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    Old 02-25-2006, 11:49 AM   #1
    jennfaery
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    Fentanyl questions

    Hello! My doc just started me on the patch 50mcg/hr every 3 days yesterday after taking Norco 10/325 2 every 4 to 6 hours for about 6 months. I don't think it is working as well as it should be and I was wondering if you guys could give me some info about it. I have tried to find a conversion chart but haven't with hydrocodone as one of the medicines to convert from. Also, how long should this be working? Any info would be appreciated.

     
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    Old 02-25-2006, 01:34 PM   #2
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    Re: Fentanyl questions

    Hi jen! I don't know the exact conversion,but i do know the patch your doc . started you on[50 mcg] is without a doubt stronger than 10 mg of norco[hydrocodone] you were taking. I'm suprised he didn't start you on the 25mcg. I forget how long it takes the patch to work,but i'm guessing around 6 hrs. Fentanyl is[i believe] the strongest pain med. I remember when i was on them,that i was tired all the time,but it helped keep my pain level down,and i broke out with a rash,so i had to be switched.If you find that they are very helpful,you may want to look into getting the covers for them,so they stay on better.You will find that info.[i think] in the insert of the box they come in.And i don't think pharmacies carry the covers,you would have to send away.Another thing i wanted to suggest to you[ask your doc first of course] is when you go to change your patch,there is going to be what i call down time,meaning,your going to have to wait all over again for the replacement patch to start working,my doc.[at the time] said to put the new one on a little early,so just as the first one is wearing down,the replacement one is starting to work its way into your system, so at one time you would be wearing two patches,just for a little while though. Does that make any sense? Let me know how you make out! madhatter

    Last edited by madhatter; 02-25-2006 at 01:44 PM. Reason: add

     
    Old 02-25-2006, 02:01 PM   #3
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    Re: Fentanyl questions

    Hi Jenn,

    As Madhatter said, Fentanyl is the strongest med that can be prescribed. Thats one of the reasons it is measured in MCG instead of MG. The Fentanyl family is the stongest made. The Fentanyl patch can take a little time to start working. They are transdermal and it depends on your body. Everyone metabolizes differently. Some people have a higher body temperature and will absorb more of the drug quicker. I believe it is about 12-16 hours when the patch hits its peak.

    As far as a conversion from Hydrocodone its harder because of its strength. Where most meds are measured in Mg, Fentanyl because of its stregth is measured in Mcg. My Equianalgesic chart shows 0.1mg of Fentanyl the same as approximately 30 mg of Hydrocodone. So as you can see, not even a Mg of Fentanyl, actually far less.

    It does see like a jump from Hydro to Fentanyl, however we all just had this discussion on a different thread. Me personally, I would rather go to Morphine or Oxycodone first. That way as I build up a tolerance there would be something stonger available. If you are already at the top med, you will eventually require higher dosages of it.

    Is your Dr a Pain Management Dr or Family Practice? There is nothing wrong with the patch, in fact it is a great pain med for chronic pain.

    Anyway, give it some more time. It takes a while to get into your system. Good luck, hope it works for you. Take care

     
    Old 02-25-2006, 07:16 PM   #4
    jennfaery
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    Re: Fentanyl questions

    Wow! Thanks for the quick and nice replies! I've been wearing the patch since about 9 pm last night central time. I'm not seeing a very big improvement at all. I was wondering if it would be ok to take a Norco? When I talked to my doctor he said that this should pretty much get rid of any pain I am having. I woke up this morning late (thanks hubby!) with my hips and back hurting more then usual so that's why I thought maybe it wasn't working. I guess I should just give it some time. I have been lurking around here for sometime but here lately I haven't been able to actually sit down at the computer so I haven't seen the post you were talking about. We just had another baby girl, Emily, 3 weeks ago and she and our other children having been taking up most of my time. Anyway, I too thought that this was a pretty big jump since I have heard that it one of the strongest out there. Should I talk to him Monday and see if they could switch me to something that wouldn't be as strong? I was really kind of scared to use the patch since I've heard differing opinions about it and all the warnings on the box. I guess that's why I waited to put it on so long since my docs appt was early in the morning. I'm also kind of scared about becoming dependent on it. It seems like it's difficult to get of off and I am really hoping I won't have to be on medication much longer. Well see about that soon I guess. Just had an MRI yesterday so I'm hoping we will be able to figure out why I've had such horrible pain and then we can fix it. I have one more question that I can think of ATM. Where is the best place to but it? And is there supposed to be redness around it? Thanks guys!

