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    Old 06-08-2005, 01:13 PM   #1
    sickofpain12
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    Exclamation Need advice with Duragesic please?

    Hey there everyone. I have been off the boards for a while. I have been going through a pretty rough time pain wise, but I think I am going to be O.K. My surgeons office referred me to a wonderful pain management doctor. He started me off on the 25 mcg Duragesic, then to 50 mcg, and am now on 75 mcg and I believe I am actually going to get some of my life back!! I remember a post by She Sparles a while back that was titled "aren't we lucky" or something like that about having understanding doctors. Boy, I was sure jealous at the time, but now I am in agreement 100% that YES...I am a very very lucky person to have been blessed w//Duragesic. My only problem is this. With this new box of 5 patches (we've been doing 5 at a time to find the right dose) I put one on on Monday after I got them, well I put it on my back and forgot it was there, took a shower and proceded to "scrub" it off with my back srubber thingy!! It was beyond repair so I had no choice but to dispose of it. So I put another one on and it was fine until today when I noticed the edges had all "rolled" up and it was really wrinkly, tried the tape again but due to the location of the patch the tape did not stick very well and that one got all hosed up as well. So I take a shower and put lotion on (like I always do) and put the 3rd patch on but apparently my skin wasn't dry and so it basically just fell off...so tried the medical tape again, but that fell off as well. We all know that once a patch comes off, it does not stick again by itself (at least mine don't anyway) I still have that patch as it did not get bent or wrinkly...I put it back into it's "pouch" and back into the box. I called Janssen and they are sending me the free overlay thingies, but in the meantime the gal there told me they recomend placing it somewhere on the body from the waist up. So the 4th one is now resting happily on my chest. I am so scared to tell my doctor about this....I don't want him to think that I am abusing them...although I have no idea how you would get the medicine out any faster but that's just me!! LOL!! I plan on using the patch that fell off today once I get the overlays so only 2 of them were "ruined" beyond use. I really am happy with my results with this medication, I can actually do the excercises in physical therapy which is GREAT for me!! How do I tell him what happened without sounding like an idiot?? Knowing me I will probably break down and cry but I hope not! I still have 3 50mcg patches left from "trying" that dose...should I just go back down to 50 and not tell him?? I really don't want to go back down though as the 75mcg is really working for me. Any help would be appreciated from you long time patch users!! Or anyone else??
    Thank you all a TON!!!!

    Karen
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    Old 06-08-2005, 01:34 PM   #2
    Rrector
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    Re: Need advice with Duragesic please?

    Hi Sick,
    I was on the patch for several months and I always put the patch on where I could see it and made sure I was completely dry if it was time to change it. You didn't say if you were on a 48 or 72 hour schedule, but if you're on a 48, can you leave the 75 mcg on and add a 50 to it to get you by. You said you have three 50's leftover, so maybe you could get by with doing some creative changing on your patches. Personally, I wouldn't say anything to the doc unless you absolutely had to. Down the road, if something happens that you have no choice but to talk to you doctor, then you have a clean slate in his eyes. In the eight months or so I was on them, I never had one fall off or get damaged. Whether I was lucky or what, I'm not sure, but you need to put that thing on like your life depended on it. Getting the overlays from Janssen should help you a lot, but unless you have an extremely good relationship with your doctor, I would do whatever you could to get through the time until you're due for your next script.

    Good luck to you.

    Last edited by Rrector; 06-09-2005 at 02:12 PM.

     
    Old 06-08-2005, 02:51 PM   #3
    sickofpain12
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    Re: Need advice with Duragesic please?

    Thanks,Director, for your advice. It's funny after you talk things out with someone, or, in this case, type it out, the answer seems so clear! LOL! I don't think I will say anything to the doctor. I know how sensitive this medication is and I do not want to do anything to risk losing it!! I have not felt this good in a very long time!! I think I will do like you said and supplement with the 50 mcg patches I have left. Besides, we're only talking like 2 days of "supplementing" anyway even w/the mess ups. Oh, and I am on the 72 hour dosing. But I notice that between 48 and 72 hours the pain does seem higher and I feel almost "withdrawal-ish"...sweats and chills only though. Weird. Anyway, thanks again for your advice, I really appreciate it!!

    Take care and have a great rest of the week!

    Karen
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    Old 06-08-2005, 03:33 PM   #4
    Rrector
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    Re: Need advice with Duragesic please?

    Hi Sickofpain...Just so you'll know (if you don't already) most people report the last 24 hours they can tell a difference in the medication if they are on a 72 hour schedule. I don't know what the percentage is, but I would guess something like 80% are on a 48 hour schedule. The patches just don't hold most people for the full 72 hours.

    You mentioned it was only two daysuntil you see the doctor. I'm not positive, but I think the patches can be cut, if you wanted to do something like that. Like one and a half of the 50's and you'd be right back to the 75 mcg. When you see the doctor you might want to mention the last 24 hours of your patches you seem to feel a decrease in the medication. Explain it to him, like you did to us.

    Good luck and please let us know how everything works out for you.

