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Thread: Long Acting Pain Meds; Lesser of the Evils

  1. #51
    Quote Originally Posted by avictoria View Post
    Charlotte, I hope things go well tomorrow. Pain and managing it requires a bit of 'tweaking' to find the right balance that reduces your pain levels without leaving you fuzzy headed or with side effects. And it's all kinda confusing and you need to communicate really well with your doc. I'm sure when you have a plan in place with your doc you'll feel less stressed and hopefully will get your appetite back.

    This forum is a wonderful resource and there are so many people willing to share their insight and advice. Please post back and let everyone know how it goes!
    All the best!
    Thank you, Avic! Today went well. He convinced my husband and I that Methadone was the best road to go. He said long acting Oxcy is expensive and he gets a lot of complaints from patients that the generic doesn't work as well and has more side effects. He Rx'ed 10 mg, Methadone, at bed and kept me on Hydro through the day, every 4 to 6 hrs. He said the Methadone will relieve the pain through the night and next day! I'm a little excited about this but hope I'm not too high to enjoy the pain relief! LOL

    I'm going to start the first dose after dinner, in case of side effects. With my history, I don't like going to sleep right after taking a new med. I may start with 1/2 and see how I tolerate it.

    This forum and the members have been a blessing. It's given me and my family a better understanding regarding my injury, needs, and things to come. I'm so glad my NS recommended you guys!!!

    You're an Angel, Avic! Thanks for everything!


    Quote Originally Posted by fromnwmont View Post
    If my Dr is correct even 7.5-500 hydrocodone will be changed to just 325mg of acetmetphen by 2013 due to liver concerns if you are cutting 10-325 in half perhaps 7.5 or even 5-500 would work for you? One pharmacy in town has yellow 10-335 other white do you have option to check different pharmacy? I have tried many types phentanol, oxycontin, Ms contin but due to cost, relief and side effects use methadone & oxy for break thru pain
    Hello, NWMont!

    I've read several times here that they are going to stop making the 500 combinations. Let's hope your doc is right - seems like the logical thing to do.

    I have a contract with my doc to use one pharmacy, but he would allow me to go where I needed. The last, (special order), white, 325 I had was back ordered from the manufacturer.

    Thanks for your input!
    T


    Quote Originally Posted by papito1 View Post
    I myself on methodone for 5 yrs as a chronic pain! I believe the pain is always here to stay unless one do as Larry Flint did, cut the cord! He said it was the best thing ever from 10 yrs of pain. Overall, as for the the pain meds, I believe that it takes our thoughts of the pain and its what the meds do for us. I realise as a SCI this is part of our lives and find te meds best keep you focus off the pain that stop us from being down and out, day in and out for what life offers. Wish us all a well balance life cause it sucks. Peace and love be upon us!
    Sammy..
    Heyya Sammy,

    I think I'll give this Methadone a shot before cutting the cord!

    There may be hope for me yet. I should know within a hour of swallowing the magic pill tonight. The only alarming side effect I noticed was: SUDDEN DEATH. LOL

    Cheers!


    Quote Originally Posted by ~Lin View Post
    you'll never feel pain free with meds. I also shoot for functional. I wasn't for years, now that I'm starting to be I consider my pain undercontrol. It's definitely not gone, but I think this is as good as it gets.
    Lin, I'll be happy if I can just do the grocery shopping again ...my grocery has a killer bakery, and I'm much better at picking goodies than my husband!!!

    Congratulation on functional! I hope to say the same soon!
    Incomplete, SCI, T1-T8, w/ Arachnoid Cyst. Bilateral shoulder surgeries, 2 on the left, 3 on the right, right forearm surgery for a crushed radial nerve.

    "We can always choose to perceive things differently. We can focus on what's wrong in our life, or we can focus on what's right."
    — Marianne Williamson

  2. #52
    Charlotte oh I am so glad everything went well with your doc! big hug! Seems like a really, really good plan--methadone has a longer half-life and stays in your system longer than hydrocodone so you can use the hydrocodone PRN as needed for pain levels that go up and down and always just take less if you feel too loopy.

    Don't forget to start taking dulcolax as a stool softener to prevent constipation and maybe senna when needed as a laxative. The side effects of drowsiness etc usually ease up after a while but constipation is inevitable and sneaks up on you quickly. A big PITA!

