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  • OK guys, the patch isn't a "fit"

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    Old 07-12-2007, 04:52 PM   #1
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    Question OK guys, the patch isn't a "fit"

    Hey everyone!
    After reading the positive stories about the help many of you get from Duragesic, and the "freedom" it gives from being tied to a schedule of taking short acting medications, I was so hoping it would be a good fit when my doctor suggested we try it.

    Sad to say, we started it two months ago, and after two months, the side effects were still just as bad as when I first started them. I spoke with my doctor the other night (he returned my call about the continued side effects) and told me to stop using them.

    I was totally unable to keep awake, couldn't concentrate, felt totally looped out of my brain, and also was a total emotional wreck for two months. I was irritable one minute, and then crying the next. I was unable to function, and totally forget about driving! I didn't miss a night's sleep though, I have to say that! haha Also didn't need to take anything for breakthrough because that really would have put me under the table.

    Anyway, we had started at 12 mcg, and then after a week, my doctor upped it to 25mcg. I was having the side effects at the 12 mcg, but since it was still early in the patch proccess for me, my doctor felt that the increase would be ok, and the side effect would wear off after a couple more weeks. I was hopeful, but like I said, 2 months later, and still not a sign of the symptoms easing up.

    First, I need to ask, did I give the patch enough of a chance? I remember that the side effects of the Neurontin and Depakote went away after a couple weeks. My dcotor told me to keep him aware of how the side effects of the patch were going, so once a week I'd call the office and let them know what was happening, and after we hit 2 months, he told me to stop using them.

    Now, my second question is this- I have an appointment this Monday and we are going to be discussing a plan "B". He has mentioned using other long acting meds such as Oxycontin or MScontin, and I am totally baffled as to which way to lean towards here. I do know that I'm not really wanting the extremely high powered meds like the Duragesic is, but I don't want to have to depend on breakthrough meds either because I'm not covered with the LA meds. I know I was on a low dose of Duragesic, but considering I was only on Norco prior to that, it seems like a huge leap to me.

    I also know Oxycontin & MScontin are considered pretty strong meds, but like the patch, they do come in "low" doses, and I'm sure my doctor will start me out low.

    I know there are adjustment periods with most medications, and I am ok with giving them a chance to work, and allowing sufficient time for the side effects to ease up, but I really, REALLY don't want to be using the "big guns" so early in the game as far as dealing with chronic pain. I'm only 38 years old, and I'm afraid that if things end up that I am in pain management for the rest of my life, then using the high power meds this soon might end up giving me nowhere to go later down the road.

    Guys- ANY suggestions are greatly appreciated here. My doctor will present me with our options Monday, and I want to be able to make a truly informed decision as to which path to take....

    Thank you

    Last edited by ozzybug; 07-12-2007 at 04:54 PM.

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    Old 07-12-2007, 05:39 PM   #2
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    Re: OK guys, the patch isn't a "fit"

    Hi Ozzy~
    Im so sorry for what you went thru with the patches. You have given them a HUGE chance in my opinion. AND i think that trying the other meds will be better for you. Some meds work for some ppl...and not for others.
    You have stuck it out longer than I would have, and I would try the oral meds. the oxy is really good for ppl....Methadone to most ppl has an EXTREMELY horrible side effect for sleepiness, and I really think that if youd like to try the other meds he has suggested, youd be fine...Im sure he will start you off of where you need to be. Have faith that this time it will work for you...I think it will. the patch is really tricky...DSome ppl do great, some not. Im wanting off of it just because of the strength of the drug, and my injury is healing slowly. I dont want to be on something so strong....Im only 45 and the reson for the patch was for my is hectic enough and I liked the idea of not having to clock watch pill does...BUT if i had the opportunity to just get by with orals every once in a while, that would be grand...
    Keep us posted and let us know if there is anything we can do. im here for any questions you may have!

    Last edited by IZZY'SMOM; 07-12-2007 at 05:41 PM.

    Old 07-13-2007, 10:11 AM   #3
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    Re: OK guys, the patch isn't a "fit"

    Hi Ozzy I wasn't aware you went to the patch, yah its a very strong medication, some people love it and others like you can't tolerate it, and you really did try so I would not use that any more.

    I have been taking oxycontin for a year now. I have had to have several increases as you do build a tolerance to It butI think I have only had 1 increase in a year as the beginnings we were trying to find an amount that worked for me, we started slow on it before I was on 40 mgs twice a day and I was having to take 6 B/T pills a day and I was running out early which was not good so the Dr said we needed to increase my base med. he was a little hesitant about it but I told him no more injections, no more PT and no surgery so he agreed to increase me, we have to be firm with these Dr's and mine is an angel I have always been compliant like you, never calling in early for a refill so he does trtust me and he does drug test a lot and I am always perfect my B/T meds I can take 4-6 a day but at 6 a day I was running out early but this is not considered taking to many it was within my right to do so. right now I take (3) 40 mgs per day and at first I felt it was to strong and I was really buzzing but it went away, and now I don't feel anything excpet pain relief. its a great drug. the only side effect I have with it, it is that it makes me feet and ankles swell..

    and it does make me a bit constipated but I take meds for that to, I also take Lyrica 450 mgs a day and oxycodone for B/T which I rarely need now. I am getting 120 a month and have used less than 20 this month already so I am going to have him give me like 40 a month just to be safe. but its a great drug and I hope it works for you to............

