Toonces1
11-21-2008, 08:36 PM
Hi There. I haven't posted in a while-not feeling well. I am currently on LA morphine and percocet for breakthrough. A few months ago my doctor mentioned the fentanyl patch to me. I do not feel like my pain is very well managed with my current regimen, and I have been needing my breakthrough meds more than I think I should. The last few days I have been thinking more about the patch. I am very reluctant, but I am not sure why. Can you patch users share your experiences with me about your decision to use this form of pain management? I don't know anyone else I can ask that would have experience with this. -B
Sponsor
shananava
11-22-2008, 10:00 AM
My PM dr just recommended it to me and I tried it. I like not having another pill to take and have absorption issues anyway due to gastric bypass. I did not know about all the dangers you hear and read about. It works for me and I dont abuse it. I do have to change every 48 hours, doesnt last 72 and really makes a sore spot on my skin around the edges over 48 hours in same spot. I started out low and then got moved up. I have been hoping he would offer to up it over last few months but it has not happened. I can tell a big difference a couple hours after I change it in my pain. I hope you get the info to make a good decision and get relief. I did not realize how well mine was working until I forgot to replace it one day and got very sick and in alot of pain.
Best wishes,
Shannon
Best wishes,
Shannon
conductor
11-22-2008, 07:09 PM
Dear B (Toonces1),
Shannon's post was pretty much the same as what I would have said. After I had been on the same fentanyl patch dosage for over 10 years, I asked my doctor about moving up to the next dosage because I felt it wasn't working as well as it once did. She, my doctor, thought that was a reasonable idea, and it has been working very well. For breakthrough pain relief, I use Dilaudid (hydromorphone) and Actiq (Fentanyl Citrate lozenges).
My suggestion would be to address this with your doctor. Shannon has a good point, too, when she discusses the fact that your body absorbs the medication with the patch. This way, you don't lose the medicine through the gastric bypass. We, in general, lose so much of our medicines and vitamins because they aren't well-absorbed by our stomachs!
Sorry to hear that you haven't been feeling well. By discussing this with your doctor, maybe you'll find a better set of medications to address this problem! Please let us know what happens.
Sincerely,
Jon (Conductor)
Shannon's post was pretty much the same as what I would have said. After I had been on the same fentanyl patch dosage for over 10 years, I asked my doctor about moving up to the next dosage because I felt it wasn't working as well as it once did. She, my doctor, thought that was a reasonable idea, and it has been working very well. For breakthrough pain relief, I use Dilaudid (hydromorphone) and Actiq (Fentanyl Citrate lozenges).
My suggestion would be to address this with your doctor. Shannon has a good point, too, when she discusses the fact that your body absorbs the medication with the patch. This way, you don't lose the medicine through the gastric bypass. We, in general, lose so much of our medicines and vitamins because they aren't well-absorbed by our stomachs!
Sorry to hear that you haven't been feeling well. By discussing this with your doctor, maybe you'll find a better set of medications to address this problem! Please let us know what happens.
Sincerely,
Jon (Conductor)
neckpatient
11-23-2008, 01:55 AM
Hi Toonces1 - I have a good story for you. I have chronic pain sinc 2004. After 2 cervical surgeries, some uncorrected thoracic issues and stenosis, I have been so reluctant to properly medicate my pain. I get lots of various spinal injections that are really short lived, and I have been taking a variety of medications from neurontin etc, with a long term dosing of Hyrdocodones. I tried LA Kadien and didn't do very well on it - it knocked me out. I also was reluctant to move up to daily percs, oxycontin, etc. Well long story short recently I had to reduce all medications down to only they hydro's after having some unrelated health issues. I can't believe that for all these years I have been so uncomfortable and just put up with it :(-- just because of my reluctance to take higher meds.
Well I recently was convinced by the PM that it is time to drive my pain levels down and to try the fentanyl patch and I didn't start at the very lowest, I started at the next one up. I still have hydrocodone for bt pain but am down to 1/3 of what I used to take. Let me tell you, I had absoloutely no problem switching at all. And now into my 5th patch I can honestly look back and wish that I had done this a long time ago. I am going slow, and make myself go the 72 hours but after several patches I can see that I would probably do better at about 60 hours. I also probably could go the next higher patch, but I will stay down at this level for as long as possible. We will see what PM says when I go back.
I have tried putting them on upper arms and around calves on legs. I would say they worked better on my legs. They stick and hold better by putting Tegaderm patches on them (I found this in the thread at the top of the forum). I cut the Tegaderm in 1/2 so I get double the amount of those out of the box since this is an added cost. I read some brands will send you a cover patch if you have trouble with them sticking.
I get a little irritation under the patch but not anything that bothers me, and it clears right up. It took to about the 4th patch for me to have a really consistent level in my body, but now I think it is working well.
I recommend you discuss it with your doctor if your pain is not managed. It is scary when you read all about these patches, but I am dilligent to follow instructions exactly, go slowly and not take any chances - with my bt meds, I take 1/2 of the dose I am allowed, wait then take the other 1/2 if I then need it. This gives me a little more piece of mind.
Good luck.
Well I recently was convinced by the PM that it is time to drive my pain levels down and to try the fentanyl patch and I didn't start at the very lowest, I started at the next one up. I still have hydrocodone for bt pain but am down to 1/3 of what I used to take. Let me tell you, I had absoloutely no problem switching at all. And now into my 5th patch I can honestly look back and wish that I had done this a long time ago. I am going slow, and make myself go the 72 hours but after several patches I can see that I would probably do better at about 60 hours. I also probably could go the next higher patch, but I will stay down at this level for as long as possible. We will see what PM says when I go back.
