onyxgates
02-25-2009, 02:33 PM
Beginning March 2nd I will go from 75 to 50 patch. In April I will go from 50 to 25 and then in May either jump off all together or go down to 12.5 (which is what I prefer). I still think these are huge jumps. Considering I still need to continue with my recovery (walk two miles a day). I do not want my weaning to interfere with my recovery and I am scared that it might. What are some of your thoughts?
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katlovesdogs
02-25-2009, 03:34 PM
do you have any BT meds ? I think these are the only "single " doses of the Patch available and of course they can't be cut.
brianpain33
02-25-2009, 06:02 PM
They are pretty big jumps and you will probably experience withdrawals so please be aware of this. You will probably experience racing heart, sweating, insomnia, diahrhea(have some Immodium on hand), and possibly cravings. If you have major problems you should talk to your doc. You can always cut down more slowly by adding the 12.5mcg patch therefore going from 75 to 62.5 to 50 to 37.5 etc. Keep us posted
brian
brian
Jema X
02-26-2009, 02:42 AM
Oh my gosh, this seems a bit extreme - does the pm think that you won't need pain relief at all? You've only just had the surgery! After my last surgery (it wasn't spinal tho) we weaned by about 20% before a left the hospital & then it' taken about 6 months to wean back to my post surgery doses. Wow. Will you have any additional pain relief should you need it? Medically (unless in hospital) it is considered dangerous to wean more than 10% per change, also weaning at a faster rate can have adverse effects on recovery, can cause addiction (from patients seeking meds to stop the pain of withdrawal) and can damage brain pathways making the process more painful. People can even experience psychosis from 50% withdrawal doses. Is there anyone you can talk to that might be able to help? Is he providing valium for muscle spasms? Bad muscle spasms could jeapordise your fusion, I can't believe he's doing this. I so hope you go ok with it all.
onyxgates
02-26-2009, 03:34 PM
I have Norco 10/325 that I take right now. So obviously I am trying to get off of those so that they will become available to me when I need them when I go from 75 to 50. That jump doesn't scare me near as much as 50 to 25. We requested to go with the 12.5 but my doc doesn't want to go that slow and he feels that the way the patches don't stick on my skin (not very well) that he doesn't want to cause any issues with that too. I don't know...like I said he kept bouncing back and forth it was so hard to follow his reasonings. He did offer Klonopin should I need it to help with the WD's.
So after Saturday, I will not take another pain pill in order to lessen my tollerance for my jump in two weeks. Total crap because I am in pain but I will live with it.
So after Saturday, I will not take another pain pill in order to lessen my tollerance for my jump in two weeks. Total crap because I am in pain but I will live with it.
slipperyslope
02-26-2009, 07:33 PM
Do you see a PM Dr or is this your surgeon making these reccomendations? It does sound extreme considering you just had a major operation. If your pain is not covered well during your weening process, make sure you let the Dr know this. You shouldn't have to suffer with pain while your healing. After my back surgery and I had a Laminectomy, I was on Norco for 2 years. I was never able to come totally off my pain meds as the pain never really got better. After a few years on the Norco my MD put me on percocet and I took 4 a day for a few years and than I had to move up to 6 per day. Than when that didn't help anymore I Went into pain management. Surgeons always want you to come off your meds really fast so they can see how the surgery worked for you. They also are very uncomfortable prescribing long term so you may end up having to see a PM Dr after your Dr releases you, or if you have a good GP Dr maybe they can help you as well. Hopefully your surgery was a success and you won't need any pain meds, so I will think positive for you as you should do too. :) I know its scary, but hopefully your Dr will work with you and your pain will come down once things settle down from the surgery. Its a scary road and I do with you the best outcome possible.
SS
SS
Executor
02-27-2009, 12:57 PM
I'm sorry that you have to go through all of this. This is definitely the "downside" of pain meds.
Personally, I think it would be wise to use the 12.5 where ever you can. From 25 to zero is way to big of a jump. If you read the white paper insert that comes in the boxes of patches, it has a conversion chart from Morphine to the patch. The 25 is indicated for anyone one about 60-134mg of Morphine per day. Oral Oxycodone conversion is 30-67 Oxy per day = 25mg patch.
Therefore, one wouldn't step off from 100+ morphine a day or 60+ Oxy per day to nothing....So, why would should the Doc expect one to step off from a 25 patch to nothing?? I'd research this and print it out and take it to your Doc.