    I bet you're looking forward to being out and doing stuff again!...I'm really glad I could offer something useful from my own painful 'education' in pain management.

    This forum is so nice in that so many people offer so much input/experience to others. I'm sure everybody would like to know how this works for you.
    Best wishes to you!

  3. #53
    Senior Member ~Lin's Avatar
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    I know what you mean about just wanting to do grocery shopping again!! For over a year my roommate did my grocery shopping probably 99% of the time. And the other 1% he was with me still to help. Now I'm not only doing my own grocery shopping 9/10 times, I'm alone for probably half of that. Thats from the combo of right meds and getting my ultralight chair. Grocery shopping, such a silly thing but it makes a huge difference and I know its a step in the right direction of becoming more and more functional.

    You shouldn't feel high from methadone. And the dose may be too low to get any help at all. Just be completely honest with your dr about what you feel. If you do feel high from a medication, I'd contact him immediately as the dose may need adjusted. I've never felt high from any pain meds, typically the doses and way pain patients take meds they don't experience those type of effects. But if you're more sensitive to a certain medication you may, for me hydrocodone makes me feel VERY ill. Not high, as I'm sure no one would do that to themselves for pleasure lol.

    When I started on methadone it did take a few weeks for me to feel the maximum effect of the dose I was on. It is a med that does build up in your system a certain amount, so thats probably the biggest reason. So don't throw it out if you don't notice anything the first few days. And you may need to go up to a higher dose or more frequently, I was taking 10mg 4x a day but experiencing side effects and was switched. 10 mg may also be too much, I think I started with 5 mg pills for the first few weeks.

    Good luck!! I hope to hear back soon that methadone is working great

    avic- does dulcolax sell a stool softener as well as stimulant laxative? I'm only familiar with the bisacodyl dulcolax, which is a stimulant and not one to be taken daily since you can lose function of the bowels and become dependent.
    Last edited by ~Lin; 06-11-2012 at 10:05 PM.
    Board Member of Assistance Dog Advocacy Project working in Education. Feel free to ask me any service dog questions!

    I am not paralyzed. I have a genetic connective tissue disorder with neuro complications and a movement disorder.

  4. #54
    Well said Lin and Avic..... I would agree methadone does need to build up in your system. And with all of us that take pain meds you should be on some type of stool softener most likely to aid with the bowel side effects providing you and your physician feel its necessary. I just take over the counter Colace. But, my level if injury is rather low compared to some--and I take less pain meds than prescribed due to my work and need for alertness.
    Disclaimer: Answers, suggestions, and/or comments do not constitute medical advice expressed or implied. Please consult your attending physician for medical advise and treatment. In the event of a medical emergency please call 911.

  5. #55
    Thanks and big hugs back-at-cha, Avic!

    Well, I made it through the night, no "sudden death" side effect...LOL! Trying not to get too over zealous about the pain relief BUT I can't believe how well it worked!!! I usually wake by 4 am with my body screaming in pain, but notta. The pain monster held off until 11 this morning! A little vertigo after I took it but I never felt stoned.

    I had a few weird side effects through the night and didn't get much sleep. I noticed my pupils were tiny an hour or so after I took it. My breathing became shallow when I laid down to go to sleep, (3 hours after I took it), like I had to make myself take a deep breath - no breathing trouble before I laid down, and returned to normal if I got up, and has been fine today. No leg spasms, twitching, or jumping, (unbelievable!), but my calf muscles wanted to draw up, more like a cramp. The really strange thing was mild spasms and needing to empty my bladder several times through the night. I don't cath but strain and twist to empty my bladder and never have to get up through the night to urinate! What's up with that?!? Well, as I type this, I'm thinking, this may have been because I was up and down all night. I called the Pharmacist, he said shallow breathing is not unusual but if it happens again tonight, let the doc know tomorrow.

    Avic, I'll have to shop a stool softener without yellow dye.

    Lin, I have felt high from the 2.5 mg, Hydro increase. I wish the doc would lower it back to 7.5 but forget to bring it up yesterday - too high to think, LOL! BTW, Lin, they do make Dulcolax w/ stimulant. My daughter has used it for years.

    Rob, if Methadone builds up and I keep getting better, I should be doing cartwheels in a few days - whoot, whoot!!!

    Hope everyone is having a great day!

    Thanks again, everyone ...I'll keep you posted!

