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Methadone and pain management
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Methadone and pain management

I have been dealing with back/neck pain for over 3 years now.  Had one surgery for removing the part of the disks that where protruding and cervical decompression.  That gave me feeling back in my hands but really did not fix the pain I am having in the upper back/neck.  I had been taking 100mgph Fentanyl Transdermal Patch, 8 mg Dilaudid up to 5 times a day and was still hardly able to function.  My pain management doctor wanted to add Methadone to the mix and try to back of the other two.  My primary care doctor is the one who writes the scripts and is scared of Methadone (I was at first until i did my research) and is not prescribing as much as my pain management doctor is wanting him to.  I am currently at 20 mg 2 x per day.  and am not seeing much improvement.  I am wondering what other people who are one Methadone are taking and if it is working.  I am a big tall guy 6'4" 250lbs so i tend to have to take a little more then the average joe.  

Also.  I am having a hard time with work.  Working really makes the pain much worse.  On weekends and vacations I have much better days.  When I am working, by the end of the day, I have to come home and go to bed for a few hours to recover.  I do not want to go on disability as I have always worked and think i would get very depressed if i was not working.  Also disability would not pay all the bills and take care of my family.  The pain has been really affecting my work and i was chewed out by my boss because i was having to take a brake and lay down to rest for a few a little bit when i could not take the pain anymore.  Found out he was taping me and was going to fire me for it.  I was so embarrassed and had to tell him what was going on.  I try to keep my private life private and was so humiliated.  
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655875_tn?1295698707
I personally would stay away from Methadone from what I have read.  I've heard that it is one of the hardest opiates to come off of.

Have you thought about a morphine pain pump?  I've heard it works very well for spine pain.
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547368_tn?1332173665
Hello MacGreek,

Welcome to the Pan Mangement Forum. I am glad that you found us and took the time to post and respond to other threads. But I am very sorry to hear about your situation. We can relate.

Methadone has always scared me too. However my physician believes it to be an effective and safe drug when used as prescribed so I tried it for a short time. I did not find it very effective in managing my pain and it gave me horrid headaches. So I no longer take it.

From what I know you are probably not on a high enough dose. This has to be worked out between your PCP and your PMP. You cannot suffer needlessly with pain.

I was where you are with employment. Struggling to work through the pain and still do be effective in my professional career. Luckily I had an understanding employer. However the pain finally won out and sadly I was forced to end my career.  I am fortunate that though I made an excellent salary I was not the primary breadwinner in the family. Had I been I don't know what I would have done.    

I can tell you that the stress of working had me on higher doses of meds than I am now. I was also able to greatly reduce B/P medications and may be going off them completely in the near future. It is such a releif not to worry about how I will make it through a day with horrid pain and collapse at night when I got home. There were days that I went in with little to no sleep because the pain kept me up. So if you can find a way to not work I encourage you to do so. If you can't I encourage you to begin financial planning for a day that you may not be able to work.

It was difficult to learn to live on SSDI, which I was fortunate to be awarded in less than four months. I did do some financial planning that has helped as I was afraid that day would come that I could not work. It is never enough but again you learn to live with less.

I wish you the very best. Ultimately it will be up to your two physicians to agree on the medications that will provide you with the best relief. One of them will have to give in to the other. Please let us know how you are doing.

Take Care,
Tuck


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Avatar_f_tn
I have had 7 surgeries on my lumbar and cervical area.  I did have to go on disability. It was extremely hard. I left a good, high paying career. I couldn't function anymore from pain. I was originally on the Fetanyl patch. I got off of it myself, the side effects were awful and long term I personally did not want to live that way.  I also was prescribed Methadone. It made me depressed and want to sleep or lay down all day.  The reason I went on it was I was taking 40mg of oxycontin per day.  I was buying generic monthly but generic is no longer available.  My insurance will not pay for brand, it's $279.00 per month.  The Methadone was so difficult for me that I am now paying $279.00 out of pocket monthly for the oxycontin. I too was like your MD afraid of the Methadone.  My breathing/blood pressure was so slowed while on it.  I was literally so weak I couldn't move and this was on a very low dose.  I am not a doctor and I have heard of many success stories of people on Methadone, I personally would not be able to take it.  
There are other narcotic medications that do work.  Oxycontin works for me.  I also take Methocarbonal for inflammation and that really helps when the back pain gets very bad.  

