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  • Help!!! On Methadone for pain, with side effects

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    Old 12-20-2005, 08:19 AM   #1
    foreverangel143
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    Help!!! On Methadone for pain, with side effects

    Hi Guys,
    New to this pain management site, but was instructed to come here from the RSD board.
    I have RSD now for 3 years. Being on lots of meds and now have a spinal cord stimulator for pain. But the spinal cord stimulator doesnt get all my pain so the PM doctor put me on Methadone 5 mg twice a day. The problem is that I took it for 2 days and I got very very nausea and so "loopy" that I almost fell down with dizzyness. If I opened my eyes the room would spin. I called the doctor and his nurse practioner told me to cut the pill in half, that this is "normal". My problems is that I am so afraid to take it again. I dont like that feeling, also I am afraid that I will fall down and dislodge my SCS. I dont know what to do. When in the hospital I was given morphine and Perocets and I got the same feeling. Maybe I just cant take pain meds. Can anyone help me about this drug? Or anyone get this same effect from the methadone as I did, I would love to hear from you. Thanks to all in advance and have a pain free day

     
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    Old 12-20-2005, 10:08 AM   #2
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    Re: Help!!! On Methadone for pain, with side effects

    Hi Angel, Because you said that Pecocet and morphine caused the same feelings it's not likely a side effect specific to methadone. It's more likely a side effect that your more sensative too that would come from any stronger opiate.

    The NP's advice was good, the dose your on should be safe if you have taken morphine and oxy safely, so it's just a matter of becoming accomadated "used" to this side effect. It does happen , it's just a matter of how long it takes. The loopyness and feeling out of sorts will likely deminsih with time,It may take days, weeks or a month. But if you only give any opiate 2 days to adjust to it, you will rule out every potential pain killer available in less than a month.

    Some people are simply more sensative to side effects and some people addapt much quicker. I hate to use drug abuse as an analogy, but people that abuse these drugs initially experience the same thing. That loopiness is Euphoria which is an escape from reality. To maintain that escape the dose must be continually increased. However with pain control, the anelgesic effect will remain much longer than the loopiness or euphoria. Meaning you don't have to feel doped or high to get pain relief.

    Most patients accomadate very well to opiates given time and those side effects like nausea, dizziness,and loopiness will deminsh and you will simply be left with the pain relief. Meth is usally a good choice for nerve pain and isn't an opiate that people need ever increasing doses to maintain the same effect. Once you reach a level of pain control, many folks including myself have gone years on the same dose without needing an increase and no longer experience those side effects.

    If these meds are used properly pain can usuallly be controlled and improve your ability to function. Some meds are more sedating than others and meth and morphine are usually the worst but that does deminish given time. For the most part, people will never even know that your taking opiates unless you tell them, which is a bad idea. But a whole nother topic.

    I would give it time, Meth serum levels or the amount in your system continues to rise for 5 days, so cutting back now makes sense, but you may not notice a huge improvement untill the the next day or the day after. Some people simply have to start slower and at lower doses, but that dosn't mean your one of the 10% that simply can't take opiates due to allergies or hyper sensativity.

    The one thing that concerned me in your post was likely just the way you worded something, but if your expecting complete pain relief as in 0 pain with a the combined SCS and opiates, that's not a realistic expectation. Docs shoot for pain control, not elimination. The only way to maintain a 0 pain would be to continually increase your dose and you would still have break through pain.

    Having realistic expectations from the SCS and from meds is the biggest part of you considering your PM a success or a waste of time. NO pain isn't a goal of pain management and simply not possible to maintain and remain functional. If the meds themself become more impairing than your condition, you do have to wonder why bother with the meds. But you are far from that point just two days into a new med.

    Give it time, your reaction is noramal for an opiate naive patient that hasn't been exposed to high doses of potent opiats. It's bad dtiming with the hlidays, but if your left with more pain than you can manage withthe SCS, this may be the only option if you have already tried other modalities. Most side effects will either deminsh or completely subside except constipation. That's a normal reaction, slowing of the bowel contractions with opiate treatment, the best way to manage it is to start using measures to manage it now before you find yourself so constipated your'e in trouble. Extra water, extra fiber, stool softeners and a stimulant may be neccesarry. There are natural products like Senna tea that will help, prescription meds for this problem and there are some recipes we can share.

