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  • Neuro Pain Meds

    Hi,

    I have intense neuro pain everywhere below my T3 injury level. I've tried all the typical drugs and narcotics to treat this but they've been no help.

    I am thinking of trying Methadone but I've heard that it can be very constipating. I don't usually have an issue now but don't want to create further issues for myself.

    Is Methadone worth giving a try? What do you do to manage your bowels and keep them in check?

    Jason

  • #2
    If you are at wit's end and feel that other medications have been ineffective, I would say that Methadone is worth trying. Many, many people find relief and do not run into problems.
    You have to get by the fact that the name conjures up reformed Heroin addicts. If you can get past that and have a really health respect of the fact that it has a half life of 55 hours then it is a great medication despite all the negative stories you may here.

    It does not have the euphoria of other opiates and less side effects. Once on a stable dose, it may work for you for many years.
    But be forewarned - it is tough to get off [but not impossible], it just has to be done slowly. I personally do not use it because of the long half life, it is hard to modify. Say you are not in pain for a day - you can't stop the med where you can with shorter acting meds.
    The good thing is that you can take it and it lasts a long time. The bad thing is that you can take it and it lasts a long time. What happens is that people have an exacerbation of pain and start taking too many and they build up in your system or someone drinks a few drinks and takes other meds with CNS effects and they don't wake up in the morning.

    There are meds for constipation. I would take pain control and deal with the constipation..

    People get in car accidents frequently and can die and we don't think of that risk every time we jump into a car. So don't be afraid, just buckle up and be careful.

    Comment


    • #3
      Originally posted by arndog View Post
      If you are at wit's end and feel that other medications have been ineffective, I would say that Methadone is worth trying. Many, many people find relief and do not run into problems.
      You have to get by the fact that the name conjures up reformed Heroin addicts. If you can get past that and have a really health respect of the fact that it has a half life of 55 hours then it is a great medication despite all the negative stories you may here.

      It does not have the euphoria of other opiates and less side effects. Once on a stable dose, it may work for you for many years.
      But be forewarned - it is tough to get off [but not impossible], it just has to be done slowly. I personally do not use it because of the long half life, it is hard to modify. Say you are not in pain for a day - you can't stop the med where you can with shorter acting meds.
      The good thing is that you can take it and it lasts a long time. The bad thing is that you can take it and it lasts a long time. What happens is that people have an exacerbation of pain and start taking too many and they build up in your system or someone drinks a few drinks and takes other meds with CNS effects and they don't wake up in the morning.

      There are meds for constipation. I would take pain control and deal with the constipation..

      People get in car accidents frequently and can die and we don't think of that risk every time we jump into a car. So don't be afraid, just buckle up and be careful.
      I am definitely at wit's end. The pain limits me from doing things I like and even getting out of bed sometimes. It takes all I've got to tell myself to get out of bed sometimes.

      I can't help but think there is an underlying issue causing the pain to be worse however. if you look at my other thread about physiatrist unable to diagnose you can see my dilemma. Pain and spasticity got out of control when I got a UTI, cleared the UTI but those symptoms never went away..they've just gotten worse.

      Narcotics don't really help...If I take enough to make me loopy then it helps as a distraction but I can't function like that.

      I have intense burning everyhwhere below my injury and a lot of stiffness/tightness in my chest/trunk.

      Comment


      • #4
        jbridge -
        If you say narcotics don't really help, then why are you considering Methadone?

        I was just sharing some of my experience with pain with someone writing an article in New Mobility. It sort of relates to this point. I said to them:
        " I think it is important to not prejudice the readers that the regime I use would work for them. There are those with central neuropathic pain that emphatically announce that opiates do not work on this kind of pain. Tell that to the 80% of people who find that opiates do work. There are those who get no benefit from Neurontin or Lyrica. And those that benefit from one of those but not the other. There are those who find the drying side effects of Elavil and Nortripyline impossible to bare. On and on. I think a great point to get across is that you can't give up trying to find a medical regime that succeeds, don't judge the medication too early till you have maxed out the therapeutic dosing and don't hesitate to revisit a med that may not have worked previously. Be methodical as possible but understand there are so many variables that it is hard to come up with clean conclusions. Be realistic about goals, it isn't to eliminate the pain all together, there are no agents yet that will do that , the goal is to somehow to remain sane, to live for the next day, and carve out a life in an impossibly difficulty situation. Consider participation in the Pain Forum at Care Cure at Rutgers University . Know there are others going through the same fight for their life."