Additionally, if it were me, I'd do what Brian recommended and use the 12.5s in addition to the bigger patch at each stage. For example go from 75 to 62.5 to 50 to 35.7 to 25 to 12.5. This a much more reasonable approach. Furthermore, when you get to the 12.5s, you could move to Mylan, which makes it's patches differently than everyone else. Theirs is a solid mass...no gel releasing. Thus, you can cut the Mylans....So, you could cut the Mylans in half, thirds, or whatever. This is perfectly acceptable and why some use them.
The only positive in all of this is that Fent WD (although worse because of it's strength) is quicker because of it's dynamics. It doesn't last nearly as long as some other meds.
Hope this helps, and best of luck to you.
Regards,
Ex
Personally, I think it would be wise to use the 12.5 where ever you can. From 25 to zero is way to big of a jump. If you read the white paper insert that comes in the boxes of patches, it has a conversion chart from Morphine to the patch. The 25 is indicated for anyone one about 60-134mg of Morphine per day. Oral Oxycodone conversion is 30-67 Oxy per day = 25mg patch.
Therefore, one wouldn't step off from 100+ morphine a day or 60+ Oxy per day to nothing....So, why would should the Doc expect one to step off from a 25 patch to nothing?? I'd research this and print it out and take it to your Doc.
Additionally, if it were me, I'd do what Brian recommended and use the 12.5s in addition to the bigger patch at each stage. For example go from 75 to 62.5 to 50 to 35.7 to 25 to 12.5. This a much more reasonable approach. Furthermore, when you get to the 12.5s, you could move to Mylan, which makes it's patches differently than everyone else. Theirs is a solid mass...no gel releasing. Thus, you can cut the Mylans....So, you could cut the Mylans in half, thirds, or whatever. This is perfectly acceptable and why some use them.
The only positive in all of this is that Fent WD (although worse because of it's strength) is quicker because of it's dynamics. It doesn't last nearly as long as some other meds.
Hope this helps, and best of luck to you.
Regards,
Ex
onyxgates
02-27-2009, 05:32 PM
I appreciate all of your help. I am in for a ride huh!!! So how fast is the withdrawal? A week? two? What I am wondering is basically I go for two weeks of hell and then I will be settled to the lower dose. Anything you recommend to help during this time. My doctor will not do two patches at once (we already requested and he refused). He is allowing me 6 Norco's. However I am still taking 6 Norco's + 75 patch right now just to get through the day. I plan to stop taking the Norco's by Sunday. I just feel like I may be stuck and in a great deal of pain if this doesn't work.
Jema X
02-27-2009, 10:43 PM
The fact that you've got norco10 rather than 5 is awesome news for you - you should be able to temper your withdrawals somewhat with these. That said, for this to work, you'll need to wean off the norco completely before you start dropping the patch. The first day that you drop the patch should be, as soon as you start to have wds though, take a norco. taking one every 4-6 hours should really help and it's what the dr has rx'd anyway, so he can't get upset. After a week or so, you could try leaving more time in between each norco so that you're getting ready for the next drop. This is how most weaning occurs but usually drs
Jema X
02-27-2009, 10:46 PM
Sorry, phone playing up. Usually drs have more empathy and most recognise that pain relief is necessary for preventing chronic pain - if you don't treat pain properly, it can spiral out of control. The plan below may help, it's worked for others. You just repeat the process with the norco each time. I hope this helps somewhat. Julie
Executor
02-27-2009, 11:56 PM
It's very obvious that your Doc doesn't understand, or care about your tapering. With all due respect, his proposed schedule is not reasonable. If it were me, instead of spending a whole month on each lower patch, I'd request two weeks at each step down and use the 12.5s. So, two weeks at 62.5, two weeks at 50, two weeks at 37.5 and etc. Would he go for this? Same amt of time overall, but more steps, and less time at each step. This would be much more comfortable for you. I would plead with him to help you with this....To be more humane and understanding.
Depending on how he received this, I'd be tempted to remind him of his medical oath of "do no harm." Stepping off from 25 to nothing is NOT reasonable. Fentanyl is the strongest opioid on the market and as I posted earlier, a 25 patch is equal to 60mg of Oxy per day. You don't step off from 60mg of Oxy to nothing.
I'm sorry if we've made things worse by telling you this, but you need to know the facts. I really am sorry.......
