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Old 06-13-2009, 01:07 AM   #1
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Unhappy New to Board, New to PM and Long Lasting Pain Meds - Fentanyl

Hi all, I found this forum about a week ago and have been coming on here to read others posts, but have finally decided that I should write and get some feedback from others in the same situation as me. I apologize in advance for the amount I write, I just really want to get some background out there. Thanks in advance for any advice.

Brief history of me: When I was 18 my doctors thought that I had depression and was put on numerous different anti-depressants at separate times to figure out which worked best. Over the years I had ups and downs and was stabilized for periods of time on different drugs but none that ever lasted. I had several periods where I would 'go off my rocker' as my mother would say and I would end up doing stupid, reckless & compulsive things which sometimes got me into trouble and others not. That behavior seemed to stop after I met my boyfriend (now of 6 years). I've been stable on Lexapro now for about four years. About two years ago, I got accused of something from a former employer that I didn't do, that has resulted in a 2 years court battle that is still outgoing. Needless to say there is HUGE stress associated with this. Jan of 08 I ended up having to have a back surgery for herniated disks at L4/L5 and L5/S1 which ended up throwing me physically and mentally into a total wreck. Luckily I was able to get a job doing accounting where I can work mostly from home which has been wonderful for me.

The last six months have been particularly difficult for me. I found myself wanting to sleep all the time and would 'sleep' for 9-11 hours a night but would wake up still exhausted. I could wake up at 10 am and be ready for a long nap by 12 or 1. Even with all the sleep, I never felt rested. I started seeing my doctor about it and we found out that my iron levels were low, probably because I'm a vegetarian, so we started an iron supplement. All of the other tests were normal. She told me the usual, get good rest, try to go to bed at the same time and get up at the same time every day, watch your diet and make sure to exercise.

After trying this for several months, nothing seemed to help. I started to develop insomnia as well as intense fatigue. I would be so incredibly tired, but wouldn't be able to sleep. About 4 months ago I started developing incredible pain all over. I'm used to the chronic pain in my back, but this was ridiculous. My bones and joints would hurt, ligaments and tendons seemed to hurt and I always had muscle aches. My doctor requested that I keep a journal of how I was feeling, my food and exercise log and a record of when I was in pain, etc... We tried fast acting narcotics for pain (Norco), a muscle relaxer for spasms (Soma), and Valium and Triazolam for sleeping. When nothing worked we tried adding Seroquel. Worked great for sleeping, except I would end up sleeping 20-24 hours and then would be in horrible pain when I would wake up. I would get parasthesias (burning and tingling sensation) under my skin under some of my large muscles, feel constantly tired and exhausted. It really started to affect my relationships with my mom and my boyfriend. They thought I was just being lazy all of the time, staying in bed for hours or days at a time. We ended up fighting constantly about it. Even I couldn't understand why I couldn't wake up and stay awake for several hours without being so tired or do simple things around the house. I would get so tired and hurt all over if I just cleaned the house or did dishes. Sometimes when I would get tired, I'd even have trouble catching my breath (maybe it was anxiety, but I'm not sure). I was starting to get so down on myself thinking that I was just falling into another depressed funk and couldn't get out of it.

Finally after more months of journaling and hit or miss drugs, my doctor finally came to a few diagnoses last Friday. She diagnosed me with Chronic Fatigue Syndrome and Fibromyalgia. She has now put me on a long lasting narcotic medicine (Fentanyl) for the pain, some fast acting pain meds for break through pain (Norco), muscle relaxers (Soma) when needed and Valium for sleep. Since starting this regime (8 days now) I have started to feel better. I'm able to fall asleep fast and stay asleep through the night and wake up feeling rested (even if only sleeping 5-6 hours). Unfortunately my boyfriend decided he coudlnt' take it anymore and we split up last Thursday before I had a chance to get these diagnoses from my doctor. Since last week, I've been able to clean my house (a huge mess), clean litter boxes and stay somewhat active. Today was the first time since starting my meds that I have had to take a nap and it was only a short one. Yay. Today I did feel pretty tired all day and was hurting despite having just taken my long lasting pain meds. We're still working on adjusting my med doses for the future.