        Comment


        • #5
          Originally posted by jbridges9 View Post

          Narcotics don't really help...If I take enough to make me loopy then it helps as a distraction but I can't function like that.

          I have intense burning everyhwhere below my injury and a lot of stiffness/tightness in my chest/trunk.
          So I take just enough oxy to not make me loopy. On the really bad days, no amount of medicine will help. On the really good days, pain is almost non-existent.

          Here is the point...you have to find what works for you. It is a long hard road of trial and error. What works for me may not work for you. That is why I keep telling you to find a pain clinic that treats the whole body/mind not just the pain. Lots of these clinics popping up treat sports injury and short term pain. You are not a short term pain patient. You have to learn to deal with this and work your life around it.
          T12-L2; Burst fracture L1: Incomplete walking with AFO's and cane since 1989

          My goal in life is to be as good of a person my dog already thinks I am. ~Author Unknown

          Comment


          • #6
            I'm waiting on a call back from a pm doctor..

            Today I'm hurting so bad I just want to die...

            50mg of oxy helps a little but makes me loopy.

            Was hoping methadone would help without making me messed up.

            Comment


            • #7
              Originally posted by jbridges9 View Post
              I'm waiting on a call back from a pm doctor..
              The waiting is the hardest. I really dread having to switch doctors again. I want to live close to a beach but I really am having to give second thoughts to leaving what it took so long to establish.

              I hope you find what works.
              T12-L2; Burst fracture L1: Incomplete walking with AFO's and cane since 1989

              My goal in life is to be as good of a person my dog already thinks I am. ~Author Unknown

              Comment


              • #8
                Hope you find something that helps your neuro pain. Narcotics have never touched my chronic neurogenic pain, but each person has to do what works for them.

                I had a bad experience over the weekend with the pain meds I take. I take 150mg venaflaxine or effexor generic & 8mg tiagabine or gabitril generic. On Friday I went to refill the tiagabine I discovered that the prescription expired since it was 1 yr old...so the refills I had on it couldn't be refilled. I called my doc but he didn't send in a new script till today, Tuesday... By yesterday, Monday, I felt like I had a bad flu which really sucked. Even though my pharmacy gave me a few days supply yesterday, I still feel crappy...but better.

                Don't let your meds run out...
                C4/5 incomplete, 17 years since injury

                "The trick is in what one emphasizes. We either make ourselves miserable, or we make ourselves happy. The amount of work is the same.” - Carlos Castaneda

                "We live not alone but chained to a creature of a different kingdom: our body." - Marcel Proust

                Comment


                • #9
                  Originally posted by arndog View Post
                  jbridge -
                  If you say narcotics don't really help, then why are you considering Methadone?

                  I was just sharing some of my experience with pain with someone writing an article in New Mobility. It sort of relates to this point. I said to them:
                  " I think it is important to not prejudice the readers that the regime I use would work for them. There are those with central neuropathic pain that emphatically announce that opiates do not work on this kind of pain. Tell that to the 80% of people who find that opiates do work. There are those who get no benefit from Neurontin or Lyrica. And those that benefit from one of those but not the other. There are those who find the drying side effects of Elavil and Nortripyline impossible to bare. On and on. I think a great point to get across is that you can't give up trying to find a medical regime that succeeds, don't judge the medication too early till you have maxed out the therapeutic dosing and don't hesitate to revisit a med that may not have worked previously. Be methodical as possible but understand there are so many variables that it is hard to come up with clean conclusions. Be realistic about goals, it isn't to eliminate the pain all together, there are no agents yet that will do that , the goal is to somehow to remain sane, to live for the next day, and carve out a life in an impossibly difficulty situation. Consider participation in the Pain Forum at Care Cure at Rutgers University . Know there are others going through the same fight for their life."
                  Hi

                  When I say narcotics don't work, it's the ones I've tried.

