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-   -   Fentanyl Patch 72 hrs or 48hrs???? (https://www.healthboards.com/boards/pain-management/459042-fentanyl-patch-72-hrs-48hrs.html)

onyxgates 01-05-2007 12:24 PM

Re: Fentanyl Patch 72 hrs or 48hrs????
 
Director and Others:

Sorry for my vagueness...

I am currently seeing a pain mgmt doctor and an orthepedic spine surgeon. I am planning on getting a second opinion from an actual nuerosurgeon and if he agrees with my ortho...will most likely go to him for the actual surgery. I have heard the same...you don't go to an ortho for a fusion. My PM doc referred me to the Ortho so that is why I decided to see him first. He is a very nice doctor and seems to know his stuff and I do trust him which is why if the nuero doesn't think surgery is correct, I will get a third opinion and go with the majority.

Now my PM doc doesn't want to go any higher on pain meds and doesn't want to keep prescribing them to me...I really don't think they are pain mgmt as much as they are those needle pushers that everyone talks about. They were fine with me when I was going through all of their procedures but now that I am not getting any expensive procedures...their tunes have changed. Can you go to another PM doc? I don't want to doctor shop but I also want to get a fair shake and treated correctly.

Rrector 01-05-2007 01:12 PM

Re: Fentanyl Patch 72 hrs or 48hrs????
 
Hey Onyxgates: You can go to any doctor you want to go to, whenever you want. Remember, the doctor "works" for you. If it were me, I would line up another PM doc before I say anything to the current PM doctor, but when you have everything all set, fire the current PM doc. Make sure of the time frame, so you don't leave yourself without meds and go into withdrawal.

I still really think it's unfair that the current PM doctor won't go to 48 hours in changing your patch, or at the very least give you something for BT pain. I have been on Duragesic (Fentanyl) Patches before, both with 48 and 72 hour changes. It's a world of difference. That third day, seems like you don't have a patch on at all.

I like your idea of getting another opinion and maybe even a third, if necessary. I think you've got things figured out and I'm glad you're going to be careful and not jump into this without all the facts and opinions.

onyxgates 01-05-2007 01:50 PM

Re: Fentanyl Patch 72 hrs or 48hrs????
 
Thank you for the assurance as right now I don't feel like I am in control or making any good choices. It is amazing the difference between the patch...Last night I went to bed at 8:00 because I couldn't take it anymore the pain was probably at an eight or nine. After tossing and turning, I finally fell asleep at 11 or 12 but it was a very fitful rest. I was waking up every couple of hours in pain. When I woke up this morning and changed the patch, I was still in a lot of pain. It took about two and a half hours before I felt like I could move without large bouts of pain. I am sitting here at work and am great. Yes it hurts when I move or if I think about it but it is closer to a five. I feel like I can tolerate this. I am meeting with my GP next Thursday and I am going to ask him if he can recommend a new Pain Mgmt doctor for me.

Thanks again for all of your help.

IZZY'SMOM 01-05-2007 03:31 PM

Re: Fentanyl Patch 72 hrs or 48hrs????
 
Thats great! I hope that you can find someone fast and fire the current moron you have now. Sorry and not trying to be rude, but you deserve so much better. Make sure as Director said to have enough meds, that would be really rough. Good luck, let us know what happens. Theres no way I could go 3 days on the patch, Id be in misery, and yet not to have andy b/t would be totally cruel. :eek:
xoxoxoxo
IZZY'SMOM

onyxgates 01-05-2007 03:39 PM

Re: Fentanyl Patch 72 hrs or 48hrs????
 
Right now would be an ideal time as I have a 30 day supply. Just got my refill. I am meeting with my GP next Thursday. We will see. Thanks to you all for all of your advice and input. You are all gems:) Have a great evening and hopefully a painfree one as well!!!

ozzybug 01-06-2007 03:17 PM

Re: Fentanyl Patch 72 hrs or 48hrs????
 
Hey Onyx-
I'd think twice about seeking another PM doctor with the situation being what it is with your current one sweetie. If you go see another PM doctor, your records from the one you are currently seeing will have to be forwarded to the new one, and he will see why your current PM won't prescribe opiates and is cutting your dose down on the patches you are using. You did the right thing in coming clean with your current PM doctor about your situation, and he chose to keep you in his practice when he could have dismissed you. My PM would have dismissed me in a heart beat. He is very clear about the rules his patients must follow. No room for errors of any kind.

