The medical director in er suggested that my dr increase my vicodin from5/525 to 10. my dr. disagrees what should i do? my pain isn't being managed.

Judgement Call: Dosing narcotics can be difficult and sometimes sensitive topic. If you have a legitimate reason to be on higher doses of opiates, you can try to make the case logically to your pcp. If you feel strongly about it and he/she does not agree then you may consider obtaining a second opinion or seeking out a pain specialist. I would advise first trialing non-narcotic agents first though.

Rock and Hard Place: In chronic pain, even the strongest opiates only "take the edge off". It's the easiset thing in the world for someone to suggest increasing an opiate. These meds are just tools. They do a little something. They can be part of a plan. A pain specialist can try to offer other tools and treatments. Unfortunately, pain is so crucial to staying alive, that we are not allowed to monkey with it much.