Well, my lady doc called this after noon. Very disapointing and in fact downright disturbing.
She asked what was going on. I described my symptoms. (all the typical moderate withdrawal symtoms, plus increased pain) She said that it sounded like withdrawal. I mentioned the equation used to figure the doses, and asked why this was happening. She said that what with the "DECREASED" dose, it was to be expected. Then she asked me if was having any repratory depression.
For christs sake. Does any one else see the irony here? This is exactly why I didn't rock the boat for this past year after I got dumped off on her. We are making an appointment with a pain specialist a (phy****rist?sp)I know, trust and have seen a couple of times over the years. She bumped my dose up 5 mg of immediate release. I told her I was pretty sure that wasn't going to cover it. She sounded real nervous then, and asked why I thought that. I could tell by the tone of her voice that I should shut up and say "ok, I'll try the 5 mg increase".
So--suddenly, after being on meds that work for years and years, I am being looked a-slant at, like an abuser, or drug seeker. I am so angry and disgusted and sick hurt all over.
The truth is, I have a considerable stash that I have accumulated over the years. If I was a freaking abuser, those would not exist. I am so tempted to take what I need to function and not feel so sick and hurt, but it would indeed be against doctors orders. Respratory depression my butt. I'm in withdrawal, NOT over medicated. I'm so darn opoid tollerant it's not funny.
Post Edited (raku) : 7/1/2008 9:17:00 PM (GMT-6)
Well guess why I'm up reading these posts at 10 pm when I get up at four am to see my wife off to work? Thats correct.
Thanks for the mention of the pain journal. I think that is a great idea, I'd heard of it years before, but never acted the good advice. Thank you the reminder, I will start tomarrow.
And to the last poster regarding not dropping the methadone all at once even hen switching to methadone, I had no idea. Actually, my experience leads me to believe that that may only be partially correct, at least in my case. I say this, because when I take enough oxycodone, the withdrawal stops. But I don't think that my doctor is aware that an equal dose just wont cut it. I think she said that for every 2 mg meth, should be substituted with 5 oxy. If that's what she has done for me, well it's not working.
I'm going to call her in the morning. I believe that the Physiatrist (is that the right title? I'm almost sure it's something like that) will be able to help me. She sent me to him over a year ago. When I followed up with this lady doc I'm having the trouble with now, she said "well, Dr. Ander--- said your definatley a candidate for opoid analgesia." Well duh. He had said the same thing five years ago. I just don't get it. I've been on these meds for YEARS with little to no problems. Why NOW???!!! I'm so angry. It's just it will probably take a week or longer to get in to see him. Meanwhile, well I just don't know.
Query: I have a dozen or so zanax I have saved from several years ago, when my father was passing from this world. I might take one or two a year, actually usually only a half of one. I'm trying to decide if maybe it would benifit my frayed nerves to have a quarter of one tomarrow if things get two squirrly. I know, no doctors here, and cant' give advice like that, it's ok. But I only have two other alternatives. one............tough it out at her dosage. which I don't HAVE to do, since I have supply. Two.............take just enough oxy to keep out of withdrawal and see what the physiatrist has to say.
Well, we shall see.
Thank you all so much. I really needed to talk to someone that knows the language. My wife knows the language of course, but she has heard enough over the years. Don't know how much more she can take.
Good nite, and godbless.
I'm a self employed potter, (hence the name "raku") No way I can work like this. I tried the last two days. Concentration just is not there. Also neck wont take the wheel now. I'm losing money every day. This could ruin us. I just can't afford to get any farther behind.
Decided against Z. Better not complicate things. Should know more later today.
Thanks for the greeting! I appreciate your kind words. Sadly, gathering strength from message boards really is one of our only productive ways for learning and giving and receiving heartfelt support. So-called "pain clinics" are popular in my area, but most are just glorified shot shops. Epidurals, anyone? This is the first time I've been back online since my mega-medical meltdown in 05/06. Prior to that, though, I met many unforgetable partners in pain while typing away at 3 AM... As you stated, at least we have eachother, and that can be life sustaining.