Unfortunately, you are in true chronic pain that needs to be managed in some way, and I do wish you the very best in being able to work with your current PM doctor in finding some way to get this pain under control. All of us here know what it's like to live in chronic pain and are all well aware of how it affects our day to day activities. We also know how much the quality of life can improve when our pain is managed properly.

I will keep my fingers crossed that you and your PM can come to some type of agreement on managing your pain. Good Luck Onyx!

irvman1021 01-14-2007 06:05 PM

Re: Fentanyl Patch 72 hrs or 48hrs????
 
I just wanted to let everyone know that I use the Sandoz brand patch and my doc said to put in on my abdominal area. Just not to put in the same spot everytime. It works great. Then nobody has to see if but your spouse or whatever. Also I have one problem with it and 18 hours after I put it on then I start to get really sick to my stomach. And that last about 20 hours and then I am fine. Does this happen to anyone else?

IZZY'SMOM 01-14-2007 06:15 PM

Re: Fentanyl Patch 72 hrs or 48hrs????
 
Hi Irv...
I have found that when I was on the 75's I had the WORST first day... and now since i went to to the 50's Im much better.
I was so spacey I couldnt drive, and irritable, and couldnt eat, until the second day.
I dont know if oyu can step down a notch, and maybe get mor b/t relief, but I know if happened to me. I use the Mylan patches, because they're cheaper, and smaller. I usually wear a tiny teeny tank, ect shirt every day, or something to where I cant wear the patch on my arm, and i wear it on my upper thigh. It works fine there.
Hope this helped!
xoxoxoxox,
IZZYSMOM
:wave:

whitfield 01-14-2007 06:45 PM

Re: Fentanyl Patch 72 hrs or 48hrs????
 
[QUOTE=irvman1021;2743315]I just wanted to let everyone know that I use the Sandoz brand patch and my doc said to put in on my abdominal area. Just not to put in the same spot everytime. It works great. Then nobody has to see if but your spouse or whatever. Also I have one problem with it and 18 hours after I put it on then I start to get really sick to my stomach. And that last about 20 hours and then I am fine. Does this happen to anyone else?[/QUOTE]

Hi Irvman1021--
Seems weird to me that doc would say to put it on your stomach--I use the same brand 100Mcg and can only get them to stay on upper arm unless I use extra tape--I think your reactions may just be your bodys adjusting to the constant med--mine were similiar in the beginning--Now I just have to make sure I am sitting down when I first put the patch on--gives an initial "rush"--or used to anyway. All the best to you--good luck--
Roger

irvman1021 01-14-2007 07:00 PM

Re: Fentanyl Patch 72 hrs or 48hrs????
 
Thanks for the reply. I have just started this patch like a two months. So my body may still be getting used to them. I just don't know if I should ask to take something else for the pain or what. I can't take throwing up for 20 hours straight. Plus I am like only 5'2 and 98-100 pounds. I take a few other meds aswell, that might be making me sick I will just have to talk to the doc when I go in. May I ask what you use this patch for? ( what kind of pain) I have ESRD which is kidney failure and am hoping to get a kidney soon. Hope to hear back from you and have a wonderful night and lets hope it's pain free. :wave:

IZZY'SMOM 01-14-2007 10:29 PM

Re: Fentanyl Patch 72 hrs or 48hrs????
 
[QUOTE=whitfield;2743386]Hi Irvman1021--
Seems weird to me that doc would say to put it on your stomach--I use the same brand 100Mcg and can only get them to stay on upper arm unless I use extra tape--I think your reactions may just be your bodys adjusting to the constant med--mine were similiar in the beginning--Now I just have to make sure I am sitting down when I first put the patch on--gives an initial "rush"--or used to anyway. All the best to you--good luck--
Roger[/QUOTE]

Hey Roger!~
Isnt it amazing the diffrerent responses? i dont feel a thing for at least 8 hours..at least. I have had to re-apply a patch that has fallen off, and have to wait for at LEAST 8 hours, and a few times with no b/t meds, and I wanted to die...
Wow, I wish they affected me that soon. Great advice, and post...everyone is sure different. Hoping you have a painfree or close to it day!~
Hugs~
xoxoxoxox
IZZYSMOM:angel: :angel:

whitfield 01-15-2007 05:00 AM

Re: Fentanyl Patch 72 hrs or 48hrs????
 
