, you’d be right. Maybe this should have gone in the “Some Days You’re the Bug” post.

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I stopped by the pharmacy over the weekend to get my next fix of PC. While there, the pharmacist, in addition to asking if I had any questions about my PC asked a bunch of unobtrusive questions about my “condition.” Since I had nothing to hide, and since I have a tendency to trust people with “expertise” (unless I know better), I told him what was going on with me.

But the questions he asked, and the comments he made, started me to wonder what his concerns were. So I did some checking. I found something interesting when I started to read my PC medicine labels.

The liquid form of my medication, the elixir, contained 7.5 mg. Hydrocodone / 500 mg acetaminophen per 15 mls. Label directions for usage were 15 mls every 6 hours as needed, for a maximum usage of 30 mg. Hydrocodone / 2000 mg acetaminophen every day.

Oral directions from my doctor increased the dose to 15 – 30 mls every 4 hours increasing my daily consumption to 45 - 90 mg Hydrocodone / 3000 – 6000 mg acetaminophen.

Now, the FDA has a 24-hour maximum limit for acetaminophen set at 4000 mg. So, the doctor’s orders for the liquid medicine puts me near or over the FDA’s maximum, putting me at risk for hepatotoxicity; severe liver damage!

When I could no longer tolerate the liquid form, I was switched to pill form of the drug. However, while my dosage schedule was increased—I am directed by the label to take 1 – 2 tablets every 3 – 4 hours as needed for pain—the Hydrocodone level was actually reduced to two thirds of the previous level! . Each dose, each tablet, now contains 5 mg Hydrocodone while still containing 500 mg acetaminophen.

That means on this new dosing schedule, my Hydrocodone consumption is reduced to 30 – 80 mg each day while my acetaminophen consumption is increased to 3000 – 8000 mg per day!!!!!! Twice the FDA’s maximum.

Sure, “the doctors are watching my consumption.” Yeah, right!

The Wikipedia article states, “Daily consumption of hydrocodone should not exceed 40 milligrams in patients not tolerant to opiates.” But they also point out that the PDR (Physician’s Desk Reference) makes allowances for higher dosages as long as the side effects do not manifest themselves.

Now, as a pain reliever, acetaminophen doesn’t work well for me at all. Over the years I have had opportunity to obtain prescriptions to Tylenol #3 with codeine. Until recently, I had two prescriptions for the stuff sitting in my dresser drawer; one prescription from 1985. I don’t know what the fuss was all about; it never did that much for me.

Current consumption of my PC puts me right at 35 mg / 3500 mg. One more tablet a day will max me out. Care to guess what one of my questions to my doctor on Wednesday will be?

Edit: Added schedule change!