Update: after being on 40mg bid of the ER, I've weaned myself off completely again, now for a week. Has not been fun, intense headaches, explosive you know what, abd. cramps, sweats, chills, "crawling" skin....I sure thought this 4th time would be easier. Have MD apointment tomorrow w bloodwork schedules (the always test for all drugs...inc recreational ). I can't say it was easy, despite very conservative titration, and unfortunately insomnia and chronic at times near intractable pain have returned. Appears at least for the present will require a manintenance dose, maybe 120 or 160. Certainly a huge improvement from pre-fusion surgery of 360 + prn breakthrough (~40-60mg more in IR).
Still wondering though, have I given long enough to drug holiday? And as widely thought, is the "rebound pain" actual, or result of new receptors the flood of opiates have found in my body?
Not averse to using it approriately even longer term if absolutely necessary, but obviously, NONE would be better.
Someone asked earlier how original injury happened: went to aid fellow nurse on lockdown BA receiving unit, PT 280lb 6' and totally psychotic, enraged at being on close obs for suicidal ideation...attacked (and eventually killed other nurse, bashed his head into concrete wall corner), I attempted to intervene as trained with rapid acting sedative syringe in hand, while bent at waist injecting into clients dorso-gluteal site he threw me about a dozen feet, landed on and broke my coccyx and compressed L4-L5-S1 with immediate loss of sensation, areflexia, intense radiculopathy. Original decompression discectomy about 6 mos later was successful for about a yr, until the then degenerated discs comressed nerve roots again. Have exhausted all alternative and conservative modalities inc acupuncture, hypnosis, traction, seroids, trigger pt injections, blocks, to no avail.
Still work psych (well, soon as fully recovered from 3 level fusion), hence the NIC, and if you know anything about Finns, the sig also....