     
    Old 02-25-2006, 07:28 PM   #5
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    Re: Fentanyl questions

    Hello Jenn,

    Maybe the operative word in your entire message is "yesterday". As the others have stated, this medication is one of the strongest available, BUT it does take a few days (depending on the individual) for the fentanyl to get into your system.

    Since you are new to this medication, you will have three choices. Of course, there is the name brand called "Duragesic". There is a generic brand, marketed by SANDOZ, which is manufactured by the same company that makes the name brand. While some may argue against what I'm about to say, I still find it to be true FOR ME: The generic brand marketed by Mylan is THE PITS!!

    I use the generic brand marketed by Sandoz. I use a 75 mcg patch and change it every 2 days. Many patch users find that the third day is not very effective.

    Concerning your Norco...That is a rather fast-acting medication compared to the fentanyl. Norco gets into your system quickly, while fentanyl--being much more potent--takes longer in some people to get into the system. However, once the fentanyl (the Superior kind, which means non-Mylan in my book) gets into your system, I think you will find great long-term relief from it.

    As madhatter stated, the patches can sometimes cause difficulty staying attached to your skin. And, yes...there are "covers" available from some of the companies. However, I find it easier to use the Johnson & Johnson First Aid All Purpose Tape (Cloth). Its packaging is white and blue. My pharmacy sells two sizes, and I use the larger of the two sizes. (I don't have the original packaging to tell you what exact size I use.)

    Also, as ARANGER stated, it does seem like a large jump from hydrocodone to a 50 micrgram patch. But, your doctor may have more insight into your pain.

    Give the fentayl a chance, and make sure you read the VAST amount of material concerning which version (Duragesic, Mylan, or Sandoz) works the best! I vote for the Sandoz version!

    Let us know how this works out. We are interested, especially since you are performing an Olympic-sized leap from hydrocodone to fentanyl.

    Sincerely,
    Jon (Conductor)

    P.S. I place my patches on my upper arms, alternating back and forth.

    Last edited by conductor; 02-25-2006 at 07:32 PM. Reason: Additional Information

     
    Old 02-25-2006, 09:36 PM   #6
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    Re: Fentanyl questions

    My pain doc switched me from 60mg avinza to 50 mcg fentayl for ddd and 2 hernaited discs. I have had other things for pain but hands down this is the best, plus they dont make me loopy. I use the sandoz with the j&j bioclusive covers. The only problem I had was them not lasting the 3 days so my doc has me put a new one on every 2 but leave each one on for 3days. I also have 7.5 vicoden for bt pain. Just make sure you keep your doc informed how they treat you so he can adjust your dose or give you other meds to help. Write things down so you dont forget. the more you tell your doc the more he can help you. Tony S

     
    Old 02-26-2006, 12:36 AM   #7
    jennfaery
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    Re: Fentanyl questions

    Thanks for all of the great advice! I am taking the sandoz kind and I really like the convenience of them but I'm kind of scared about staying on them. I have been trying to research it a bit and from what I've been reading the withdraw is horrible. I have a really high tolerence to pretty much anything I take which I'm sure will make it harder to get off them. I really don't want to go through something like that. I really don't want to be taking medicine at all but I am very thankful for it since it helps tremendously.

    I guess I should just give it sometime to work but I have had to take 2 Norco since I was feeling pretty bad. I don't know if I am suposed to take them or not. From what I got from my PM doc was that he is switching me over to the patch and nothing else. I would call the office but it's the weekend. Oh well.

    Anyway, I took a shower earlier and it started to come off so I strapped some bandaids to it. I will get the kind of tape that you suggested, Conductor. I put it on my chest since I thought it would be out of the way and my children wouldn't mess with it but it is probably not the best place to have it. I do alot of moving and have to use my arms alot so it's been getting alot of action. Hehe. I will try putting it on my upper arm on Mon. I hope it lasts til Mon.

    I don't know if this is psycological or what but I feel kind of off. I have this almost sick feeling in my back like I get if I can't get around to taking a Norco along with the pain. My PM doc told me that I would not have any withdraws at all so it's prolly all in my head I guess. I don't know.

