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    Old 12-11-2014, 07:38 PM   #46
    tortoisegirl
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    Re: Withdrawal from med switch, doctor refusing to raise dose

    Still doing well. Its 10mg Oxycodone for breakthrough pain, 1-2 as needed, 56 every 4 weeks. Surprisingly its helpful, even though I was on 60mg before! My tolerance sure dropped quickly...I guess its all those weeks of withdrawal. I'm happy I'll be able to enjoy the holidays. Best wishes.
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    Old 01-07-2015, 12:28 PM   #47
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    Re: Withdrawal from med switch, doctor refusing to raise dose

    Quote:
    Originally Posted by tortoisegirl View Post
    Grandmawwifemom: Ask your dr to check the conversion. The highest dose on the Butrans is well under what you currently get with the Fentanyl patch. It would be ideal for someone opiate naive though. Suboxone could be an option as it has larger dosages. Some folks get pain relief. The only tough part is to have to start in withdrawal. Its quite doable though. I still think my first med switch from methadone to oxycodone was tougher as I didn't know how long it would last (ended up being ~8 days) and I was trying to work. Best wishes.


    Thank you Kate for responding.
    I just don't think I have the stamina actually - to
    go thru withdrawl ... I really feel beat down this past year.
    I think my doctor thinks "Oh just do it and it will be better!"
    And I know he has the best intentions - he just doesn't
    understand what its like waking up to some level of pain
    everyday for 14 years. I'm getting older now ... I just don't
    have the stamina anymore

    I'm not giving in that's for sure
    I have a son & grandson that I adore and they can't be without me
    ...so I'm here for the long haul - but boy o boy somedays its a struggle.

    I've decided to just keep everything the same -
    not changing doctor and not changing the patch ...
    and deal with the lack of pain relief. I'm sure if I wasn't on
    the patch the pain would be worse than it is now.

    I often say a prayer that maybe tomorrow...or the next day
    they will come up with something new to help. It could happen

    I really am blessed in the fact that I love my doctor and his staff.
    They never fail to make me laugh ...
    heck, I've been going there 9 years in Feb. They are like family.

    Okay well I'm just rambling now
    thank you Kate for the response.
    You confirmed what I was thinking.

    Big hugs

     
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    Old 01-16-2015, 08:59 PM   #48
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    Re: Withdrawal from med switch, doctor refusing to raise dose

    Quote:
    Originally Posted by tortoisegirl View Post
    Update: Thankfully I'm doing better now. Little to no withdrawal symptoms besides first thing in the morning, but I've figured out a routine of taking my pills and getting back into bed for a bit while waiting for the shivers to subside. I even got by on a lower dosage today, so my tolerance must be dropping some. Figured out the best dosing regimen with the short acting meds is to take a pill every 2 hours while awake, which is quite annoying. Only six more days to go! Unfortunately though I've had way too much time to research this whole thing, but yes, like gmak said, I'm trying to see the positive in this. Best wishes.
    hey kate, i have been so caught up in my own miseries i just seen your post and all i can say is bless your heart......i don't know if i could come off of all that. you are brave and hopefully doing well on your taper or change....the subs....i don't much like...they were hard to come off of.....how are u doing now? what dose/meds are u on

     
    Old 01-16-2015, 09:14 PM   #49
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    Re: Withdrawal from med switch, doctor refusing to raise dose

    Quote:
    Originally Posted by grandmawwifemom View Post
    my God - this is CRIMINAL!

    I hate to hear this story...why?
    Because I feel for the person going thru this but also -
    because I know it could happen to me.

    I was referred to my 1st pain management clinic about 13 years ago.
    I have broken yes BROKEN RODS (Harrington) in my back.
    The screws seemed to have come lose and traveled UP my spine area
    and the rods dropped - it looks to me to be about 2 inches.