                  75mcg duragesic, 4mg Dilaudid, 2mg morphine IV, 50mg oxycodone (5 percocet), 20mg Opana IR are ones I've tried. They don't even have any CNS effects on me.. Doc was surprised my eyes didn't even get dilated from all the Dilaudid. I've tried Methadone before for a little over a week at 5mg TID and it didn't do anything.

                  Does this indicate that Methadone in higher doses wouldn't work? Are there any drugs I haven't listed?



                  I got a new PM doctor but he just gave me 10mg Oxycontin twice a day which obviously doesn't touch it.

                  I also can't do MJ anymore because the doctor does drug testing and said because it's illegal I can't do it
                  Jason

                  Comment


                  • #10
                    The doses that you listed are to me very low. I can tell you without hesitation that taking any of the opiates that you listed at doses that low would not have any noticable effect on my pain either. Furthermore in my experience until the dose is increased to a level that is sufficient to manage my pain they do not seem to help much at all. for example, for a while I was on 40mg morphine 2 times per day I was in excruciating pain constantly and didn't even think it was helping until I ran out and had to go for 4 days without anything. I use 10 to 20 my oxycodone just for my breakthrough pain. Also when the pain is bad it takes a considerably larger amount of pain meds to bring it back under control than it does to keep it under control. So just because 5 percocets didn't help you one time does not mean that taking the same dose on a regular basis would not work for you. However I would also warn you that using percocets for a managed long term pain management regimen is not a good idea because the acetaminophen may cause damage to your liver. I take 40mg oxycontin twice per day with 300mg gabopentin 3 times per day currently with 5mg oxycodones for breakthrough that I take 2 to 4 of at a time as needed. And although not medically recommended I throw in a pint or two of vodka or gin when that isn't working for me.

                    Comment


                    • #11
                      I should also mention that you need to ramp up your intake of opiates slowly to avoid the possibility of overdosing and to see hoe your body reacts to them. Personally my body has never experienced any problems with taking high doses of opiates even when no tolerance was built up, but not everyone is like me so you need to be very careful. I don't want to be responsible for someones death by telling them that it's ok to take 80 or 100 mg's of oxycontin and drink a half gallon of gin just because I can do it with no problems does not mean that you can. So be careful and treat opiates with respect and listen to your doctor, but also let them know that what you are taking isn't working. It took mew over a year of bitching and complaining and slowly increasing my doses and trying different medications before I got to where I am now.

                      Comment


                      • #12
                        Originally posted by nauticalmike View Post
                        I should also mention that you need to ramp up your intake of opiates slowly to avoid the possibility of overdosing and to see hoe your body reacts to them. Personally my body has never experienced any problems with taking high doses of opiates even when no tolerance was built up, but not everyone is like me so you need to be very careful. I don't want to be responsible for someones death by telling them that it's ok to take 80 or 100 mg's of oxycontin and drink a half gallon of gin just because I can do it with no problems does not mean that you can. So be careful and treat opiates with respect and listen to your doctor, but also let them know that what you are taking isn't working. It took mew over a year of bitching and complaining and slowly increasing my doses and trying different medications before I got to where I am now.
                        I, of course, will follow my doctor's instructions, but I am curious what doses of what meds you are on and how you titrated up?

                        I am curious about taking Nucynta ER again. I was taking it last year, Nucynta ER 250mg 2X/day and it was helping for a bit then I ran out. I got a new prescription but my partner (at the time) ripped it up and threw it away because he thought I didn't need it.. Grr.

                        Could I combine the Nucynta with OxyContin for more adequate pain relief or does it not work that way?

                        My only hesitation to Methadone is that you really can't take any other "breakthrough" meds with it since it blocks them all and that the new Dr thinks methadone is a "horrible" drug.

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