    I'm so sick of being in pain. I know there are people out there who have way more pain then I do but I just want to feel normal. I want my energy back. I want to be able to play with my kids on the floor and not take 15 mins to get up. I want to go somewhere and not have to take my pills with me . I don't want to take medicine anymore. I want to have sex again w/o any pain! LOL. Ok I'm done venting for now.

    You guys are awesome! You made me feel welcome and wanted and for some reason I'm really needing it right now. It's been a looooong few months but I'm trying to take this one day at a time.
    Jenn

     
    Old 02-26-2006, 01:45 AM   #8
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    Re: Fentanyl questions

    Hi Jenn,

    Just a couple things to add. First, don't get real tied up with the warnings and hype that go along with opiates. These drugs can be very dangerous and cause death if not used properly. So as long as you are using them as prescribed, you shouldn't have anything to worry about. I know people that take 50mg of Morphine a day and know others that take 300mg a day. The goal is pain relief. Not trying to figure out how many Mg's John Doe takes. If it works him, great. Everyone is going to respond to these things differetelt.

    About getting off of them. If the time comes and you no longer have pain, your Dr will taper you down with meds to lower the dependancy of the drug. Again this is different from addiction. You would'nt want to just stop CT with these meds. To calm your nerves a little; Fentanly is the strongest prescribed drug. However, it is used in very small quanities for good pain relief. Me personally, I like to kinda go up the latter if you will with pain meds. I started on Hydrocodone, then Morphine, Then Oxycondone, Then Fentanyl. This is just the way that I prefer to do it. If the patch works for you, great. I'm not knocking down how effective the patch is. I think its a great form of treatment of chronic pain.

    A great benefit of the patch or any other LA med is that you don't feel the ups and downs as would with Hydrocodone. An LA med slowly enters your system and stays for an amount of time. Where as SA meds peak within 1-2 hours.

    As far as taking Norco with you patch, that is used pretty commonly. HOWEVER, please check with you Dr first to see what he wants you to be taking. When I was on the patch, my PM had me on 180 Percocet 10/325 a month. These meds are given for break through meds. So it is pretty common, but I would be checking witht the Dr on what you should be taking. Your local pharmacist is also a great deal of information that can help you out.

    If you can, communicate with your PM. Tell him any of the worries you have. He will probably tell alot of we have posted here. Sounds like he is a nice guy and commpassionate and willing to treat you aggresivally . So thats postitive. If your Dr is a PM Dr and you feel comfortable, then everything sounds like with it will out for you just fine. Your Dr. should know your pain problems and should be adjusting from there. So if he wants you to take it, then take it. Just keep a diary of what happens each day or week unitl you see him again, Just remember to always follow all the prescribing info.

    If the patch is not working and keep in noted. This way you can go back and show him your level of pain at each dose. Dr's are usaully going to start at a prertty low dose. So if soo you don't start feeling any more relief, you base dose may need to go up. I would also ask about BT meds like Vicodin, Percocet, etc. You will just notice that the BT meds may be a little more potenet now with the Fentanyl in your system.

    I was using surgical tape to secure my patches after the first day. But I think the Bioclusive strips are better.

    Anyway, let us know how it goes. Take Care

     
    Old 02-26-2006, 03:55 PM   #9
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    Re: Fentanyl questions

    Hi Jenn....I use the Sandoz patches and to me, they are the same as brand name Duragesic. I forgot who said it, but they are indeed manufactured by the same company that sells them to Janseen Pharmaceuticals that distributes brand name Duragesic. I've tried the Mylan, and it SUCKS! I'm on 150mcg of the fentanyl patches and I also take the fentanyl lollipops called Actiq. Now, with the Actiq, I am on a huge amount. I take the highest strength 1600 mcg up to 5 per day, which comes to 8,000 mcg of fentanyl if I take 5 in one day. Like someone said, don't get caught up with mg's or mcg's or with what someone else is on. I'm only 34, but I've been in chronic pain from my kidney for 26 years. I'm so desperate for pain relief, that my docs and my family (me included, of course) have opted for a risky procedure. I'm having my kidney removed the first week in April. I've been told the pain may not go away completely, but it's a chance I have to take.

    Also, my other kidney is a little jacked up, but not as bad as the one about to be removed. I've been told that total renal failure is a high probability within 2 years. I understand the risks and accept them fully. I just have to try this last surgery (I've had over 60 surgeries) to see if I can get some relief. I'm willing to die for that opportunity because I can't live in this type of pain anymore. Like I said, I'm only 34, but I feel like I'm in my 60's.

