Pain Management :: Methadone With Emotional And Stress Issues

I had my long-anticipated consult with a Pain Management doctor yesterday (Monday 1/27) It went reasonably well, though as expected we both have HEAVY accents, with his being Egyptian and my being SOUTHERN=) We had some issues understanding each other, but nothing we can't work through. I was "happy" to find that I had nothing to prove to him because my pain is well documented (partly due to my OCD) through my medical records and subsequent reports on various treatments. He had no interest in repeating any of the modalities that I have already tried with no success. That, too was well documented, including but not limited to Injections, PT, TENS, Biofeedback, Cognitive Therapy, Psychotherapy (counseling). He seemed "baffled" that I am "still standing" with the extensive problems that I have. He said it was most helpful that I have seen specialists in all fields of expertise pertaining to my pain, to rule out the need for further surgeries and treatments.

Now, we go forward with pain management. There is an IRONY here. I have finally found a doctor who will help me to "manage" my pain through medication. However, as of January 2014 my insurance will not cover medication. Believe me, I'm not complaining, as I realize I am fortunate to have insurance period, in today's environment. It just horrifies me to know that I cannot afford most of the medications that a PMD would prescribe for me.

He has no problem prescribing the Fentanyl patch for me, with my gastric/absorption issues. However, without further research into a generic option (which will still be expensive) I don't feel that I can afford that. I used the patch successfully in 2005-2006, but I had excellent insurance with $25 script co-pay. We discussed that Morphine has helped me, but he says that, too is extremely expensive. He suggests Methadone for not only its similarities to Morphine, but also its steady release once established. I must confess I freaked out (just a teeny bit) because I asked him if that was like the drug on "Breaking Bad". Yea...He thought I was silly, too. He chuckled and said "Funny you think I prescribe that".

He suggests that if I can't afford the patch (I can't ) then let's try the Methadone, starting with 5 mg twice daily with the option to increase if necessary. He wants to try one medication at a time (I agree) so that he can determine it's effectiveness vs. multiple meds causing multiple side effects. He explained that he will work with me until I can achieve an acceptable level of pain relief, by seeing me once per month. WHEN, not IF...say hallelujah...we reach success, he will start seeing me every 3 months. I can certainly do THAT.

I have concerns before filling the Methadone script and starting to take it. I'm hopeful that some of you may be able to share your experience. Is it effective for pain relief? Is it sedating or is it mood-elevating? I cannot cope with sedative effects because my career is demanding that I am alert and on my game at all times. I could benefit from my "mood" being elevated, as these past months of "fighting" for help have really dragged me through the depths of Hell. I take medication for anxiety and depression, but they're not magic pills...I guess I will always battle those demons. I just want to be very selective and careful to avoid any pain medication that may exacerbate my emotional issues.