     
    Old 06-09-2005, 02:03 PM   #5
    spongebobgamma
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    Re: Need advice with Duragesic please?

    My mother is using the duragesic patch 50 mcg. When she went on this patch I read up on it so I could understand this method of pain relief.

    I thought I read that the patch cannot be cut, it will release all the pain med and cause a overdose.

    can someone please clarifly this for me?

    Thank you

     
    Old 06-09-2005, 02:25 PM   #6
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    Re: Need advice with Duragesic please?

    Hi Spongebob...Thanks for the info on the patch and cutting them. I just did some quick research on them and you are absolutely right. They are not to be cut. It also says to apply the patch as soon as you open the package. So Sickofpain, you should take note of these things. Sorry I gave you a wrong steer on what you can do with the patch.

     
    Old 06-10-2005, 12:56 PM   #7
    vamp36
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    Re: Need advice with Duragesic please?

    I had a "shower problem" with one of my patches. I do cover them now in the shower so they cannot get wet. I haven't had any problems since then. I do cover them with a piece of plastic right over the patch and then tape the whole thing over.

     
    Old 06-12-2005, 12:37 PM   #8
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    Wink Re: Need advice with Duragesic please?

    The thread about the Duragesic patch was interesting. Because of the kind of insurance I have (SeniorCare, for low incomers), I have had to change from Duragesic to the generic that just came out last month because that insurance won't pay for the Duragesic. Called "Teva". It's so much easier to handle than Duragesic, it's just a little bit of a thing, 1" wide, 1-3/4" long, and so much easier to apply than that squishy Duragesic. It seems to be working, but next time I see my primary, I am going to ask for 75 mcg. (using 50 now)

    I also take 2400 mg. of Neurontin a day. That also has a generic as of last month, which is doing what the original is doing, for my nerve pain. But I still have lots of back pain, if I try to stand at the kitchen counter for more than a minute it hits me in the L-3-4-5 so bad it makes me breathless --- and sends me scuttling for a chair, where it can subside. Hah. I am so frustrated, can't do much of anything like I used to. I miss my volunteer work at our Humane Society, for example, I absolutely loved going there every Sunday morning and helping the Vet Tech with dispensing meds for the "guest" cats/kittens/dogs/pups. What a joy. Now.....all gone. I worked 12 years as a volunteer at our big beautiful hospital. No more.

    I use the patch on a 72 hour schedule. I like the first day. Hah. Then it's kind of like, countdown till I can put on the next one. I miscounted one month and I still don't know how.....I mark the number of the patch on all ten I receive for the month, circle the day on the calendar, et al. But I ran out way before it was time to renew. I pleaded, and even cried to my primary's nurse that I was not "over-using the patches". Well, much to my utter humiliation, I was asked to come in, donate some urine, and see what happens. Well, of course I was innocent!! She (the doctor) allowed a 'script for the missing THREE patches to get me thru those 12 days till a new script could be forthcoming.

    Well, I've heard about Fentanyl being a controlled substance, a narcotic, blah blah blah, too many times and I was tired of it. I am not senile, nor am I a backward kind of school dropout, I maintain two websites (one is a blogpage). Doc blamed my insurance carrier for the big fuss about getting the exact amount needed for one month. Good Grief!!! What a big to-do. Ditto to Neurontin. I wasn't aware that was a controlled substance until I tried to refill my script "as long as I was there" (at the hospital at the time) Got a no-no again.

    And, I don't know about the rest of you, but I am really getting very sick and tired of righteous publications like "American Pain Foundation" (e-magazine I subscribe to) who tell us we don't have to be in pain, there's no reason why anyone today needs to suffer, etc etc. And don't try to sell me a TENS, that cute little apparatus where you stick these electrode pads on your back, then the little box lets you choose which program you want and wheeeee, tingle, pause, tingle, pause. You can be "electrically" stimulated as fast or as slow as you like. I had a unit on trial from my hospital's Pain Management Clinic (where I don't go anymore as they didn't do squat for me) and returned it there.

    Well, thanks for letting me ramble on and on. I do have a tendency to babble. Next time, when I come back, I will try to take it down a few notches. Then I will tell you about my "owie" if you all will tell me about yours. OK?

    Last edited by agelessannie; 06-12-2005 at 12:44 PM. Reason: grammatical mistakes, take some words out

     
    Old 06-12-2005, 01:08 PM   #9
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    Re: Need advice with Duragesic please?

    Hi Spongebobgamma.....I'm new to this place. But I am way too curious to pass up on your posting. I suppose the first question would be, Why do you want to "cut" the patch in the first place? I assume your mother's physician prescribed this medication "as is" so wouldn't she just use it the way it was prescribed? I just wrote a (long) post about the generic Duragesic, but I have used the Duragesic brand for quite a while. I cannot imagine how one could "cut" it without releasing some of the medication?? Were you going to tape the cut edges or something? Why not allow your mother to have the full benefit of pain relief with an intact patch??

