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    Old 07-25-2003, 03:41 PM   #1
    HikingFan
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    Post Doc prescribed methadone??

    Hi guys! I got a question I really need some help with.

    I don't know if you are familiar with my history, but basically I am being treated for severe DDD, arthritis and pinched nerves/numb arms. My med progression looks like this:

    06/02 - 1/03 Prscribed 5/500 vicodin (6/day)
    1/03 - 03/03 Upped the Vicodin to Oxycodone (6/day)
    03/03- 06/03 Switched from oxy to 10/325 Norco (8/day)
    06/03- 07/03 Switched from Norco to SR Morphine (45mg/3xday)
    07/03- Current SR Morphine made me itch, back to Norco

    I really don't want to be on the short-acting meds, and since the SR Morphine made me itch, I asked my doctor to switch me to something else long-acting. Her office called me today, and said she left a script for Methodone for me. She apparently had a family emergency, and will be gone for a week. There was nobody to ask questions to, so I don't know much about this drug. Its seem extrememly irresponsible to just leave this script without talking to me about it (I have been calling the office for a week, and this is the response I finally get). I have read some past posts about the methadone, but still have a few questions:

    1) If the main advantage to this drug is that it doesn't give you the "high" that short-acting meds do, what exactly is so addictive about it? All the literature I read on the internet talks about it being the most addictive opiate, and this worries me.

    2) My doc didn't leave me any instructions about break thru meds. Is it okay to still take my norco (hydrocodone) if I absolutely need it?

    Any advice you can provide would be greatly appreciated.

    Sara



     
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    Old 07-25-2003, 04:20 PM   #2
    HockeyCrystal
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    Sara-
    Wish I could help, but unfortunately I have almost no knowledge of methadone... Sorry hun.. I was worried about you, I hadn't heard from you in a few days.. And I didn't see you post anywhere else for a couple days either. I just wanted to say good luck finding your answers... I hope you get the advice you need. Unfortunately, I have no clue about this drug... Keep me posted what you find out though...

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    Crystal

    P.S. I've updated me on my post about upsetting doc appt...Just in case you wondered how i was doing...
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    Old 07-25-2003, 07:52 PM   #3
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    Hello All,

    To give you all a little info on methadone. Methadone is one of the only true long acting meds. But it is also the only med that has given me truely lasting pain relief. It is a very potent narcotic. I'm on 70 mgs a day taken in 2times 2 a day then 3 10 mgs at night. I need to tell you that I titrated up to this dose very slowly. To start I was given 5 mgs 3 times aday and over 2 months I was brought up to the current dose. I need to express upon you that you need to titrate slowly up to the optimine dose. So I would tell you all to start out like I did and then go up slowly every two days to the dose that your DR. Has persribed. Methadone is not any more addictive that the other Narcs out there. It's just that it is very long acting and it builds up in your system. I was very upset to my stomach the first week. I even thru up the first couple of days. But I over came those sides and now truely benfit from this very wonderful Med. It has given me my life back. Yes I do take BT meds I Can take up to 20mgs of Oxy IR 4 times a day. Due to taking MSM 3000mgs a day I now take Only 15 mgs a day Max of Oxy IR for BT pain. I cannot stress enough that you need to go slowly with methadone. It is a great med for CP as it has given me my life back to some degree. I do suffer from mutiple chronic pain. I have broken my back and have 4 surgerys and have HepC and several surgerys on my liver and ducts from my Hep C which I contracted from my first surgery on my broken back in 1985. Yes I am very familar with pain. And I am a advocate for methadone. It is a second line med. Most Docs like to try all the other meds first because of methadone long acting attributes. I hope that you all have the same degree of success that I have had in my recovery and pain free statis. Methadone has not taken away all my pain. But I am able to work and continue on with a more normal life than any other time in my Adult life since breaking my spine. If I can be of further assistance I would be more the greatful and it would be my pleasure to help you in any way that I can......

    Matt


    [This message has been edited by grizzk62 (edited 07-25-2003).]

     
    Old 07-25-2003, 08:18 PM   #4
    Jack Beanstalk
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    I truly hope that you guys out there just starting Methadone treatment will read the Grizz,s post and then read it again.He said a few key statements that need to be paid close attention to.The main one is to start out slowly with this Med.Like most good,potent Pain relievers,it will be good to you if you,ll just respect it.It can be deceptive cause of the way it begins working.Unlike most of the Opiates,Methadone hits a few of the different pain receptors than they do,so it doesn,t really "feel"like it,s doing much,but don,t be fooled.When I switched from Oxy to Methadone,my doc put me straight on it from 640mg Oxy a day,to 40-50mg of Methadone,taken 3-4 times a day.I did,nt need to take nearly that much.I played it safe and settled on 20mg,4 times a day,been on that dose for about 2 years(was recently given extra 20mg a day option).Sara,what is the dosage info on your script?Jack B.