My concern is that I won't ever be able to deal with this on my own. I do NOT want to stay on narcotics and muscle relaxers forever. I want to know how any of you cope with your Fibromyalgia on a daily basis and how do you function. I dont want to give up my life but am not sure how to keep going every day once I get off the medicines. Also, how do you deal with the stigma of FMS not being a 'real disease'. I'm so scared of judgement from people and not sure how to explain it to all them. If any of you have any coping suggestions or recommended reading, I would greatly appreciate it! I'm sorry for writing so much, but I wanted to provide a background for what I'm dealing with. Thanks so much and have a great weekend everyone.
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Old 06-13-2009, 01:32 AM   #2
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Exclamation Fentanyl & Chronic Pain Meds - Several Questions Please

Hi all, I recently posted another post that gives a good background on my story with Fibromyalgia, Chronic Bain, Herniated Disks, Depression and Chronic Fatigue. The link to that post is as follows (not an advertisement or anything, just to my other post) I apologize in advance for the length of this post, but I really need some advice from seasoned or former patients of Fentanyl.

http://www.healthboards.com/boards/showthread.php?t=698143


Anyhow, I have several questions about Fentanyl and other Chronic Pain Meds.

1. I read a posting that said one shouldn't take narcotics with any vitamins... Is this accurate? Neither my doctor or my pharmacist said anything about vitamin-drug reactions with Fentanyl, Oxycodone or Norco.

2. I've read some of the other threads regarding getting the Fentanyl patch to stay on... I got a Tegaderm patch at the pharmacy and tried it, but it was so huge and had a big frame around it that showed under my shirt sleeve. Is there a reason to not cover the whole patch with first aid tape? It says to only cover the edges of the patch, but I've seen several other users that they use tape, 'press n seal', condoms etc... to keep the patch on. Does the patch need to 'breath'. Is that why they recommend an occlusive patch? If so, can anyone let me know of a place to look for them. None of my local pharmacys have occlusive patches besides the huge Tegaderm patch.

3. Side Effects- First got on the Fentanyl patches last Friday (7 days ago) on the 50mcg patch every 72 hours. I picked it up at the pharmacy and it was a Watson brand (gel filled patch) and applied it. My doctor told me to take a dose of Norco for the immediate pain, as it would take several hours or a day for the Fentanyl to take effect. I took the Norco before bed along with my Soma and slept well (first time in weeks). The next morning I woke up and had that 'high' feeling sort of. Was a little euphoric, a bit light headed etc.. Couldn't pinpoint an actual 'feeling' but just new that there would be no way for me to drive... Maybe like having a few drinks, not sure exactly. Anyhow, within a few hours I felt much better and decided to try and clean my house after drinking a big glass of grapefruit juice. I didn't know that I wasn't supposed to eat or drink anything with grapefruit in it (as it can cause more meds to be absorbed) or to watch my activity level until I was used to the drug. Well the combo of the juice and the activity caused my temp to raise and within an hour I was sweating like it was raining outside, got real flushed, felt faint and nauseated and eventually vomitted. I called the pharmacy and they told me that the exertion and juice probably caused it and to have somebody with me for the next few hours to help watch my breathing. In the mean time, I reached my doc and she told me the same thing and not to remove the patch unless I got sick again or started hypoventilating. Sat night went fine. I went to get the Rx filled the following day and ended up getting a different patch (Mylan). Noticed on day three that I had almost zero pain relief. Changed to the Mylan patch and took a dose of Norco. Day two on the second patch I felt that same euphoric high feeling and called my doctor. She said that it would probably go away within two weeks or so of use. She also said that she wanted me to change my patches every 48 to 60 hours instead since I was getting no pain relief on day three. Well I'm on my third patch now and felt fine last night when applying it (had to use Norco for breakthrough since I forgot and ended up going a bit longer than 74 hours) and woke up this morning again with that euphoric, high feeling. I have noticed constipation and have gotten some Miralax. Another side effect that I've noticed is that sometimes I feel as if it's hard to catch my breath. Not shallow breaths, but almost like I'm having an anxiety attack and that I have to try one or two times before I can get a deep breath.

One other thing I've noticed is that I'll be fine all day and feel fairly energetic and 'normal' but that all of a sudden I get really sleepy around bed time and drowsy almost. When that happens, I have to get up and go to bed pretty quickly. It may be that I've fought insomnia for several years, but I just wanted to make sure that this was 'normal' for some. The immediate desire to sleep in the late evening or bedtime.

