Need to get this off my chest!

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shaw31
Regular Member


Date Joined Mar 2007
Total Posts : 167
   Posted 12/20/2010 11:43 AM (GMT -6)   
Hello all!  I hope you all are doing as well as possible!
 
I am here to get something off my chest.  I have been talking the past few months about my forced change from methadone to another long acting opiod for PM.  If you all have read my earlier post you know what I have been going through.  If not, please go back and read my earlier post as I do not want to repeat myself here.  I just want you all to know what a tough time I have been having.  I was doing some research today and found the reason I might have had such issues at the very beggining of the transition.  I was on 70mg of methadone a day.  3 am , 2 midday, and 2 pm (10mg each).  When my PM doc told me he could no longer prescribe methadone becuase of the new FL laws he said the best bet would be morphine cr.  I said ok.  I felt he knew what he was doing.  He put me on 30mg morphine cr every 12 hrs or every 8 hrs if I absolutley needed it.  Heres the thing.  I went online and found several conversion charts that say how you should go from one med to another and what does is equal to another dose of another med.  Say I take 50mg of med X  I should take 150 of med Y to have a safe and consistant transistion.  All charts say that I should go from taking 70 mg of methadone (which is what I was on) to taking (at a starting dose) 262.5 of morphine cr daily.  I have to ask you why why why did my doc convert me from 70mg of methadone to 60-90 mg of morphine cr daily?  It almost seems to be the doctor did not konw what he was doing?  Thats a 172 mg difference.  If all the charts I have found online are correct then no wonder I was and am having issues with transition!  I am not real happy about this and I would like you all to voice your opinions.  I have just found out that my doc is leaving to go to another office so I will be getting another doc.  Do you thing I should bring up the information I have discovered myself or leave it alone.  I would just think any educated doctor would do their research as I did to find out the proper conversion.  Any comments would be appreciated ....
 
Thanks

JNO2
Regular Member


Date Joined Jun 2010
Total Posts : 62
   Posted 12/20/2010 12:11 PM (GMT -6)   
I don't know about Methadone having never taken it, however I do take 30mg of Morphine Er 2x daily, and I can say it barely takes away my pain. (not very strong in my opinion)
If I was you, it would be the first thing I said to my new Dr. After all, that is what you are paying for.

Retired Mom
Veteran Member


Date Joined Feb 2010
Total Posts : 1753
   Posted 12/20/2010 4:52 PM (GMT -6)   
I think I would just be factual to the amount of pain you are having and the historical information on the change of medication and the date. I would then "ask" the Dr if perhaps there could have been a conversion issue since I was still having so much pain. An educated Dr would, as you said, know the proper conversion.

You certainly don't want to go in to see a new PM and bash the old one. It won't get you anywhere, that's for sure. If you just give a history and a summation of the pain you have been having since the change, it may help put you in a good light. The Dr should immediately know why there is an issue when you tell him/her. If not, then you can go on from there. It's just my 2 cents, but coming on too strong on a first visit with a new Dr doesn't always work out as well as we expect. Sometimes they will even turn us away because they may consider us "problem" patients and I don't want that to happen to you. Your chart should validate everything you are saying and I'm sure the Dr will take the time to look it over when you mention the med change, even if they haven't had time before the apt to do a close evaluation.

Best of luck!
Failed fusion L5-S1, Pituatary damage, HGH Def, Fibro, Bladder surgery failure, Nissen Failure, GERD, OCPD, GAD, MDD, CTS (Bilateral Surgery completed), CFS, TMJ, Migraines, Vit D, A, Magnesium, deficiency, HBP, Idiopatic Reactive Hypoglycemia, serious Edema, too many Drug/Food allergies, sensitivites, and current meds to list.

White Beard
Forum Moderator


Date Joined Feb 2009
Total Posts : 3702
   Posted 12/21/2010 12:23 AM (GMT -6)   
shaw31

I think I would tell your new pain Doctor what you were taking ( dosage wise) when you were on Methadone, and then when you were changed over to Morphine, and that now you are having a very difficult time with pain control. I do not think I would mention that you looked up the conversion. But you might want to ask him if you are getting the same amount of pain control being on your current dosage of Morphine as you were getting when you were on the Methadone? Maybe he will look it up or refigure the proper amount, and realize the error????? The main thing is to let him know about your pain and if it is worse then how much worse and how it is affecting your life. Be up front and honest, but let him make the decisions, that is what you are paying him for. Getting off on the right foot so to speak is have the battle with working with Doctors, but just don't sugar coat your pain and make light of it, if your having pain let him know, and if what your on is not handling it, then by all means make sure he knows that too!

I do wish you well on this! Good Luck to YOU!