    T
    Last edited by Charlottes Web; 06-13-2012 at 03:36 PM. Reason: unexplainable space bar tap between the cart and wheels.
    Incomplete, SCI, T1-T8, w/ Arachnoid Cyst. Bilateral shoulder surgeries, 2 on the left, 3 on the right, right forearm surgery for a crushed radial nerve.

    "We can always choose to perceive things differently. We can focus on what's wrong in our life, or we can focus on what's right."
    — Marianne Williamson

  6. #56
    Charlotte that's so great that your new pain medicine regimen is working well!


    But keep a close eye on the side effects and medication interactions. Apparently the optimal dose and schedule can require a bit of tweaking because 1) it stays in your system a long time and accumulates 2) everybody metabolizes it a bit differently and 3) the pain relief effects wear off sooner than methadone clears your system.

    http://www.medicinenet.com/methadone-oral_tablet/article.htm


    Keep in touch with the pharmacist and your doc and a close eye on the shallow breathing. The medical info on line about accidental OD's with methadone in pain management is kinda scary. If you do a google search on methadone pain management there's a ton of great information.


    Yeah the Ducolax brand sells both stool softeners and stimulant laxatives. And there are OTC generics for all the medications.


    I bought a small lock-box and kept all my medications locked up-especially when my nephews or friends' children visit. That protects you and any 'inquisitive' kids!

    Hope it keeps going great!

  7. #57
    Senior Member ~Lin's Avatar
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    Quote Originally Posted by Charlottes Web View Post
    BTW, Lin, they do make Dulcolax w/ stimulant. My daughter has used it for years.
    Yes, but avic said dulcolax stool softener. Dulcolax is typically referring to the stimulant laxative bisacodyl, which should not be taken regularly if not needed because you'll become dependent and lose bowel function. I'm not familiar with a dulcolax stool softener, only with the stimulant laxative. So I asked if they made a stool softener as well, to make sure there was no confusion and the stimulant being taken thinking its just a stool softener. Stool softeners act by preventing too much water from being taken out of the stool. A stimulant works by stimulating the bowels peristalsis and sends stool through faster so that not as much water can be absorbed. You don't want to become dependent on stimulants if you have bowel function.
    Board Member of Assistance Dog Advocacy Project working in Education. Feel free to ask me any service dog questions!

    I am not paralyzed. I have a genetic connective tissue disorder with neuro complications and a movement disorder.

  8. #58
    Dulcolax brand stool-softener https://www.dulcolaxusa.com/consumer/softener/index.jsp

    Apparently Dulcolax is a brand-name for several different products. Thus the confusion.

    The website gives the straight poop on constipation. LOL
    https://www.dulcolaxusa.com/consumer...tion/index.jsp

  9. #59
    Moderator jody's Avatar
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    My brother in law had no cord, it was liquified in his accident, so about then vertabre and his cord were removed. He still developed a pain syndrome. rsd or something like that.


    He was told that with no cord this is not possible, however it was agony, never went away, and eventually a combination of methadone and ghb caused him not to wake up.

    I did some study, and concluded that methadone, can accumulate in the system, so should be used very carefully especially when taking other drugs. as some people do not process it the same all the time, and dangerous levels may cause overdose, even if you have not increased the dose.

    I asked my Gp about this, and she says that some elderly could have a problem with methadone accumulating. I wonder if some people with sci would be just as sensitive.

    This topic did come up in another thread, but I can't find it.
    anyway, this is the reason I have not tried methadone.
    I have been on fentanyl since 2000 though, and I think it may be the cause now of my blood pressure problems. Up until a few months ago however, going to a patch has been very good, and pain control was variable, but did improve quality of life until recently. I would be aware that sometimes you can get a bad patch, or some brands have problems, and you have to have a few days of hellish withdrawal until the new patch kicks in. that could take up to 12 hours, with days of recovering from the wipe out of having to withdraw.

    In my opinion it is worth trying. you must always fill in the patch info, so as not to lose track of when it went on. In this way you always know when you get a new one, and you don't run out.

  10. #60
    My hats off to you , Jody, for doing the patch for a over a decade and still finding them valuable. I had so much variability in delivery of drug I would be on a roller coaster of semi withdrawal symptoms that I had to stop. Has that not been a problem for you where one patch wears off or isn't as effective and you go into a bit of withdrawal symptoms?

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