With the Norco dose for BT pain, it doesn't seem to affect me much at all, so my doc is thinking of giving me Oxycodone for BT pain... Is this going to make me high and dysfunctional??? I can't take it if it does. I still haven't driven since I started the patches (8 days ago) and want to know if this 'feeling' will go away or whether she's going to have to lower my dose, switch me or what.


Has this happened to anyone else? One difference with me is that I was taking Norco on a fairly regular basis before the patches but I was in no way on a high dose or 'Opiate Tolerant' so to speak. So how long did it take for any of you to stop having the 'high' feeling when starting the Fentanyl patch? Did any of you experience any of the breathing things and is Miralax effective for any of you?

I'm soooo sorry for the length of this post, but I know that y'all can provide a lot of advice and suggestions that a doctor or pharmacist (having never taken the drug) could give me. Thank you in advance for your help and I really appreciate any insight you can provide!!
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Old 06-13-2009, 02:18 AM   #3
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Re: New to Board, New to PM and Long Lasting Pain Meds - Fentanyl

Well first off I am sorry you are having to deal with all those symptoms but I applaud you and your doctor for sticking to finding a diagnoses. No one can say how long you have to stay on these pain medicines but for sure you will need them for as long as you need them ....and now the part about other people knowing...I would suggest you never tell anyone other than very close family and a very close and dear friend if you are lucky to have one. And never ever tell an employer what you are dealing with. Having all those drugs in your system many bosses think your decision making ability is compromised so it is just wise for you to not tell anyone. Also when you have these very valuable drugs at home you don't want anyone to know or you might be robbed by someone that knows you have them. Who cares if others don't 'see' that you are sick and to tell you the truth you shouldn't be telling others or convincing them it is real...they don't really care ...everyone has their own lives to deal with so you will need to just take care of yourself without others knowing. Your support system should be close family or support group of like minds. Keeping a positive attitude is a great pain killer as well. I am sorry your boyfriend gave up on you but there will be more coming along but don't be quick to move them in with you....see how it goes and reveal your medical issues slowly so they get to know you without dropping the whole enchilada on them and scare them to death....but even they don't really need know anything anyway unless it gets to be a serious relationship Always keep your meds out of the bathroom that visitors use. good luck!

 
Old 06-13-2009, 07:07 PM   #4
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Re: New to Board, New to PM and Long Lasting Pain Meds - Fentanyl

Thank you Ann.

I appreciate your kind words. I think you are right. It doesn't seem that many other people understand this disease or CP and they just think i'm faking it. I was scared that my mom and best friends would be the same way about it. When I first got the diagnosis and told them about it, they were kind of skeptical about it. I sent them several links to info on Fibromyalgia and Chronic Pain and after they had read them and had a chance to really sit down with me and talk about it, they have been very supportive. This past week, one of my best friends driven me to my office a few times to pick up my work. (I'm really lucky at being able to work at hom) because I didn't feel as if I could drive on the Fentanyl yet. My mom and I have two houses on the same property and today I took a bunch of laundry over to her house to wash and did some housecleaning. I didn't even have to tell her (she could just tell by talking to me) that I was hurting really bad after cleaning and she finished doing my laundry for me. I feel so guilty sometimes getting help from people. I'm still young. I'm only 26 and my 65 year old mom is having to help me with my laundry...
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Old 06-13-2009, 08:55 PM   #5
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Angry Extremely Frustrated with my Fentanyl Patches

Hi there all, I'm a newbie to both this forum and to Fentanyl patches for PM. I am SO frustrated!!! Today is supposed to be my 4th patch ever. The first one was a Watson patch and it satyed on fairly well for the first two days on upper left arm, then on day three it started falling off. I was able to tape it down with waterproof first aid tape and it managed to stay on until it was time to change. Second patch was a Mylan (upper right arm)... Enough said. Had the whole thing taped down and it still kept coming off. Third one which I put on two days ago was back to a Watson (upper right arm) and per my doctor I am now supposed to change them every 48 hours. It managed to stay on 'ok' for two days. Started lifting at the edges and then really got loose as I was cleaning the house today but I didn't worry about it too much since I knew I would be taking a shower and putting on a new one in a few hours, so I just took it off. So I took a shower and did NOT put lotion on my upper body. I waited an hour after showering to make sure my skin was really dry before applying. So I put the patch on my upper right arm again and within 30 minutes it was starting to come off. It was lifting and 'cracking' whereever the skin bends. So I taped it down. That wasn't working. Both the patch and the tape kept bending when I moved my arm. So I moved it to my chest below collar bone and used fresh tape. Didn't stay on there either. I then tried it on the left arm and by this time there was no sticky left on the patch so it wouldn't stay on at all. I am so frustrated. A $17 patch down the drain now. So I washed both upper arms again and am letting them dry, but am really nervous about putting a new one on again... Is there anything that will get them to stick on. I did order some of that OpSite Flexifix Transparent Film that was recommended highly by someone else on this board, but it won't be here for at least 3-4 days. (That's 2 patches from now).

