Methadone Users

Neco · Post by **Neco** » Sun Mar 01, 2009 12:56 am

I was going to recommend that too, although unless your pharmacy is at a chain store like Walgreens, or other 24 hour thing, the likelihood of them being open on the weekend is very slim..

Spiticus · Post by **Spiticus** » Fri Mar 06, 2009 2:37 pm

Well, It's almost 9am and I've slept around 2 hours in the past 24. Going a little crazy. I finally e-mailed my doctor this morning about increasing the methadone. It's just ridiculous now. I've been doing my shaking my legs back and forth rapidly while staring at my computer screen, often without even looking at anything on it, for the past few hours.

Sorry if this post is confused. My head isn't in the right place atm.

Neco · Post by **Neco** » Fri Mar 06, 2009 2:40 pm

That sucks man, I hope you get an increase

woodsie357 · Post by **woodsie357** » Fri Mar 06, 2009 6:22 pm

I've been there Spiticus I know how you feel.

Hang in there

Spiticus · Post by **Spiticus** » Sat Mar 07, 2009 6:11 am

No go. 2-3 hours of sleep a night means I can be more productive right? right?!? RAGE!

Post by **ViewsAskew** » Sat Mar 07, 2009 8:05 am

He said no? Oh, I am so sorry.

That is truly one of the worst things you can hear. You want to ask all these questions, but you know he either wouldn't listen or would talk doctor-speak instead of answering you. I can't tell you how much I long for empathy from a doctor. True empathy. You know, sit in front of me, look me in the eyes, and tell me they feel my pain.

Spit, I hate to say this, but I honestly think you are going to have to find a new doc. Oh, I hate typing those words, because it sure isn't easy. But, you deserve to sleep. You deserve to have your life back. You deserve to be listened to, heard, and treated appropriately. We all do.

The hard part is finding it.

Post by **Polar Bear** » Sat Mar 07, 2009 9:42 am

So sorry your doc was not accommodating. It is a horrible situation you are in.

SquirmingSusan · Post by **SquirmingSusan** » Sat Mar 07, 2009 9:44 am

Oh, so sorry. That really bites. I hope you can find a doctor who will treat you better.

Spiticus · Post by **Spiticus** » Sat Mar 07, 2009 10:14 am

I have no idea how to go about finding another doctor. This one has been incredibly kind to me in terms of payment. I have no insurance and basically he just asks me to pay what I can.

Basically, if I was to switch doctors, I would have to know for sure that this new doctor would be one I could stick with, which is impossible, unless I find someone else who goes to this doctor for the same reason.

For now, it seems, I'll just have to keep making my case.

Post by **ViewsAskew** » Sat Mar 07, 2009 10:40 am

Sounds like that's the only option.

Is he good about explaining things to you? It is sooooooo very, very hard to take yourself out of the conversation, but if you can do that, you might have success in finding out what the resistance is.

He agrees that methadone is OK to use. But, he thinks it should only be used at a certain amount.

Potential questions to ask (with "Please help me understand" used liberally)

1. What do you think will happen if the methadone is increased? (follow up on whatever he says until you understand what his concern is)

2. It seems like you feel methadone is a good treatment for RLS, but that you have concerns about using it over a certain amount. Please help me understand why you feel that way.

3. I am currently only sleeping 1-2 hours a night. This affects me in X ways(list them all, including inability to work, cognitive function, etc.). It's very important to me to find a resolution; what do you suggest we do?

4. This may sound cheeky, and it isn't mean that way. It sounds to me as if you are saying it's OK for me to get only 1-2 hours of sleep a night. Again, this isn't cheeky, but I really want to know: if you were in this situation, what would you do and how would you want your doctor to help you?

Each of us has our own style and not all of us would be comfortable using these questions. They are based on a technique used in mediation where you help people identify what is truly causing their resistance and where you help them see it from a different perspective. They can be incredibly effective. That said, they are often not effective if done in anger or with high emotion, so they aren't always a good thing to use. A friend, spouse, parent, etc., however, might be able to use them for you.

Of course, this is only one of many ways that could help; each of us has to find a way that works with who we are, where we are, etc.

Spiticus · Post by **Spiticus** » Sat Mar 07, 2009 2:44 pm

Asking certain questions is a dilemma. Here's why:

1. He is an understanding doctor. He empathizes with me and I believe he honestly tries to learn more and approach each problem with full vitality. He often asks me how I feel about his decisions regarding me and looks at various things I show him regarding research, medication, etc... (including rls.org..though I don't believe I've ever brought him the mayo algorithm, but he may have found it himself).