Take care,
Ex
Depending on how he received this, I'd be tempted to remind him of his medical oath of "do no harm." Stepping off from 25 to nothing is NOT reasonable. Fentanyl is the strongest opioid on the market and as I posted earlier, a 25 patch is equal to 60mg of Oxy per day. You don't step off from 60mg of Oxy to nothing.
I'm sorry if we've made things worse by telling you this, but you need to know the facts. I really am sorry.......
Take care,
Ex
Jema X
02-28-2009, 03:56 AM
Hey there, I just had a chat to an anaesthtist friend and what Ex says is true - this is totally unreasonable and really not considered to be safe practice. Perhaps you could ask him how you are to deal with muscle spasms during the process and can he assure you 100% that these spasms couldn't hurt your new fusion? He won't be able to answer this and fentanyl is known for spasms during withdrawals. Using the norco's will help but it's not ideal.
Do you think he'd consider Ex's plan instead? 10% every couple of weeks is considered the benchmark, why wouldn't he just follow the guidelines for safety, you need pain relief post surgery anyway. Best of luck.
Do you think he'd consider Ex's plan instead? 10% every couple of weeks is considered the benchmark, why wouldn't he just follow the guidelines for safety, you need pain relief post surgery anyway. Best of luck.
onyxgates
02-28-2009, 03:02 PM
The reason why he said he doesn't want to use my prefered and suggested method (which is utilizing the 12.5 patch) every two weeks is because the patch tends to not stick on my skin. The thing is as I get smaller patches, it will be easier for them to stick so I think that he should give it a try but he won't. I am going to do as you all requested and start doing the research now so that when I have my emergency meeting (which I know I will end up having), I will have back up. The 75's already don't last all the way to the 2 1/2 day mark so I know the twitch and spasm that you are talking about and I am scared to death. It lasts about 2 days and 8 hours. So I am very scared right now (which I have also told my doc about and he told me to take this time to get streatched out to 2 1/2). How do you do that? It's been two weeks and I still feel like crap for 8 hours until the new patch kicks in. I guess a preview for my 50 patch. I will feel like crap for 24/7.
Executor
02-28-2009, 10:23 PM
The reason why he said he doesn't want to use my prefered and suggested method (which is utilizing the 12.5 patch) every two weeks is because the patch tends to not stick on my skin.
You are not alone...Many have the same issue. Wearing a patch for three days without it pealing any, is alot to ask of a product. In fact, if you wear the brand, Duragesic, the company will send you special covers that seal the patch. You have to call the toll free number and request the covers. They will send up to a three month supply.
If you are wearing a generic, you can cover it will several different kinds of transparent tape. This helps seal it to the skin.
I am going to do as you all requested and start doing the research now so that when I have my emergency meeting (which I know I will end up having), I will have back up.
Personally, I wouldn't wait until you have an emergency...I'd give it one more try given this new information you've gathered...Print it out and take it in to see him. What Juliet says about spasms threatening your fusion is a very good point.
The 75's already don't last all the way to the 2 1/2 day mark so I know the twitch and spasm that you are talking about and I am scared to death. It lasts about 2 days and 8 hours.
It's common knowledge that the patch doesn't last the full 72 hours. In fact, if you read the white prescribing paper that comes in the box with the patches, it says that for some patients, patch rotation is required every 48 hours. Many patients report that it doesn't even last that long.
The patch was originally developed for cancer patients at the end of life. Therefore, the original test group had limited mobility and many were bedridden. When bedridden, your metabolism is much lower and you don't sweat & etc. Hence, the patch was rated for 72 hours and it stuck reasonably well.
The manufacturer has since petitioned the FDA for a broader label and was successful in doing so. Thus, the patch is now prescribed for all sorts of chronic pain. However, the manufacturer is still required to publish the original test data. Since pain patients today are much more mobile than the original test group, and few are bedridden, the patch doesn't last the full 72 hours, and there are issues with sticking & etc.
Best of luck with this, and again, I'm very sorry that you're going through this due to your doc's incompetence.
Regards,
Ex
You are not alone...Many have the same issue. Wearing a patch for three days without it pealing any, is alot to ask of a product. In fact, if you wear the brand, Duragesic, the company will send you special covers that seal the patch. You have to call the toll free number and request the covers. They will send up to a three month supply.
If you are wearing a generic, you can cover it will several different kinds of transparent tape. This helps seal it to the skin.
I am going to do as you all requested and start doing the research now so that when I have my emergency meeting (which I know I will end up having), I will have back up.