    As I said in my first post, the generic brand, called "Teva", has the same kind of medication inside as Duragesic....fentanyl. It is an amazing little patch. Lies flat and nice, right on any part of my chest. well, breastbone. I never had any problem with this little patch and as far as that goes, with the Duragesic patch, either --- in the shower or coming off for no reason. I think the secret with Duragesic patches might be what everyone knows...the skin where you're going to put it must be perfectly dry -- and it shouldn't be in a position where you squish and wrinkle it by lying in such a way while you're sleeping that would make it do that --- when you peel off a Duragesic patch from its backing, try to just take that itsy bitsy corner, put it where you want it (and don't change it around, losing the "clinging" back of the patch), then carefully smooooth it out, keep your whole hand over the patch to hold it down while the backing takes hold. I used to kind of stroke the four sides of the patch to make sure there were no openings of any kind.

    OR! Ask the doctor if the generic would be OK for your mother, it's cheaper, it still gives pain relief (not enuf, but I wonder how much it would take for any of us to be pain-free, eh?), and gosh, it sure is the cutest darn thing. Soooo easy.

     
    Old 06-13-2005, 12:31 AM   #10
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    Re: Need advice with Duragesic please?

    Hi Agelessannie,

    Welcome to the boards.. My post about cutting the patch was to the poster before me who had mentioned cutting the patch. I had read that cutting it could be dangerous,, overdose.. I'm no expert but I wanted to see if I had read that correctly.

    My mom is doing good with her patch but I will tell her about the smaller one, the one she has now is really large plus she also uses a estrogen patch.

    Thanks for the information..

     
    Old 06-19-2005, 04:47 PM   #11
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    Re: Need advice with Duragesic please?

    I need to know if anyone has been on the duragesic patch, and noticed any severe weight loss and significant muscle waisting. My husband has been on it for about 8 months, [email protected],then75,then100mg. He used to have great pain relief, now not so good. Lost 50 pounds,has no appetite, and withdrawel happens after 24 hours. He wants off this med but has tried EVERYTHING, and this one gives him the best relief. He is 55 years old and uses it for extreme back pain. Her. disc. But according to insurance , not bad enough for surgery. Any one with any similar problems, would love to hear from you!! scarlett2

     
    Old 06-20-2005, 09:03 AM   #12
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    Re: Need advice with Duragesic please?

    scarlett2,
    He needs to ask the doc about being changed every 48 hours instead of 72. I was in withdrawal after 48 every time. It is very common. He is probably so sick on the third day that he is losing weight. Also it has less constipation issues as some other meds. That might be contributing also.

     
    Old 06-20-2005, 03:20 PM   #13
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    Re: Need advice with Duragesic please?

    I was on the patch for quite a few years, went off of it for idifferent reasons.

    One thing that helped me keep the patch on was to make sure that even though I put cream all over my body, I DID NOT in the area where the patch was to be put on so I never had a problem with my patch coming off. I also have very sensitive skin so the doc gave me a low-steroid spray to put on the area, let it dry, than apply patch. ALso this helped me in never having a problem with irritation. I made sure that I switched places on my skin every time, same area, just not in the exact spot. This also helps with irritation.

    I found that I put the patch on my lower back to be the best spot, it just has to be where your clothing doesn't rub it too much. There usually isn't alot of hair there and your body doesn't give off much natural oils. I am talking below the pant line. After a while your body heat should make it feel like second skin. I never put it in any area that was exposed to the elements. Any type of heat affects the glue and it can come off. I am surprised to hear about people having problems keeping it on but everyones skin is different.

    This was my experience with the patch which I consider a very good pain control med. Hope this helps anyone using it.

    Janet
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    Old 06-20-2005, 07:39 PM   #14
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    Re: Need advice with Duragesic please?

    Hi there everyone,
    Well I picked up a new script on the 15th and am having the same problem! I called Janssen and they are sending me the overlays. It's been almost 2 weeks since I talked with them, how long does it usually take? Also, I am not too bad, but am fairly overweight and my back has a lot of "extra skin". I tried putting one on my chest w/medical tape around the edges, but when I sleep I sleep on my side and the patch got all wrinkly and distorted. Tried on my shoulder blade...same thing...my skin wrinkles so the patch wrinkles and comes off. This is the best pain control I have had, they just wont stick!! I am so frustrated it's not even funny!!!! I read your posts and you say "I never had a problem with them not sticking"...makes me jealous!! So, how long do those overlays take? Next script I am also going to pick up some of those great big band-aids---like when you hurt your knee and stuff and put one of those over it...maybe that will help till the overlays get here?
    Thanks...

    Karen
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    Old 06-21-2005, 04:13 AM   #15
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    Re: Need advice with Duragesic please?

    I have been on the Duragesic patch for 2 years now.I also had the problem of it sticking.I got some liquid from the drug store called Benzoin Tincture and put it on the spot where the patch is going.It is very sticky and helps hold patch in place.I cover patch with a clear dressing called Tegaderm.It works great for me.I also had problems finding a good spot for the patch and the spot I use most is the top of my legs.I alternate legs.Good Luck to you and I hope this helps.
    Backdeb

     
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