Thanks Shoreline - Pain Management Message Board

Sick of Hurting · 10-04-2006, 02:46 PM

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

Shoreline · 10-04-2006, 03:33 PM

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

Sick of Hurting · 10-05-2006, 02:40 PM

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

Sick of Hurting · 10-06-2006, 09:40 AM

Shoreline,

Thanks for your response.

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

mpvt · 10-06-2006, 12:39 PM

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