Personally, I wouldn't wait until you have an emergency...I'd give it one more try given this new information you've gathered...Print it out and take it in to see him. What Juliet says about spasms threatening your fusion is a very good point.
The 75's already don't last all the way to the 2 1/2 day mark so I know the twitch and spasm that you are talking about and I am scared to death. It lasts about 2 days and 8 hours.
It's common knowledge that the patch doesn't last the full 72 hours. In fact, if you read the white prescribing paper that comes in the box with the patches, it says that for some patients, patch rotation is required every 48 hours. Many patients report that it doesn't even last that long.
The patch was originally developed for cancer patients at the end of life. Therefore, the original test group had limited mobility and many were bedridden. When bedridden, your metabolism is much lower and you don't sweat & etc. Hence, the patch was rated for 72 hours and it stuck reasonably well.
The manufacturer has since petitioned the FDA for a broader label and was successful in doing so. Thus, the patch is now prescribed for all sorts of chronic pain. However, the manufacturer is still required to publish the original test data. Since pain patients today are much more mobile than the original test group, and few are bedridden, the patch doesn't last the full 72 hours, and there are issues with sticking & etc.
Best of luck with this, and again, I'm very sorry that you're going through this due to your doc's incompetence.
Regards,
Ex
brianpain33
03-01-2009, 04:41 AM
some things can help with the withdrawal symptoms such as clonidine or Klonopin which you would need to get from your doctor. I know that it will not be easy and that is pretty crappy of your doc to do that to you. I am sure that he would not want to go through it.
brian
brian
IZZY'SMOM
03-02-2009, 12:07 AM
Hi Onyx~
Sorry Ive been away, but I want to let you know that I went from the 25's to nothing and had no problems. None at all. I went from the 75, to 50, stayed there for maybe 6 months? Then went to the 25's for maybe 2 months, and then nothing. and I had so much trouble with them sticking as well. Look up my posts if you can.
Everyone is different, and your doc is a total *ss if he wont help you more than that. Gosh, you have been an amazing pt. and why is he being so bad?
I was on 10 mg of hydro for my BT, BUT I was also on 15 Mg of my "long acting" compound meds, which were not the 12 hr LA, more like 2 hrs to hit. The compound "LA" meds are just slow release, but only for 2 hr. the pharmy told me...
Basically I was on 35 mgs of Hydro, plus my 25 mg patch. I would take the hydros every 4-6, BUT I will say that I didnt even notice when I quit my patch. Probably b/c I was on a dose of hydro that was kind of high.
All I can say is I had no problems.
I agree with Ex about pleading with him, and also reminding him of his oath to "do no harm."
My old doc actually told me that a doc can be sued for not treating pain.
Here are his words..."Doctors are in a rough spot...A doc can be sued if they dont treat pain adequately, and also be sued if they over prescribe."
My old doc was about 64 yrs old, and very very laid back. He used to bring up the fact that docs arent covered very well if a person wants to sue tem for not prescribing for pain.
I hope that you can get things worked out for you...If I know you, you wont back down from a fight.
Im here for you, girl~
xoxoxoxox,
IZZY
Sorry Ive been away, but I want to let you know that I went from the 25's to nothing and had no problems. None at all. I went from the 75, to 50, stayed there for maybe 6 months? Then went to the 25's for maybe 2 months, and then nothing. and I had so much trouble with them sticking as well. Look up my posts if you can.
Everyone is different, and your doc is a total *ss if he wont help you more than that. Gosh, you have been an amazing pt. and why is he being so bad?
I was on 10 mg of hydro for my BT, BUT I was also on 15 Mg of my "long acting" compound meds, which were not the 12 hr LA, more like 2 hrs to hit. The compound "LA" meds are just slow release, but only for 2 hr. the pharmy told me...
Basically I was on 35 mgs of Hydro, plus my 25 mg patch. I would take the hydros every 4-6, BUT I will say that I didnt even notice when I quit my patch. Probably b/c I was on a dose of hydro that was kind of high.
All I can say is I had no problems.
I agree with Ex about pleading with him, and also reminding him of his oath to "do no harm."
My old doc actually told me that a doc can be sued for not treating pain.
Here are his words..."Doctors are in a rough spot...A doc can be sued if they dont treat pain adequately, and also be sued if they over prescribe."
My old doc was about 64 yrs old, and very very laid back. He used to bring up the fact that docs arent covered very well if a person wants to sue tem for not prescribing for pain.
