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Old 06-30-2010, 08:49 AM   #1
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Methadone vs Fentanyl for relief

Edit: The thought appearing in the back of my head as I type this is I am desperate and to be honest I don't think I can take this anymore. I have the most amazing and supportive wife. I love her but I sit here thinking I cannot take this anymore. I am sick of the stress, the anger, the depression and pain. I didn't ask to be hurt as a Marine I don't regret it but I am at the end of the road here.


C4-fusion x3 surgeries
L3-S1 x 4 surgeries with rod/screw placement/fusion
Left knee replacement

All injuries received on duty USMC last set of surgeries 1998 Lumbar

Tons of chronic pain both nerve pain like my nerves are playing their own unique symphony of pain. Everything from feeling like I have boiling water or hot irons placed on legs and upper arms to sharp stabbing pain and then also mechanical pain. I am 6'4 and the fusions and knee stuff have changed my gait, nerve damage has made various muscles not work too well atrophy.

Currently seen by VA (utter nightmare) I hate to be mean but my doctor barely speaks english there is a huge communication gap. she is very nice but seems baffled sometimes when I explain things to her. I have had her right down left arm pain when I JUST told her right arm pain. Stuff like that. As if she doesn't understand me and is off thinking about something else. she says oohhh that's nice a lot when I tell her what hurts? ***? And the math she uses is odd. I think she gets all of her patients med reorders mixed up because I have heard others complain.

My work has me traveling to a lot of odd countries that also are hot and I sweat a lot in hot humid places. I have tried at least 3 million times to explain these crap mylan patches do not stick to me. for 2 months they sent me Sandoz patches and it was a miracle. For 2 months the first time in almost 15 yrs of pain I was at a level that didn't have me gritting my teeth. Literally have broken/cracked teeth clenching my jaws in pain. I am a mess.

Unfortunately the Sandoz was a temp situation. Back to Mylan. Last visit she mentioned Methadone.. I have heard of methadone primarily for heroin addiction treatment and just now reading about pain management.

My question idoes anyone know of instances or studies where methadone has successfully replaced Fentanyl (100mcg) every 36 hours. I know Fentanyl if in the right form is a godsend I have had 2 months of life with it.

I can't take the mylan patches, the stress of patches falling off. So willing to try anything including methadone. but i'd like some info and to be informed.


So can someone PLEASE help me figure this out?

 
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Old 07-01-2010, 05:01 AM   #2
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Re: Methadone vs Fentanyl for relief

I can completely understand your pain and have full sympathy for you!!!! I have very much similar pain issues as yourself; herniated disc at C5-C6 touching the spine and surrounding discs degenerating. I also have T6-T12 and L1-S1 with Degenerative Disc Disease. I am in extreme pain every single day of my life and I'm only 34. I too have that burning feeling in my legs, nerve pain (radiculopathy), myofascial Pain Syndrome and sciatica constantly. I was using the Sandoz Fentanyl Patches and they were doing pretty well until my pain got much worse with a recent car accident (hit a telephone pole @ 50mph to avoid an accident!). When I was on the patch I was changing the patch every 48 hours as the 3rd day I would get zero relief. I did have to purchase waterproof medical tape which kept the patch on through the hottest days and water activities. I had to stop using these patches because they made me sweat so so bad; I'd have to take 2-3 showers a day since it would get to the point that my shirt was actually drenched in sweat. My kids and husband wouldn't even touch me; I'd sweat just making breakfast for my kids!! So then I was switched to Methadone; what a difference!! It took a couple of days to a week for the medication to set in but once it did I have had a much much better relief on my back. I still have a pain level of 7 but thats only because of the recent car accident which I'm going to request an increase. Prior to the accident the Medthadone kept my pain level at a steady 3. I was able to play with my children and interact with my family.
I think its definitely well worth it for you to consider changing to the Methadone; I feel you will get a much better pain relief. What I like about it is that there is no euphoria at all, just pure relief. I will stress to you that it does have to build in your system to get the full effect of the medication but once it does you'll be so glad you made the change!!!
Good Luck to you!! I truly wish you all the best and pain relief!!!!

