Is patch better liver wise? - Pain Management Message Board

Ladybug46 · 03-20-2005, 10:42 AM

Hello to fellow pain sufferers. I have had severe chronic pain for years, was sent to a PM 2 years ago and what an experience it has been. My referring GP had me try the Fentanyl patch and it put me to sleep, and I only tried it for a few days. PM Doc gave me roxycodone to begin with, and it was working fine, then changed me to oxy-I didnt like the way it made me feel and he ended up giving me methadone 5 mgs tid. Now 2 years later he has never upped the dosage?? Needless to say I have been in constant pain for many months, 5mgs helps a little for maybe 2 hours. the only other med he has given me is Zanaflex down to 1 a day. I have liver disease early cirrhosis (not from alcohol) i do not drink. I have taken the meds exactly as prescribed and just suffer intense pain. @ months ago he told me the methadone wont hurt my liver and i should remain on it . Last month he was rude and said you need to come of all meds and then did some strange chiro moves on my back and neck-(which put me in the bed for 3 days, wrenching pain)-then wrote the same script. He acts all offended and defensive when I ask if he can up the dosage or put me on something else since my pain level is is around 7-9 on scale. I am not a problem patient I follow all his orders, and give urinaylsis every 3 months, have never ever got an early refill etc. QUESTIONS-what would any of you suggest I could do? Would the patch be better for me liver wise? Or do you know of anything else? Thanks so much.

SheSparkles · 03-20-2005, 11:55 AM

[QUOTE=Ladybug46] My referring GP had me try the Fentanyl patch and it put me to sleep, and I only tried it for a few days.<

Probably an incomplete trial...and perhaps the strength was too great to start out on.

> giving me methadone 5 mgs tid. Now 2 years later he has never upped the dosage?? Needless to say I have been in constant pain for many months, 5mgs helps a little for maybe 2 hours.<

I think this is completely irresponsible pain management. Tolerance occurs. Of course it is up to you to do a war dance to make sure the Dr. hears you say your pain is uncontrolled.

> Last month he was rude and said you need to come of all meds and then did some strange chiro moves on my back and neck-(which put me in the bed for 3 days, wrenching pain)-then wrote the same script 90 5mg methadone tid as usual. He acts all offended and defensive when I ask if he can up the dosage or put me on something else since my pain level is is around 7-9 on scale. QUESTIONS-what would any of you suggest I could do?<

I would never let him put his hands on me again. Period. You need to interview either new PCPs or be referred to new PM. Soon. Now.

> Would the patch be better for me liver wise? Or do you know of anything else? <

Most of the pure narcotics are friendly to the liver. The patch is no exception. I would encourage you to find a Dr. who will try you on the patch again. Do you recall the strength you were put on at first?
Sparkles

Ladybug46 · 03-20-2005, 01:05 PM

Thank you SSparkles for your suggestions and advice, it is very comforting to me. I just went to my lockbox and found 2 of the duragesic patches unopened-been in there 2 years! says 25 ug/h expires this month. If i remember correctly i only had it on no more than 2 days,

What would a complete trial be?

My regular PCP of 5 years has moved to another state. He was the nicest doc I ever had. I went to see the doc left at the same building the other day for GERD problems, and he spent 90 seconds with me and said double the nexium I am on. So Looks like I need to find new PCP as well as PM. How should i go about that?

You are so right I need a different PM I am on Medicaid, and know nothing about "interviewing" for another one. How do I handle that? Do I ask for my pain contract back, I do not have a copy of it. Should the PM or PCP do referring to another PM? With Medicaid I will have to be referred.

I dont want him to put his hands on me again either, I am fearful he may have caused more damage. In the past he administerd a few trigger point injections, which also was painful and didn't help. I am beginning to wonder if he has any training at all with the chiro stuff. I have that gnawing feeling in my gut something just isn't right with this doc.

You mentioned "pure" narcotics not hurting liver, i know i sound dumb- but is methadone one of them? Or what kinds are pure?

I have got to get startd on this asap, as you said. I dont have much of a life the way it is- with the conditons i have-I stay in almost all the time, in a recliner. I try to clean and can only do a bit at a time and have to lay down. I am thankful I have a supportive husband and no children at home. If I am able to get out my hubby has to drive me, and soon give out in less than an hour. I am 47, and its so hard to accept.

Sorry for the long post, again thank you for answering my posts. Hope you and everyone else is having a happy day. LB

twisten · 03-20-2005, 10:23 PM

Sorry to hear of the doctor troubles you're having Ladybug. Sounds like your doctor is a real abomination. I second Sparkles in that you need to find a new pm doc. Trust your gut feeling as intuitions are usually correct. I'm from Canada so can't help you with information on "interviewing for a new doc " unfortunately but I do wish you luck.

In my opinion an adequate trial for the patch would be at least a week, preferably two. When I was on the patch the sleepiness was a side effect that did diminish for me. I think that took close to a month though. Good luck with everything.

LibraBalancer · 03-22-2005, 12:02 PM

Lady...I'll second the 'finding a new doctor' motion. You know...I grew up watching my mom go through doctors for pain. For a long time, she was on Ultram and this doctor was her friend from HS. So she liked him, but was always in pain, constantly laying down (missing my childhood events, ugh!) Then one day in HS I told her about this Dr that was friendly with patients and very compassionate (later turned out the dr. was a 'drug dealer' and got arrested, but the point is...she HELPED my mom get out of pain. Put her on methadone and BAM...I got my mom back. She didn't think once that she should see another doctor for ALL those years...but once she did, it hit her...I'm seeing a dr. for pain control, not for the hell of it. You just have to take care of yourself...if your unhappy, move on...there is ALWAYS a dr. that would love your money. And now in my 20's I"m going through PM for my own problems, so I deff. knew what to do. My 1st Pm dr. had me on oramoprh, Kadian, Duragesic...all these expensive meds. I told her I couldn't afford these meds anymore, can we try methadone...she go irate and said thats a Euorphic drug and she NEVER prescibes it...so I said fine, I can't afford to see you anymore then. So I called this one office for PM and asked before I even made an appt. 'do you and are you able to Rx methadone there' I was told yes, so I made tha appt. So, now after taking a stand for my self, I'm in much better shape and I'm not climbing the walls figuging out how I'm gonna shell out 300.00 for some patches. But the patches are SAFE ON THE LIVER! So maybe thats a good thing for you. But don't be afraid to asks questions like I did b4 making an appt. Ask, do you Rx methadone for PM? If they can't tell you, then move on. JUST DO IT! for yourself. xo James

- I am curious though, why such a low dose on methadone? Is it because of your liver problems? I was put on 80 mg's daily and was told I might have to go to 120mg's daily. And I was new to methadone. I'm just thinking your mg seems like a infants dose...?