I hope that you can get things worked out for you...If I know you, you wont back down from a fight.
Im here for you, girl~
xoxoxoxox,
IZZY
onyxgates
03-02-2009, 12:42 PM
Well I only took two norco's yesterday but today is the last day of my patch which makes my pain increased so I need the increase in relief. I do change my patch every 60 hours (the only concession he will make). He refuses to get up to 48 hours. It is amazing how poorly trained he is as when I was in the hospital I was seen by three different pain mgmt people with the CDH hospital group, the all agreed to a totally different plan. First they said they would put me at 48 hours since the patch wasn't lasting. They also said that they would utilize 12.5 patch and bring me down slowly once I was ready. Unfortunately they were not accepting new patients. I begged but they couldn't get me in. I know that I could be getting screwed here so I that is why I feel like banging my head against a wall. My husband even tried to talk to him and nothing. So my best bet is to hope that my withdrawal won't be that bad. I just keep praying. I am doing everything in my power to help by getting off the Norco's even though my pain will be higher. I will just deal with it.
Anyone know what I can expect...nausea, spasms (legs) and what else? Appreciate your help.
Anyone know what I can expect...nausea, spasms (legs) and what else? Appreciate your help.
onyxgates
04-03-2009, 04:56 PM
Okay guys here it goes...I went from 75 to 50. I took my changed to 50 on Tuesday AM. I have my Norco (but they aren't helping) and Clonidine .1mg (which is a miracle) and finally some leftover zofran and valium. I am taking everything in moderation and only as things get to an intense level. The thing is I am wondering how long withdrawals will last? I am so tired of feeling yucky and exhausted. I also have no attention span. I hate this!!! I appreciate any help you all can provide.
Jema X
04-04-2009, 01:40 AM
Oxy, I'm so sorry, any sort of withdrawals are horrible but what you're going through must be terrible.
Withdrawals from fentanyl are usually horrible but relatively short lived - within a week you should be feeling a great deal better. If you're needing zofran, make sure you ring your pm and tell him and also tell him you need something for muscle spasms.
These are just little things but they may help - when withdrawals are bad, try and sleep through them (if you can), have sweet lollies on hand as they will give you an insulin boost (apples are better if you feel sick, especially if you poach them). Try and drink 8 - 12 glasses of water a day, it will help you clear the wds a little faster.
Can you ring your dr and tell him you need more norco? Tell him that the 'yucky' feeling is driving you mad and also about your pain level. It doesn't sound like it'll make much difference but it may help.
Good luck.
Withdrawals from fentanyl are usually horrible but relatively short lived - within a week you should be feeling a great deal better. If you're needing zofran, make sure you ring your pm and tell him and also tell him you need something for muscle spasms.
These are just little things but they may help - when withdrawals are bad, try and sleep through them (if you can), have sweet lollies on hand as they will give you an insulin boost (apples are better if you feel sick, especially if you poach them). Try and drink 8 - 12 glasses of water a day, it will help you clear the wds a little faster.
Can you ring your dr and tell him you need more norco? Tell him that the 'yucky' feeling is driving you mad and also about your pain level. It doesn't sound like it'll make much difference but it may help.
Good luck.
Executor
04-04-2009, 02:13 PM
The thing is I am wondering how long withdrawals will last? I am so tired of feeling yucky and exhausted. I also have no attention span. I hate this!!! I appreciate any help you all can provide.
This whole thing is really terrible. Your Doc ought to be brought up on ethics charges and sued for pain and suffering.
I hate to be the bearer of bad news, but as I said originally, it's gonna be rough the whole way down because the steps are too big. Therefore, I'd be tempted to check myself into treatment and just get it over with in one fell swoop. You're gonna suffer from 75 to 50 and then 50 to 25, and then the biggest drop will be from 25 to nothing.
The Norco isn't working because it's a drop in the bucket compared to fent.
Isn't there any way you could get a new Doc somehow...Even a GP to help you develop a reasonable ween plan?
I'm so sorry.....
Regards,
Ex
This whole thing is really terrible. Your Doc ought to be brought up on ethics charges and sued for pain and suffering.
I hate to be the bearer of bad news, but as I said originally, it's gonna be rough the whole way down because the steps are too big. Therefore, I'd be tempted to check myself into treatment and just get it over with in one fell swoop. You're gonna suffer from 75 to 50 and then 50 to 25, and then the biggest drop will be from 25 to nothing.
The Norco isn't working because it's a drop in the bucket compared to fent.
