Methadone??

[Lishypaz]

I am beginning methadone as a treatment beginning May 2. It scares the heck out of me, though if I could eliminate 4 or 5 of the other meds that have not been working, I can live with it. I have been in a horrific flare for the last 4 days--contractions that leave me rolling around on the floor and screaming until they subside. One of the things that really aggravates my pain levels is constipation, and since they have taken zelnorm off the market, my gastro won't let me continue with it. I have tried the miralax, stool softeners, and laxatives to no avail, but the zelnorm really, really worked.

Please, someone who has utilized methoadone, let me know how well it has worked for you and whether or not you are able to "function" normally during the day. I am an administrator for an SACC program in an Elementary School, and I cannot be "spacey" at work. I am able to take the valium, 1/2 vicodin and the other meds and still work, but the same time they are upping my methadone I wil up my gabapentin to 900 mg a day and that can make me a little tired. My doc will be taking me off of elavil and celexa at the same time and put me on noratryptaline instead (he says it will make me less sleepy).

I also, coincidentally, begin a new form of PT for Pelvic Floor Rehabilitation--something different than what I did in the past utilizing electr-shock stimulation. I am not certain what it all entails, but at this point I guess I am willing to try anything to begin leading a more normal life.

Luckily we are on Spring Break and I can work from home entering data and grant info, otherwise I would have to call in sick because the pain is in the "way off the chart" realm.

Please, someone who has tried this answer. Thanks in advance for your help!

[IC SARAH-CPP]

He is taking you from 1/2 a vicodin to methadone? That seems like a HUGE leap in medication to me. I was taking 12 percocet a day, the max number, when I went to the long acting med and still got a little "funny headed" the first few days I took it.
Another thought I had is that if you are going to change so many of your meds around, you might want to try to do them one at a time. Sometimes that is easier and then you really know which change in the med really helped or didn't help.
Sarah

[Sarojini]

Ummmm.... I'm a bit confused. Are you starting methadone for the first time, or just increasing your dosage? You say in the beginning you are starting it, but later you say you will be increasing your methadone and gabapentin (Neurontin).

As for methadone itself, I find it does a good job on my pain -- I prefer it to the other long-acting pain medications I've tried. I didn't have too much of a "fuzzy-headed" feeling when I began taking it, but some people do. We are all very different, so if possible, try it on a weekend or a vacation so you can see how you react to it.

One note of caution is that methadone can cause delayed drowsiness. This means that you can be fine for a while after taking it, but hours later you can find yourself quite sleepy. This effect may pass, but again, it's good to try on a day when you do not need to work or drive too much so you can see how you react.

I agree with Sarah that it might be better to try your medication changes one at a time. Changing everything around at once makes it impossible to figure out what caused a side effect, if you get one. For example, increasing gabapentin can make you sleepy on its own...and adding methadone at the same time might be rough going for a while.

[cass2376]

Hello Lish,
You have been given great advice already so there is not much more I can give. The only other thing I could say is that I went from taking about 6-7 Vicodin ES pills a day to starting Methadone. The first few days to a week I was a little more groggy than usual and was slightly nauseated as well. Then it got better. As said by the others, everone reacts to meds diferantly so like they said, start it on a day when you can be home to see how you feel. I am now up to 20mgs 3X aday and I still take care of my four kids and drive as well. I can't work but that is not nessesarly from the Methadone, it is from being too ill. Anyway, good luck and I hope you find the right "combo" of meds that will work for you!
Take care and God Bless, Cassandra

[Lishypaz]

I guess I was a little confusing. I can take 1/2 vicodin, a valium, and a muscle relaxer while working--I am an administrator in an Elementary School. I am prescribed 500 or 750 mg. every 4-6 hours for pain (I decide which level to take) and 5 mg of valium per day, 300 mg Gabapenten and the other meds I talked about. I just don't take all of them at work because of the type of work I do. Trust me, when I have time at home like I do this evening, I do an instillation, take a full vicodin, a muscle relaxer and a valium.My questions and concerns are about whether or not I can take methadone and work. This week I was on the floor in the yoga "child pose" on 3 separate occasions because it was the only way I could keep the pain from reaching the "10" level. Thankfully, my assistant has been with me throughout the different stages of this and she can close the door, rub my back and help me breathe through the contractions.

I just want to know if there is "spaciness" with the methadone like when I first tried valium and vicodin together. Now, I have very little of that, but because often my job requires fast thinking, mobility, stregth and a clear head, I limit my doses to much less than is really necessary to take away my pain. Hopefully, this makes sense--I'm in a bad pain flare and have not yet taken my full dosing. I will first increase the gabapenten and switch to the other antidepressant and introduce the methadone. An interstim is the next step, but I need to wait until summer break for that.

In addition, I am beginning new PT in two weeks. Once weekly for 12 weeks, and then we shall see whether or not the interstim is a possibility. There are so many circumstances as to why I this is happening in this manner, insurance is a huge issue, the fact that the only PT that can see me is 75 miles away and the new urologist is almost 200 miles away, and the co-pays on the 14 meds and co-pays to my docs and PTs we pay for are more than 1/2 my salary, so the fewer meds for me, the better.

So, bacck to the methadone question.......

[cass2376]

Hello Lish,
Yes, you might get a little of the "fuzzy" head at first when you switch over from Vicodin to Methadone but like I said, it may not happen to you like it did me. Everyone responds differantly to meds. My "medicine" head lasted for a couple of days than my body ajusted to it. When ever my Doc ups my dose I go through the same thing but only for a day or two. I can drive and function normally on Methadone my body just had to get used to it first. I would try the switch on a Fri. and use the weekend to let your body get used to the Methadone. I hope you do well on it, I know Methadone was an answered prayer for me, it helped my pain so much. Is your Doc going to give you a breakthrough pain med as well? Mine gave me Percocet to take for b/t pain inbetween my doses of Methadone or when I was having a flare-up and my pain level was through the roof! He eventually took me off the percocet (it was not working very well for b/t pain), and gave me Daulidid for b/t pain. This combo has helped greatly!! Well, good luck and I really hope it works for you! I will keep you in my prayers for the Methadone to work for you and for your flare-up now. If you have any more questions feel free to write back here or PM me anytime!
Take care and God Bless, Cassandra

[Babs RN]

I am a nurse and have had great success continuing to work with this med. Please PM me if you would like some details on my personal experiences.

Hugs,
Barb

[Lishypaz]

thanks for your input--I might PM both of you. I haven't driven much in the last few months due to the side-effects of what I think is from gabapentin. Plus, its been that long that we've had several feet of snow on the ground and I didn't want to take the chance with the kids. Maybe, as we take some meds away, I won't feel so spacey and can deal with adding driving back in to my life. I feel trapped quite a bit relying on others.