    Now three different surgeons said they would not touch the surgery
    (of taking the rods out) because of all the scar tissue around the area ...
    so 13 years ago -
    they put me on meds.
    Back then - they didn't have some of the non-narcotic pain meds they have now - so I was thrown on Celebrex (which after a few months the Dr called to say stop taking them immediately) and they were pulled off the market for awhile - but back then - they placed me on Vicodin 500 3 - 5 times a day.
    That worked for almost 7 years...
    I've been told that's great that they worked for that long without tolerance taking over ... after 7 years - I guess I grew tolerant and here came the level 9 - 10 pain ... oh gosh - I only wish
    that the drs. I saw back then could feel the pain I was in for 20 minutes. AND during this 20 minutes - I wish they did not know if that pain would ever go away again ...
    After searching I found a multidisciplinary type of clinic -
    there was a chiropractor - massage therapist - physical therapist and a medical doctor. IT WAS HEAVEN! Between being placed on the Fentanyl Patch, therapy, traction, and being adjusted - my pain dropped (in 1 month) from a 10 to a TWO!

    Heaven -
    I was in HEAVEN!
    Then - because of all the new laws - the clinic changed.
    No more PT, no more chiro, no more massage.
    The medical dr opened his own place and I stayed with him.

    The bad thing?
    Well now I've been on the Fentanyl patch 75mc for 8 years.
    It has NEVER been increased. So naturally, my level 8-10 pain has returned.
    The dr that was with the clinic before it closed -
    is not the dr who placed me on the patch and sadly ...
    he (my current dr) says he doesn't like fentanyl and wants me to switch to the butrans patch ...

    I adore my dr. on a personal basis. I've known him for 5 years (he came in 3 years AFTER I started at the clinic). I don't want to leave him - but I have a lot of allergies and sensitivities to meds. Neurotin makes me feel like I am walking at a slant and so dizzy I can barely stand up. Oxycontins made my chest and neck have red blotches and made it difficult for me to breath.
    Norco barely touches my pain. Plus, I don't really want short acting medication. As a chronic pain sufferer - I have to tell you - it IS euphoria to be able to put a patch on - and your done for 3 days! Its nice to wake up and not have to roll off the mattress to reach your pills so you can take 1-2 and then lay down again, waiting for it to kick in.

    These clinics - placed a lot of us who had chronic pain 10 plus years ago ... on narcotics. And they worked. Now all of a sudden - they want us to go thru withdrawls or try new meds.

    I personally never want to take another medication that has been out for less than 6 to 7 years IN the United States. I've been that route and it didn't go well for me.

    Once they put me on Lyrica (this in the first several years)
    I was passing out 2 to 3 times a week! That was fun. I thought for sure I had something else health related - no one knew what was wrong with me. I went thru a bevy of tests...a heck of a lot of worry - guess who figured out what was wrong with me?
    ME ...
    I was up late watching TV and heard one of those commercials that say the symptoms of a medication and fainting was one for Lyrica!
    Plus - it didn't seem to help the pain.

    Now - I am at a place where I feel like I know what helps and what doesn't.
    I've had 11 epidurals - 3 nerve blocks - a mylogram (oh that WAS fun - not at all), bone scans (also a fun time for a person with back problems) and about 20 different people telling me to lose weight and I'll be alllllllllllllll better ...
    frankly ...
    I feel like if the fentanyl, physical therapy, massage therapy and gentle chiropractic adjustments have helped me - lets stay with this!
    My dr says 100 mc of fentanyl is a high dose and he won't up the patch -
    but "I" think ... its not so bad when you think, I may not need to up the dose again for several years. I'm scared to death to leave the practice I am at (after 8 years)
    And I have no desire to start the gammit of trying new meds again ...
    been there - done that.

    Do we really have a say in our medical care or no?
    I say ... NO.
    I've read the pain patients bill of rights...
    that's about as true as Cinderella guys.
    We don't have rights.
    People automatically think we are junkies
    I hate to even use that word.


    Isn't it criminal that this person was placed on these meds
    BY A DOCTOR and now - they have to suffer withdrawls ...
    Their whole life will be put on hold for months
    And
    what about the pain once they kick the habit of the narcotics?
    Just because there are no narcotics in this persons system
    doesn't mean their problems are all gone now!

    Darn it - this makes me mad.
    It is INHUMANE....

    But - what can we do?
    Who will listen to us?
    Who will even believe us?



    I'll say a prayer cos I think that's all "I" can do.
    Good luck tortoisegirl
    and my thoughts & prayers are with you.

    i don't think half these doctors understand withdrawls or anything.....i mean face it if they have no pain they probably haven't been on pain meds and probably aren't aware of how actual addiction whether it be physical or emotional. I think this is a problem but there isn't much they can do about that. I had never taken anything until i was 38 years old. i was a LPN for years and gave out lots of pain meds. I truly had no idea of addiction or withdrawls or anything like that. I can say life situations have definitely allowed me to put it all into perspective. I am in lots of pain, although definitely no hardware in me like what you are going through. I can not even begin to imagine all of that...I am so sorry for you and I will say prayers for you.