Isn't there any way you could get a new Doc somehow...Even a GP to help you develop a reasonable ween plan?
I'm so sorry.....
Regards,
Ex
onyxgates
04-05-2009, 04:52 PM
Would switching to a morphine based pill and then titrating down be a better withdrawal? I am worried come the next two-three jumps I will be miserable and I will also be back at work. I work a part time schedule. Back in 07 I came off of Norco without incident. I am just wondering. I have an appointment tomorrow afternoon. I am starting to feel better but still am yucky everytime I eat something. I can't lose a week of recovery everytime I drop a step down. How will I heal from my surgery?
Executor
04-06-2009, 02:19 AM
Would switching to a morphine based pill and then titrating down be a better withdrawal?
I think so, yes. But, because Fent is so strong, it's critical that you get the transition right. Also, please remember that oral morphine has poor bioavailability, thus, you have to take more of it vs. other meds. Think of bioavailability as miles per gallon (MPG) or efficiency in a car. Oral morphine has poor MPG.
I am worried come the next two-three jumps I will be miserable and I will also be back at work.................... I can't lose a week of recovery everytime I drop a step down. How will I heal from my surgery?
I would make sure I told him this. What he's doing to you is nothing short of controlled torture, IMO. That's why if it were me, I'd be tempted to come off all at once, if he wasn't going to help me...In a controlled setting with medical professionals and get it over with.
The best route is a slow steady decline to where your body doesn't notice anything, or very little. You could also achieve this with another med, whatever your Doc was comfortable with. The 25mcg steps are HUGE. According to the white paper insert that comes in the boxes with the patch, a 25mcg patch should be used with patients who are already on roughly 50mg of Oxy per day or 100 mg of oral morphine per day. One wouldn't step down from those dosages all at once, so I don't know why this Doc expects that with the patch. At the very least, he should be using the 12.5s as a supplement, but we already went over that.
I sent you a PM. Best of luck with this.
Take care,
Ex
I think so, yes. But, because Fent is so strong, it's critical that you get the transition right. Also, please remember that oral morphine has poor bioavailability, thus, you have to take more of it vs. other meds. Think of bioavailability as miles per gallon (MPG) or efficiency in a car. Oral morphine has poor MPG.
I am worried come the next two-three jumps I will be miserable and I will also be back at work.................... I can't lose a week of recovery everytime I drop a step down. How will I heal from my surgery?
I would make sure I told him this. What he's doing to you is nothing short of controlled torture, IMO. That's why if it were me, I'd be tempted to come off all at once, if he wasn't going to help me...In a controlled setting with medical professionals and get it over with.
The best route is a slow steady decline to where your body doesn't notice anything, or very little. You could also achieve this with another med, whatever your Doc was comfortable with. The 25mcg steps are HUGE. According to the white paper insert that comes in the boxes with the patch, a 25mcg patch should be used with patients who are already on roughly 50mg of Oxy per day or 100 mg of oral morphine per day. One wouldn't step down from those dosages all at once, so I don't know why this Doc expects that with the patch. At the very least, he should be using the 12.5s as a supplement, but we already went over that.
I sent you a PM. Best of luck with this.
Take care,
Ex
onyxgates
04-06-2009, 04:49 PM
Well I went to my appointment and the doctor basically said with my response to the decrease he felt that maybe a detox program would be the best option. I quickly responded that I did not feel ready for that...the problem with my doctor is that he doesn't listen. I requested to either jump down by 12 or switch to morphine. He heard that I wanted to go back up to 75. I was like no way...I have already crossed that bridge there is no way I want to go up. I just want my next step to be as functional as possible. So in the end he agreed to go down by 12's with the knowledge that if I start having issues with the patch sticking than we will go back to one patch at a time. I don't think it will be an issue because the size is so much smaller. It is just so frustrating how he doesn't listen.
Thank you Ex for your email and everyone's post. I will continue to update you on how I am doing. My next step down will be next Friday.:dizzy:
Thank you Ex for your email and everyone's post. I will continue to update you on how I am doing. My next step down will be next Friday.:dizzy:
Executor
04-06-2009, 11:10 PM
So in the end he agreed to go down by 12's with the knowledge that if I start having issues with the patch sticking than we will go back to one patch at a time. I don't think it will be an issue because the size is so much smaller. It is just so frustrating how he doesn't listen.
Thank you Ex for your email and everyone's post. I will continue to update you on how I am doing.