I have tried putting them on upper arms and around calves on legs. I would say they worked better on my legs. They stick and hold better by putting Tegaderm patches on them (I found this in the thread at the top of the forum). I cut the Tegaderm in 1/2 so I get double the amount of those out of the box since this is an added cost. I read some brands will send you a cover patch if you have trouble with them sticking.
I get a little irritation under the patch but not anything that bothers me, and it clears right up. It took to about the 4th patch for me to have a really consistent level in my body, but now I think it is working well.
I recommend you discuss it with your doctor if your pain is not managed. It is scary when you read all about these patches, but I am dilligent to follow instructions exactly, go slowly and not take any chances - with my bt meds, I take 1/2 of the dose I am allowed, wait then take the other 1/2 if I then need it. This gives me a little more piece of mind.
Good luck.
katlin09
11-23-2008, 02:54 AM
Toonces,
I just actually moved down from the patch to Oxycontin. The patches were getting harder and harder to keep on, and I was having lots of skin irritations from the patches and the tegaderms. Also I was going to have to go up again on mcg's and didn't want to be on the 100's, so when I had my knee reconstruction/tibial ostiotomy at the end of August and found out I was going to be on Oxycontin anyways with the Fent patches, I just weaned off the patches and went to Oxycontin 40/20/40 a day, and Percocet for BT.
Good luck on whatever decision you make.
Kat
I just actually moved down from the patch to Oxycontin. The patches were getting harder and harder to keep on, and I was having lots of skin irritations from the patches and the tegaderms. Also I was going to have to go up again on mcg's and didn't want to be on the 100's, so when I had my knee reconstruction/tibial ostiotomy at the end of August and found out I was going to be on Oxycontin anyways with the Fent patches, I just weaned off the patches and went to Oxycontin 40/20/40 a day, and Percocet for BT.
Good luck on whatever decision you make.
Kat
brianpain33
11-27-2008, 02:03 AM
Hello toonces1
I was very reluctant to try the patch as well. I knew that it was not a decision to make lightly. So you know what I did? I came here to these boards and asked nearly that same question that you are asking. I have been on the patch for about 1 year & 2 months.
I came to the decision after realizing that I had tried nearly every medication available to treat this nerve pain that I have and I will still living in agony and not being very productive at all. This is what helped me to make the decision. Your doctor should start you out at a low level depending on your dose of morphine currently. I would image he would start out at 25mcg and go from there.
From my experience I have found the generic brand Sandoz to work the best and be the most effective for me. I know many others here on the boards would agree with me. Many have found the Mylan brand to be fairly ineffective and some have gone into withdrawal after being on the Sandoz brand for awhile and then getting the Mylan brand for a month.
If you do decide to go on the patch, realize that this is a very, very potent narcotic medication, which is why it is measured in mcg(micrograms) as opposed to mg(milligrams). It releases a steady amount of medication over a 72 hour time period. However, many people including me have found that it does not last for 72 hours and have had to ask to be changed to the 48 hour dosing schedule. This will be something to just keep in mind.
Please realize that once you go on the patch it would be a very long and unpleasant withdrawal if you ever needed to or wanted to go off of them. Many doctors will make the withdrawal anywhere from 3-6 months depending on the dosage that you are on. I have heard that people who went cold turkey or went off of them extremely fast had withdrawals similar or worse than heroine addicts go through. I don't say this to scare you but just so you have the information to make an informed decision.
The fentanyl patch has made a HUGE difference in my pain and my abilities. It does make me tired and drowsy but so do some of the other medication that I take. Good luck with deciding and keep us posted.
brian
I was very reluctant to try the patch as well. I knew that it was not a decision to make lightly. So you know what I did? I came here to these boards and asked nearly that same question that you are asking. I have been on the patch for about 1 year & 2 months.
I came to the decision after realizing that I had tried nearly every medication available to treat this nerve pain that I have and I will still living in agony and not being very productive at all. This is what helped me to make the decision. Your doctor should start you out at a low level depending on your dose of morphine currently. I would image he would start out at 25mcg and go from there.
From my experience I have found the generic brand Sandoz to work the best and be the most effective for me. I know many others here on the boards would agree with me. Many have found the Mylan brand to be fairly ineffective and some have gone into withdrawal after being on the Sandoz brand for awhile and then getting the Mylan brand for a month.
If you do decide to go on the patch, realize that this is a very, very potent narcotic medication, which is why it is measured in mcg(micrograms) as opposed to mg(milligrams). It releases a steady amount of medication over a 72 hour time period. However, many people including me have found that it does not last for 72 hours and have had to ask to be changed to the 48 hour dosing schedule. This will be something to just keep in mind.
Please realize that once you go on the patch it would be a very long and unpleasant withdrawal if you ever needed to or wanted to go off of them. Many doctors will make the withdrawal anywhere from 3-6 months depending on the dosage that you are on. I have heard that people who went cold turkey or went off of them extremely fast had withdrawals similar or worse than heroine addicts go through. I don't say this to scare you but just so you have the information to make an informed decision.
The fentanyl patch has made a HUGE difference in my pain and my abilities. It does make me tired and drowsy but so do some of the other medication that I take. Good luck with deciding and keep us posted.
brian