I am overweight so there is really no where that doesn't have even a thin layer of fat on it. I think it's the fat that keeps moving when i bend or somethign which is causing the patch to get the 'ripple' effect in places. Then it starts lifting away from the skin.

So does anyone else have this problem? What did you do to fix it? Is there anywhere that may stick better than others for someone that is overweight? I appreciate any suggestions.
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Old 06-13-2009, 08:58 PM   #6
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Angry Am So frustrated with the Fentanyl Patches Staying On!!!

Hi there all, I'm a newbie to both this forum and to Fentanyl patches for PM. I am SO frustrated!!! Today is supposed to be my 4th patch ever. The first one was a Watson patch and it satyed on fairly well for the first two days on upper left arm, then on day three it started falling off. I was able to tape it down with waterproof first aid tape and it managed to stay on until it was time to change. Second patch was a Mylan (upper right arm)... Enough said. Had the whole thing taped down and it still kept coming off. Third one which I put on two days ago was back to a Watson (upper right arm) and per my doctor I am now supposed to change them every 48 hours. It managed to stay on 'ok' for two days. Started lifting at the edges and then really got loose as I was cleaning the house today but I didn't worry about it too much since I knew I would be taking a shower and putting on a new one in a few hours, so I just took it off. So I took a shower and did NOT put lotion on my upper body. I waited an hour after showering to make sure my skin was really dry before applying. So I put the patch on my upper right arm again and within 30 minutes it was starting to come off. It was lifting and 'cracking' whereever the skin bends. So I taped it down. That wasn't working. Both the patch and the tape kept bending when I moved my arm. So I moved it to my chest below collar bone and used fresh tape. Didn't stay on there either. I then tried it on the left arm and by this time there was no sticky left on the patch so it wouldn't stay on at all. I am so frustrated. A $17 patch down the drain now. So I washed both upper arms again and am letting them dry, but am really nervous about putting a new one on again... Is there anything that will get them to stick on. I did order some of that OpSite Flexifix Transparent Film that was recommended highly by someone else on this board, but it won't be here for at least 3-4 days. (That's 2 patches from now).

I am overweight so there is really no where that doesn't have even a thin layer of fat on it. I think it's the fat that keeps moving when i bend or somethign which is causing the patch to get the 'ripple' effect in places. Then it starts lifting away from the skin.

So does anyone else have this problem? What did you do to fix it? Is there anywhere that may stick better than others for someone that is overweight? I appreciate any suggestions.
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Old 06-13-2009, 09:16 PM   #7
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Question New to Fenanyl, Need help with Side Effect

Hi all, I wanted to touch base with some of you regarding the Fenanyl patch and side effects with it. I just started the patch last Friday and vomited Sat. It turns out that it was a combination of drinking grapefruit juice (which I didn't know I wasn't supposed to do) and exercising and exerting myself, raising my body temp. Well Sat night I felt 'high' or 'stoned' yet euphoric. It worked pretty well over the weekend except for the third day, a lot of BT pain. I called my dr Mon and she said that the patch probably put out a lot more meds on Saturday due to my exercise and exertion that's why it wore out on day three. So she wrote my script to change every 48 going forward so if i exercised I could change at 48, but most of the time I will continue to change at 72. She also said that in time my body would get used to the Fentanyl and I would stop getting the 'high' feeling.

Since then, I've used 3 more patches (most on the 72 hour switch and one on the 48 hours switch). By the time I put the new patch on, I am having BT pain and have to take my dose of Norco to help. But then between hours 7-22 after applying the new patch I get that feeling of being 'high' or 'stoned' euphoric feeling. Aside from that I also get the 'babbles' and just talk talk talk talk talk... Not too bad of a side effect. How long does this last? I haven't driven since I got on the patch since I feel intoxicated in a way. Does anyone else get this feeling with their patches and how long does it last?? Do I need to decrease my dose?