    Anyway, just give the patches some time to work. They have to build up a little in your system first. It's not like taking a Norco or Percocet in that you feel the pain diminishing within a few hours. Once you find the dose that works best for you with the patches, I think it's one of the best meds out there. Good luck and let us know how you are doing, ok? Just remember one thing too, there is no ceiling effect with pure opiates. You can go as high as you need to (and as comfy as your doc is) as long as there are no bad side effects. The majority of people will be on chronic opiates the rest of their lives. So, you do have room to go up if needed. And when and if the time comes to come off of them, your doc will taper you and you should not feel any withdrawal. Take care.

    Last edited by friendly_one; 02-26-2006 at 03:57 PM.

     
    Old 02-26-2006, 05:39 PM   #10
    conductor
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    Re: Fentanyl questions

    Dear Jenn,

    A while back, another Healthboards user sort of "blasted" me (at least I felt that way) because s/he felt I was "over-suggesting" a particular break-through medication called Actiq. I don't mention its usage very often, but I feel that I should in this case.

    Actiq is referred to as a "lozenge", but it resembles a lollipop! The company (Cephalon, I think) says the flavor is raspberry, but I'm not so sure.

    Actiq is made of fentanyl. The strengths available are 200, 400, 600, 800, 1200, and 1600 micrograms. While the physician can Rx any number s/he wants--they come in boxes of 30. Originally, Actiq came in boxes of 24. When they switched to 30 per box, the consistency also changed--for the better, I think!

    My PM doctor explained Actiq's method in this manner: Since I am using a 75 mcg patch of fentanyl (every 2 days) already, the Actiq adds extra fentanyl when I need more pain relief. This makes sense for me by adding a small amount of the long-term pain medication. Not every doctor (even PM physicians) will want to simply hand out this potent medication. As has been pointed out repetitively, fentanyl is one of the best opiods available. In fact, fentanyl is probably the most potent opiate available for most people (since we all react differently to various medications).

    I must warn you that one box of 30 "lozenges" costs about $280 WITH INSURANCE!! I truly don't know what the cash price is without insurance. Frankly, this is something I use sparingly--BUT...it has saved me from emergency visits that normally would have required IM injections or IV dosages of Dilaudid to relieve the pain. I've even had expensive injections of fentanyl. I should point out (if it isn't already apparent) that I have an extreme tolerance to opiates.

    I want to make sure I "cover" myself by saying that I might have previously made an Actiq Rx appear arbitrary or casual to ask of your physician. Please understand that I don't mean it that way. Furthermore, its expense prevents it from being a medication a patient can use in a whimsical manner.

    This post was not intended to bore you all simply by its length!! However, I feel strongly about the use of opiates. I have severe pain associated with my Lupus condition, and these several forms of fentanyl have saved me from constantly living in the ER or PM office.

    Someone correctly noted earlier that just because you are forced to use these opiates for pain relief--doesn't mean you are an "addict"! If, for some reason, you need to cease their usage...your doctor would slowly and safely taper you off of them. Going "cold turkey" could cause seizures and other serious health problems.

    Again...we wish you well and want to know your progress. Feel free to discuss your situation with us. After all, that's why we are here.

    Sincerely,
    Jon (Conductor)

    P.S. friendly_one has a GREAT point! There isn't a "ceiling" effect with pure opiates. So, don't let people tell you that your dose is too high. Only YOU and your doctor can decide your proper dose. Keep track of your pain--especially changes--and always keep your doc informed.

    friendly_one: I hope you know we are supportive of your situation, too!!

    Last edited by Administrator; 10-20-2007 at 04:33 PM.

     
    Old 02-26-2006, 06:22 PM   #11
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    Re: Fentanyl questions

    Hi conductor...thanks for the support, I need it!! I'm still trying to figure out why your insurance is so high for the Actiq. I get 1600 mcg quantity 150 and pay only $30. I know the cash price for 1 box (quantity 30) is over $900. I just don't understand why they are making you pay so much. That's not right..you have insurance!

