Bomb319
Bluelighter
- Joined
- Nov 26, 2011
- Messages
- 583
I'm sorry - this is kind of a long story, but if you have any experience with methadone and its side effects - particularly the dangers of heart conditions (long QT syndrome) that may be caused by it, I REALLY need your help right now I will try to make it interesting to read, at least I realize that this forum is no place to ask for official medical advice. However, it isn't my sole resource of course, and I realize that what I find out here can't be taken to be absolute fact. Yet, ANY information, stories, etc. I learn from you guys, would really go a long way to help me find out more about this, and possibly inform me of other potential options at my disposal. With that in mind......
Here's what happened: I had an EKG done about a year ago, and both the operating technician and my doctor told me that it was normal, but slightly on the elevated side (referring to the QT interval which can be increased with certain drugs, methadone included). A very long interval means the heart takes too long to repolarize, and can lead to an arrythmia called Torsades de Pointes. In turn, this condition is extremely dangerous, and can cause sudden death via ventricular fibrillation (though most episodes of Torsades apparently resolve without incident). I got a call from my doctor this morning, informing me that she needs to see me earlier because of my latest EKG results. Rather than keeping my appointment 4 weeks from now, she wants me to come in in 2 weeks. At least it's not likely to be something so critical I have to get medical help ASAP, but still, she only comes in to the clinic on Wednesdays, and since next week is New Year's and tonight is Xmas eve, that may still be the earliest appointment I can make with her. She told me my QT interval was too high, and that we need to discuss options to deal with it (in the words of her secretary who was the one who called). Now, my first EKG done a year ago was also "a bit high", but not as much as this one.
I wish I knew the actual values, but they didn't say. I don't know what I'm supposed to do here....even disregarding the potential danger of having a prolonged QT, what exactly am I supposed to do, cold turkey 220 mg methadone or even rapidly taper? I'd be dead from that first. I also commonly combine part of my next day's dose with the current one (usually taking 370 mg maximum, then the other 150 about 12-15 hours later. It works best for me that way because the high dose gets me through the day and gives me more motivation and drive, while the rest later that night helps me sleep and also prevents me from going through withdrawal the next day when I have nothing).
I've been on a high dose of methadone for almost 2 years now, as some of you probably know from my other posts. More recently, but also for nearly the past year or so, I've been taking Clonidine as well - up to 0.6 mg throughout the day - because of my rapid methadone metabolism and resulting propensity toward morning withdrawal symptoms; also for the induced sweating which I can't stand, and my blood pressure which can climb pretty damn high. I also take diphenhydramine and have been doing so for 15 years. If Clonidine is causing or contributing to the problem, it would obviously be so much easier for me to quit that, eat better, exercise more, or literally ANYTHING ELSE but quitting such a high dose of daily methadone.
I obviously realize that this is not exactly the best place to ask for medical help. I DO believe that it's a good place to ask about things like this without expecting official or legal responses. Many of us are on maintenance therapy, we are well-educated and therefore familiar with many medical issues and potential complications such as this, etc. So if anybody knows about this or has their own experiences upon which may shed light on what may be happening with me, I would be very grateful for more information - how serious it is, or if it's likely just a precaution, and especially what possible "options" we can discuss other than discontinuing the methadone in some way.
The thing is, I'd probably be dead by now anyway if it weren't for the methadone. I had a very intense and expensive habit for 6-7 years; student loans and moving to a different city at the beginning of an addiction is a horrible combination since I had all the money I could ask for at first because of bank, government and family loans. Getting clean - even staying on such a high dose of methadone without using any other illegal drugs whatsoever was not easy. I can't go back to the way things were....I just can't. I don't want to use again, but I would be sick as hell for a very long time if I went off methadone, even via an extremely slow taper. I hate withdrawal beyond reason as most people do, but the physical symptoms from just heroin w/d always seemed to affect me more than everyone else and for a much longer time. For instance, the one and only time I was able to stay more or less clean for a reasonable period of time, I still woke up in the morning with brutal sweating and chills 6 to 7 months later!! And that's just from H, Dilaudid and Oxy. Imagine me coming off 300 mg of methadone.
