Central Apnea, Methadone Withdrawal, and Other Trials and Tribulations

[debbluebird]

I don't know. What I read about that from this site, I don't think I will try that, thanks anyway. I was able to sleep an hour and a half. Feel a little better right now. I will just tuff it out.

[debbluebird]

I was able to sleep an hour just after lunch time. Then electricity started going through my arms and woke me up. Then just now I remembered we have a tens unit. I put it on. Feels pretty good. Hope it helps.

[debbluebird]

Tried to sleep again. Leg won't let me. I am optimistic though. Hope withdrawal won't last long. I'm going to keep tends unit on all night. I'm taking gabapentin 300 mg three times a day.

[sleepdancer2]

Were are you placing the electrodes on your TENS?

[debbluebird]

Right now they are just below neck, around that vertebrae that sort of protrudes. I thought there since my arms are so bad too. Maybe it should be at lower back ?

[debbluebird]

Having a very difficult night. Decided to take a Methadone. Hpe it helps a little.

[ViewsAskew]

Any better?

[debbluebird]

Slept two hours. Woke up ith leg jerking.
How long do you take a DA ? What mg ? And do you alternate it with the Methadone? I took a DA for 8 years before I augmented. But the augmentation was hell.

[stjohnh]

I had been on mirapex 0.375 milligrams for RLS ( no other medications) for 2 years when I augmented. After 10 days of Hell getting off of mirapex (horrible experience, even with the help of Kratom and Gabapentin, with occasional Vicodin). I was able to restart mirapex at 0.125 milligrams daily. Over the past couple of months I have fine tuned my ancillary treatments (ketogenic diet, kratom, edible MMJ) and have managed to reduce my pramipexole (mirapex) 0.0625 milligrams daily. That is 1/2 of the smallest size pramipexole tablet. While I hated the idea of restarting the dopamine agonist, it was either that or go to methadone and I wasn't ready to head to methadone yet. With my current regimen I get 7-8 hours of sleep 6 nights a week, one night weekly, on average, less. Side effects are mild, some run-down feelings in the daytime, occasionally short-lived mild morning headache.

I am starting to wonder if the optimal treatment for RLS, using currently available treatments, is somewhat off base. High blood pressure treatment used to be based on the idea of using one medicine, increasing to maximum dose, then adding a second medicine until the patient's blood pressure was controlled. This took longer to get control of the blood pressure and caused more side effects than the current blood pressure treatment philosophy, which is use low doses of multiple medications right off the bat. While more complicated, this results in better blood pressure control and fewer side effects. I am wondering if treatment for RLS works better if multiple medications are used at very low doses to start with.

[ViewsAskew]

Holland, Dr. Buchfuhrer and a few others have said just that (and operate that way). Many of us here feel the same.

Deb - I've successfully used pramipexole without augmenting again by using it in various ways. Most recently, 5 days on, 2 off. Before that, I used it just 2 on 1 off, or 2 on 2 off. I have alternated it with methadone the entire time. I'm trying to stop the methadone now to see if I can reduce dosage and reset my brain by taking at least a month off. Also to get rid of any dependence. Will see if that works.

My current theory is that alternative drugs with problematic side effects - tolerance, dependence that comes with nasty withdrawals, augmentation - so that these things never occur is an excellent strategy. of course, you have to have two things that work in order to do that....or you have to suffer during breaks.

[debbluebird]

Well, I broke down and took a Mirapex 0.125 mg about 3 am. I slept 5 hours.
I'm thinking that I will follow Ann's advice and do five days on and two days off. Not sure what I will do on the two days.
The other issue is the Gabapentin. Right now taking 300 mg a day to help with the withdrawal. How long does Methadone withdrawal last ?
So after the withdrawal, do I stop the Gabapentin? Or take that on the two days. But after I say that I don't think that is a good idea. I've taken it for a couple of days before and felt horrible for a day when I stopped it.
So, do I just take the Methadone for two days. I'm wondering if I would have central sleep apnea on those two days ?
It's just never simple.

[ViewsAskew]

It really isn't just simple, is it?

I've read that because methadone has such a long half life, withdrawal can take as long as 20-30 days, but the worst is the first ten. And, it creates movements that are very similar to RLS, so it will seem as if yours is worse most likely.

I honestly wish I had another option for you for what to take on the weekends. You will be miserable if you take nothing. Will your doc give you a short half-life opioid for the weekend that you could take in the evenings at least?

I know you have no extra money...some people find that the kratom does relieve all their symptoms. Not sure if it would for you, but trying it could be helpful. And, so does MMJ. Wish you had access - wish all of us did!

[debbluebird]

What are the short life opioids ?

[badnights]

Codeine has a pretty short half-life but it's not very strong. Oxycodone and hydromorphone, which are strong, have half lives of only a few hours (3.5 to 4 hr for oxycodone, 3 for HM.) The long-lasting versions of those are oxycontin and hydromorph contin (contin = continuous release)

[debbluebird]

I have taken Norco when I had my joint replacements, it's hydrcodone and tylenol. I know it is below Oxycodone. Oxy is from Morphine and hydrogen is from codeine. I just looked up the half life, 4 to 6 hours. So it looks like codeine would be the best.
I go to doctor Tuesday. She is not knowledgeable on RLS, but she usually goes along with what I suggest.
I just looked up codeine, its 2 to 4 hours.
Thanks