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My PM Dr.'s Appt., and what I Learned! - Printable Version

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My PM Dr.'s Appt., and what I Learned! - Still in Limbo - 07-23-2009

I had My Usual 3 Month Dr.'s Appt. Yesterday, and We Spoke for a while, and I wanted to Share what I Learned, in Hopes it Helps Others! Now BX4, Cycler, Red, or any Others Please Correct Me, I am just going to Use Layman's Terms and I May Miss Something, so Please Correct Me so that Others can Read and Hopefully get a Little Better Understanding on Their Pain!!

As Usual, My Dr. asked How My Pain was, and I told Her that I was still Living in the 7-8 Range, and I didn't want to Raise My Methadone Strength until I couldn't Stand it Anymore, because being only 47, I don't want to get to the Top of the Med. Scale too soon, and then Nothing is going to Work!! She said without the Correct Pain Med. Program I was Correct, but a Good PM Dr. can Stop that from Happening by Using the Med. Change Route. She went on to Explain that Different Pain Meds. Effect Different Pain Receptors at Different Levels, and if the Meds. We are given are Changed from Time to Time, and a Different Med. and Strength was Switched, it would Effect Different Receptors at Different Levels, and give the Mind a Break from the Med. currently being Used, and by doing so, the Brain Over Time Forgets the Current Med. being Used, (Such as Methadone in My Case) and then when the as in My Case Methadone is Re-Introduced into My System after Time My Receptors will Accept it as a New Med., and Again be able to Give Pain Relief!!

That's when We Discussed a New Med. named Opana (SP?). This Med is a Derivative of Morphine and 5 Times Stronger than Morphine, and Stronger than Methadone in the fact that it is Much Longer Acting. I have to take Methadone 10mg. every 6 Hours, along with My Morphine Sulfate IR 30mg. every 8, when I should Only have to Use the Morphine for Flare-Ups, and not as a Part of My Normal Routine, and this New Drug only has to be Taken Twice Daily. It will Work on Different Receptors than the Methadone has and at a Different Level, so If this Med. gives Me Relief, in Time when My Body becomes Immune to this Med and Dosage, We can Use the Methadone again, and get the Relief I felt when I First Starting Taking it!! I know this is a Bit Confusing, and I will Probably, which I Invite by the Way be Corrected, but I Hope this Gives You an Idea of how the Brain Works when Dealing with Pain Meds., and it May be Something to Speak to Your Dr.'s About!!Wink



RE: My PM Dr.'s Appt., and what I Learned! - monster - 07-23-2009

I'm glad they have figured this out and that you will once again get the relief that you need.

I'm not real coherent today but will you go through withdrawals or anything being switched from your current meds to new ones?

Sorry this is short my brain is not functioning clearly today.

hugs,
monster


RE: My PM Dr.'s Appt., and what I Learned! - Bummer Knees - 07-23-2009

Still In Limbo

I do hope this information helps you with treatment of your pain.

This is good information to know and helps me understand pain management a little better.

I saw my doctor yesterday and we talked about my pain levels which have increased.

Course we all know if it were my choice I would not be taking any meds.


RE: My PM Dr.'s Appt., and what I Learned! - Still in Limbo - 07-23-2009

Monster, I switched Pain Meds. a Few Times, and I actually had Little to No Withdrawals, because One Med. was Replacing the Other, and the New One is Usually Stronger than the Last! I went from Morphine 200 mg. every 8 to the Fentanyl Patch 100mcg. per Hour 3 Day Length, and then to Methadone 10mg. every 6 Hours. This New Med. should Arrive in a Few Days, and I will Keep Everyone Updated on how it's Working!Wink

Bummer, I Hope this Helps give You some New Questions for Your Dr., what I Love about My PM Dr. is She is Very Young, and goes to Any and All Seminars She can to Learn!! She is Qualified in Acupuncture, Psychological Pain Relief Methods, and the List Goes On, and She is Very Easy to Talk to!! We are on File #3, and Each One is about 4 Inches Thick!! I Love Her Demeanor, and wanting to Learn and Pass on New Methods, She has Tried Many Things on Me, including a $3500.00 Tens, Muscle Exercise System. Even though that didn't Work, and I Returned it, at Least She Tried!!Wink


RE: My PM Dr.'s Appt., and what I Learned! - Bad Boy Bad Boy - 07-23-2009

Limbo, I'm not at all confused. As I do feel your PM Doctor to be correct also. I might say, that I don't think you will fully get that burst from your first time use of the Methadone, but you will get the relief that Methadone has to offer you.

When in pain, the old brain can and will get stuck into thinking the body, or body parts are always in pain. When this happens only a Medication change will help. Now, much like you, I too am this way. I was given EFFEXOR to alter chemicals going to my brain, to then help the brain from thinking I'm in constant pain, when I'm not. Yes, it did work. But again like you, this is only performed on a one on one basis with our doctor's.

