It appears you have not yet Signed Up with our community. To Sign Up for free, please click here....



Pain Management Message Board

  • Patch and Exercise

  • Post New Thread   Closed Thread
    Thread Tools Search this Thread
    Old 05-27-2009, 12:20 PM   #1
    silentwarrior
    Member
    (female)
     
    silentwarrior's Avatar
     
    Join Date: Apr 2009
    Location: USA
    Posts: 65
    silentwarrior HB User
    Patch and Exercise

    Okay I know that many who are on the patch are unable to exercise much but I also know that some of us do exercise at least a little bit. So how has increasing your activity level (be it exercise or chores around the house etc..) affected how the patch works for you?

    One of my biggest struggles mentally has been going from someone who went from extremely fit (6 feet tall 145lbs soccer goalie who worked out 5 hours day) to moderately fit ( despite SLE was working out 90 mins day) to ZERO NADA ZILCH.

    I always knew that by 38 I would not be the athlete that I once was but I always assumed I would be able to stay fit and enjoy playing sports for fun. I took this for granted I guess.

    Anyways, been on the patch a few months and low & behold suddenly I want to exercise. Nothing overboard just get the ol heart pumping.

    A few weeks ago before my surgery I went for a walk with hubby. A slow enjoyable walk. We did about 3/4 a mile. About an hour later I got flushed, dizzy, tad bit confused, fast heart beat etc...

    I am guessing that was from the walk.

    So how does one increase acitivity level while on the patch?

    Thanks for any input.

    __________________
    SW

     
    Sponsors Lightbulb
       
    Old 05-27-2009, 04:08 PM   #2
    brianpain33
    Senior Veteran
    (male)
     
    Join Date: Aug 2007
    Location: COLUMBUS, OHIO
    Posts: 2,153
    brianpain33 HB Userbrianpain33 HB User
    Re: Patch and Exercise

    It can be a trade off but where you put the patch is a big factor. If you put it on the upper arm, that is where there are the least amount of sweat glands. It's probably also the part of your body that stays relatively cool with a short sleeved t-shirt. Of course any time the body temperature raises, it is going to release more of the fentanyl from the patch. My biggest problem is that I like to take hot showers sometimes and this releases alot of the fentanyl. Where do you wear the patch?

    brian

     
    Old 05-27-2009, 06:48 PM   #3
    cheryl810
    Member
    (female)
     
    cheryl810's Avatar
     
    Join Date: Dec 2008
    Location: LI NY USA
    Posts: 95
    cheryl810 HB User
    Re: Patch and Exercise

    I can't say that I've had this problem. I've been wearing the patch for about 6 months and have been workingout for a month; no side effects with body temp on the rise. I mean I had some nausea in the first week but it all subsided. If you just started to excercise then maybe it's just that your body will adjust to the patch and will go away...

     
    Old 05-27-2009, 07:49 PM   #4
    Executor
    Inactive
    (male)
     
    Join Date: Jan 2008
    Posts: 3,998
    Executor HB UserExecutor HB UserExecutor HB UserExecutor HB UserExecutor HB UserExecutor HB User
    Re: Patch and Exercise

    Quote:
    Originally Posted by silentwarrior View Post

    A few weeks ago before my surgery I went for a walk with hubby. A slow enjoyable walk. We did about 3/4 a mile. About an hour later I got flushed, dizzy, tad bit confused, fast heart beat etc...
    I would talk to your Doc about his, because your experience could definitely be from the patch releasing more medication than normal. Exercising while on the patch can be somewhat of an issue, depending on the type of exercise you do, intensity, and etc. Here's why....

    (1) The patch is a great med that slowly releases med through the transdermal layers of your skin in a very consistent manner. The manufacturer instructs patients to change the patch every 72 hours. However, the manufacturer also says in it's white prescribing paper (comes in your box of patches) that some patients require 48 hour dosing.

    More frequent dosing is the result of one's activity level and metabolism. Those who are more active or have higher metabolisms, will burn through the med quicker....More med will be released quicker, therefore the patch won't last the entire three days. When I was on the patch, my dosing was frequent because of my very high metabolism, or what they call "super metabolizer."

    Also, the patch will release more med if one's body temperature is raised. For example, there is a very clear warning by the manufacturer to notify one's Doc if you have a fever. In fact, a high fever can cause an severe overdose. The manufacturer also has a warning label for using the patch in conjunction with hot baths / showers and electric blankets.

    So, putting all of this together, exercising raises one's body temperature, and it also increases one's metabolism....During the exercise and afterwards. It's well known in the exercise field that those who exercise, keep an elevated metabolism throughout the day.

    (2) The patch is susceptible to sweating. You can get covers or special type of surgical tape to keep them on, but if you lose the tight seal with the skin, the patch isn't going to work very well. As Brian suggested, it's best to use areas of your body where you have the least amt of sweat glands... Outer arms are a good place, as well as your side, down from your arm pit about 8-10 inches. The manufacturer describes this area in their directions as the "flank."