     
    Old 07-25-2003, 10:32 PM   #5
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    Thanks for the helpful advice Jack and Matt! And hello, Kadogo, and welcome to the forums...I read your history on the "Identity outside of CP" post and you sound like you've had a really unique life experience.

    Jack, I was prescribed 5mg and the label says to take 1 every 8 hours. I hope this is going to be enough to work...I will heed the advice to stick exactly to the directions. I asked my pharmacist a lot of questions, and he gave me some good info about the action of the med (with respect to building up in your fatty tissue, and its affects on your respiratory system if you try to take too much, and the importance of having patience to wait for it to work) Too bad he made me mad because he told me (twice) that he doesn't think this med should be presribed unless it is for cancer pain. I started laughing when he said that...I thought to myself "this isn't a battle I feel like fighting today."

    Jack, I am worried that my doc is not monitoring me closely or talking to me about this stuff. I had a bad reaction with the facet joint injections, and had called to talk to her about it. I was sweating profusely and had wierd throbbing headaches. I called every day this week, and they kept telling me that she was getting my messages and was just really busy, etc, and that if I was REALLY in that much pain, that I should go to the emergency room. That is the worst advice possible...I've taken that route with the ER before, and I am not going to pay $100 copay to sit in the ER for 6 hours, just to be told that I should call my PM doc in the morning and they can't do anything for me! The cycle makes me want to pull my hair out!!

    Finally today I called again for the 5th time (and was about to lose it I was so mad!) and the nurse says, "oh yea, I forgot to tell you when you called yesterday that your doc left you a script for methadone." I said to the nurse, "can I talk to her about this?" She she said, "She will be gone for 2 weeks and its policy that the other doctors in the clinic can't treat you or give advice because it might be contradictory to her treatment plan." I said to her, "isn't methadone a pretty serious narcotic with very different dosing instructions and expectations than your usual narcotic? can it be dangerous?" (I basically just wanted to talk to a doctor before beginning any new med) And this nurse actually says to me, "Well I take aspirin every day, and this could be dangerous too....any med can be dangerous." I just held the phone to my ear for a minute and felt like I had entered the twilight zone. Its like, what the hell does your aspirin intake have to do with my methadone prescription? And isn't admitting that any drug is potentionally dangerous all the more reason to let me talk to her? Not to mention, I had no idea about what I was allowed to do for breakthru pain. I'm smart enough to know that I shouldn't take the norco unless I can't handle the pain anymore, but what if I wasn't a well educated patient? She never indicated (and the nurse didn't mention) discontinuing the norco...what if I started taking them together?

    Sorry this turned into a venting session...I just can't believe the lack of care I am getting from my doctor. It seems like there is probably something illegal going on...I looked on the website that someone posted that links to all the state DOH depts and how to file complaints, but I figured out that HMO's don't fall under this umbrella govt' watchdog.

    I am sinking into a depression with all this. I feel like I keep walking into walls, turning around and walking into another wall.

    Any advice you can provide would be great.

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    Sara

     
    Old 07-26-2003, 01:36 AM   #6
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    Hi Matt
    Is there any reson that ypu are not taking your methedone with the MSM? The rason I ask is I am not real familiar with MSM and I do take 10mg of meth for chronic pain no more than twice a day and was wondering if they mix well or not??
    Thanks for any answer

     
    Old 07-26-2003, 05:11 AM   #7
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    Hello again,

    Lacy, I am still taking my methadone. I am just not taking as much of the Oxy IR as I once was. I was up to 20mgs 4 times a day a day of Oxy IR for BT pain. Now I am only takeing around 15 Mgs a day max. I hope that I didn't scare anyone w/my advice. I just know like jack said that you need to respect this med. Hiking Fan I would think that it would be ok to still be able to take you norco for BT pain. Just be careful about it for a couple of days till the methadone takes effect. I only hope the best for all of you. Please let us know if we can be of further help.....

    Matt

    [This message has been edited by grizzk62 (edited 07-26-2003).]

     
    Old 07-26-2003, 06:10 AM   #8
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    Hi Sara!

    Looks like Matt & Jack have very good advice on the methadone. And, your pharmacist (although not very sensitive and/or smart to cp's) gave you more info than your doc's office, at least.

    I would write down all the times you've called the office, who you spoke with, what they said, ending w/ the script being left w/ no instructions on the BT med, and the nurse's analogy to her ASSpirin. She may have thought she was being helpful, who knows.

    I hope you get relief and, when you see your doc again, answers to why you were handled this way.

    Take good care of yourself, k?

    Karen

     
    Old 07-26-2003, 07:31 AM   #9
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    I don't have much to add to what has already been said except to say that I to am on methadone and have had wonderful pain relief on it compared to vicodin and percacet. I take 10mg in am and 10mg in pm. For breakthrough pain I take another 10mg of methadone. Constipation is a problem for me also but easily remidied.

     
    Old 07-26-2003, 10:44 AM   #10
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    hi, is this correct: "The usual adult dosage is 2.5 mg to 10 mg every three or four hours as necessary."

    if this is correct, why sould a doctor rx 2.5 mg every 12 hours and expect it to be effective?