Another one that freaked me out is that I've noticed a few times since I started the Fentanyl that i'd have a bit of trouble catching my breath. Not shortness of breath or hypoventilation but just yawning a lot or just trying to catch my breath. Usually I don't notice it at all but when I do, I then get nervous about it and start having a panic attack which makes it harder to catch my breath. I used to get panic attacks all the time and have an Rx for Clonazepam RRN. I don't want to take something else though that is a respiratory depressant if I'm having trouble catching my breath. Has anyone else noticed this with the patches?

Also, sometimes I'll be awake and fine doing something and then when it gets kinda close to bedtime I will get this overwhelming feeling of sleepiness and drowsiness and have to stop what I'm doing and go to bed. It doesn't happen every night, but it's happend 2-3 times since I started it. I dont' know if that's unusal or something to worrry about but wanted to ask. It's kinda strange for me too, since I've had major problems with insomnia and not sleeping through the night until I got on the PM drugs.

Last thing, I read on one of these posts, that you shouldnt' take vitamins with Fentanyl or other narcotics? Can this be right? Neither my doc or pharmacist mentioned that and my doc wants me to add a B12 supplement... Any thoughts.

I'm sorry about the length of this post, but wanted to get all of my questions and concerns out on this board and talk to people who have 'been there, done that'. Thanks again!
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Old 06-13-2009, 11:44 PM   #8
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Re: Am So frustrated with the Fentanyl Patches Staying On!!!

I have experienced the same problem and I am also waiting on the Opsite Flexifix. I used the waterproof band-aids and they cause me "itch and scratch" and that left a horrible rash. In the meantime, I bought a box of "Tegaderm Transparent Dressing" by "Nexcare". These have worked wonderfully! They are like big band-aids without the pad. They are very thin so they move with your body. There are 8 in a box and they are kind of expensive. However, they will get you through until your Opsite arrives. I found them at Walgreens.

One more thing - my doctor told me to wear them above my heart. I tried my upper, outer arm and my thigh but I don't think it worked as well. I have gone back to putting them under my collar bone. It still bends there but, it's hard to find a place that doesn't bend or ripple no matter one's size IMO.
I hope this helps;0)
weezi

 
Old 06-14-2009, 12:11 AM   #9
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Re: Am So frustrated with the Fentanyl Patches Staying On!!!

Thansk Weezi,

I appreciate the info. I'm going to try those for the interim. I'm not so worried about the patch bending or rippling as long as it stays on my skin while it does that. When you put it under your collar bone, doesn't it start getting spots on the sides or in the middle that lift and look like waves. The thing that concerns me is that if it's not sticking well or keeps lifting that it won't be touching my skin and providing the medicine that I need. When you put it under your collar bone, do you put it smack dab in the middle above your sternum or move it to one side or the other. I'm a side sleeper so at night my breasts smoosh together causing the patch to ripple, bunch and come up. Do you think the Tegaderm will help smoosh it back down? Thanks again!!
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Old 06-14-2009, 12:13 AM   #10
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Re: Am So frustrated with the Fentanyl Patches Staying On!!!

Is there anyone that can help you put the patch on your upper back?that is where I always put my husbands for years because his arms were always moving so it is a difficult place to put it. Also the tops of your legs/thighs and the chest...are options. The tape you are using doesn't sound very good but until your Opsite arrives for now just use bandaids around the edge of the patches. It also depends on what size pain patch...there are tiny ones 12.5 mcg to 100 mcg that are very big. My husband has had them all but like the other post suggested you can buy individual tegaderm at the store pharmacy...if you can't find on the shelf ask for help. They are expensive but will get you through a couple more patches. If you have the smaller pain patch you can cut down the Tegraderm to make them go further. Good luck.

 
Old 06-14-2009, 12:49 AM   #11
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Re: Am So frustrated with the Fentanyl Patches Staying On!!!

