Director
08-15-2005, 04:00 PM
I need some fellow CP'ers opinion on increasing pain meds. I see my doctor next week and I have been having increased pain or my meds aren't doing the job they once did. It's been over two years I've been on the same dose of Methadone and I called the doctor's office about three weeks ago and asked the nurse if the doctor would consider bumping me up a little becausing I seem to have an increase pain that the Meth isn't handling like it did. I should also state I take no BT meds with the Methadone. The doc turned my request down and the nurse called and said he would like me to get by with my present dose. Is over two years at a dose reasonable when asking for an increase? Or is Meth one of those meds that an increase shouldn't be necessary? I would appreciate any feedback. Thanks.
Sponsor
jdlfmc
08-15-2005, 08:42 PM
I'm no expert by any means but it sure doesn't seem unreasonable to me, how many times a day are you taking your meth?
Linda
Linda
Director
08-15-2005, 11:48 PM
The script said TID (3XDay), but the doctor said I could break it up and take it in several doses throughout the day if it worked better for me that way. I've tried it both ways and I think taking it throughout the day works a little better for me.
BTW, because of my high tolerance of opiate meds, I'm on 180 mg per day. 60 mg TID. That's the main reason I have no meds for BT pain.
BTW, because of my high tolerance of opiate meds, I'm on 180 mg per day. 60 mg TID. That's the main reason I have no meds for BT pain.
Shoreline
08-16-2005, 09:52 AM
Hey Director, If a patient was taking meth for maint of addiction, therew ould be no need to increase a dose once a stabalizing dose was found.
But when used to treat CP, meth is just another opiate with the same ablity to grow tolerant. Personally I think 2 years is a testiment to how well meth works and how it slows rapid tolerance. I doubt you would see those types of number with OC, I guess someone in his practice must be his highest dose patient. If you happen to be the one, you are somewhat his ceiling
I would certainly bring it up again, but not necesarrily as an increase, ask him what he can do to make the meth more effective, fif he has no ideas ask to talk to a pump doc. I can't recall how much of your pain is nerve pain, but it may be the next step and He shouldn't have the same "pill counting and mg scrutinizng" concerns about what level of medication you recieve through a pump. I haven't seen the DEA scrutinizing pump patients doses, at least not yet. :rolleyes:
You would at least be letting him know that things are so unsatisfactory you are willing to do or try anything.
Good luck, Dave
But when used to treat CP, meth is just another opiate with the same ablity to grow tolerant. Personally I think 2 years is a testiment to how well meth works and how it slows rapid tolerance. I doubt you would see those types of number with OC, I guess someone in his practice must be his highest dose patient. If you happen to be the one, you are somewhat his ceiling
I would certainly bring it up again, but not necesarrily as an increase, ask him what he can do to make the meth more effective, fif he has no ideas ask to talk to a pump doc. I can't recall how much of your pain is nerve pain, but it may be the next step and He shouldn't have the same "pill counting and mg scrutinizng" concerns about what level of medication you recieve through a pump. I haven't seen the DEA scrutinizing pump patients doses, at least not yet. :rolleyes:
You would at least be letting him know that things are so unsatisfactory you are willing to do or try anything.
Good luck, Dave
Director
08-16-2005, 02:07 PM
Thanks for the info Dave, I appreciate it. I guess you're right about the Oxycontin. When I was on it I went from 20 mg TID to 160 TID in about eight months. Can't be sure, it's be awhile ago. The Methadone dose I have been at for close to two and a half years now. I thought my doctor would up the dose, but maybe he will when I see him next week.
As far as the pump goes, I did check into that and was accepted in a program for trials. I thought I'd do it, but the hospital that the Pain Center is located is about two hours away. They might have a doc here that could do the refills, etc. but I decided to wait. I think that's when I went on the Meth. My doctor started that low too (which I've read since you 're suppose to do), but I wasn't really confortable until we got to 180 mg.
I just wanted to get other's opinions on the length of time I've been at the present dose and if it appropiate to ask for an increase when I see him next week. He only has me come in every two months, so he can show in my records he is treating me.
As far as the pump goes, I did check into that and was accepted in a program for trials. I thought I'd do it, but the hospital that the Pain Center is located is about two hours away. They might have a doc here that could do the refills, etc. but I decided to wait. I think that's when I went on the Meth. My doctor started that low too (which I've read since you 're suppose to do), but I wasn't really confortable until we got to 180 mg.
I just wanted to get other's opinions on the length of time I've been at the present dose and if it appropiate to ask for an increase when I see him next week. He only has me come in every two months, so he can show in my records he is treating me.
Shoreline
08-16-2005, 10:17 PM
Hey Director, It was right at about 2 years after switchng back to meth from morphine when I needed to go from 120 mgs to 150, but the side effects pushed me over my ability to deal with them, so I pursued the pump. I wonder if the trial you were talking about 2 hours away was the trial going on for the synchromed 2 at the time. A half dozen or so testing sites were given these pumps and the new telemetry units while they made sure it was just as safe and predictable as the older unit.
You might want to inquire with medtronics about pump docs in your area. Medtronics is great about patient support, They allowed me to talk to R&D and gave me the direct line to our local medtronics rep. Very patient friendl company. If you had invested in them 20 years ago you would be a multi millionaire now.
I can't vouch for everyone, but when I asked the NP about an increase she flat out denied it, but I insisted on talking to my doc and he felt 2 years was excellent and had now problem with an increase. It;s not like your at any ceiling unless side effects are a problem. I know one patient taking 160 4 tmes a day. I was my first PM doc that prescribed LA opiates highest dose patient at 120 mgs of oxy a day and then 80 mgs of meth. She would gladly send me into a stupor with Nueontin, Zanaflex, Remeron, soma, and Xanax, but god forbid she increase my opiate dose. Go figure.
But it sounds like you have a good relationship with the doc, sometimes it's just a matter of getting past the NP's and PA's which seems to be a growing problem with the monthly DEA apts to check fill dates and count pills. :rolleyes: Mesaages loose their imact when relayed as I'm sure you know.
Goodluck and let us know how it goes.
Take care, Dave
You might want to inquire with medtronics about pump docs in your area. Medtronics is great about patient support, They allowed me to talk to R&D and gave me the direct line to our local medtronics rep. Very patient friendl company. If you had invested in them 20 years ago you would be a multi millionaire now.
I can't vouch for everyone, but when I asked the NP about an increase she flat out denied it, but I insisted on talking to my doc and he felt 2 years was excellent and had now problem with an increase. It;s not like your at any ceiling unless side effects are a problem. I know one patient taking 160 4 tmes a day. I was my first PM doc that prescribed LA opiates highest dose patient at 120 mgs of oxy a day and then 80 mgs of meth. She would gladly send me into a stupor with Nueontin, Zanaflex, Remeron, soma, and Xanax, but god forbid she increase my opiate dose. Go figure.
But it sounds like you have a good relationship with the doc, sometimes it's just a matter of getting past the NP's and PA's which seems to be a growing problem with the monthly DEA apts to check fill dates and count pills. :rolleyes: Mesaages loose their imact when relayed as I'm sure you know.
Goodluck and let us know how it goes.
Take care, Dave