 
Old 07-01-2010, 09:45 AM   #3
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Re: Methadone vs Fentanyl for relief

Quote:
Originally Posted by cheryl810 View Post
I can completely understand your pain and have full sympathy for you!!!! I have very much similar pain issues as yourself; herniated disc at C5-C6 touching the spine and surrounding discs degenerating. I also have T6-T12 and L1-S1 with Degenerative Disc Disease. I am in extreme pain every single day of my life and I'm only 34. I too have that burning feeling in my legs, nerve pain (radiculopathy), myofascial Pain Syndrome and sciatica constantly. I was using the Sandoz Fentanyl Patches and they were doing pretty well until my pain got much worse with a recent car accident (hit a telephone pole @ 50mph to avoid an accident!). When I was on the patch I was changing the patch every 48 hours as the 3rd day I would get zero relief. I did have to purchase waterproof medical tape which kept the patch on through the hottest days and water activities. I had to stop using these patches because they made me sweat so so bad; I'd have to take 2-3 showers a day since it would get to the point that my shirt was actually drenched in sweat. My kids and husband wouldn't even touch me; I'd sweat just making breakfast for my kids!! So then I was switched to Methadone; what a difference!! It took a couple of days to a week for the medication to set in but once it did I have had a much much better relief on my back. I still have a pain level of 7 but thats only because of the recent car accident which I'm going to request an increase. Prior to the accident the Medthadone kept my pain level at a steady 3. I was able to play with my children and interact with my family.
I think its definitely well worth it for you to consider changing to the Methadone; I feel you will get a much better pain relief. What I like about it is that there is no euphoria at all, just pure relief. I will stress to you that it does have to build in your system to get the full effect of the medication but once it does you'll be so glad you made the change!!!
Good Luck to you!! I truly wish you all the best and pain relief!!!!
Thank you very much for this reply. that euphoriaa thing you spoke of is important to me I travel globally A LOT and like to have a clear head. Fentanyl was much better for me in that regard opposed to the MScontin. That just made me droopy. I was worried Methadone would be like that.


again thank you very much exactly what I was looking for.

 
Old 07-01-2010, 10:57 AM   #4
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Re: Methadone vs Fentanyl for relief

4loveofcountry,

Please let me say thanks for your service. It saddens me to see one of our young men and women loose their health due to a huge sacrifice they made on my behalf. Im very grateful and sorry this has happened.

I have wondered about the exact same question, switching from fentanyl to something else. I would just like to be able to get adequate relief with something not so powerful. In my research I have come to the conclusion that methadone scares me more than the Fentanyl. I've seen numerous posters declare that meth is the most difficult med to come off of. I have wondered about oral morphine and in my part of the country, doc just wont rx oxychontin so that isn't an option. Maybe some kind of LA oxycodone?? I use percocet for BT.

I think a conversion is certainly possible but it needs to be done with very experienced PM docs or at the very least knowledgeable primary physicians. I have a fear that may not be possible for you with this doctor you have. The VA is quite something else to deal with. I'm an army brat and have seen the level of care one receives there. My dad died at 42 from lung cancer. Come to find out, the lesion was visible on his xrays two years before it was finally diagnosed thanks to the VA system.

I would really do some serious research on what meds you are considering and take a very clear plan to this doc and see if she would agree to go with a reasonable conversion plan. If she say's mista may not be good for you....
I'd hold out until you can find someone you can trust.



<edited>




Good luck with your meds country. God Bless

Bullymom

Last edited by Administrator; 07-01-2010 at 11:56 PM. Reason: rude

 
Old 07-01-2010, 12:36 PM   #5
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Re: Methadone vs Fentanyl for relief

4love of country.....My spympathies for the VA system. My husband is 20 yr AF retired. We are lucky that we only use Champus as secondary insurance. I know how our bnefits have erroded over the years.

My questions to you isare the Pain Management doctors at the VA you frequent? If there isn't, perhaps this would be a way for you to get a referral to a civilian doc.. do you think it would work?

I too offer my thanks for your sevice. My oldest serves in the Navy. He's my AF brat born in an Army hospital who joined the Navy...somehow he missed the Marines......

the best to you!

Last edited by Administrator; 07-01-2010 at 11:55 PM.

 
Old 07-01-2010, 01:46 PM   #6
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Re: Methadone vs Fentanyl for relief

bullymom thanks,

And it was my pleasure and honor to serve you all and our nation. Anyhow, What I was able to glean from my "research" is it depends a lot on the type of pain. Mechanical, nerve, muscle pain are all treated a bit differently and methadone is supposedly very good for nerve not so much for mechanical because of all the hardware etc.

I truly appreciate your input. And sorry to hear about your dad. The VA system is filled with horror stories and it breaks my heart when I see how they treat old WW2 vets.

The other problem with the VA is I think much of their decisions is based on cost. For example the Sandoz works for me, they know it works and sticks but they won't give it to me even though they have it because it has to come from a different region. I have offered to take the prescription to a civilian pharmacy but apparently the docs at VA are not allowed to write prescriptions for civilian pharmacies. Which kind of freaks me out...



thank you again.

Last edited by Administrator; 07-01-2010 at 11:49 PM.