    Sara, I hope you have better luck with yours than I did mine

    [This message has been edited by Wes1212 (edited 07-26-2003).]

     
    Old 07-26-2003, 08:51 PM   #11
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    Hi ALL, I just had to put in my 2 cents here, After my surgery 12-02 (ALDF L-3-4) and a nasty strep infection to go with it fom my discogram in 6-02 I was on 150 mcg of duragic patches along with 100 mg of Oxycontin 2 times a day,I asked my new doc to put me on methadone again to try to lower my high tolerence to opiate paimeds. I was on methadone 1 time before(coming of of 75mcg of durigesic patch changed every 48 hrs)and couldd not believe the pain relief I got from it. He started me out on 160 mg a day ( 40 mg x 4 times a day with 8 mg of dilaudid for BT pain. I adjusted immediately with no complications, I am currently tapering down by 10 to 20 mgs a month. Right now I am taking 140 mgs a day divided 4 times a day. I hope you get the pain relief that we all have gotten from this med. The thing about it though is that I was in hospital when this all happened and I saw my doc every day. There has to be some doc in that practice that can moniter you and answer any questions about the meds. THATS MY STORY, BUT REMEMBER THAT I HAD A SKY HIGH TOLERANCE at that time. Good luck and God Bless, Rick

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    Old 07-26-2003, 08:55 PM   #12
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    I totally understand why you would be discouraged having to deal with those terrible"Middle-People".That was quite un-professional treatment you got from this nurse from H---,but you CAN choose to play the positive on the negative,that being ,as Chris mentioned,to be thankful you have a doc that will Rx the type of meds you need to help your pain.It,s true,that she seems to be almost too busy to handle her clients in a proper manner,but often these dr.,s will give the"middle-folks"info to pass on to inquiring patients and that seems to be where you,re gettin the trouble.This nurse forgets to tell a CP patient they have a RX waiting for them,probly forgot what the doc told her to tell you about the med changes,tells you to go to the ER,man,this lady needs to be reported.But,back to the meds,the 5mgx3 per day is,believe it or not,a very close conversion from 80mg of Hydrocodone(ain,t that the dose you,re on?),so I,d take the Methadone as directed and follow the Pain,s "lead".If you get to hurtin bad,use a Norco,but just remember the Grizz,s post,take it easy with this stuff.It is a very good Pain Med for most folks.The other few things are that BT meds WILL work while taking Methadone,it,s just that you don,t"feel"them perhaps as you might have before.The Meth action keeps certain receptors blocked from the tingly feelings some get from Opiates.And,yes,you can overdose on Methadone,especially from taking too many BT meds cause you don,t feel like they are working.You must give the Meth some time.You will be rewarded with some of the best pain control you,ve probly ever had.Jack B.

     
    Old 07-29-2003, 12:10 AM   #13
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    Thank you everyone for your helpful advice.

    I haven't been on the boards to post for the last couple days because I am deathly ill to my stomach. I don't know if this is from the methadone, and again, I am waiting for the D*#% doctor to call me back. Until I hear back from her, I can't just discontinue with the meds, so I am hoping and praying that maybe I have a stomach virus. If it is the meds, I am going to need to add in an anti-nausea...Racer, you said the phenergan helps? Has anyone else had success with that drug? I remember getting it Interveinously when I had food poisoning, and it worked wonders.

    Thanks again everyone!

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    SAra

    PS- Jack, yes I was taking 80mg of hydro a day, so it sounds like the conversion she made was accurate. As always, thanks for your consideration and for TRULY listening and providing excellent feedback.

     
    Old 07-29-2003, 03:19 AM   #14
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    Hi Sara,

    The 2.5 mg of methadone 2x/day, i was prescribed left me feeling slightly intoxicated with very little pain relief. If you read my previous posts about that, you might have noted that i asked for a referral to another clinic that could more success.

    i was referred to the clinic that prescribed NSAIDs, PT, and biofeedback. That clinic had already said they could not help me because my gastro ORDERED no NSAIDs, and that i would not allow them to contact my 9 year old daughter.

    I hope your nausea is temporary either from a bug, or that you are adjusting to the new meds that will subside.

    I hope you get relief after everything settles.

    All the suffering people are enduring just reminds me of how barbaric our worldwide medical community has their approach and solutions.

    it is incredible how science is advancing every day, but the issue of pain control seems to remain in the dark ages.

    Best Wishes,

    Wes

     
    Old 07-29-2003, 04:40 AM   #15
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    Sara-
    Phenergan is a wonderful anti-nausea pill at least for me... I have to take it when taking hydrocodone since it makes me pretty nauseated and at times I have like projectile vomitting...And I mean EXTREMELY projectile...hah... But phenergan helps that out quite a bit... I might still get a tad nauseated, but not horrible at all, and I definitely don't vomit when I take it. Good luck, hun. I hope you feel better...

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