2. He is incredibly sensitive to my financial situation. I mentioned this in a previous post, but I'll explain a bit more here. I haven't had health insurance for a while (I would really love to have it, just can't afford it at the moment), so going to the doctor is a big deal monetarily speaking. He ask me to pay what I can and doesn't freak out if I happen to bounce a check every now and then (has only happened once thankfully). Also, as mentioned before, I'm not in a position where I could try to switch to a number of other doctors, and in many ways, I would want to. He's been excellent thus far in everything except for this.

3. Despite all of this, I sometimes think he has suspicions about possible drug seeking behavior. Given that I believe he is a very good doctor, he hasn't kicked me out or upbraided me. I think his approach is more subtle, which makes me asking for an increase in a dosage that much more nerve-wracking. I'm not sure if I will hit a point with him where he thinks I am merely trying to milk him for scripts. It would be devastating for me if he were to decide to no longer see me as a patient for a number of reasons.

He has prescribed me other controlled substances and in all of them I have actually requested a DECREASE since I've been on them (around 2 years). Opiates are the only thing I've ever asked for more of because the RLS has either gotten worse or the medicine is not as effective as I would like it to be.

So, I hope that better explains where I'm coming from and maybe some of you have had experiences somewhat similar to mine. Thank you, Ann, for your continued advice and thanks to Zach, Susan, Polar Bear, Woodsie and everyone for your support and suggestions. Please don't hesitate to post again if you think of anything else in light of this more detailed explanation.

Post by **ViewsAskew** » Sat Mar 07, 2009 4:31 pm

Spit - I get it.

But, I still stand by what I said. If said without anger and asking for true understanding, it's the only way to have an honest relationship.

You are guessing this is what's happening - maybe it's not. You will only know if you ask. Belligerence isn't at all what I'm suggesting. Neither is demanding.

I wish I could record tone of voice, because it's really important, at least from what I've seen. I've been privileged to work with about 200 mediators for the last few years. I'm continually amazed at what you can get if you ask the right way.

The problem with this equation, admittedly from me looking in, is that you're selling your own needs short. In every relationship each person has needs. You need a doctor who will help you. And do it within your budget restraints. But, helping you in a way that doesn't solve your problem isn't really helping. At least not the way you need it.

When we feel disadvantaged in some way or that we're lacking power (usually because the other person has more power, either because they do or we've given away our power), it's really, really hard to say, Can we talk? I have needs that aren't being met.

This guy sounds like a great guy! It sound to me that he's not fully appreciating your situation for some reason, not fully understanding your situation, or has some reason to feel that he can't or shouldn't help you in the way you are wanting.

Again, just me, but if you say something to the effect of, "Doc, I appreciate you. I can't tell you how much you've helped me. I really don't know what I'd have done without you. I still need your help because I just can't do well in my life when I'm only sleeping 1-2 hours a night. I can't imagine who could, can you? The only thing that seems to make sense to me, given everything I've tried is to increase the methadone and that seems to be something you are uncomfortable doing. Since this is something you feel uncomfortable with, will you please help me find a solution? I really need one and I'm counting on you to help me, as you've always done."

Neco · Post by **Neco** » Sat Mar 07, 2009 6:14 pm

If you think he is concerned about drug seeking behavior.. You need to flat out ask him. Because if he thinks you are drug seeking and then is still giving you the stuff, he is in no position to dictate your treatment.. Period.

You need to ask him flat out.. Yes it is a risk, but he's going to keep walking all over your quality of life if you keep letting him.. TAKE the Mayo and ask him if he's seen it before, don't assume.

http://www.ncbi.nlm.nih.gov/pubmed/1558 ... d_RVDocSum

Print this out and take it to him as well. Ask him what he feels about your dose compared to the results of these studies.. You need to find out if he is hesitant to increase your methadone - for whatever reason.. Make sure and tell him this printout came from PubMed - its a medical database that is a service of the US National Library of Medicine.

Also... If you have a web came or digital camcorder, record yourself trying to sleep for 8 hours or whatever. Sometimes visualization is a powerful motivator.. If you need help burning it to an actual DVD any player can read, I can help you with that.. or if you have a laptop just take the thing in with you and play the video for him.

Neco · Post by **Neco** » Fri Mar 13, 2009 6:37 pm

Here's a funny question..

Do any of you get temperature changes after you first dose for the days?
I often get them, and they tend to vary in strength and duration, but invariably I'm always left feeling hot, like the heat has been turned up but at the same time like its radiating off my skin into a cool environment.

I think it tends to be more noticed when I wait long periods of time between my doses each day.. Almost like I was teetering on withdrawal but the new dose of meds is somehow competing with whats left from the previous day and kicking them off as the new molecules replace them..

Which doesn't make sense I guess.. I dunno.. Its only the temp issues tho, no other typical withdrawal symptoms.

Post by **ViewsAskew** » Fri Mar 13, 2009 7:36 pm

Not with methadone...but Mirapex was truly terrible. I'd be freezing cold or burning up...