Anyway, when it comes to pain the thing that works for me better than anything else is methadone. It's a powerful drug, but if used properly under the supervision of someone with experience in its use there is almost no chance of abuse or addiction.

I'd suggest writing down all of your pain symptoms, with a description of where the pain is and what it feels like (burning, stabbing, aching, etc.) and the level of the pain on a scale of 1 to 10 (10 is worst possible pain you can imagine, like a gun shot). A good pain specialist can take this information and know what the best meds are.

For pain treatment, I think it is more important that they concentrate on the pain symptoms, and understand that you are being treated for Lyme elsewhere.

What has helped my muscular pain is Flexeril combined with myofascial release (hands on work) building to stretching and strengthening. Exercise is crucial to my keeping pain down.

Sometimes trycyclic antidepressants are helpful, as are muscle relaxants. It depends very much on the source of your pain, and also your individual body chemistry what will be helpful.

Every drug, even within a class, has a slightly different action. If one doesn't work, get them to try something different.

Each time I experience a significant drop in pain but have unbearable headaches and dizziness.

Last time I tried a patch, I took Gravol at the first sign of dizziness/nausea. Gravol took care of the nausea but not dizziness and headache.

Removed the patch each time within 24 hours but of course the dizziness remained for about 8 hrs.

Anyone have any suggestion how to better manage use of Duragesic patches? I would like to try again as they are so very effective for the pain.