I don't know what to do. I have a very strong family history of heart disease on my mother's side as well; almost all the males (6/7) dropped dead from heart attacks before age 60. My Dad's side is fine, but that's some pretty fucking crazy Russian roulette right there. Above all, I don't know how dangerous an elevated QT actually is, or if there is anything I can do to mitigate this now other than stopping the methadone. Any insight is very much appreciated...I'm a mess right now.
Here's what happened: I had an EKG done about a year ago, and both the operating technician and my doctor told me that it was normal, but slightly on the elevated side (referring to the QT interval which can be increased with certain drugs, methadone included). A very long interval means the heart takes too long to repolarize, and can lead to an arrythmia called Torsades de Pointes. In turn, this condition is extremely dangerous, and can cause sudden death via ventricular fibrillation (though most episodes of Torsades apparently resolve without incident). I got a call from my doctor this morning, informing me that she needs to see me earlier because of my latest EKG results. Rather than keeping my appointment 4 weeks from now, she wants me to come in in 2 weeks. At least it's not likely to be something so critical I have to get medical help ASAP, but still, she only comes in to the clinic on Wednesdays, and since next week is New Year's and tonight is Xmas eve, that may still be the earliest appointment I can make with her. She told me my QT interval was too high, and that we need to discuss options to deal with it (in the words of her secretary who was the one who called). Now, my first EKG done a year ago was also "a bit high", but not as much as this one.
I wish I knew the actual values, but they didn't say. I don't know what I'm supposed to do here....even disregarding the potential danger of having a prolonged QT, what exactly am I supposed to do, cold turkey 220 mg methadone or even rapidly taper? I'd be dead from that first. I also commonly combine part of my next day's dose with the current one (usually taking 370 mg maximum, then the other 150 about 12-15 hours later. It works best for me that way because the high dose gets me through the day and gives me more motivation and drive, while the rest later that night helps me sleep and also prevents me from going through withdrawal the next day when I have nothing).
I've been on a high dose of methadone for almost 2 years now, as some of you probably know from my other posts. More recently, but also for nearly the past year or so, I've been taking Clonidine as well - up to 0.6 mg throughout the day - because of my rapid methadone metabolism and resulting propensity toward morning withdrawal symptoms; also for the induced sweating which I can't stand, and my blood pressure which can climb pretty damn high. I also take diphenhydramine and have been doing so for 15 years. If Clonidine is causing or contributing to the problem, it would obviously be so much easier for me to quit that, eat better, exercise more, or literally ANYTHING ELSE but quitting such a high dose of daily methadone.
I obviously realize that this is not exactly the best place to ask for medical help. I DO believe that it's a good place to ask about things like this without expecting official or legal responses. Many of us are on maintenance therapy, we are well-educated and therefore familiar with many medical issues and potential complications such as this, etc. So if anybody knows about this or has their own experiences upon which may shed light on what may be happening with me, I would be very grateful for more information - how serious it is, or if it's likely just a precaution, and especially what possible "options" we can discuss other than discontinuing the methadone in some way.
The thing is, I'd probably be dead by now anyway if it weren't for the methadone. I had a very intense and expensive habit for 6-7 years; student loans and moving to a different city at the beginning of an addiction is a horrible combination since I had all the money I could ask for at first because of bank, government and family loans. Getting clean - even staying on such a high dose of methadone without using any other illegal drugs whatsoever was not easy. I can't go back to the way things were....I just can't. I don't want to use again, but I would be sick as hell for a very long time if I went off methadone, even via an extremely slow taper. I hate withdrawal beyond reason as most people do, but the physical symptoms from just heroin w/d always seemed to affect me more than everyone else and for a much longer time. For instance, the one and only time I was able to stay more or less clean for a reasonable period of time, I still woke up in the morning with brutal sweating and chills 6 to 7 months later!! And that's just from H, Dilaudid and Oxy. Imagine me coming off 300 mg of methadone.
I don't know what to do. I have a very strong family history of heart disease on my mother's side as well; almost all the males (6/7) dropped dead from heart attacks before age 60. My Dad's side is fine, but that's some pretty fucking crazy Russian roulette right there. Above all, I don't know how dangerous an elevated QT actually is, or if there is anything I can do to mitigate this now other than stopping the methadone. Any insight is very much appreciated...I'm a mess right now.