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Old 10-04-2006, 01:46 PM   #1
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Thanks Shoreline

Shoreline,
I just wrote a page explaining what has happened in the past but for some reason it didn't enter in. I'll try to rewrite it later.

I was wondering how methadone worked for you and how much you were taking to get relief from pain? He has only been on it for 3 months, started out on 20 mg a day in July, to 40 mg a day in August, to 80 mg a day in Sept. and now 100 mg a day.

One reason he didn't try the Opana ER longer is that we a going to the Smoky Mountains next Friday and he was afraid he would not be over the side effects in time to go, and there was no way he could have went in the shape he was in.

Thanks,
Mary

 
Old 10-04-2006, 02:33 PM   #2
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Re: Thanks Shoreline

Hi Marry, All Total I probably took it for 2/1/2 years. maybe a little longer. After titrating and a doc change I biounced between 120 mhgs of meth and 600 mgs of morphine "kadian/mscontin" I really didn'tlike the way it made me feel but it made the pain tolerable. I had a huige increase in pain in thespring of 2004 and after some duiagnostics that showed more hardware breakage and damage they increased the dose to 160 mgs and after 3 months I was ready to do another pump trial. The did a siggle bolus injection instead of the inpatient, the first inpatient was skewed by a spinal fluid leak and I wasn't ready to make a decsion.

I couldn't stand the side efects at the higher dose so I went with the pump. Medicare didn't have script insurance and this allowed me to use something other than meth becausee they do cover the pump and refills. Going from meth to IT "intrathecal" morphine was like going from a very grey depressed world to life full of color with motivation to make some changes. I'm not getting tremendously better relief, but I'm not as sedated/impaired and the life that meth made exceptable was no longer acceptable.

Pain wise it worked well, I never woke up feeling the need to take a dose, It stays in your system and is very forgiving about missing a dose, Tolerance really wasn't an issue and is one the known benefits of meth. I just think it didn't mix well with me or my mental state about being disabled. It lowered my testosterone leves significantlyly, and kind of made an unexceptable situation exceptable. I understand pain meds make unexceptable levels of pain exceptable, but there was a greater effect that I found very negative about methadone.

I'm sure that's different for everyone, it became worse at the higher dose , so I'm not saying that to warn you. But if he loses his sex drive, I would definitely get his T levels checked, It can be supllemented. Which gives guys energy and motivation to thump their chest once in a while. As far as dose I would see that as tolerance, but as titration. Docs have to start low and moving him up slowly is normal. If he's undermedicated, it takes a week to level out, but waiting a month between adjustments sucks.

I was able to switch to morphine 3 times and once we had my dose figured out it was always a cold switch and days 4-14 where pretty hairy. I remeber not being able to focus my eyes, and being very depressed. It wasn't so much the classic opiate withdrawal, but it was pretty unpleaseant switching away each time but never a problem switching back.It was worth it because my head felt much clearer on morphine.

Everyone is different though. Some folks tolerate it well and although it's been 3 months, his dose may still not be right. The idea is to be productive as he can, I think he said it in his post that you do have to put up with some pain if you don't want to be a zombie. That's true with any med and any route of delivery.

I'm no different than anyone else though, there are plenty of days I wish I could be pain free for just a few hours and not a day goes by I don't wonder if another surgery would be the answer.
Take care, Dave

 
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Old 10-05-2006, 01:40 PM   #3
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Re: Thanks Shoreline

Shoreline,

I was wondering about the methadone and problems in bed. Did you say that methadone made that problem worse. and that there was something that he could take for that? He has that problem now. He takes enzine??? and his doctor gave him some samples of Viagra. He has a low harmone level now but to a surgery when he had to have a testicle removed. Is there anything else he that would help him. I am not worried about it except for him. It effects him mentaly really bad and he thinks it bothers me, but it don't. Any advice on what we need to do? If you have had the same problem, how can I help him unserstand that I'm okay with it?

Thanks,
Mary

Last edited by Sick of Hurting; 10-05-2006 at 01:46 PM.

 
Old 10-06-2006, 08:40 AM   #4
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Re: Thanks Shoreline

Shoreline,

Thanks for your response.

Anyone else with advice please post. We need allof the advice we can get.

 
Old 10-06-2006, 11:39 AM   #5
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Re: Thanks Shoreline

I've been on methadone for chronic pain for 4 years after 22 years of taking every known opiate there is.Methadone is an exellent pain killer for people who are chronic and well seasoned with opiates.It does lower the bio-available testosterone.I get a shot of testosterone every month and about 3-4 days later I can feel the effects of the shot.I get about 10 days out of it and then I lose my libido until my next shot.I also get my psa checked every 4 months just to make sure that the testosterone isn't causing any prostrate problems.Alot of people complain about increase sweating but I don't seem to suffer from it.I'm lucky I geuss because other then not being able to sleep very well and my low testosterone I don't suffer from any other side effects from methadone.I was at 400mgs a day for the first 3 years and in the last year I have actually come down to 300mg/day with no problems.I recently had another ct scan which showed moderate stenosis in both the lower lumbar 4,5and 6 and the upper lumbar 1and 2.Also I have 2 new herniations one above and one below my fusion on l4-5.So I'm going to likely have increases in pain in the years to come so coming down on my daily intake turned out to be a good is idea.For me personally, methadone has been the best pain killer to date.Anything I took before I would get tolerant to inside of a year.I was taking 3,000mgs of morphine a day before I got on methadone,it was crazy.The problem was even at those high amounts of morphine it wasn't taking my pain away and it was making me extremely depressed.All of that disappeared once I started the methadone.Good luck.....Dave