     
    Old 01-17-2015, 11:04 AM   #50
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    Re: Withdrawal from med switch, doctor refusing to raise dose

    Quote:
    Originally Posted by oxygirl View Post
    hey kate, i have been so caught up in my own miseries i just seen your post and all i can say is bless your heart......i don't know if i could come off of all that. you are brave and hopefully doing well on your taper or change....the subs....i don't much like...they were hard to come off of.....how are u doing now? what dose/meds are u on
    I am currently on the same pain meds as the last time I posted, 40mg/day Methadone (10mg four times a day) plus 10mg Oxycodone (1-2 pills as needed, prescribed enough for 2 pills a day). I was doing seemingly really well at first, but I'm not doing as well now. I think at first by comparison to no pain relief, a constant migraine from the Suboxone, and continued withdrawal symptoms, anything was better than that! Suboxone was not a good med for me, and I was not willing to give it a chance as I had a constant migraine the entire time on it and wasn't getting significant pain relief. I'm very lucky my pain clinic let me re-start the Methadone, as it would have been an easy time for them to say no. They have however clearly stated that they have a dose ceiling in the neighborhood of 60-80mg/day for Methadone. I think they must be getting some sort of outside pressure, from the DEA, state, insurance companies, or all three.

    Also, I had two weeks off from work for the holidays not too long after re-starting the Methadone. Going back to work these last couple weeks has been rough. I am adjusting though. My pain levels at work are so much higher than at home and off from work. Apparently that is typical with headache. Although I don't feel under stress, and have a desk job (so its not physical activity spiking the pain), something about just knowing I am going to work increases my pain from the first thing in the morning even.

    I'm still figuring out how best to take the Oxycodone. I'd do best with a higher level of medication at work all the time. However, I had previously tried spilling the Methadone to have a higher dose at work and nothing in the evening when I could manage ok, and it didn't work well (I had such high pain levels when waking up that I spent all day catching up). I think if I had an extra Methadone pill to split and take during work but still take it four times a day that would do well, or something longer lasting than Oxycodone (it honestly take about an hour to kick in then lasts about 2 hours). However, with the known dose ceiling, I want to leave some wiggle room for later. Some pain relief is much better than none! Honestly though I think I'm pretty close to where I was before this mess, at 80mg/day Methadone (which I had tapered to just before the Suboxone switch).

    I think however I may just have to take two Oxycodone each time and see if they work better and longer, and ask my doctor for a higher dose or quantity if needed. 20mg Oxycodone would be more in line with what I previously took, exactly 1/3 of the previous 60mg Oxycodone dose for breakthrough (as the 40mg Methadone is 1/3 of the previous 120mg Methadone). I've been trying to just take one at a time and I often end up just taking another after a couple hours, and we all probably know its better to take two from the start for best results for whatever reason.

    I just don't like leaving myself short. I'm the type who always questions if I should take the medication or save it in case the pain is even worse later. We all probably know however that often getting ahead of the pain lets us use less meds and get the pain under control earlier though. However, I'm always the type of person who has short acting meds left at the end of the month, so I really shouldn't worry about it (although I don't want to get in the habit of taking more than my month's prescription). So, I'm questioning what we should do with my meds as needing breakthrough meds each day at work isn't really breakthrough pain, as it is known (and then I wouldn't really have anything for true breakthrough pain above my work pain levels).

    I'm curious what my doctor will say if I just lay it out there that I am predictably using my breakthrough meds at work. Maybe there is a compromise, such as a bit more Methadone to take during work and a bit less Oxycodone so I'd use it strictly for breakthrough pain. That could work against me long term through as I would be closer to the ceiling, and its tough to get more breakthrough meds after being on less. I may just give it some time for things to settle though, as I don't remember my pain levels being this different between work and not, although there has always been a significant difference. Sorry for the essay! I was more or less using this to think things through. Best wishes.
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    Old 01-17-2015, 12:18 PM   #51
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    Re: Withdrawal from med switch, doctor refusing to raise dose

    Hey Kate-

    Are you being seen more frequently for dose adj's?