 
Old 07-01-2010, 02:03 PM   #7
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Re: Methadone vs Fentanyl for relief

Quote:
Originally Posted by ibake&pray View Post
You go Cheryl!

4love of country.....My spympathies for the VA system. My husband is 20 yr AF retired. We are lucky that we only use Champus as secondary insurance. I know how our bnefits have erroded over the years.

My questions to you isare the Pain Management doctors at the VA you frequent? If there isn't, perhaps this would be a way for you to get a referral to a civilian doc.. do you think it would work?

I too offer my thanks for your sevice. My oldest serves in the Navy. He's my AF brat born in an Army hospital who joined the Navy...somehow he missed the Marines......

the best to you!
My dad was a career USAF officer, we have probably lived in some of the same places. He was a pilot with primarily the Strategic Reconnaissance Wings. I am glad I didn't go Navy, I don't think anyone works harder than they do while underway on a ship. They do bone crushing hours and work. We are lucky to have them. And he'll learn a trade in the Navy we just learned how to break stuff in other countries.

The good news is I have signed up with a civilian doctor via my insurance from work. I never felt right having a work insurance partially pay for injuries on duty but I have to look out for myself. The bad news is understandably he doesn't want to prescribe anything until he gets a copy of my records and we have had the request in for 2 months to the VA to send them copies.

Over 2 months to send records about 10 miles. That may give some who are not clued in to the VA how goofy they can be.

As I write this I think my option is clearly to wait however long it takes to be able to get a benefit from this new civilian doctor. I just am not sure how long that will take and part of this thread is to explore that option of changing should it arise. But since I am not as of yet officially in the care of the other doc I don't want to confuse the issue.

And lastly the other fear I have which might be a stupid one is that the VA Doc will not stop the patches once I start with this new doc and I do not want to get in to trouble. I think though with that I have some clear cut options. Like refusing the packages, calling and raising a real fuss.

Thanks for your input. And thank YOU for your service as a military wife and mom. I know my wife and mom both had it very hard while my dad or I was away. You did both jobs.

Respectfully

John

 
Old 07-01-2010, 04:38 PM   #8
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Re: Methadone vs Fentanyl for relief

Quote:
Originally Posted by 4LuvofCountry View Post

And lastly the other fear I have which might be a stupid one is that the VA Doc will not stop the patches once I start with this new doc and I do not want to get in to trouble. I think though with that I have some clear cut options. Like refusing the packages, calling and raising a real fuss.

John
John, I don't think it's a stupid concern at all. It shows you're thinking ahead and thats critical in PM. You really do have to watch everything you do once you sign a pain contract. I do think that simply making sure your new doc is aware of your concerns regarding this problem should protect you. If you have to take the patches to your new doctor and have them dispose of the unwanted patches should do it. Seems like a waste of money but you certainly don't want to get stuck with them.

After bashing the militarys way of doing things I do need to remember that they saved my life at Fort Bliss Army hospital when I was 11 years old and had bacterial meningitis. I had really good care back then and I need to give um some slack. LOL

Good luck dear,

Bullymom

 
Old 07-02-2010, 08:01 AM   #9
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Re: Methadone vs Fentanyl for relief

Quote:
Originally Posted by bullymom View Post
John, I don't think it's a stupid concern at all. It shows you're thinking ahead and thats critical in PM. You really do have to watch everything you do once you sign a pain contract. I do think that simply making sure your new doc is aware of your concerns regarding this problem should protect you. If you have to take the patches to your new doctor and have them dispose of the unwanted patches should do it. Seems like a waste of money but you certainly don't want to get stuck with them.

After bashing the militarys way of doing things I do need to remember that they saved my life at Fort Bliss Army hospital when I was 11 years old and had bacterial meningitis. I had really good care back then and I need to give um some slack. LOL

Good luck dear,

Bullymom
Definitely don't want to get stuck with them. I have two Jack Russell terrorist dogs and they find a way in to everything they are more like monkeys than anything else.

About 2 months ago I had just put on a new patch and was watching TV. I looked down and rowdy was at my feet wagging his little tail furiously with the patch hanging out of his mouth. Freaked me out. That patch had lasted I guess less than 10 minutes.