Well, as I do understand what your talking about, many others may not, till they bring the issue up to their doctor, and they work hand in hand to confront such issue.

Now, like you, me, or anyone else, we fully need to learn and understand, there is no medication anywhere in the world, that will remove ones pain. Medication take the edge off, or turn a sharp pain into a dull pain, or lighten the pain level, but that is truely about it.


RE: My PM Dr.'s Appt., and what I Learned! - capricorn - 07-23-2009



Thanks you Limbo for the info. My husband is in the process of doing this right now. Adding, subtracting, changing in general. I hope to God it works for you both. I am switching PM Dr.s and hope I find someone as good as yours.Wink



RE: My PM Dr.'s Appt., and what I Learned! - chrischris - 07-23-2009

Hi Still, I hope you are doing ok today. And thanks for sharing. It does make sense. You PM doctor is a good one.

I have a new PM doc and the first thing he did was raise my Lyrica to 450 mg. per day. I was hesitant because as anyone who takes this medication knows, it really makes you feel loopy. Well, it does control the overall pain more, but I sleep a lot more too. I just don't know what is worse; the pain or the sleeping. I need to talk to him more about what you said on my next visit. Thanks, and take care.


RE: My PM Dr.'s Appt., and what I Learned! - Still in Limbo - 07-23-2009

I'm Very Happy that this is Peaking Some Interest, and Hopefully will Help Others when they Discuss Their Pain Issues with Their Dr.'s! And BX4 I Totally Agree that Our Pain is Not Cured with Medications, it's just Suppressed by the Medication, and allows Us to feel Relief for a Time! Now I Wanted to make Sure and Post this, as I forgot to in My Original Thread, so Some of the Newer Members Understand where I am Personally in My Battle with Pain, and Why Something like this Med. Change System is so Important for Me, and Others that have to Deal with Chronic Pain Daily. My Meds are Listed Below:

Methadone- 10mg. 4 Times Daily

Neurontin- 600mg. Twice Daily-1200mg. at Bed Time

Morphine Sulfate IR-30mg every 8 Hours

Lyrica- 50mg. 3 Times Daily

Promethyzine- 25mg. 3 Times daily

Valium- 10mg. at Bedtime

Simvistatin- 40mg. at Bedtime

Atenolol- 25mg. Once in the Morning

Lisinopril-5mg. Once in the Morning

Spariva- One Capsule Inhaled for COPD Daily

Andro-Gel- Rubbed into the Shoulders Daily for Testerone Replacement, (Opiates and Chronic Pain has Stopped My Body from Producing)

Primatene Mist- Inhaled as Needed for Asthma Relief

So as You can Clearly See, any Change for the Better, even if the Slightest, Carries a Wealth of Importance to Me!! Just as a Foot Note: Before My Injury, I only took a Small Dose of Diovan Daily for Mild Hypertension!!

So if You are just on Mild Meds. at this Point, this Discussion May not Pertain to You Right now, but I would Suggest if You think Your Meds. are going to Continue, You may want to Book Mark this for Future Reference!! Have a Great Evening Everyone!!Wink



RE: My PM Dr.'s Appt., and what I Learned! - bronco54501 - 07-23-2009

My god still, you should at least have stocks in your pharmacy... Thats a butt load of meds and I only take 3 meds for pain and I pray the lord it stays that way...... I to take lots of meds but not just for pain............I take 5 in the morning along with advair and pro air inhaler, then if I needs pain meds, then nightly I take 3.

I see you take Primatene Mist, is this somthing by choice or is it perscribed.? I'm asking because when I was younger I could buy those but really never helped much. It kind of gave me a perfumy smell taste and this is going to sound wierd but I am alergic to almost all perfumes and deorderant. It depends on the smell & the strenghth but within minutes I'm having a asthma attack....

Have you ever tried a different type of inhaler, or is this the one that works best for you, knowing meds treat others differently..................

But Still, I hope this works for you.............with the change of meds. It must play hell on your system...............................Bronco


RE: My PM Dr.'s Appt., and what I Learned! - Cycler - 07-23-2009

Opiate rotation works because of the difference in drug binding preferences among the mu, gamma, kappa, epsilon and maybe a few other pain receptor types. So you give one drug for awhile with a high affinity for the mu receptor, such as morphine and when tolerance develops you can either increase the dose or change to an opiate that has strong affinity for a different receptor type; ie; oxycodone and the gamma receptor.

Opana and Opana ER (the new extended release formulation) is oxymorphone, an old drug useful in chronic pain. Interestingly, your body makes oxymorphone when the liver breaks down oxycodone ( Percoet, Oxycontin,etc )

It's less toxic than methadone but may cause shakes or jerks at higher levels.