I am getting very close to my wit's end in my pain management issues. I will start with some background and then present what the issue(s) are. My problem started when I had an almost fatal automobile accident in 2006. I will try to keep it sort because you are a DR and so very busy! I had to be extricated from the vehicle after it hit a power pole. Fortunately my vehicle was the only one involved. According to the EMT records I was able to obtain, they thought I was already dead or dying and they flew me to the hospital in a helicopter. They had to perform brain surgery to remove pieces of plastic from my brain. I was put into a medical coma for 4 days and then I was transferred to a rehabilitation hospital for care. For about the first 2-3 weeks, I had no memory of my past and that included not knowing anyone including my wife. I was hospitalized for about 3-4 months and I started regaining (fortunately) my memory and had gotten it mostly back prior to being released from the hospital. I was ‘rushed’ back to work (mostly due to insurance issues) and that's the continuation of my story. I am currently on long-term disability since about Sept. 2008 because of my current pain issues. I have had problems with extreme pain due to headaches. I never had migraines before and several doctors I have seen regarding the pain have all agreed that they aren't migraines. I have also had issues with lower back pain but most doctors don't want to address that issue (I know it's my fault because I could press the issue) and they would rather concentrate on the head pain. The head pain is actually worse so it does need to be addressed. I have had a couple of MRIs and I have been to a pain management clinic but they haven't helped. The pain management clinic kind of made things worse for me because they were preaching anti-narcotic propaganda to my wife (you’d think they would be open to any pain management techniques) and she is/was anti-narcotic anyway. Trying to keep this 'story' as short as possible, I have been taking hydrocodone with acetaminophen (10/325 MG) (generic Vicodin), since about Feb 2007 for the pain. I started with 7MG, 1 pill every six hours and then it was changed to 10MG, two every six hours. Doctors of course, don’t like to keep prescribing it because it’s a narcotic, so I’m wondering when they’ll stop! . My main issue right now is that the hydrocodone stopped relieving the pain in about late 2008. It still has SOME pain relief because the pain is not UNBEARABLE yet, but I feel it will become that way soon because it has been getting worse, so I need some advice on different medications, obviously something with more pain relief. I don't know what medications are currently available, but some that I found are: oxycodone (which offers higher MG than the hydrocodone that only has 10MG as the highest dosage), fentanyl TD (which I think may be too strong) and there are several generic forms of oxycodone. Although it is my desire to be pain free (or as much so as possible) in my head and my back, I also don't want to take something that would be stronger than I really need. I do need to mention the fact that I have a high resistance to pain medication. Thanks for any help and/or advice you can provide for me.