The other problem with Mylan patches I have never seen discussed before is the quality control. I am assuming this... Anyhow they often have a good bit of the sticky stuff on the other side of the patch around the edges. If you don't get it all off it will stick to your shirt and the first time you move it will pull it off. So now I take extra care to get the glue off (wish it was extra on the skin side) and check it frequently it would be a bad day indeed if one of our dogs got a hold of a patch and died. Luckily we don't have kids yet or probably ever

 
Old 07-02-2010, 08:12 AM   #10
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Re: Methadone vs Fentanyl for relief

Dear administrator I received a message from you to not discuss how the country is run. I don't recall making any comments about how the country is run. Sorry to ask here but your PMs are off and I cannot reply. I do understand that on forums there are no free speech rights and I understand that and I am more than happy to comply with the rules of YOUR forum it isn't my forum I am a guest but if I am confused about what part of the post below discusses "how the country is run" I am afraid of running afoul of the rule again. I am sorry it took so long to see your messages but I am not well versed in forum stuff and didn't note the new message box.

If you are talking about the VA portion it wasn't mean to be political that was not my intent. No one is voted in to the VA so I didn't see any political impact just making a factual claim. They are in fact making decisions on cost no way around it. We all make decisions based on cost.

Anyhow, didn't intend for this to be any sort of a political comment but merely a part of the issue that is definitely an impacting factor. My apologies to the board and the members.

respectfully,

John

thanks,

And it was my pleasure and honor to serve you all and our nation. Anyhow, What I was able to glean from my "research" is it depends a lot on the type of pain. Mechanical, nerve, muscle pain are all treated a bit differently and methadone is supposedly very good for nerve not so much for mechanical because of all the hardware etc.

I truly appreciate your input. And sorry to hear about your dad. The VA system is filled with horror stories and it breaks my heart when I see how they treat old WW2 vets.

The other problem with the VA is I think much of their decisions is based on cost. For example the Sandoz works for me, they know it works and sticks but they won't give it to me even though they have it because it has to come from a different region. I have offered to take the prescription to a civilian pharmacy but apparently the docs at VA are not allowed to write prescriptions for civilian pharmacies. Which kind of freaks me out...



thank you again.

 
Old 07-04-2010, 11:19 AM   #11
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Re: Methadone vs Fentanyl for relief

John,

Absolutely no apology necessary from this member

Take care,

bullymom

 
Old 10-24-2010, 08:43 PM   #12
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Re: Methadone vs Fentanyl for relief

I do not have the extensive problems that you have but I can tell you about my experience with methadone. I was on methadone 450mg in divided doses over 24 hours with fentanyl 100mcg every 48 hours. The fentanyl made me nauseated every morning and I also felt like I was in a fog most of the time. Taking Phenergan for the nausea made me sleepy and increased my feeling of "fog." After talking to my doctor every office visit about tapering off the fentanyl and increasing the methadone my doctor finally agreed. Long story short--methadone works great for relieving the peripheral neuropathy pain as well as the bone pain that I experience. There is really no maximum dose when taking methadone as long as the dose is increased slowly to avoid respiratory depression/death. I have read articles that said doses above 1400mg/day have been utilized without adverse reactions. If you do start on methadone please, please make sure that you read how methadone builds up in your body and how the analgesic properties do not last as long as the respiratory depression during dose escalation. The dose can be increased until your pain is relieved. Most newer doctors have never prescribed methadone and are unaware of its unique properties. You may even run into some doctors that will tell you methadone is not used for pain control, it is only used for opiate withdrawal/opiate maintenance therapy. I believe you receive your meds from the VA so hopefully that will make receiving your medicine easy. Some civilian pharmacists do not believe that they are allowed to dispense the drug, or in my case one pharmacist refused to dispense "that much" drug to one person at one time. I also have to remind the pharmacy to reorder the medicine each time I get it so that it is there the following month. It can be a real nightmare to go to the pharmacy to fill the prescription to discover that the medicine didn't get ordered (it can take 2 weeks at my pharmacy) or a floating pharmacist that thought the note that said, "Save 900 10mg methadone for Mr. M's prescription" was written in error and the medicine was dispensed to someone else. I only mention these things so that you can be on guard to keep these problems from happening to you. I also use oxycodone 30mg immediate release tablets ii (2) as needed for break through pain. I hope that this helps you find some relief from your chronic pain.

Last edited by dgnboy2; 10-24-2010 at 08:46 PM. Reason: typos

 
Old 10-25-2010, 09:12 AM   #13
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Re: Methadone vs Fentanyl for relief

My experience with methadone is this...a great , inexpensive treatment for chronic pain. I had injuries, similar to yours, and it help ed me greatly. I did not have insurance at the time, so the price is really affordable. Have you tried Opana? I really thought it masked some of the nerve issues better then anything else/fentanyl/methadone/lyrica/gabapentin/etc. i thank you for serving our country, and by any means you should not have to be in pain. If you cant see a pain management dr on base, or feel comfortable with the one you have, seek another opinion....maybe they will have someone else or send you somewhere else....good luck

 
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