[QUOTE=irvman1021;2743405]Thanks for the reply. I have just started this patch like a two months. So my body may still be getting used to them. I just don't know if I should ask to take something else for the pain or what. I can't take throwing up for 20 hours straight. Plus I am like only 5'2 and 98-100 pounds. I take a few other meds aswell, that might be making me sick I will just have to talk to the doc when I go in. May I ask what you use this patch for? ( what kind of pain) I have ESRD which is kidney failure and am hoping to get a kidney soon. Hope to hear back from you and have a wonderful night and lets hope it's pain free. :wave:[/QUOTE]

Good Morning Irvman1021--I use the patch for chronic pancreatitus, which like yours is pain in the guts--was hospitalized after developing a psuedo-cyst from infected pancreas--had a drain tube put in which I had to wear for 8 weeks--twice over 2 years--I only have 1 kidney (born that way)--now, I use the oxycontin 40mg tab for "breakthrough" pain on day 3--just had my right hip replaced and now need the left--always seems to be something--after seeing 2 "Pain Specialists" (both declined to treat organ pain) I just went to my Primary and he prescribes most of my meds--I also have a Gastroenterologist(sp?) who prescribes enzymes and omizaprole for digestion.
I never threw up but as IZZYSMOM says--"everybody is different"--what size patch do you use?
Roger

forginon 01-15-2007 11:55 AM

Re: Fentanyl Patch 72 hrs or 48hrs????
 
[QUOTE=whitfield;2743829]Good Morning Irvman1021--I use the patch for chronic pancreatitus, which like yours is pain in the guts--was hospitalized after developing a psuedo-cyst from infected pancreas--had a drain tube put in which I had to wear for 8 weeks--twice over 2 years--I only have 1 kidney (born that way)--now, I use the oxycontin 40mg tab for "breakthrough" pain on day 3--just had my right hip replaced and now need the left--always seems to be something--after seeing 2 "Pain Specialists" (both declined to treat organ pain) I just went to my Primary and he prescribes most of my meds--I also have a Gastroenterologist(sp?) who prescribes enzymes and omizaprole for digestion.
I never threw up but as IZZYSMOM says--"everybody is different"--what size patch do you use?
Roger[/QUOTE]
Are you sure that you're taking oxycontin for breakthrough pain? Could it be oxycodone? Xycontin is an extended release formula and would normally be a very poor breakthrough medicine. The narcotic in oxycontin is oxycodone, which when used w/o the extended release formula is a great med for breakthrough pain.

I ask because if you are using oxycontin, then along with the patch you are using two long-acting narcotic meds. Most docs will not prescribe this way and it may be that you are getting really poor support for your breakthrough pain. Is the same dr prescribing the patch and the oxycontin?

It's best to have one dr writing scripts for all of your pain meds. That gives you the best shot at the relief you are seeking.

conductor 01-15-2007 06:35 PM

Re: Fentanyl Patch 72 hrs or 48hrs????
 
OK...In the Physician's Desk Reference (the infamous PDR), there are at least 2 PERTINENT statements located in the Duragesic Full Prescribing Information

[[COLOR="Silver"]removed[/COLOR]]

Since I feel like a doctor's office due to the amount of meds I take, I purchase a PDR every other year or so--for my own personal reference.

Certainly, I hope this helps those of you who are looking for written documentation of 48-hour dosing of the fentanyl patch and documentation of 'breakthrough' medication suggestions.

Sincerely,
Jon (Conductor)

whitfield 01-16-2007 06:48 AM

Re: Fentanyl Patch 72 hrs or 48hrs????
 
Thank you Jon! I found it--then went to pick up my new supply yesterday and pharmacy gave me the Mylan brand--first time I have seen them--put on my first one this morning and started looking for the same statement regarding 48 hours vs 72 hours and I found it--If anyone is interested in the full prescribing information for the Mylan brand patch I found the same statement--It is the 3rd paragraph under Notes After Table D1--(hope this brand is as good as the Sandoz--will know soon enough!)--Thanks again Jon.
Roger


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