Med increase - Pain Management Message Board

RetiredDirector · 08-15-2005, 01:00 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.

jdlfmc · 08-15-2005, 05:42 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

RetiredDirector · 08-15-2005, 08:48 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.

Shoreline · 08-16-2005, 06:52 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.

You would at least be letting him know that things are so unsatisfactory you are willing to do or try anything.

Good luck, Dave

RetiredDirector · 08-16-2005, 11:07 AM

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.