    Norco is a great pain reliever but like you said, its short acting and you have to take it around the clock to control your pain. its nice for me to only take 3 pills a day vs the 12 I used to take of vicadin or norco's or percocet IR.

    Good luck and keep us posted. I would try the oxy first as its soooooo wonderful for pain relief. i can so feel when its wearing off so I know it works.

    Hugs, SS

    Last edited by slipperyslope; 07-13-2007 at 10:14 AM.

    Old 07-13-2007, 10:20 AM   #4
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    Re: OK guys, the patch isn't a "fit"

    I gave the patch a month and a half so I think that you gave it plenty of time.
    As far as the doses and the different kinds of LA meds I have been on most of them. I havent tried Methadone.
    I am on Oxy and Morphine for breakthrough.
    I started out on Norco’s and went to MS Contin after the Norco's were not working as well as they should have.
    The doses can be as small as what the Norco’s were which is 10mg. The plus is there is no Tylenol in them like the Norco’s so less damage to you kidneys and liver. If the Norco’s were working for you then 10 or 15 mg of MS Contin or Oxycontin will be about the same.
    MS Contin made my stomach a little bit upset and that is why I am on Oxys now.
    MS Contin made me tired a lot of the time where the Oxy doesn’t.
    The Oxys actually wire me out and that is why I get Zanax to sleep some nights.
    Good luck with the new orals and I hope that the switch goes painlessly.

    Last edited by mindmltn; 07-13-2007 at 10:22 AM. Reason: Spelling

    Old 07-13-2007, 02:46 PM   #5
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    Re: OK guys, the patch isn't a "fit"

    Izzy, SS & Mind-
    Thank you all for your help. It means a lot to me. I don't want to make the wrong choice, so getting feedback from people who have had experience is really important to me.

    My cousin was on Oxycontin for several years and got great coverage from it. She was even able to taper down when the time came to do so. She has dealt with sometimes debilitating pain/problems from Chron's since her extremely early teens. She's now in her 20's.

    My PM doctor usually will present me with two, sometimes three options for certain treatments and we decide together which route to take, and as I said, at our last appointment, he talked about the Oxycontin, MScontin and the Duragesic. At that time, he felt the patch should be our first course of action, and I agreed. So, unless something has changed since our last appointment, I am assuming he will re-discuss the MScontin and the Oxycontin Monday, in which case, I will opt for the Oxycontin if he allows me to decide.

    I honestly do not feel that I "need" to make a jump to the more potent meds since the Norco keeps the pain levels hovering around the 4-5 range, BUT it is bothersome to have to follow the every 4-6 hour time schedule, so it makes perfect sense to start trying the LA meds. And since he starts me at the low doses, I am hoping that the lowest dose will be good enough. I know I won't be totally pain free, and if a med allows me to function and keep pain levels managable, then I am ok with that and consider myself blessed.

    Besides, I don't want to flat out refuse to do anything he suggests because he is the doctor and I trust his judgement. I am very thankful that he does listen to me and is willing to consider my thoughts and ideas as well. He doesn't always agree, but he does listen and if he disagrees he explains why and I appreciate that.

    Anyway, sorry to ramble. Thanks guys for all the help and support. I hope others will chime in too!!

    Old 07-13-2007, 02:56 PM   #6
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    Re: OK guys, the patch isn't a "fit"

    Hey Ozzy,

    Have you ever taken percocet, oxycodone? I would make sure you can tolerate it, as oxycontin is just the long-acting form of percocet. This is what I take, and I am still on a 50% reduction from my surgery. It was not too bad of a drop overall, but I once had to stop this med cold turkey for a test, and it was terrible.

    Overall, I think it is a good drug. I find that it only lasts me 8 hours, not 12. Make sure your doc will do the 8 hour dosing, if it doesn't last that long for you. Mine won't, and so my break-thru meds are used during these times, and not for true break-thru pain.

    Let us know how it goes, and I pray this is the med for you!

    Your Friend,


    Old 07-13-2007, 03:25 PM   #7
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    Re: OK guys, the patch isn't a "fit"

    Thank you Amanda!!

    I have taken pecocet. After all seven of my knee surgeries. I was taking 10mgs every 4-6 hours, and as long as I ate some toast or a couple of those little peanut butter crackers with them I was ok.

    I can say, that any time my doctor starts a new medication, he does note that I can increase after a certain amount of days and also notes on the prescription that an earlier than 30 day refill may be required. He also notes something to the effect of "Chronic pain patient. Patient is monitore and is titration phase"

    Thank you for you help, I appreciate ALL the information I can get.

    Hope you are feeling better too be the way! Haven't seen you post about going back to work. (Hope I didn't miss a post!!) I've been hoping to hear from you.

    Take care and have a great weekend!

    Old 07-13-2007, 06:52 PM   #8
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    Re: OK guys, the patch isn't a "fit"

    Yes, Butterflygirl, I join Ozzy in wondering about you returning to work. I know you weren't ready to go back when you first thought you might. How is your med schedule going and is the pain decreasing for you post op?? Just checking with you - we care here, ya know??! KathyMac

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