I really enjoy most types if history, except for my dreaded medical history. The list is so long now, in terms of diagoses made and unmade. I feel like some sort of freak or unwitting subject of one of those graphic medical cable shows. Cervical spine sports injuries and a MVA in which two of us, backseat passengers, were actually thrown through the canvas of a closed convertible top during the impacts. The wreck was hard on spinal and other body parts.
As we all are aware, it can take many years to actually stumble upon a well-trained pain management doc. And left to our own devices, we endure pain that reaches levels when proper medical intervention may have at least slowed deterioration. Instead, damage compounds over time and pain can be much more complicated to manage. Thus our experience with the 'heavy guns' used to reduce our misery and disability. We tried everything else. And in that cruel twist, the compounds that are succesful will become less effective over time simply due to their nature. A true emigma, and just for us. I'm off on the tangent again...sorry! It's taken me two years to reach the point where I'm okay to talk a little about the meltdown.
Althouth I'd been medically disabled several years before, I was ambushed in May of '06 by what the docs called a "massive, bi-lateral pulmonary embolism. The stats indicate about 80% instant mortality and approaching 90% during the first hour of treatment. They couldn't agree on 'why' it happened, but they were happy to report that embolization had blocked the flow of blood to my lungs, and extensive damage was done to the right side of my heart, most to my lungs, as well as other assorted parts. Now I have lethal stuff to deal with. Exceptional! I'm not an 'old guy' by any standards, but these last two years have often reduced time to having good hours over many 'good days'. Like many of you, I drag myself through days which are nightmarish enough that I don't always recall them later with typical clarity. I blame it on the oxygen deprivation during my PE!
Appeciate your reading this. I'd like to hear from Katu and hopefully any progress!! It's somewhat therapeutic to post like this, so I'll be looking for some news.
Happy Independence Day!!! Deeper again this year. A prayer for our soldiers today.
Best Wishes & Godspeed,
Darkstar, well arne't you an interesting fellow! (I'm not sure why I think your a fellow as apposed to a gal, but I do) And I mean that. I enjoyed reading you. Articulate and interesting. Thanks for writing.
And sometimes it's good for me to hear from folks that have had many more complex pain issues than myself as it is quite humbling. I see that I really don't have life so bad. Still though, things are not great, but much better than a few days ago.
I can tell that I'm going to do some Googling today regarding this "theory", or at least "proclamation", that Oxycontin gives 12 hours of steady state blood plasma level. Isn't it Purdue that makes Oxycontin ? Whatever. I do know that whoever makes it claims 12 hours. I call BS on that. If there were a 12 hour steady plasma level, then a twice daily dose of 40 mg would not leave me with 3 hours twice a day of pain and withdrawal symptoms, correct?
When my GP made the switch from three 20's to two 40's, I figured things would be better(and they are), but since she made no statement on how many 5mg immediate release oxy's were to be had, I was kind of left to my own devices. I've tried one 5, seven hours after dosing the 40, and it has nil effect. Takes two. That works. But I fear she will not go for for that many I.M.'s a day. Realisticly, it would probably take six a day to truly cover. Problem is, she has demonstrated that she is one of those people that seems to think that "less is more". Heck, I was already taking eight of those a day, plus the twice daily dose of 10 mg methadone.
I am shocked at how much oxycodone it is taking to take up the slack from the lack of such a small amount of methadone. And I think she will be too. I guess I just didn't realise how much those 20 mg's of methadone were doing to me. I can tell any one-- one thing, and that is that now that the methadone has pretty much cleared from my system, I really "feel" those 40 mg Oxycontins. And I really don't want to "feel" any thing but pain relief. I consider any "feelings" unwanted side effects. They are unwanted distractions. I don't have time to be sedated, high, or anything like that. It P's me off, costs me money from lost time at productivity. If I recall though, it will pass. What DOESN'T pass, if I recall, is the "mini"-withdrawal and recurrance of primary pain that begins occuring approx 7 or 8 hours after doseing with oxycontin. And I think that this confuses and confounds these doctors. I'm not sure what the definition of "breakthrough" pain is. You know, the pain that is typically treated with I.M. release something, between doses of E.R. something. Is this it, or is it something else.