This is GREAT news! Very good job on being persistent. I learned long ago, that in PM, you often have to be your own best advocate, because otherwise, things may not work out well. Using the 12.5s along with the standard sizes is very prudent. You'll find the step down approach much more reasonable.
I've used the 12.5s before....They are very small and stick well. I doubt you'll have problems. You could always cover them with the medical grade tape. I found that the patches (any size) stuck best if I applied them immediately after showering and my skin dried. I made sure I washed the area where I put the patches very well. The natural oil in your skin is what causes the patches to work loose.
I also found that the Duragesic brand stuck the best....By far. Even though Sandoz is made by Janseen (owner of Duragesic), they use different glue for the generics (Sandoz). The Mylan's stick pretty well too. But, Duragesic is the best. Hopefully, you can work it out with your insurance company, or pay a slightly higher co-pay. It may be worth it, depending on the price difference....As long as it's not too much.
Best of luck to you and I'm glad things worked out with your Doc. If you don't mind, I'd love to hear more specifics of how you "sold" this to your Doc.
Regards,
Ex
Thank you Ex for your email and everyone's post. I will continue to update you on how I am doing.
This is GREAT news! Very good job on being persistent. I learned long ago, that in PM, you often have to be your own best advocate, because otherwise, things may not work out well. Using the 12.5s along with the standard sizes is very prudent. You'll find the step down approach much more reasonable.
I've used the 12.5s before....They are very small and stick well. I doubt you'll have problems. You could always cover them with the medical grade tape. I found that the patches (any size) stuck best if I applied them immediately after showering and my skin dried. I made sure I washed the area where I put the patches very well. The natural oil in your skin is what causes the patches to work loose.
I also found that the Duragesic brand stuck the best....By far. Even though Sandoz is made by Janseen (owner of Duragesic), they use different glue for the generics (Sandoz). The Mylan's stick pretty well too. But, Duragesic is the best. Hopefully, you can work it out with your insurance company, or pay a slightly higher co-pay. It may be worth it, depending on the price difference....As long as it's not too much.
Best of luck to you and I'm glad things worked out with your Doc. If you don't mind, I'd love to hear more specifics of how you "sold" this to your Doc.
Regards,
Ex
onyxgates
04-07-2009, 04:14 PM
I think I frightened him by telling him I did a lot of research on the web so I understand that receptors in the brain react differently and even though I may have had the equiv of 12 via the norco, it will still be a huge jump to go 50% down when I cut from 50 to 25. I guess the fact that I also agreed that if the patches don't stick that I would go down by the original plan. I really have no idea why he changed his mind. I did remind him that I came off Norco a couple of years back without incident and that I am vested in getting off of these patches. I used those words exactly. "vested"
He did tell me he has never had anyone have as much problems coming off medication as me. I find that pretty amazing considering this board. So my hat is off to you all for giving me the information to have a back bone!!!
He did tell me he has never had anyone have as much problems coming off medication as me. I find that pretty amazing considering this board. So my hat is off to you all for giving me the information to have a back bone!!!
Jema X
04-08-2009, 01:14 AM
Well done! I'm so glad that you got a good result, it's about time. How is your fusion healing?
I find it so condescending that he put you down like that - any patient, no matter who they were, would have withdrawals to a terrible degree when reduced on meds like that. Doctors like that shouldn't be allowed to manage patients, it goes against all medical advice.
I hope that patches work for you, let us know how you go :)
I find it so condescending that he put you down like that - any patient, no matter who they were, would have withdrawals to a terrible degree when reduced on meds like that. Doctors like that shouldn't be allowed to manage patients, it goes against all medical advice.
I hope that patches work for you, let us know how you go :)
Executor
04-08-2009, 11:45 AM
I think I frightened him by telling him I did a lot of research on the web so I understand that receptors in the brain react differently and even though I may have had the equiv of 12 via the norco, it will still be a huge jump to go 50% down when I cut from 50 to 25.
This was exactly the right approach, I think! Sometimes in life you have to fight fire with fire. I think Docs get used to dealing with a lot of people who don't know a whole lot, and therefore, are just walking zombies. I get a whole different attitude out of my Doc when I tell him that I read this, or I read that....Starts things off well.
And when I come across something that may be perceived wrong, or is a hot topic, I'll often preface myself with "I know one has to take things with a grain of salt when you see something on line, but......"......Lets, them know right up front that you're not claiming to be an expert, but that you are informed.
