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    Old 07-06-2008, 07:29 PM   #31
    forginon
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    Re: New medication...need information and advice

    Richard,

    You're going to find that this group has more understanding than you have frustration. Vent if you need to. Get upset. We've all done it. And we're all still here. And you should be here too.

    I didn't bow out because of any frustrating or venting in your posts. But I learned enough to know that you are up against challenges I've never faced. With so many others here, and with so many different life experiences, I was certain that others here, like Fabby, do understand and could be of help to you. So I was just leaving it to them to help with this topic. I would much rather write nothing than post something that could point you in the wrong direction.

    I'm sure there will be other posts or threads where I can be helpful to you, just not this one.

    steve

     
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    Old 07-06-2008, 11:15 PM   #32
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    Re: New medication...need information and advice

    Richard- Thanks for posting your apology. It's wasn't necessary, but I appreciated it nonetheless. Again, I was just trying to help. I realize how back pain can be sometimes and we all have days where we don't feel very well. I am not familiar with bipolar....So, I really can't help you there.

    But, I just want to stress that moving to the patch is a major decision...One that will forever change your pain regimen. Once you go to a 24/7 med, you will have significant physical dependence. This isn't necessarily a bad thing for those with chronic pain where it's been determined that they will more than likely be on meds forever. However, I'm not sure your case is in the same category...Not sure. If the patch doesn't work for you, you'll at least be tied to taking some form of long acting pill due to the physical dependance developed by the patch. Additionally, because the patch is so potent, your tolerance will skyrocket.

    I would go back to my Doc and just explain that your pain isn't being controlled and see if he/she can do something about it. Tell him/her that the pre-set schedule isn't working because it doesn't necessarily correspond with your pain. Some days you are not to take any meds, but what if you have pain those days??

    I would refrain from specifically asking for more meds and just talk about the pain. If the Doc brings up the patch again, tell him/her that you've done some research and you've discovered it's 100x powerful than morphine and ask if he/she is sure that such a big jump is warranted? If so, then maybe you should go with it. However, I would try to keep treating the pain "as necessary" as long as I could. As long as your body gets some type of break from the meds, you won't develop much dependance. Once you go 24/7, it's a whole different story....And one that may last forever. I can't stress this enough. The patch is almost always for those who don't respond to other long acting meds, or have horrific pain. A great med....But, one that should not be used as the first (or second) line of defense.

    Hope this helps some, and good luck.

    Ex

     
    Old 07-07-2008, 04:31 AM   #33
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    Re: New medication...need information and advice

    Executor, thank you! I know you were only trying to help and I apologize again for my rude behavior. I am so confused and scared about Thursday!!! There are a lot of people that are going to be there. Now it is going to be, my doctor, of course, my therapist, my sister, my girlfriend(I guess life partner would be more pc. We have been together for almost 20 years, but never got married, but have two wonderful kids), and my son. He is only 17, I try to keep him out of all of this mess but he is insisting to go. I don't know what he is going to say but I can tell you he is extremely upset. He has told me the doctor is not going to like what he has to say. Believe it or not he is probably my biggest supporter. He goes away to school in 5 weeks and 5 days.

    Sorry, I get back on point. Executor, I truly believe you are a 100% right, but I believe my options on Thursday will be 40, patch or nothing. I am definitely at a point where I believe I will choose, nothing. I just feel like giving up and putting my outcome in the hands of a higher power. I am tired of struggling, I am tired of pills, I am tired of the pain, both mentally and physically, I am tired of the hardships I know my kids are going through because of me. I guess I am just tired of being me!

    Thanks

    Richard

    Last edited by rich57; 07-07-2008 at 04:34 AM.

     
    Old 07-07-2008, 09:32 PM   #34
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    Re: New medication...need information and advice

    I would hope Rich that your Doc doesn't give you the choice between 40 pills or the patch. Certainly, you wouldn't choose "nothing" would you? If the Doc insists on the patch, I would just tell him you're a little concerned about how potent it is and that you don't want to be tied to a med 24/7.

    The other thing that you need to discuss is the timing of all of this. I was taken off the patch recently due to the heat of summer. I will go back on it in the late fall and wear through Spring again. Any type of sweating makes the patch peel up off your skin. Sure, you can tape it down, but that's a lot of hassle and effects performance some. Also, the "heat" in general causes the patch to dispense more med than normal. It's also effected by electric blankets, hot tubs, saunas, and if you have a fever. Being out in the hot temps isn't good either and falls in this same category as the previously mentioned situations. This time of year is NOT the time to be starting the patch.