    Yeah 40mg is just not gonna be your friend for long-imho

    Methdone is a hard drug to bt even at a low dose 40mg-the oxy will still help to some degree.

    I was wondering about how they are treating your pain levels you que them-are they saying you have to deal with a certain dose for a time or to apt to apt?

    My Pm told me when I was on methadone,there is NO ceiling and would be a decision he would make according to how I was managing-I believe I leveled out pain wise at about 110mg w/30msir for bt.
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    Old 01-17-2015, 05:36 PM   #52
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    Re: Withdrawal from med switch, doctor refusing to raise dose

    They have a dose ceiling for all patients for all meds, including Methadone. Its a new thing in the last year though. And they are by far the most opiate-friendly pain clinic in my area (I've been to the others). I think its dumb, as some patients will have a high tolerance, and after a certain point they will not be able to maintain the pain relief. I think its a combination of DEA pressure and new state legislation (which sets a 120mg/day morphine dose limit as a threshold to consult with a pain specialist, but doesn't set an actual dose limit). Its getting to the point where not having a dose limit will get rare. We've had quite a few folks here lately who have also been forced to reduce their dose.

    They have told me the dose ceiling and have left it up to me pretty much as far as if my pain is managed enough right now. So I've just been going in every 4 weeks as usual. We started at 30mg, then went to 40mg mostly because it doesn't last 8 hours (more like 4-5 hours). I had been doing well at first. But, the first bit of time on an opiate is always the best...I remember how low my pain levels were when I first started Methadone, and have never been able to get to that point again.

    However, I will take whatever I can get. My pain is manageable as-is...I just wish it would be better. Its probably pretty close to where I was before this mess. They are hoping that I can comfortably maintain my dose under the ceiling with the time I had on Suboxone, although we had hoped for better (ie. at least staying on it longer, if not indefinitely). Best wishes.
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    Old 01-17-2015, 06:21 PM   #53
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    Re: Withdrawal from med switch, doctor refusing to raise dose

    You are absolutely right.

    But at the very least I am sure glad they didn't keep pushing the Bup.

    Good Luck!
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    Old 01-17-2015, 09:07 PM   #54
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    Re: Withdrawal from med switch, doctor refusing to raise dose

    Me too! I was afraid that I wouldn't be allowed back on opiates. In the end, they were appeased by me trying it...I think they mostly wanted to put it on my chart as being tried (although were hoping it would work). Best wishes.
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    Old 01-18-2015, 05:22 PM   #55
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    Re: Withdrawal from med switch, doctor refusing to raise dose

    I am a patient at the methadone clinic and they tell me that you dont need to even TRY switching to suboxone unless you take 40mg of methadone a day or LESS.. Suboxone has an effects ceiling of 24-32mgs.. meaning you dont get any more effects past that daily dosage. It's best to ween yourself down to below 40mgs/day of methadone THEN try and make the switch to the sub. Just my 2 cents.

     
    Old 01-18-2015, 06:02 PM   #56
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    Re: Withdrawal from med switch, doctor refusing to raise dose

    Yes I agree...I did not switch directly from Methadone to Suboxone. i was on Oxycodone for about 3 weeks in between. Even with that however it was not a smooth transition. My tolerance was too high so I had continued withdrawal (although not the dreaded precipitated withdrawal). I had wanted to wean and not try Suboxone at all, but it wasn't exactly my decision (when you are at a pain clinic you don't want to refuse to try any treatments they want to try you on for fear they will cut you off). I definitely won't be trying Suboxone again though as it gave me a constant migraine. Thanks for sharing. Best wishes.
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    Old 01-19-2015, 11:58 AM   #57
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    Re: Withdrawal from med switch, doctor refusing to raise dose

    geesusfish-

    The OP's reason for being on methadone was for pain--op was not trying to "kick" an opiate addiction, there are some Pain Mngt Docs who believe in buprenorphine for chronic pain.


    OP's main problem being on the subs-op suffered needlessly in pain.

    you go to a methadone clinic for addiction? But this is the PM forum an the OP was put on the subs to see if they would work for op's pain and keep OP out of wd- it didn't work out.

    Good luck to you on your journey.
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    Last edited by BB07; 01-19-2015 at 12:21 PM.

     
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