Hello Ann,
I have been apologetically absent from site activity for a long spell due to the demands of work. This is only my personal experience, but if you check out the progression of my posts here on the site, you'll see that I swore by many pain medications, at first, but each would lose it's effectiveness. Although Neurontin and Lyrica may have brought some relief, the only thing that really worked, for me, for a long time, were standard issue opiods. I started with Hydrocodone, followed by Oxycodone, Fentanyl, Methadone, Oxycontin, or those medications in various combinations. Every time I had thought I had found the "silver bullet", I was proven wrong. My body would adjust to the medication, any my pain level would rise to meet the level of pain medication I was taking, until in November of 2012, I realized that the cure had become worse than the disease to me. At least the disease was not killing me professionally and physically. Red, a top contributer of content and advocate for facial pain patients for a number of years, once shared with me that he only knew of one person who had been able to manage taking opiates of chronic pain for 20 years. Since Trigeminal Neuralgia is chronic and debilitating, yet not fatal, I realized that I would either let the medications slowly kill me, or fight for life with pain. My Pain Management doctor was prescribing me 40 mg. Methadone and 90 mg. Oxycodoe daily when I checked myself into a dual diagnosis unit for detox, as I did not want my family to see me go through suddenly withdrawing that medication from my opiod dependent body. By that time, I was experiencing horrible stomach pain on a daily basis, waking up in the night almost every two hours, having to lie down at lunch in my car at work because I felt so poorly, and nodding off in meetings. My eldest daughter had told me that I was not "really alive, just less dead". So, something had begun to click inside of me.
I realize, at this point, what I am saying does not pertain to you, being on Vicoden. As a Mother, I had been chasing a way to get rid of the pain and be myself again, taking good care of my children. Opiates had been the only thing which had ever worked, but always, for me, needed in ever higher doses, to control my ATN pain.
A dual diagnosis unit - I do not know if I recommend this, or not. I was thrown in with street drug abusers, and people with severe emotional disorders for a week. When they told me their stories of craving a drug, or having deep seated traumatic scarring, it was hard for me to relate. I had lost a husband young, and have suffered many traumatic events in my life, but it did not make me unable to function. The doctor did not recognize that Methadone is different to withdraw from because it is a synthetic opiate, etc. Overall, a horrifying experience. However, I emerged leaving Methadone, at least, in the dust. My body needed something when I came out to be able to work, as I was still in horrible withdrawal. I took my Oxycodone and Diazepam. Finally, I had had enough. My pain always reached up for more Oxycodone. I was DONE!!
Now, here is the part which may pertain to you, and I would really like to know what your experience has been if you've tried Suboxone. I began Subutex (Suboxone without Naloxone) treatment in April 2013. The pain control is not as perfect as it was taking traditonal pain killers, yet it definitely exists and is consistent. My pain does not always rise to meet and exceed the leve of Subutex that I take, either. After almost a year of being more life myself, able to work, and to go places with and take care of my daugters the way that I did before ATN, I feel safe in saying, it was a good bet for me, someone who needed pain control and was also opiod dependent as a result.
In my minds-eye, you have three options. 1) You could find another doctor who woud allow you to stay on the Vicoden, hoping that your pain levels do not "rise to meet" the level of the medication. If you are doing all of the things you normally do and without many side-effects, this could make sense, 2) You could wean yourself off of the Vicoden, of you do not wish to be opioid dependent. This would be the most idea thing, although difficult, and without the pain control that leading an active life may require, or 3) You could try the suboxone, as I read, it is easier to taper off of than most other pain killers. Simply speaking from personal experience (everyone is different, and this is not to be taken as a recommendation for any medication), this has been the best solution for me.
I take the kind that dissolves under my tongue. It works for my pain. I do have to watch my dosage, as it can make one drowsy, but nowhere near to the level that the other medications which I took! I do not have the gastric problems which eventually started with the other medicatios. I have clearer thought processes than I did even when I was only taking Hydrocodone for pain. Honestly, I pretty much feel the same, mentally and physically, as I did prior to ATN, or to taking other opiods. Another benefit, is that I can go a long time without a dose, if I am not in pain, and feel no withdrawal symptoms. I can only take them when I really need to, if I want, because of the long half-life.
I feel that Subutex (Buprenorphine) saved my life! I've had ATN for 11 years now, and have run the gauntlet of options, both with opiods, and with many other medications used for pain control (almost - you name it, I've tried it). That's me, though. I hope you do not let the doctors push you around into ANY method of treatment that you feel uncomfortable with.
I'm interested to know what you decided and what the outcome is.
Please excuse any typo's here. I don't have time to proof prior to posting, as it is time to pick my youngest up from ballet! :-)
Please update us when you have the chance.
Best,
Stef