 
Old 10-06-2006, 01:05 PM   #6
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Re: Thanks Shoreline

As far as T levels, It was obviously the methadone that had the biggest impact based on testing. I was taking meth when I first started noticing a problem, i had my levels tested and they were very low.They started me on Androgel which is a topicalgel you rub on your belly and arms. They retested 3 months later and I was still taking meth, It was still low but I was at least at the bottom of the normal range. So my doc decided to ago to 10 grams a day or 2 packs a day, That made a huge difference in labido or drive. They retested 3 months later while I was still on meth and I was in the mid to upper range for my age.

So life went on, my wife got a new job with better script insurance and I switched to Kadian, I had a follow up with the endocrinologist after 2 months on kadian and still using 2 packs of Androgel a day, My T levels were twice what was concidered high for my age. Basically I went from 100 -200 to 360.Switched to morphine and using 10 granms of androgel a day my T levels shot up to 880. The only thing that changed was going from meth to morphine, so we cut back to one pack a day, I ended up switching back to meth due to anual limits of scrpt coverage and my levels dropped back down to low normal.

Eventuyally I had the pump put in, I did fine on morphine but they switched me to dilaudid to extend time between refills, again my T levels dropped so I went back to the doc, had it checked and started on androgel again. I basically stoped using it when I had to switch back to meth, I couldn't afford the 200 bucks a month on androgel.

Now medicare has a prescription plan, I had my T levels checked and they were low again so we went back to 1 pack a day. A month later I started working out, I was trying different meds like Cialis and Levitra and they worked OK, but working out daily did more than Cialis or lavitra ever did.I haven't filled that script since the month I started working out, now I don't need it. I think it's safe to assume that excercise also has something to do with T levels. Not to mention confidence, simply feeling good about yourself, feeling strong and depression is a factor with low T levels.

Basically all the things that happen to women when their estrogen declines as far as mood , sex drive, etc, works the same for men when their T levels decline. I don't bother with the ED meds any more, between the excercise and 1 pack of androgel per day, I'm functioning and feeling like a 25 year old again. The only thing holding me back is the crucnhing in my back.

T levels really are important, It doesn't matter why they are low, whether it's one med or another or from injury or surgery to the testicles, testosterone simply makes men feel like men. If his levels are low and he's not at high risk for prostate cancer, I would look for a supplement. I was offered the injections too, but daily supplementing maintains levels better than weekly or monthly injections. It's nice having a normal life in the bedroom and not worrying if the pill works or T levels are high enough, actually taking a pill like Cialis or Viagra seemed to put more presure on me to perfoorm. Or at least I wondered too much if it was going to help which puts your head in the wrong place.

I crertainly emphaize with the problem, It's extremely depressing if you have always had a good relationship that way, 40 your not quite ready to give up something so important to a relationship. Particlcuklery if he's disabled, loosing that ability too is something that can really cause major depression.Men put so much emphesis on who they are by what they do and can do.

I'm aware of the risk to prostate health using testosterone, It is a very real risk, but it's also imporatent to be able to function and find that intamacy that was lost during years of pain and meds. There is a solution worth trying, testosteron is available in small patches worn below the belt, the gel you apply "androgel" or by injection. Placement of the patch was kind of a negative, I knew the injections would wear off, so as long as I have insurance and feel I neeed It it part of staying and functioning normally. It's been extremely benfiicial. Probably in more ways than I'm giving it credit. I imagine It would be hard to motivate to do things you once enjoyed if T levels are drastically low, those levels are what seperates men from women and it's tough coming to terms with one more loss that quantifies who we are, sexual beings.

Try to be suportive and enourage him to try one of the products, not just to improve your sex life, but to increase his feeling like a man, feeling strong, motivated and wanting more than just to manage pain. Obviously there is a lot of psychology involved but a shrink can't even begin to fix the problems low T levels cause untill they know it's the problem. All the viagra in the world won't have an effect if he doesn't have the drive. Viagra helps the mechanics of things work, but testosterone is what creates or deminsihes labido or sex drive. Testosterone alone may make a big difference or it may simply allow the Ed meds to work since the person now wants or cares if things work.

Take care, Dave

Last edited by Shoreline; 10-06-2006 at 03:08 PM.

 
Old 10-06-2006, 01:26 PM   #7
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Re: Thanks Shoreline

Thanks to both of you, mpvt and Shoreline:

I will make a note of this and tell my husband. I just want him to feel good about his self. This is really taking a toll on him I can tell. Sometimes life don't seem fair but I know that everything happens for a reason. We have to keep telling ourselves this.

This seems like a wonderful board to get help on. You can talk to people that really understand you and your problems. If someone has not experienced it then they really can never understand. I want to thank everyone for any advise I get.

Thanks again,

Mary

 
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