20 September, 2009

Methadone Treatment Begins Tomorrow

Yep. This is going to be a post, on a blog called The Fibromyalgian, about fibromyalgia. What can I say (write)? It's a crazy world.

As I think I mentioned in an earlier post, I'm switching meds, most likely tomorrow, from Oxycodone to Methadone. Why tomorrow? Because I have an appointment with my pain management doctor tomorrow. Let's call her Dr. Not-Too-Damn-Bad, or Dr. NTDB for short. Or Dr. N for even shorter.

Dr. N is not too damn bad because she hasn't been afraid to prescribe me the dosages of painkillers I have required. She also came around on my Klonopin, and I'm on my necessary six mg per day, instead of the four mg she was previously stuck on. This is to her credit because every doctor is wary about prescribing a patient two central-nervous-system (CNS) depressants, which can result in the patient ceasing to breathe. And the vast majority of doctors like to keep their patients breathing.

The only problem I have with Dr. N is that she prescribes me Provigil for my chronic fatigue disorder. Before I came to Portland and began being treated by Dr. N, I had been taking Ritalin, which worked extremely well and, which is very important to someone who relies solely on Social Security Disability for his income, dirt cheap.

But Dr. N wasn't comfortable with prescribing speed to a fibromyalgian. It seems to her that speed and opiates and Klonopin are at odds with one another.

And I suppose I agree. But agreement doesn't make Provigil affordable. And so my chronic fatigue is left untreated.

On the first of October I will have Medicare. But Medicare doesn't help one out with prescription drug costs, and getting private insurance to help with my drug costs may actually be antithetical, since the cost of my monthly drug copays and drug insurance are likely to cost more than just buying my meds outright.

...Unless I start filling my Provigil, which costs something like four hundred and fifty dollars a month. Yeah. No typo: four hundred and fifty dollars a month.

Which reminds me to beg: Please help me get the treatment I need by donating. Please please please PUH-leeze! The button is right there... Right there on the right... And any amount helps! Any amount at all!

OK. begging done. On to the Methadone.

It's a tricky bastard of a drug because its half-life is longer than its active life. That is to say (write), that Methadone provides pain relief for a shorter time than it stays in one's system, in which it depresses breathing. So one has to be very OCD about one's Methadone schedule: If you're having a bad day and in a lot of pain and take more some Methadone to help you out, then take more... and maybe later some more, one can find oneself with enough Methadone in one's system to make their breathing cease before one's pain does.

Anyway, it's likely to be a good thing for me to be on Methadone. I'm currently taking so much Oxycodone that Dr. N doesn't feel comfortable prescribing a higher daily dose. For a patient to be taking one hundred and thirty mg of immediate-release Oxycodone per day could attract unwanted attention from the feds. But I can't take Oxycodone together with OxyContin (long-lasting oxycodone) because -- got a guess? -- OxyContin costs too much. That, and OxyContin is scarce because the feds are so overly concerned with the drug being diverted and under-concerned with the needs of people who are in constant pain -- which includes people who have terminal cancer, multiple sclerosis, and a bevy of conditions besides fibromyalgia.

The government is more concerned with keeping people from having fun by taking pills than it is with the quality of life of tens of thousands of people. And we're talking about pills that keep people from killing themselves or wanting to.

So tomorrow Methadone begins. I'll follow up tomorrow with the plan for how my transition from oxy to 'done is going to play out.

("'Done" work for you as shorthand for Methadone? ...Yeah. Didn't think so. And I agree.)

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