Thanks Ann for your suggestion. I might be able to get someone to help mith with it occasionally but not all the time unfortunately. I did go get one of those Tegaderm patches although they didn't have them boxed by Nexcare. They had some really expensive sterile one (ran $2.60 for a 4 x 4 patch), but I got one to get me through until I can try a different pharmacy. Do you think that the Tegaderm will keep the patch from rippling and coming up on the edges. I don't care what it looks like as long as it's in contact with my skin. Yeah both tapes I tried held the patch onto my skin, but would just move and ripple with the patch when I moved and the middle part would end up lifting anyway. Hopefully the Opsite will hold it in place well. Thanks again!
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Old 06-14-2009, 01:32 AM   #12
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Re: Am So frustrated with the Fentanyl Patches Staying On!!!

paper tape ---that white tape-- its medical tape, get it from the drug store and it will solve this problem.. shower and baths dont seem to effect mine..

 
Old 06-14-2009, 08:35 AM   #13
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Re: Extremely Frustrated with my Fentanyl Patches

Hello.....And Welcome to Healthboards. I'm sorry you're having problems with your patches. In the end, they might not be a good fit for you, but let me give you some tips and see if things don't improve......

(1) Best time to apply the patch is right after a shower, allowing the skin to completely dry of course. Apply to areas of your body where you have the least amt of sweat glands....Outer arm area (where people often get tattoos) and the flank area. Both of these areas are recommended by the manufacturer as well. Stay away from the back and stomach area as people tend to sweat a lot there.

(2) Have you tried the "Duragesic" brand? I found them to be quite sticky...More so than other brands. They are the original maker of the patch and considered the "brand"....I think they are the best by far. Conversely, many have reported lots of problems on this board with Mylan. If you do a quick search, all sorts of things pop up and they aren't positive.

(3) If you're still having problems with the patches sticking after 1 & 2, then try taping them down from the beginning. It's critical that you get a good seal, or they won't work properly.

(4) If all the above fail, then the patch may not be for you. I would report everything back to your Dr. and let him / her recommend a new LA med.

Best of luck to you.

Regards,

Ex

 
Old 06-14-2009, 08:50 AM   #14
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Re: New to Fenanyl, Need help with Side Effect

Many of the side effects you report will diminish as your body gets used to the medicine. For example, the "chatting" is the result of stimulated endorphin pathways. This should subside soon as well as some of the other symptoms.

It's very important that you do exactly as your Doc ordered regarding changing the patches, so that your blood plasma level (BPL) stays consistent. The BPL is the amt of med in your system....It needs to be consistent in order for the med to work properly. Otherwise, your BPL will drop and then you may get mini WDs and / or your pain could increase.

You have made a very wise decision to watch what you take with the patch....Any type of combination effect between multiple depressants, can be big trouble. Please keep a very close eye on the shortness of breath as that could be a sign of respiratory depression. The sleepiness / sedation is normal, and will improve with time.

Any type of exercise will slightly raise your body temp, which will draw more med than normal (from the patch) and it will also increase your metabolism some, which also draws more med. Many have set themselves up on a regimen where they exercise in between patch changes.

I would keep in close contact with your Dr re: your side effects. I'm really surprised that your Doc changed you to 48 hr dosing so quickly...It can take up to two weeks for your body to stabilize on the patch. Because fentanyl is the most potent pain med available, one has to be very cautious.

Take care, and hope you start to feel better.

Regards,

Ex

 
Old 06-14-2009, 09:19 AM   #15
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Exclamation Re: New to Fenanyl, Need help with Side Effect

Thanks Executor, (see notes below please)

Quote:
Originally Posted by Executor View Post
Many of the side effects you report will diminish as your body gets used to the medicine. For example, the "chatting" is the result of stimulated endorphin pathways. This should subside soon as well as some of the other symptoms. That's good to know that this will subside with time. Although I've had a great time catching up with old friends, and talking about all kinds of stuff with my friends.

