Big Changes - Pain Management Message Board

forginon · 05-16-2007, 11:53 AM

I've just been diagnosed with heart failure and it's very scary. It came on fairly sudden after a bad bought with the flu. I thought my struggle with pain management was difficult enough and I'm having a hard time handling this emotionally.

I am undergoing medical tests and treatment and the doctors have agreed that the methadone may be at fault (causing prolonged Qt intervals-haven't really studied this but it has been getting some press lately).

So, my pain doctor was consulted and I was switched from methadone (80mg daily) to MS Contin (300mg daily) with MS Instant Release syrup for breakthrough pain or withdrawal symptoms during the transition.

Over a number of weeks I have worked my way up to the 300mg/day dose of MS Contin and require very little syrup, and less as time goes on.

I'm just wondering if anyone else has had to switch from methadone to MS Contin and how it went for them? I'm feeling down because I really felt methadone was the answer to my chronic pain, and I had been able to hold my daily dose for years. Now I'm back on an opiate that brings much more in the way of tolerance challenges than did my methadone (at least that's what I hear and from personal experience I noticed that once I reached the 80mg/day dose it was easy to stay there).

Anyone with similar experience with added heart failure or conversion from methadone to MS Contin I'd love to hear your thoughts...

steve

BrittleBones · 05-17-2007, 07:23 AM

Hi Steve - I'm sorry to hear about your heart problems and the changes you are being forced to make regarding your pain meds. I was on Methadone for almost 2 years at 120 mg. per day with oxycodone 30mg. for breakthrough pain. When I was first placed on methadone it took some adjusting to my dose to get to a place where my pain was manageable. I eventually was up to 180 mg. per day and then titrated down. During my time on the drug I experienced some heart abnormalities but didn't attribute them to the methadone. This is the first I hear of a possible correlation between the two. But, one of my heart problems was also the long Q-T intervals which showed up on three of my electrocardiograms! So I'm really interested in what you've been thru! At the time I had an indication after a stress test of a blocked artery but after heart catheterzation it turned out that my arteries were perfect and my heart looked normal. The docs were not sure what had caused my heart problem - at the time I was taking another drug for severe anemia that could have contributed to the chest pains that prompted me to go to my doc. Just like you, I found that methadone was the best drug for me as far as a steady dosage and the lack of a "buzz" or euphoric feeling. Unfortunately my pain has increased substantially over the past 3 months and my doc just took me off the methadone and switched me to the Duragesic patch. I just wasn't willing to go any higher on the methadone (and he wasn't happy about upping my dose). So far the patch is working well for me. I'm also hoping to get a trial on the pain pump by the end of the summer which would allow me to get much smaller dosages of drugs directly into my spinal column. It's very hard to figure out what drug is causing which side effect when you take many medications. I take about 7 or 8 different meds every day from prednisone to lipitor to synthroid and more. KathyMac

forginon · 05-17-2007, 08:47 AM

KathyMac,

Thanks a bunch for the input!

The Drs. are admitting that the suspicion of the methadone is a reach, but they're having trouble nailing down a cause. It's very unusual for someone to get heart failure at 51 years of age and they're a bit stumped. They've run a bunch of tests, and some have been very positive for heart failure but nothing definitive for the cause being the methadone. More often, the association has to do with much higher methadone doses than I was taking, but they wanted to rule out everything. As you wrote, it's also very hard to nail anything down when one is taking so many meds. Since the heart problems they've added about 4-5 different meds to my list and I don't see how it's possible to ID a definitive culprit when so many things were changed.

If I learn anything more solid I'll be sure to post the information.

steve