Hello Scotty!


Wow, I just read the words "only" and 3600mg of gabapentin in the same sentence, that doesn't happen often. That's typically the highest dose they'll dish out on that drug as a FYI.

Methadone...now there is a topic. Methadone is a stronger analgesic than oxycodone, and is becoming increasingly popular among physicians for chronic pain treatment. I have experience with just about every opiate pain medication out there ranging from hydrocodone to 200mcg's of fentanyl/hr, but I've never used methadone. I did have a local cancer patient I helped that was prescribed it shortly after going into hospice care and she wasn't a fan. It definitely should be respected though, On November 29, 2006, the U.S. Food and Drug Administration issued a Public Health Advisory about methadone titled "Methadone Use for Pain Control May Result in Death and Life-Threatening Changes in Breathing and Heart Beat.". This was the results of a study done between 1999-2004 where deaths attributed to prescribed Methadone use skyrocketed from around 800 in 1999 to around 3000 in 2004. The issue lies in that unlike oxy and the other popular pain medications is it's more difficult to regulate the levels in the blood.

Now my question would be the same as your Dr's, "why" are you having so much pain this far out of treatment? If it's neuropathy (nerve pain) which is generally what gapapentin is prescribed for, then methadone (or any opiate really) isn't going to help much either as they aren't effective in treating that condition. Neuropathy (pain resulting from nerve damage) is difficult to treat really, antiseizure meds, like gabapentin, or low dose tricyclic antidepressants show the best results however those are weak at best, which is why the lidocaine is often used topically and offers a short reprieve in turning off the nerve.

Neuropathy in the Head and Neck region is generally very difficult to treat as a number of the nerves in your face terminate in the same area (trigeminal nucleus) in the brain, which results in "cross talk" if you will. When one of the nerves activates pain it can activate the other nerves, it's the reason when you have a bad toothache your entire face feels like it's going to fall off. It's also the reason "Trigeminal Neuropathy" or TN, (the trigeminal nerve is your C-5 or Cranial Nerve 5) is considered to be one of the most painful conditions known, and also very difficult to treat.

My 7th Cranial Nerve (C-7, responsible for facial motor function) was damaged during my mandiblectomy and I suffer from chronic nerve pain due to this issue. It did lessen considerably when I had my C-12/C-7 facial nerve graft done a few years ago in an effort to restore function to my face. The operation failed to restore function however did have a positive side effect in lessening the pain. This is also the reason I know so much about this crap

If I were you I'd see what the Mayo Clinic has to say as you are in MN. Most of the answers I found during my search was from their website and I continue to use the site today when I need to look something up. I'd also say that I would look into depression as your body "amplifies" pain when in a depressed state (which opiates can contribute to as how they work on your system), here is a link to a Neuropathy.org's newsletter http://www.neuropathy.org/site/DocServer/Issue_31_Sept08_.pdf?docID=1661 that maybe helpful. Skip to pages 8-9, which detail what I mentioned above.

Personally I use "alternative" methods in dealing with my chronic pain so I'm not pumped full of prescriptions. Nutrition and exercise, breathing techniques, meditation (part of biofeedback routine), natural anti inflammatory foods like tumeric, ginger (watch dosage) among others. As a last resort I'll use cannabis (vaporized, never smoked) if I can't "get my head wrapped around it", which shuts my facial nerve down every time and eases the pain in the donor leg where my fibula and tissue was taken to repair my jaw and face. I try not to use it much however as with any drug it has it's own set of side effects (mild paranoia, memory loss etc...) the biggest however is always the effects it has on my waist line.

Sorry for the book, from someone who's been there and understands, I'm sorry you are having these issues. I was on pain meds for a total of 23 months and haven't touched them in over 2 years, I hope you find answers my friend.

Keep your chin up, we are here to support in anyway we can!


Eric