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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LAZINESS IS POSTING AN E-MAIL!

Someone e-mailed me, having just found out that I have fibro through the Interwebs. She told me she has been in pain for years and her doctor, who has been giving her Lyrica for years, has thought she's had fibro for years. My response is below (notice the emphasis on drugs drugs drugs, even though I don't know whether Lyrica works like an atomic clock for her)... Also notice that I am, in fact, sleazy:

Begin:

There is one thing you must do immediately: Find a doctor who PRESCRIBES OPIOIDS! I can't stress that enough. I get pain relief only from them, but the asshole doctors I've found in Lummox [I change the names of people and places, nothing else -Ed.] won't write scripts for them (especially since I was taking one bomber of an amount of Percocet... Which still didn't work close to well enough! -- even my DC doctor was super-reluctant to get me on COAT -- Continuous Opioid Analgesic Therapy... but he WAS going to, right before I was yanked home by my parents (I was having a very very nasty flare).

[Wow! I can't use punctuation properly! -Ed.]

So I never have been able to experience anything close to 100 percent relief. Which makes me pissed off enough to write a blog. How nerdy and 1990s is that? I write a blog...Well, my first book wasn't picked up through the traditional channels (it sucks), so maybe I can sell my diary...

OK -- also, get yourself some Ritalin or Provigil. I'd be on the latter if my doctors had any desire to allow me to be somewhat awake and coherent during the day. Might as well get some kick-ass speed while you're at it....

And -- stop.

Wow. Rants like those just pop right out.

Anyway, of course I remember you! In fact (not to be off-putting or sleazy), the last time I recall seeing you was at Mutual Friend's graduation party. I was drinking a fifth of Bombay Sapphire and kinda hitting on you. Later it was tent time and I was between you and Erin Lastname (how is she doing? any idea?), trying to decide if I should make a move on you or not -- despite Erin being there.

The booze must have gotten to me... Then again, not enough for me to actually try something, get rejected, and possibly kicked out of the last available tent.

So that's that... Sorry it had to be weird.

OK, so yep, I have fibro, but I'm having pretty good days now. The flare is over, and things are pretty calm now.

EXCEPT I'm coming off some pills (including my beloved sweet divine Percocet so save me jeebus), and it's making me more aware of the world. Which sucks, because I'm stuck at my parents' house. Goddam it.

Sorry to be lengthy

--DBM

[Pain: I will discontinue this portion -- I'm coming off Percocet, etc. and onto the all-natural hell that will be me without it. Not the withdrawal, mind you, but the pain of being alive. With fibro. So figure it's 1,500/10 until this feature resumes, or is brought back by popular demand. Wuss.

Anxiety: 10/10. I'm freaked right the fuck out all the fucking time.

Being lazy enough to post an e-mail: Hey that's pretty lazy!

Sleazy?: Umm-um!]

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DR. DOOM!

So the nameless doctor in a nameless place in a nameless state did the following for me: he gave me trigger-point injections in my lower back. The pain was so excruciating I almost bit through my clenched fist, and my screams(?)... sounds kind of effeminate... likely were heard by all the other patients. It was the worst pain I've ever experienced, and I've bruised a kidney, broken a wrist, and have had a really bad paper cut on my thumb. It was such that, when the doctor was done with my right side I said, "Don't do the other."

"But the treatment works best if we--"

"Don't do the other. I can't stand it."

I looked at the nurse, who was looking at the doctor -- I'll call him Dr. Hilarius -- and knew what was coming: five more stabs in the back.

Which is the best way to describe what Dr. Hilarius did for me overall. After giving the injections, he told me to get a prescription for 600mg of Lyrica per day, an increase from my then-current 400. And that's all he did.

I informed the nurse, who was the only one who would talk to me after the injections, that I take Percocet 10/325s (10mgs oxycodone, 325mgs acetaminophen) and, since the doctor had prescribed nothing (I was to get the Lyrica, even, from my general practitioner) I was going to go through withdrawal, and then the pain that returned was likely to be so unbearable that I was bound to think of suicide.

She talked to Hilarius outside my room and came back and had to report what Dr. H said:

"If you have any problems, just go to the ER."

...My parents had told me that he was the only pain specialist in town, and that I had to deal with him for better or worse. So I held my tongue... After I said

"Well, could you please tell him that it's extremely negligent on his part to let a patient go through withdrawal -- and especially one with a history of suicidal ideation?"

The nurse left and came back:

"The doctor says you can get the narcotics through your family doctor. Otherwise, I guess you just have to go to the hospital."

And I held my tongue.

Next week I see a psychologist at the same treatment center. I have come to the early conclusion that I am trapped in a pain management center that manages pain by increasing it or letting it be.

Whenever I enter the clinic doors, I'll be surrounded by doctors who do not believe in practicing medicine.

[Not bad for today... Left a lot out, though. I'll have to tell you about how I now have 150 Percocet tabs, at the cost of being dumped by my GP. In Bush's America, no one wants to prescribe narcotics. They could end up in Bush's niece's hands! (Was it his niece that had the jones for Xanax? ...Anyway...)

Pain: 5/10.

Anxiety: 8/10.

--Anxiety is a new one! Which reminds me to tell you about the shrink I visited November 27th! Wow. It was classic. I've never come so close to hitting someone.

So you have a lot to look forward to. If my Dad still had some Provigil, this would go a lot faster. Oh well -- the suspense builds!]

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