Diet really plays a part in pain.  Simple sugars, white flour, white bread, white potatoes, white rice all make pain much worse.  I eat these foods but in limited quantities. I learned over the years how much they can make the pain worse.   Drinking water is one of the best things for back pain, I can't recommend that enough.   Also if you talk to your doctor and it's ok, getting in the pool at your gym, a warm pool and walking is excellent for the back.  I started 5 minutes per day and I'm up to 40 minutes. I lost 20 pounds doing this and it's helped my back tremendously.  

I couldn't not go daily without pain medication and for that I struggle.  But doing other things especially if you plan to keep working will really help you.  

Based on your user name I wasn't sure if you are a computer professional of what kind of work you do but you may need to cut back your hours.  As for your boss taping you, if you have a Human Resources Dept. at your place of employment ask to speak with them. DO NOT make your health issues the topic. Make his treatment as your boss the topic.  He is not allowed to tape conversations with you without your knowledge and even then that's a real grey area.  In addition try and keep all of your health issues especially medications you are on completely private. In my experience in recruiting and Human Resources it is not supposed to used against you but very well could be. They can turn a termination in to your performance suffered because of heavy medication you are on.  
In addition I would see another surgeon for another opinion.  If your surgery was less than 1 year ago you are still healing.  If it was longer than that you need to get another opinion and other CT scans to determine whether there is something going on to cause you so much pain.  Three of my 7 surgeries were to correct previous surgeries that were done either incorrectly or caused issues above and below the original surgical site.  You may have ruptured below or above where you were operated or developed arthritis in your spine.  All of which should be addressed and documented in case you do ever need to go on disability.  

All the best and please don't  let a bad boss add to your stress and pain.  
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767538_tn?1276578920
I am so sorry that you are having such struggles controlling your pain at present. UI can tell you I've been there and sometimes I am still there.

As for the Methadone I would strongly urge you to steer clear of it if you can, feel free to look back at some of my journals and if you look at my user id it may tell you why.

It worked ok at first but it took more and more to help control the pain and it made me SO drousy I'd fall asleep in meetings adn during interviewing prospective employees.

As for coming of of it, WOW. very very tough, it took me three times to finally rid myself of it but I also hear that Fentanyl is no cake-walk either. I am using Fentanyl now 100 mcgh plus endocet 10/325 for break throiugh and the Fentanyl does a good job for me just hate the sweats that come on for no reason. I'm suprised the Fentanyl is not working for you, have you discussed this with your doctor?

PROS; It's very cheap to make and is a cheaper prescription than most other opiates.

Feel free to PM me anytime and I'll answer any questions I can.

All the best.

-Brian.
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Avatar_m_tn
Dear MacGeek,
All the research I have done in the past they list methadone as a fairly poor drug for effectiveness for relieving pain.
I once was using Suboxone for my back pain, but after a one year trial with it I ended up putting up with more pain than I could tolerate, and I literally had to beg my PMP (pain doc) to put me on something else.
Today I still have to suffer a lot, and I am presently using 40mg of oxycodone twice a day.
I also get RFI's radio frequency interuptions (they burn the nerves), trigger point injections, and of course those good old caudul epiderdural injections.
I get the trigger point injections about every month, the RFI's about every three months, and the epidurals about every other month. They all hurt, but they do bring some relief for a short time.
I go through all the damn treatments in hopes that someday one will work for a long time, but so-far no luck.
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