It's very important that you do exactly as your Doc ordered regarding changing the patches, so that your blood plasma level (BPL) stays consistent. The BPL is the amt of med in your system....It needs to be consistent in order for the med to work properly. Otherwise, your BPL will drop and then you may get mini WDs and / or your pain could increase. Thank you, I am aware of this and trying to get the BPL even. She and I are going to have to keep discussing this (see also below about the 'upping' of my dose)

You have made a very wise decision to watch what you take with the patch....Any type of combination effect between multiple depressants, can be big trouble. Please keep a very close eye on the shortness of breath as that could be a sign of respiratory depression. The sleepiness / sedation is normal, and will improve with time. What I'm currently taking besides the Fentanyl is: Soma (muscle relaxer, no respiratory side effect noted in info packet) at night before bed, Lexapro (Anti-depressant, I'm not sure about any respiratory side effects) at night before bed, Wellbutrin (anti-depressant, not sure of respiratory side effects) Yaz (birth control, no side effects), and Triazolam (benzo for insomnia, can cause respiratory depression). I'm really thinking that I can stop the Triazolam, because with the others and not being in as much pain anymore I actually sleep through the night and then don't nap all day, making me tired at night. I don't think that it's really a shortness of breath really. I don't have shallow breathing and don't really struggle to catch my breath. It's nothing that looks like what asthmatics have to deal with on a daily basis. I think when I get tired though I have trouble taking deep breaths or I yawn a lot. I will mention this to my doctor. In the mean time, what are the other things I need to watch for with the respiratory depression?
Any type of exercise will slightly raise your body temp, which will draw more med than normal (from the patch) and it will also increase your metabolism some, which also draws more med. Many have set themselves up on a regimen where they exercise in between patch changes. Yes, I'm going to have to do this. I'll just set up to exercise on the days that I'm changing patches and do it in between changes, because it's really diffifcult on the patch. Makes me kinda light headed, start sweating like crazy and then really tired. Patch then doesn't usually work for long afterwards.

I would keep in close contact with your Dr re: your side effects. I'm really surprised that your Doc changed you to 48 hr dosing so quickly...It can take up to two weeks for your body to stabilize on the patch. Because fentanyl is the most potent pain med available, one has to be very cautious. My doctor chose to change my Rx to change every 48 hours as necessary if I were exercising or exerting myself and then the patch would wear off after 2 days, but preferred that I try and make it last 72. Since I'm going to adjust my exercising and house cleaning to 'patch changing days' then I'm just going to tell her I want to stay on th2 72 hour dosing.

Something esle that has me a bit worried is what has happenend in the last 24 hours or so. Yesterday was going to be my first 48 hour patch change since I had A LOT of housework to do. So mid-day yesterday I did my housework, starting getting flushed, really sweaty and a bit light headed (not as bad as last time though). With all the sweat, the patch fell off around 6. I finished house-cleaning and showered and went to apply the patch to my upper right arm around 8. It would NOT stay on. I tried taping it there and it kept rippling and such. I tried then moving it to my other arm (same thing) and then my chest (same thing). At that point, I gave up on that patch thinking it might be dysfucntional. I called a girlfriend of mine who's been on Fentanyl for years and asked her advice. She told me to do something that I've read I'm not supposed to do in the info packets. She told me to wipe down my arm with rubbing alcohol and then wait for a few hours to let any irritation go away and then try and apply the patch. She said she did that a lot when her patch wouldn't stay. Well like an idiot I did it. I wiped the area down gently with alcohol and then waited 2 hours and put it on my upper arm and taped it down with first aid tape around ten last night. I was also having some breakthrough pain badly so I took a dose of Norco. The Norco kept me awake, so I didn't go to bed until 6 this morning. At 9 my dogs wanted out, so I got up to let them out and was typing and email when I got REALLY nauseated. I went to the restroom and then ended up vomiting twice. I have almost NO gag reflex and almost never vomit unless it's self induced (due to my bariatric surgery). There was no way I could have stopped it. It was coming up no matter what which is Very strange for me. Scared that I was in an overdose, I took the patch off. So now I'm laying on my couch not knowing what to do. The pharmacies aren't open right now so I can't call them to ask about this. Does this sound like and overdose from using the rubbing alcohol and switching to the 48 hr dosing or does it sound like a withdrawal from not having the patch on for 6 hours or so last night. It REALLY scared me. I'm afraid it was a mild overdose. Other than being really tired and sleepy (only having 3 hours of sleep and having taken my insomnia meds) I'm not having any other side effects. I don't know what to do and I'm totally freaked out about this... Any thoughts??? Thanks so much!

Thanks again!!!




Take care, and hope you start to feel better.

Regards,

Ex
__________________
New to CP

-An eye for and eye leaves the whole world blind.

 
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chronic fatige, chronic pain, depression, fenanyl, fentanyl, fentanyl patch, fibromyalgia, norco, overdose, oxycodone, pain management, pain mangement, withdrawal



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