    Just give it time, It takes 5 days for meth to reach full effect and then may take several weeks for the side effects to subside to the point you are simply left with the pain relief that these meds can offer.Not total relief, but enough to improve function and quality of life. That's the goal.

     
    Old 12-20-2005, 02:20 PM   #3
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    Re: Help!!! On Methadone for pain, with side effects

    Angel: I think you need to give yourself some time, like Dave (Shoreline) suggested and see what happens. It may turn out you just can't take Methadone, but if you give your body time to adjust, it might work out you can. Maybe you'll get the desired pain relief from a fairly low dose of Meth, which would be beneficial to you. I take Methadone too, and I have to take 180 mg per day.

    If it turns out you can't adjust, there are other long acting opiates out there that could be tried. Hopefully, you and your doctor will get your meds adjusted so you get the relief without undesired side effects.

    Good luck and please let us know how things are going with you.

    Last edited by Rrector; 12-20-2005 at 03:25 PM.

     
    Old 12-20-2005, 03:38 PM   #4
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    Re: Help!!! On Methadone for pain, with side effects

    Thanks guys for all you help. I have to go back to the pm doctor on Friday and I am going to let him know what happened while taking it. I know that 2 days is not enough time, but it scared me so bad that I am afraid to put the pill in my mouth. Silly, but it is a fear I have. Maybe if I try again when someone is home, like on the weekend, I might be ok. I guess my fear is if I fall I will dislodge my SCS, and I dont need that.

    Shoreline, I guess you are right about my high expections of the SCS and pain meds..I had it in my head that I would have 0 pain. I am learning slowly that it is not going to take all my pain away and I have to live and deal with some. I get relief with the burning pain from the SCS, but I get alot of break through pain..sharp stabbing pain that last up to 30 minutes at a time.
    Maybe I might not beable to take Methadone or Percocet or Morphine, and if that is the case, I guess 50% of the pain is better than "all" the pain.
    Thanks again for all you help. I wouldn't know what I'd do without this board. All of you have a happy holiday. I will keep in touch with you and let you know the outcome.

     
    Old 12-20-2005, 04:16 PM   #5
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    Re: Help!!! On Methadone for pain, with side effects

    I think it's kind of strange that your doctor put you on Methadone when you'd not had successful trial by LOWERING the dose of OTHER pain meds. I too thought I could not take percocet, etc. Now I'd have to take 20mg to notice (so far as pain--I'd definitely NOT get loopy on that dose!). Imagine my surprise though when--years later-- some Doc gave me 5mg percocet (I'd been given 10mg in the hospital) and I was fine. Initially the Percocet made me a little nauseated, dizzy, and I had a slight pressure headache at the base of my neck. This went away after a few days. It was well worth the trade of having my DDD, Stenosis, Facet joint arthritis throughout, carpa; tunnel, tarsal tunnel (feet), etc, controlled! Now I take MSContin b/c eventually a short acting drug like percocet was not good for my situation. They say methadone is great for long term pain. I'm going to talk to MY PM Doc about it next month as the MSContin is being pretty ineffective!

     
    Old 12-20-2005, 05:18 PM   #6
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    Re: Help!!! On Methadone for pain, with side effects

    Hey Dang: I think MS Contin (Morphine drugs in general) is about the only long acting med I haven't been on, but if it isn't effective for you any longer, I would definitely reccomend you try Methadone. It took me awhile to get to the correct dose to handle the pain, but I've been at 180 mg a day for almost three years now. I think you would like it, if you can get titrated to the proper dose. It sometimes takes some trial and error and if your doc is willing to work with you, it can be a great LA pain med. The only side effect I really dislike, is the nodding off most people get with it. I have trouble driving long distances, without dozing off. I have to take a small dose (just enough to get by) until we reach our destination. Fortunately, we don't travel by car too much. Also, when I was working, there can be a problem if your work is sedentary and/or redundant in nature.


    Let us know how you come out with your PM doc next month. Is he the type of doc that you can work with on something like this? Sometimes it takes awhile to hit the correct dose.

     
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