Hey all - thanks
so much to everyone for taking the time out of your busy lives to spare me some advice on this issue because it has really been worrying me lately and it's nice to have that open and honest support from people who've been in my shoes before.
I doubt we're filling you with optimism here rybee but unfortunately it's the truth....
No, you're not! But I knew that I'd get honest advice from you guys on BL and that matters way, way more to me than a sympathetic, sorry and misleading reply that could lead me to initiating Methadone without being as informed as I should be.
Sorry for the late reply, but I really appreciate your detailed reply here mate, especially as you've got pressing matters at work to deal too. As you say, no - it really doesn't fill me with confidence, but it does confirm what I already thought about initiating Methadone. After reading the replies from this thread, I saw my pain doc yesterday (Friday 20th) and opened up to him about my concerns and worries regarding Methadone and he was very understanding. I know he's also uncomfortable about rotating me on to it and he's always been very adamant that it would be his last choice of opiate to try.
I can't believe you were on 400mg of Oxycodone! That's absolutely jaw-dropping. I think I'm quite fortunate that I've managed to bring my opiate load down to just 50mg Oxycodone, which is relatively low in contrast to some people, and still much lower than the 200mg of MS Contin that I was taking in September 2013. So in that respect, I think I've actually made some pretty good progress with regards to pain management over the last 18 months and that did leave me with the option to wriggle out of starting Methadone for the time being because I still had the option of increasing my opiate dosage back up a little bit more.
I do plan on going away for quite a few months later on this year and I'm really concerned about obtaining Methadone abroad because of the stigma attached to it and the problems in obtaining it in a foreign country. As you say, it's hard enough to obtain it in England without being treated like absolute scum, so I don't know how I'd be treated in Thailand/Indonesia/Cambodia/Australia - even if it is for pain management.
So on that basis, during our consultation yesterday, we both felt that it was best that he rotated me back round to a 25mcg Fentanyl patch, and we're also going to give Pregabalin another shot to supplement the Fentanyl. I was on Pregabalin last year (100mg twice daily I think?) and whilst I used to find it very effective for relieving a good chunk of the neuropathic pain, it really did make me feel foggy in the brain and I was studying for my masters at the time so I really struggled with the negative effects on my cognitive functioning. Other than that, it was brilliant for pain so I'm happy to give it another shot now that I'm in a fairly stress-free 9-5 job quite local to home. I've also gone back to having intensive physiotherapy 2x weekly which has really helped with reducing and relieving the pain, as well as strengthening my core muscles, and since doing so, I've not experienced any severe breakthrough pain for the last 2 weeks. I just get that horrible dull-achey feeling down through my lower back, bum, quads, hamstrings and calves - so I guess that's also another factor helping to deter me from starting Methadone at the moment.
I've also been referred to a spinal consultant for a surgical opinion on whether he can actually fix the Pars defect permanently, or just do carry out some surgery on it to help reduce the pain that I experience. I guess I'm quite lucky in the sense that I do actually have clear, verified, physical damage to the lower spine that *may* be fixed by surgery. A lot of neuropathic pain sufferers don't have the option of surgery to actually fix the root cause of their pain so I guess that's something to be grateful for.
I'm really grateful for you guys to take time out of your busy lives and bother providing me with the advice I was after, and it's good to know that I still have a few options left before Methadone becomes my last and only choice. Once again, thanks to everyone who's taken the time out to show concern and reply to this thread with information on your own experiences. It's something that's really been playing on my mind over these past few weeks, and I really don't have any shame in putting my hands up and admitting that I'm genuinely terrified at the thought of initiating Methadone - so thanks!
Rybee
![:\](https://bluelight.org/xf/BL_Images/Orig_Emoji/wrygrin.gif "wry grin :\")
) and one thing I have learnt over that period is that doctors will do anything within their power to shunt pain management patients off onto mental health and/or addiction services. This would seem to be fine (albeit less than ideal) because these services will indeed prescribe for such cases... as long as you will lie to them about why you are under these services.