White Beard
Moderator Chronic Pain
After spending nearly 22 1/2 years in the USAF, I retired in Sept, 1991. I then went back to school and became a licensed RN in 1994, and I worked on Oncology and then a Med Surg Unit, I became disabled in late 1999 and was approved SSD in early 2002!-- DDD, With herniated Disk at T-12 and L4-5. C5-C6 ACDF in Sep 2009, C6-C7 ACDF in Mar 1985, Osteoarthritis, Ulcerative colitis, Chronic Pain, Fibromyalgia, Complex Sleep Apnea, and host of other things to spice up my life!(NOT!) Medications:Oxycontin, Percocet, Baclofen, Sulfasalazine, Metoprolol, Folic Acid, Supplemental O2 at 3lpm with VPAP Adapt SV I am White Beard with a White Beard!

purplereading
Regular Member


Date Joined Nov 2010
Total Posts : 108
   Posted 12/21/2010 11:49 PM (GMT -6)   
I was forced to switch from Methadone also, but due to the fact that the pain managment dr I had left town, and left her practice to a GP, and he was not comfortable taking care of pts. on methadone or prescribing it. Originally I had been on 100mcg patch,duragesic, that quit working and the dr gave me methadone 5o mg daily. That turned out to be too much for me right then. so I b acked down to 40 mg. Anyway, it worked fairly well, but I was never prescribed breakthrough pain meds. The GP gave me oxycontin and it was like 30 mg twice a day, and I went down from the methadone 10 mg a month over a three month period. I had withdrawal symptoms for two to three months later after getting off. He gives me oxycontin 40 mg three times a day,(every 8 hours) It feels just like taking a vicodin to me, and it wears off in less than 8 hours, although he told me originally that the literature showed it lasts 12 hours. the dose of oxy was way too little for the small amount of methadone I was on. It is very difficult to get off methadone, and I imagine you are having withdrawal symptoms. Drs tend to lean toward the low end when it comes to conversion. I think they sometimes forget that afte time, we become tolerant of the dosage we have been on, and must increase to keep even the same level of pain control. MS does not work for me at all. I am thinking about going back on the durgagesic. GOOD LUCK

spinal soldier
Veteran Member


Date Joined Dec 2009
Total Posts : 687
   Posted 12/22/2010 4:05 PM (GMT -6)   
it,s absolutely incompetent, i noticed that a couple months ago when it happened and it,s stupid because tons of people hear in VA are on methadone with roxicodones or dilaudid for brkth. they even give out high doses of methadone and send you to get a EKG when your at 80mg and up. i also believe your getting a unfair trail of the morphine because truly it is the gold standard. i figured you would start to slip into withdrawals from the methadone when they gave you a starters dose of morphine. i would come right out and tell him your not in any kind of pain control, you hurt bad all the time and tell him you don't want the Opana because it cost too much and your insurance is complaining. i take 3 100mg MSER a day, one every 8 hours and it helps a lot. good luck with your tight doctor.

straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 16787
   Posted 12/22/2010 5:46 PM (GMT -6)   
Shaw I know you have been struggling ever since this whole mess began with the discontinuance of Methadone. But, I can see why the dr did not start to out on such a large dose, and I am not saying I agree with him. But, keep in mind its the same old song and dance, they always start us out on a low dose in the beginning on a new medication and slowly increase it as times goes along. This is why I am not surprised that you were not started on the larger dose. Everyone reacts so differently to these medications and none of it is cut and dried no matter what we may think. Just been there and done that too many times.

I do hope you can get some relief soon. Take care. Susie
Moderator Chronic Pain Forum

Chartreux
Veteran Member


Date Joined Aug 2006
Total Posts : 9664
   Posted 12/22/2010 6:00 PM (GMT -6)   
I think Susie/Straydog summed it up good for you, your doctor started you on a lower dose
because in case you had a reaction to this medicine...If you had a reaction to this medicine
would you then be screaming mad at your doctor for it...Its a crazy world anymore...
Maybe your doctor is planning to up the dose at your next visit...be patient with
this doctor and give him a chance....

Hope this info helps and I hope you get a low pain day soon...
(((((((((((((((((((((((((((((((((((((Shaw 31))))))))))))))))))))))))))))))))))))))
healing hugz
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* Asthma, Allergies, Osteoarthritis, Spinal Stenosis, Degenative Disc (Lower Lumbar S1-L3 and Cervical C5,C6, C8 and T1), Fibromyalgia, Gerd,
Enlarged Pituitary Gland, Sjogren's, Ocular Migraines, mild carpel tunnel, ect.... "Would be nice if we could use the edit button in real life"...

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