He did tell me he has never had anyone have as much problems coming off medication as me. I find that pretty amazing considering this board. So my hat is off to you all for giving me the information to have a back bone!!!
That's total BS. He knows better than that. He's just saying that because he knows he's screwed up and is trying to cover himself by saying that you're a big exception. It's amazing how stupid some people think others are.
Not sure why I thought of this, but I got a quote for some tires on my car and the guy I usually use was quite a bit higher than usual...So I shopped him. I ran into him in the store and he asked when I was going to order the tires. I told him that he was high and needed to match a competitors price. He stumbled and mumbled and then said that he probably quoted me the wrong tire......Yeah, right. Same type of situation. Saying something stupid to try to cover for yourself. Better to be honest I think.
As we've said all along, the fentanyl is no joke. It's the strongest med out there, bar none. Not even close to anything else. I'm on it, so I know. Anyone doing some basic research about the med, it's strength, and comparisons to other meds, knows this. Great job on being your own advocate!
I'm glad this is working out better for you.
BTW, I PM'd you.
Take care,
Ex
This was exactly the right approach, I think! Sometimes in life you have to fight fire with fire. I think Docs get used to dealing with a lot of people who don't know a whole lot, and therefore, are just walking zombies. I get a whole different attitude out of my Doc when I tell him that I read this, or I read that....Starts things off well.
And when I come across something that may be perceived wrong, or is a hot topic, I'll often preface myself with "I know one has to take things with a grain of salt when you see something on line, but......"......Lets, them know right up front that you're not claiming to be an expert, but that you are informed.
He did tell me he has never had anyone have as much problems coming off medication as me. I find that pretty amazing considering this board. So my hat is off to you all for giving me the information to have a back bone!!!
That's total BS. He knows better than that. He's just saying that because he knows he's screwed up and is trying to cover himself by saying that you're a big exception. It's amazing how stupid some people think others are.
Not sure why I thought of this, but I got a quote for some tires on my car and the guy I usually use was quite a bit higher than usual...So I shopped him. I ran into him in the store and he asked when I was going to order the tires. I told him that he was high and needed to match a competitors price. He stumbled and mumbled and then said that he probably quoted me the wrong tire......Yeah, right. Same type of situation. Saying something stupid to try to cover for yourself. Better to be honest I think.
As we've said all along, the fentanyl is no joke. It's the strongest med out there, bar none. Not even close to anything else. I'm on it, so I know. Anyone doing some basic research about the med, it's strength, and comparisons to other meds, knows this. Great job on being your own advocate!
I'm glad this is working out better for you.
BTW, I PM'd you.
Take care,
Ex
onyxgates
04-08-2009, 02:18 PM
EX: Yes I received your PM and I thank you for the link. I had it as a back up in case we were to go with the switch to morphine. I agree with you in that we have to be our own advocate. What I have learned from this is that in the future...I am sure I will need PM again as my back will have problems. I have other discs that are bad but aren't as bad off as the one that were operated on.
What I learned...I will only see a PM doc who actually has PM background. My current doctor is an orthopedic...now in the practice there are PM docs but he himself isn't one. When I was in the hospital I could tell the difference because my consults with those doctors truely understood where as mine doesn't.
I was so niave (sp?) when it came to this process but I have learned so much. While I pray that I don't need PM in the future, if I do, I will interview them to find the best!!!
What I learned...I will only see a PM doc who actually has PM background. My current doctor is an orthopedic...now in the practice there are PM docs but he himself isn't one. When I was in the hospital I could tell the difference because my consults with those doctors truely understood where as mine doesn't.
I was so niave (sp?) when it came to this process but I have learned so much. While I pray that I don't need PM in the future, if I do, I will interview them to find the best!!!
Executor
04-08-2009, 11:23 PM
EX: Yes I received your PM and I thank you for the link. I had it as a back up in case we were to go with the switch to morphine. I agree with you in that we have to be our own advocate.
Great! Wasn't sure if you got it or not. I haven't used the PM feature very much.
I can't tell you how happy I am for you. Even though we don't know each other at all, I really did worry a lot about you....It was on my mind a lot.
Take care, and I'm glad things are looking up!
Regards,
Ex
Great! Wasn't sure if you got it or not. I haven't used the PM feature very much.
I can't tell you how happy I am for you. Even though we don't know each other at all, I really did worry a lot about you....It was on my mind a lot.
Take care, and I'm glad things are looking up!
Regards,
Ex