Who said their doctor doesn't believe in I.M. beds for "breakthrough pain? Was that you Darkstar?
Said they believed it was too dangerous? I would like to hear an elaboration on that philosophy.
It's just that-- over the years, I have established that if we can find some stable combination, I'll stay right there for years. I don't come back begging for more, more more. That's one of the troubles with narcotics for chronic pain isn't it. The "it's never enough" sydrome which can be brought on by the phenomana of "tolerance". It's a difficult nut to crack. Takes discipline, determanation. And a willingness to suffer some darn unpleasn't side effects every now and then. It turns us into liars sometimes, since we know from experience that if we tell our doctors, then they start fishing. And when our doctors start fishing, we suffer. What I do, is when I figure it's as "good as it gets", I tell the doc, that "it's good enough". I guess that's not really lying. But crap, I wish my old doctor was still around. He understood that I am the one taking this stuff. It's MY pain. I am going to know MY PAIN, and how these meds affect me. I'm so sick of doctors listening to me, then going to the BOOK and reading what IT says, seeing a discrepancy, and then believing the book, instead of me. 12 hours my butt. Not for me anyway. Maybe the twelve hour thing is true for the Opoid naieve, and that is where that comes from. Dont know. That does seem to make sense though, now that I think about it.
Anyway, I am completely rambling, and sorry for it. I DO wonder about an earlier statement about Methadone, and not being able to "just stop", even with other Opoids availiable. Makes me wonder if that is still a part of my problem, and that in another week or so, things will settle down.
Lastly, I want to share something a physiatrist told me many years ago regarding long term chronic opoid use for pain. I'll have to paraphrase, I can't quote. too long ago. He said when a patient is considering jumping into chronic opoid use, that the patient needs to be aware of the many difficultys involved. Like, social stigma. Fighting doctors. Fighting pharmacists. Opoiphobic professionals in medical community. Doctors on vacation. Insurance companies that think opoids are for the dying only. (but for Gods sake, don't get the terminally ill addicted!!, so don't give even them too many!) His list went on a bit, I can't remember all of it now, but every now and then I sure do think of him. Aint it the truth. And sure there are alternatives. The descision is a heavy one. Indeed, ALWAYS best to try all the SAFE alternatives prior to chronic opoid treatment. But who decides what is safe? I took Celebrex for a year, Viox for six months, so DON"T tell me that the FDA has their s--- together. We gotta use our heads and do our own research. Even then, it's a dangerous world. And who to trust? You, that's who.
Well, I see that I've begun to rant. I've a day ahead, so here I go.
Best of luck to all, and see ya around,
Post Edited (raku) : 7/5/2008 1:04:29 PM (GMT-6)
Reluctant Survivor, my apologies to have given the impression that I only read "part of your story". I read all you have written with keen interest. But my attention span at the keyboard is not up to snuff since these abrupt changes were thrust upon me. Not only is memory all askew when under medicated, but I also seem to have suddenly become dislexic! I mean that I'm typing crazy mispelling which are not found untill I reread the post the next day! Now I'm not that great of a speller anyway, but usually I at least KNOW when I screw up. Also, Ive got fast fingers, and they get ahead of my train of thought, and I inow I am not always making sense. But yes, I read all of your posts, you too Plady, welcome stuff all of it.
It is clear by this afternoon that I am only have eight hours of comfort from 40 mgs of Oxycontin. 10 miligrams of IM oxy fixes it for next four hours. So for to six IM's a day will do it. I fear she is going say that I get none. In which case I am screwed. Won't know untill Wednesday. I think I had said Friday, but I was looking at my calender wrong. Will definately check in here after to announce how it has gone.