    Good luck @ your appt. If the Doc forces you into a weird choice, then you'll just have to decide what to do. I guess you could always try the patch and see how it goes...No harm there. If you don't like it, you could always discontinue after a few days. You wont' develop any dependance in that short of a time period.

    Please report back and let me know how it goes.

    Ex

     
    Old 07-07-2008, 11:32 PM   #35
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    Re: New medication...need information and advice

    Quote:
    Originally Posted by Executor View Post
    I was taken off the patch recently due to the heat of summer. I will go back on it in the late fall and wear through Spring again. Any type of sweating makes the patch peel up off your skin. Sure, you can tape it down, but that's a lot of hassle and effects performance some. Also, the "heat" in general causes the patch to dispense more med than normal. It's also effected by electric blankets, hot tubs, saunas, and if you have a fever. Being out in the hot temps isn't good either and falls in this same category as the previously mentioned situations. This time of year is NOT the time to be starting the patch.


    Ex
    Ex, don't you go through withdrawals when you go off the patch? What strength are you on? I don't think I will ever go off of it. Of course my situation is a lot different than most. Because of the Lupus I can't go out in the sun anyway. My whole life has had to be adjusted. I don't have a hottub and not a big loss compared to what I gain with the patch. Hate saunnas. Haven't been faced with a high fever yet! Just dont take real hot showers or use an electric blanket or anything hot over patch. I use the Mylan brand of the patch and it is very small and not full of liquid like the others. Some how it is in the glue. I just put two curad "fabric" bandaids over it and it never falls off. And boy do I sweat with all that I have wrong. I have been on it for 2 years now and it has always lasted the same amount of time and I live in Oklahoma where it gets to 10 below and 110 above.

    I do agree to not take it lightly but if you are in a lot of pain always, and nothing is helping and the Dr. says it's ok (I know most Drs. don't like to prescribe it because it is watched so closely)...it was a great choice for me. I also agree with the big jump between a few low meds and the patch. I would think the Dr wouldn't do that if that is the case. Maybe the 12.5 would be ok. I never used it myself. So I don't know how strong it would be to me. Like I said before, it only took about 5 days to get me up to the Duragesic 50 in the hospital. I was only on tramadol and flexeril before that. Of course I had pain meds after all the surgeries but only for about 3-4 days. Hated all of them or was allergic to them.

    Don't want to confuse Richard anymore. I just hope he trusts his Dr. and if he doesn't, he needs to get a new one. I trusted mine with my life many times. When I didn't like one of the Specialists he sent me to or what they wanted to do...I called and talked with my PCP before I did it.
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    Old 07-08-2008, 10:51 PM   #36
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    Re: New medication...need information and advice

    Quote:
    Originally Posted by empressofq13 View Post
    Ex, don't you go through withdrawals when you go off the patch?
    Minor WDs....Because my Doc put me on another med in it's place....I didn't come off meds completely. Because the patch is so potent, nothing else works the same. That's one of my points.

    Thanks for sharing your situation. Sounds like you've got a good system. I'm a huge supporter for the patch, but under the right situation(s).

    Regards,

    Ex

     
    Old 07-09-2008, 07:33 AM   #37
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    Re: New medication...need information and advice

    Sorry of your dilema. Pray your appt goes well today. I have a pdoc for depression meds. I am on some of same ones as you but no where near those doses. I would never get out of bed. My sleep is messed up but when I double my seroquel it only serves to make me more drunk, not wake up less. I only take 25 when I am prescribed 50-100 a day. My shrink knows this. Pain dr treats my pain. I had patch added to my hyrdo 10's 4x day. I had a few percoset but cant take them alot due to itching. Did take a few after back surgery. The surgeon was concerned if my pain meds were reduced after surgery but pain dr hasnt even mentioned it. I also have fibro on top of it, so I guess that is why. When I was switched to the patch I had no idea of what a jump it was. I did read that you should be on other drugs first but it may be that the other meds I am on prevent that, who knows? I never realized that the patch helped so much til I went out of town and forgot to replace mine after a shower before I left. I am on it now and know its helping, not knocking it all out. I have mentioned to pain dr but he isnt interested in upping so Ill just deal. I have good and bad spells. Pray you find an answer. I dont know what in the world I would do if so many people were involved in my meds and treatment. I get enough flack for taking meds without them being at my appts. Id be a nut all the time if I had to deal with that. You must need that or you wouldnt let it happen. I commend you for that, knowing when you need help. Let us know your outcome.Hugs,
    Shannon

     
    Old 07-10-2008, 06:51 AM   #38
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    Re: New medication...need information and advice