    Jenn...like conductor said, Actiq isn't readily handed out by docs. It's usually reserved for a terminal condition. But without, I and conductor (forgive me if I'm wrong, conductor) would basically live in the hospital, whether it be admitted or in the ER. My PM doc feels the benefits far outweigh the risks of me taking this medication. Obviously, I have a high tolerance for opioids. The other meds used for breakthrough pain won't touch me. This didn't happen overnight, it took 26 years. This is another reason my doc prescribes it because he knows it would be worthless for me to go to ER. The amount of Demerol or Dilaudid they would have to give me, they won't. They are afraid they would kill me. I've had to go before and they talked with my PM doc and he told them the amount to give me, and they refused. It's a very useful med (the Actiq), but again, alot of docs won't prescribe it. Hopefully, you will never need it. After the Actiq, there is nothing left. It is the most potent med out there. Anyway, I just forgot to say that earlier. Conductor's post reminded me about the criticism of using Actiq. But, you do what you have to do and with your doc's knowledge, I hope your pain can be manageable. Have a good night.

    P.S. Conductor, how have you been??

     
    Old 02-26-2006, 07:04 PM   #12
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    Re: Fentanyl questions

    I just wanted to give a little warning about Actiq. I was on it for about 2 years and it caused me over $5,000 of damage to my teeth. I got 15 cavaties in a period of a year and a half. I am 31 and have had 2 small cavaties before this. Now I am facing route canals etc. from this. The cavaties are all up near the gumline where the meds would sit. Be very careful and brush your teeth immediately after taking one. Also get a prescription tooth paste with flouride. It caused me to have decalcification of all my teeth. I also had such a terrible time with withdrawl between doses and what I would say would be addiction to actiq. The taste is very comforting and the high you get you feel you need this taste after you get used to it to relax. It was just my experience but wanted to share it. I still feel the need to take the med. to this day and have NEVER in my life had addiction problems.. I think it has to do with the taste being enjoying etc. It does work...but the withdrawls are hell. I actually asked to be put in the hospital to get off it and I was only on 400mcg maybe 4 times a day tops. This was 2 years ago and still feel the need to take it sometimes...2 years later! I've been on pills (dilaudid) and can take or leave them. Somethign about this medicine..maybe that it's like candy..that I find worrisome. Plus if you read the insert it is not made for back pain--can cause increased back pain. It also is only for cancer patients..makes them not liable for anything since I was prescribed for back pain. Also the pamphlet warns about the teeth so that makes the company not liable for the 5K+ in dental work I have had so far! Just my opinions on it.

     
    Old 02-26-2006, 08:41 PM   #13
    conductor
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    Re: Fentanyl questions

    Dear kstone_queen and SecretAgent2,

    I'll start with friendly_one simply since her response came first. Most of my Rx "coverage" is good. However, Actiq is on the highest tier--which they state is 50% plus some other amount (that I don't recall) added. I am "allowed" 1 box every 15 days. The most I am allowed to use in a day are 3 800 mcg lozenges. Fortunately, I usually use 1 box per month (or 3 weeks during a "bad" month). Other than that, most of my other medications--blood pressure stuff, sleep stuff, Elavil (for help in pain relief), Tegretol (for pain AND past seizure problems related to the Lupus Anti-Coagulant), Dilaudid, Fioricet (and Fioricet w/Codeine), etc.--all cost me $10 each per month. I tend to think this is good. Let me tell you, though, that I pay a $340.32 premium each month for this insurance. This insurance is through Principal and extends to doctors' bills and medication bills.

    Now...SecretAgent2. You mentioned the need to be careful concerning one's teeth. By all means, this sugary "lozenge" particularly requires being careful. My dentist prescribes PerioMed, a .63% Stannous Fluoride Concentrate, which is available in several disgusting flavors. However, this seems to work. Just in case others are interested...the Rx # is NDC 48878-3315-0. This is a fluid that you swish in your mouth after brushing and flossing. And, you are absolutely correct--Actiq is primarily indicated for patients with malignancy (cancer). I guess these companies can get away with all sorts of things when they state that the medication can be used for "off label" uses. HONEST TO GOODNESS...I can't locate it right this second (of course), but I know I have read this somewhere--maybe on the pharmacy information that isn't very specific.

    To quickly (Ha!) tell everyone what I have...I have Systemic Lupus and the Lupus Anti-Coagulant. Frankly, I have joint pain, muscle pain that doesn't stay in one place, diagnosed migraine headaches (versus just "bad headaches"), peripheral neuropathy, extreme pleurisy that comes and goes--just to name a few of the symptoms. I do not have any of the skin symptoms that often accompanies this dreaded disease. Oh, I have had, in the distant past, glomerulonephritis. There are quite a few other symptoms, but pain in various areas have caused me some of the worst problems!

