conductor...question for you - Pain Management Message Board

friendly_one · 03-14-2006, 09:55 AM

Hi conductor....how have you been? My question is this....where do you wear your fent patches? I put mine on my chest, but they are tearing my skin up! I'm on 150 mcg, so I wear 2 75 mcg patches. I've tried them on my upper arms, but it didn't seem to absorb very well. I asked my doc where else I could wear them. He said basically anywhere above the waistline and not to put them on top of bone, like the breastbone or shoulder blade. He also said they have to build up a "reservoir" of fent in the fat layer and then abosorbed into muscle layer then bloodstream.

Have you tried wearing them on a different site after you have been using the same site? I know we have to alternate the patches. You alternate both upper arms, right? I alternate the sides of my upper chest, just below the collarbone. Just curious if you have ever chosen different sites and did you notice a difference in your pain levels the first few times you used a new site. He will be increasing my dose of Duragesic prior to surgery so I will have better pain coverage ( I will also have an epidural and PCA pump).

Anyway, just wondering about the patches and potential sites. I hope you are doing well! Bye for now

friendly_one · 03-15-2006, 01:02 PM

Conductor.....I have one more question. How long have you been on Duragesic?

conductor · 03-15-2006, 06:33 PM

Dear kstone_queen,

Wow!! I rarely--if ever--get my own question! If it matters in the overall equation, I am 36 years old and have Lupus.

I have been using Duragesic since late 1996 or early 1997. For a while l was using the 50, but was titrated up to the 75 microgram version. I've been using that (every 2 days versus the typical every 3 day treatment) for most of that time.

Yes...I understand, as well, that the patch must build up a reservoir over a fat layer. TRUST ME WHEN I TELL YOU THAT FINDING A FAT LAYER IS NOT A PROBLEM!!

I use both of my arms by placing the first patch at the very top of an arm. Then, I use the exact same spot on the other arm. When I return to the first arm, I place patch #3 about an inch lower than patch #1. Finally, by patch #4, I do the same thing on arm #2. At that point, I can start over. I hope that made sense.

Now, I should tell you that I use Johnson & Johnson Cloth Tape (the one that has the blue on its dispenser). By placing the tape half on the patch and half on the skin, I get pretty good results. Of course, I am aware that "covers" are available, but the J & J Cloth Tape is very easy to get.

Finally, I hesitate making the following statement, but what I'm about to tell you helps me in difficult times. Furthermore, I wouldn't recommend this unless a physician has given the patient an "OK". My doctor has told me that I can place a warm (NOT HOT) compress on my patch for 30 seconds or so if I don't think I'm receiving adequate relief. This is especially important to me now since my Actiq price has significantly gone up recently--in spite of my insurance. The pharmacist told me that his wholesale price has gone up $120 per box in the last few months. And, he showed me the invoice to prove it, although this guy is exceptionally trustworthy!

As for utilizing other sites, I have tried both my upper back and upper chest. Truly, the best relief I get is from using my upper arms. My cousin, who died from AIDS (significant IV drug abuse and unprotected sexual encounters), used the patch a little bit above his waistline during the end of his life. However, he only used a 25 and received tremendous pain relief. In spite of all the various behaviors to which he admitted, we all still love(d) him.

Please know that I would be glad to answer any other questions you have for me.

Sincerely,
Jon (Conductor)

P.S. I hope your surgery goes well and consider me jealous concerning your various routes of pain relief during that time! Again, please know that I am just kidding with you. I truly wish there was no single reason that you needed surgery.

P.S. EVEN THOUGH I TEND TO USE CAPITAL LETTERS FREQUENTLY...I MEAN IT WHEN I TELL YOU TO KEEP ME INFORMED!

conductor · 03-16-2006, 12:31 PM

Dear kstone_queen,

Just in case others are reading, I wanted to add a little more information. I sure you, kstone, already understand these concepts.

However, for those that are new to using fentanyl patches (or for those that don't use them at all), the literature does state to place the patch(es) from the waistline or above. There are areas, though, that are difficult when it comes to keeping them attached to the body.

I, for instance, am an example of a person that has more "folds" than needed for a body (that is read, "I like food too much!"). So, you need to place the patch or patches on areas that remain reasonably flat. This is why I use my upper arms. Even when I raise my arm, the patch stays on pretty well.

As I stated earlier in this thread, I also use the 1 inch x 5 yards Johnson & Johnson All Purpose Tape that is made of cloth. The packaging also has the words "First Aid" (and the "+" insignia) on it. ***For those who are sensitive to these kinds of adhesives, J & J also makes a version made of "non-irritating" paper. I have noticed that the paper version doesn't stay stuck as long as the cloth version--on me, at least. These both come in 1/2 inch x 5 yards sizes, too.

Sincerely,
Jon (Conductor)

P.S. For kstone_queen: I really want you to keep me posted on your surgical issues. Many of us are interested!

friendly_one · 03-16-2006, 04:45 PM

Dear Conductor...I will definitely keep you and the others informed about my surgery and the outcomes. It's getting closer, a little over 2 weeks now. I thought you wore the Duragesic on your upper arms, but wasn't positive. I've tried them in that location, but it didn't absorb very well in that area. I have found the best place for me is the upper chest. Since I wear 2, I put them side by side. I have to wear the J & J overlays because tape doesn't work for me. Those overlays really stick!

I'm a little nervous about the epidural for surgery. I've never had one before, even with all my other 60+ surgeries. I don't like the idea of someone putting a needle then a catheter up my spine.

I think you are really getting screwed with your Actiq!! What's up with that?? Mine was just increased. I'm still at 1600 mcg (obviously, LOL) but I can go up to 6/day instead of 5. I still only pay $30/month. Well, have a good night and thanks for replying. Bye for now.