    Rich,

    Please excuse my stupidity if I've gotten off cue here, I've tried to follow along. Am I correct in that you're Psychiatrist is prescribing your pain meds? I only ask because as a BiPolar patient myself on Lamictal, Seroquel, Zoloft, Neurontin, and Topomax...my Psychiatrist would never think of prescribing my pain meds. He does keep in touch with my other docs to make sure all my meds play nicely with each other, but that's the only involvement he has in my pain management. I have a pain managment doc that does that and I'm on the Fentanyl patch 50mcg/48 hr, ultram 150mg/day and norco 10/325 prn for BT pain. I also see a Psychologist for therapy, a Neurologist for Cluster Migraines for which I take Axert and a Seizure Disorder, Urologist for Kidney Stones, and a GP for IBS and Allergies...my other general meds are Singulair and Premarin. So like you I have quite a laundry list...but appropriate docs for appropriate conditions. Once again if I'm wrong in my assumption please disregard the question, as I do not wish to add to your frustration.

     
    Old 07-10-2008, 10:20 AM   #39
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    Re: New medication...need information and advice

    Makes sense I guess...believe my I understand the trust issue with your Psych, mine also has saved my life on a number of occasions and once you find a good one that has earned your trust, that's the one Dr. that you just don't switch. So from one compicated BP'er to another I wish you all the best and hope that you can get some relief from this very complicated situation. If you ever need to just vent, you know where I am, here or on the BP Board.

     
    Old 07-10-2008, 09:06 PM   #40
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    Re: New medication...need information and advice

    Rich,

    What did you find out at the Dr. today?
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    Old 07-10-2008, 11:38 PM   #41
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    Re: New medication...need information and advice

    Quote:
    Originally Posted by rich57 View Post
    I trust my Psychiatrist and like him. He has saved my life more than once, and I truly believe that he has my best interest in heart. If you have read some of my previous posts you can tell that there has been some doubts on my part whether I should either turn to my primary care physician or a specialist. I decided to stick with my Psychiatrist. We will see what happens.
    If you feel good about things, then that is what is most important. It sounds as if you really trust him, which is important. I hope your appointment went well and hopefully, your pain will decrease. Best of luck to you moving forward.

    Ex

     
    Old 07-11-2008, 06:42 AM   #42
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    Re: New medication...need information and advice

    Executor, you were right on the money about the patch being a big jump. The meeting was intense. The room was full of people with a lot of opinions. There was my doctor, his PA, my therapist, my sister and my girlfriend. First my doctor, the PA and my therapist talked. Then they brought me in and we talked. Then they brought in the rest of my family and we all talked.

    My psychiatrist explained that after much discussion that they were going to try the patch. It was almost like talking to you when he went over the possible pitfalls of the patch. He informed me that I was to be closely watched for the first 72 hours and if there were any signs of incoherence, slurred speach, etc., that the patch was to be removed.

    Executor, I know you probably don't agree with his decision, and to honest I am still not completely sure myself. I talked with my therapist after the meeting and told her that I was still a little scared. She told me that I have been taking pain meds for a long time and that they believed this was the way to go to try to help me handle my pain, and they thought this would be better than just handing me a handful of pills since I am taking so many pills now.

    I start the patch on Sat. I will keep you guys informed. God bless you all for your kindness and support!

    ps...If you were me, where would you put the patch?

     
    Old 07-11-2008, 09:57 AM   #43
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    Re: New medication...need information and advice

    Rich,
    You need to put the patch were it will be let alone as much as possible. ie, no sun exposure, no friction from clothing, no bending or pulling of skin. I take turns from one side of my rib cage to the other. Right under my bra strap. Easy for me to get to, no friction, under clothes. BUT it might be a problem for you if you have a hairy torso. I don't think you would want to choose a place where you have to shave. Skin will get irritated. You might try putting a bandaid in several different places you think would be good for today and see which one you like for tomorrow.
    I wish you all the best to be in less pain!
    __________________
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    Old 07-12-2008, 07:35 AM   #44
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    Re: New medication...need information and advice

    Well guys, I put the patch on at 8:00am. To be honest I don't understand what all the fuss was about. I can't tell any difference in my pain level. Did I put the patch on wrong? Does it take some time for the patch to work? Do you think I was expecting too much from the patch? Just some questions that maybe someone could answer for me.

    Thanks for your assistance!

    Richard

     
    Old 07-12-2008, 09:13 AM   #45
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    Re: New medication...need information and advice

    The word is that it takes 17 or so hours for the patch to be at full strength.
    So hang in there. I hope this works out for you!~Mush
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