    Although I don't like to divulge this, I am on permanent medical disability due to this fun condition. My medical records--that quite adequately document the ongoing pain, as well as the Lupus diagnosis--are thick!! These records truly demonstrate the years of problems pertaining to the Lupus. It took only 5 months to become approved for Social Security Disability. TRULY, I AM NOT ONE TO PARTICULARLY BECOME INVOLVED IN GOVERNMENT "HANDOUTS", BUT I WAS VERY FORTUNATE TO BECOME ELIGIBLE FOR THIS. Just so you know, I have a Bachelor's and a Master's. I taught public school (Choral Music) for 6 years. Plus, I attended Law School for 2 years. I've had to give all of that up. My only involvement in Music now is that I CONDUCT (hence, my screen name) a Church Choir. Finally, I should tell you that I live with my aging parents. They are some of the best people in the world. My brothers and their families are also people I could not survive without. I am truly blessed and fortunate!

    Yes, fentanyl is the most potent opiate. So, its use should carefully be monitored by a physician. It's fantastic that we have each other from whom to learn.

    Pertaining to this particular post within this thread, I say "thank you" to friendly_one and SecretAgent2.

    To everyone...I will be glad to address anything I can. Take care of your pain by communicating with your doctor. I do realize that it can take time to locate the "perfect" one. While I have had both MD's and DO's treat me, I have found that DO's treat my pain in the best manner. However, this could easily be a regional "truth". It has been my experience that DO's appear to be more concerned with my comfort than the MD's. Because I prefer to keep some of my info reasonably private, I will simply state that I live in the Southeast. Please don't take my statement as though I am condemning MD's--I am not. It was an MD who put everything together and finally found out I have Systemic Lupus and the Lupus Anti-Coagulant! When it comes to Pain Management, the DO's have been more effective in my case.

    Sincerely,
    Jon (Conductor)

    Last edited by Administrator; 10-20-2007 at 04:42 PM.

     
    Old 03-03-2006, 01:02 AM   #14
    jennfaery
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    Re: Fentanyl questions

    Thank you everyone for your thoughtful advice! I just wanted to let everyone know that I don't think this med is working for me as well as it should. It's little more then taking the Norco. Do I just have a high tolerence? What should I tell my doc? Both of them together though works great! My pain was at a 4 when I took a Norco. My pain hasn't been below a 7 or 8 since this all started. Should my BD be bumped up or should I ask for BT meds? How do I go about bringing that up? I don't want him to think I'm not thankful for what he is doing for me because I am but the pain is still severe. I don't know what I would do without him. Before I started going to him I could barely walk. I could only go somewhere where they had the moterized carts because I couldn't walk for a prolonged period of time. I still use them if I have to be there for a while but if it's in and out I am able to walk now. Anyway, any more advice would be much appreciated! Thanks!

     
    Old 03-03-2006, 09:18 AM   #15
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    Re: Fentanyl questions

    Hey Jenn,

    You mentioned the patch is not working as well for you. A couple things regarding that. First, you have not been on it that long, correct? I don't think you'll find anyone here that will tell you to give up on a med right away, unless you're having severe side effects or allergic. Unfortunantely, dealing with chronic pain can be a pain. We have to go through titration periods where the Dr, with our feedback, changes the dose over a period of time to find out what works. You haven't really mentioned any serious side effects that would warrant you stopping other than its not working. That tells me that you may not be at the right dose.

    Fentanyl is a very potent medication. Most Dr's are not going to start you at a high dose of any med, but probably this med in particular. 50mcg/hr is on the lower side of this med. Its a good starting point, but you may need to go up. In addition, BT meds are usually given with the patch. Even the prescribing info says that BT meds should be given.

    I think it is important that you keep a diary of your pain levels daily. When you go to the Dr, you can show this. I think before you give up on the med, give the med and your Dr a chance to get you to the proper dose. This can take some time.

    It sounds like your Dr is treating your pain aggresively. There are many people on this board who have been through the ringer trying to find a Dr to treat their pain aggresively. You're already there, so my advice to you would be to report this back to your Dr and work with him to get you to the proper dose. Its Ok to give up on a med, however, I feel that you should give it plenty of time and make sure you have exhausted all other means.

    Hopefully you will be able to get to a dose that works for you. I know it can take some time, and be painful, but hopefully in the long run you'll be telling us how pain free you are.

    Take care.

     
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