[bradfiej]

My daughter has had a neurastimulator implanted into her cervical spinal thecal sack area, this is for pain management of a compressed thorazic vertebra that is causing nerve pain up and down her arms, shoulder and back area. This is a worker's comp case. She is 28 years old. She has been in pain since 31 May 2002. She has had all of the trigger point series and steroid injections, they have tried neurotin, she has taken hydrocodone, percacet and now is on methadone-only because she has to use the stimulator too much and they are afraid that it will run the implanted battery down to fast. She is completely wiped out now, if she sits down she falls asleep. She is also on lexapro for depression. The reason why she had this stimulator implanted was so she could get off the drugs. The stimulator helps her pain however they want her to turn it off at night, to conserve the battery, she wakes up in severe pain, if she turns it off. So her doctor prescribe methadone after the insurance caseworker stated that the adjuster may not approve a battery replacement if the battery didn't last the 4-7 years like it is suppose to. The methadone is terrible, she is so drugged out that she can't sit down with going to sleep, but I guess you can buy a lot of $14 bottles of methadone for the price of the battery. MY QUESTION is would she be on methadone if this wasn't a workmans comp case??????????????
Another thing, I am so afraid that my daughter will give up, she told me once that the only thing that kept her going was her nine year old son, now with the methadone, she says she doesn't even think that she is good for him. I am afraid that I will lose her to the pain, frustration and drugs-and she has so many leftovers drugs it wouldn't take much. HELP ME!!!!

Jan

[melikissyface]

I don't think that if she wasn't on w/c then she would get metadone. I am a w/c adjuster and the only advise that I can give you is that you may need to call an attorney because he/she can get the w/c to add this medacation to her claim.

[Beeblebrox]

Holy ******** first of all, I feel for all of you and my thoughts are deep and wide for you all. Secondly, I certainly hope there is a lawsuit somewhere in this whole thing if she is having to go through all this and probably more in the future. Especially if she's looking at wearing something to help the pain that takes a 4 year battery. Further more I would seek some time of pain managment course through your (her) doctor and see if he can come up with any kind of alternative treatment. Perhaps a second opinion on her diagnosis as well as treatment. Allot of these workers comp issuses tend to use whatever lowcost treatments they can for the sake of a dollar. Sad, but true. Methadone/morphine/roxanol/ect are very strong medications and tend to drain the life from those who take it. These things re often enough perscribed to hospice patients as "comfort meds". Im not telling you this to scare you Im simply trying to give you an idea of just how strong these things are. If she is seeing a doctor that was given to her by her job/workers comp, I would seek an opinion outside of that. I would also consult a lawyer for this cost as well as pain/suffering/other/etc. Geez... Good luck to all of you and g_dspeed.

~Z~

[Phospheros]

Sedation is a commonly side effect adjusting methadone. It usually means they are ramping it up too quickly. Perhaps they need to back off 5-15mg for a week on it, let her body catch up and then try increasing it more slowly. Or add some small doses of amphetamines to the mix to combat sedation. If it's still intolerable, they need to try something else. It's not unusual for there to be a prolonged adjustment period (2 months+) getting used to it. Start low, go slow <--. The falling asleep on the potty/sitting down side effect is not uncommon during the adjustment period, and sometimes it persist after. It's going to be up to her what is worth it, there are alternatives. A lot of people don't like methadone because it doesn't deliver as much euphoria as other opioids, for some people that artificial lift is important and depression does set in. It sounds to me like a strong case of the blues is at work here as well, so you have some reasons to be concerned. She may do better on another opioid for pain relief, or she may just need to give it more time to adjust - or something to battle sedation. -- But she definitely needs to get the depression in check, that can be just as crippling as the pain so keep an eye on her if she has truly lost interest in everything.

It's not just workers compensation that likes methadone. It's widely used in cancer treatment, neuropathic pain, pain management centers, the VA, phantom limb pain... Cost is a factor in that, 100 80mg oxycontins a month is over $700 even for the generic, an equivalent amount of methadone can be had for $50 or less. IV delivery systems in the home can run a couple hundred dollars a day, and it does compete directly against that. Cost is not the only factor though - for a lot of people it provides better relief. It works as an Mu agonist, NMDA antagonist, and partially inhibits the reuptake of serotonin and norepinephrine. All of those functions are important in chronic pain control. It also weakly binds to Delta & Kappa receptors.



Are you numb yet? No. AARRGGGGGHH! I told you I wasn't numb! Sorry, I didn't believe you.