    Conversely, the back is full of sweat glands as well as your stomach area. Some women have put the patch under their breast and have experienced overdoses from the heat built up from the breast touching the body cavity. Location is everything.

    In summary, I would discuss in detail with your Doc. Depending on the type of exercise you do, the intensity, and duration, this can be a very complex question / recommendation.

    I had great success with the patch, even though I had some issues with metabolism.....But honestly, metabolism effects every med we take. I only changed from the patch due to the recall last January and thus, had a very hard time finding adequate supply.

    Hope this helps, and best of luck to you.

    Regards,

    Ex

     
    Old 06-01-2009, 04:11 PM   #5
    silentwarrior
    Member
    (female)
     
    silentwarrior's Avatar
     
    Join Date: Apr 2009
    Location: USA
    Posts: 65
    silentwarrior HB User
    Re: Patch and Exercise

    Hi Ex and Brian,

    Thanks for your responses. I wear the patches either on my outer upper arm, on my flank or on my lower leg.

    I just spoke with my PM and I found his answer quite unexpected...

    He wants me to now use a 25mcg patch and switch it daily as opposed to wearing two 25mcg patches every 48 hours.

    He said to simply time my exercise around switching my patch daily. He gave an example of taking my patch off at 7am, exercise, shower, put on a new patch and then dress and go about my day.

    I asked if exercising would still release too much med since from what I have read and been told that the med stays on your skin 6-12 hours AFTER removing the patch.

    He said I have nothing to worry about and to do as he says.

    I mentioned the fever thing too since with SLE (Lupus) my baseline temp runs about 100.4 and occasionally spikes to above the 102 range.

    He said that I worry way to much and to trust him.

    Am I nuts? Am I being a "cry baby" for asking such questions?

    Or.....is it time to start finding a new PM Doc?

    Thanks for any and all words of advice.

    Sincerely,
    __________________
    SW

     
    Old 06-01-2009, 04:37 PM   #6
    brianpain33
    Senior Veteran
    (male)
     
    Join Date: Aug 2007
    Location: COLUMBUS, OHIO
    Posts: 2,153
    brianpain33 HB Userbrianpain33 HB User
    Re: Patch and Exercise

    silentwarrior:
    I think that you should be alright. However, you are going to be decreasing by 50% your patch now since you were at 50mcg and now going to 25mcg which is a pretty big decrease. Don't be surprised if you go through some withdrawal symptoms (racing pulse, nausea, upset stomach, anxiety. creeply, crawly symptoms, muscle cramps). I would give it a try and see how your pain does. If your pain is too much then have your doctor increase it to a 50mcg patch every day. Is there a reason you were on 2 (25mcg patches) instead of a 50mcg patch, just curious.

    brian

     
    Old 06-01-2009, 09:45 PM   #7
    Executor
    Inactive
    (male)
     
    Join Date: Jan 2008
    Posts: 3,998
    Executor HB UserExecutor HB UserExecutor HB UserExecutor HB UserExecutor HB UserExecutor HB User
    Re: Patch and Exercise

    Quote:
    Originally Posted by silentwarrior View Post

    He wants me to now use a 25mcg patch and switch it daily as opposed to wearing two 25mcg patches every 48 hours.
    I agree with Brian on this....Cutting your patch in half is a huge reduction. It doesn't matter how often you change it, you now have one 25mcg on instead of two.


    Quote:
    He said to simply time my exercise around switching my patch daily. He gave an example of taking my patch off at 7am, exercise, shower, put on a new patch and then dress and go about my day.
    Assuming you were on the same strength patch as before, this would be a very progressive idea. When I was on the patch, my Doc had me change mine every day. Not because of exercise, but because my blood plasma level (BPL) was dropping....I have a fast metabolism and I was burning through my med fast. About half way through day 2, I was having lots of problems, so he moved me to once every 24 hours. Worked great.


    Quote:
    I asked if exercising would still release too much med since from what I have read and been told that the med stays on your skin 6-12 hours AFTER removing the patch.
    He is right...The med is stored between the layers of your skin after being absorbed. The patch is only going to release too much med if it's on when your body heat is increased....Exercise, fever or whatever. The high body temp or excess heat (heating pad, electric blanket) causes the patch to dispense more med than normal. If it's not on, it can't do this. Putting it on after exercising will be fine, because your body temp has dropped.

    Also, but not having one on during exercise, you don't have to worry about sweating & etc and losing the good seal the patch makes with the skin.


    Quote:
    I mentioned the fever thing too since with SLE (Lupus) my baseline temp runs about 100.4 and occasionally spikes to above the 102 range.
    I can only go by what the manufacturers information says. I don't remember the exact quote or if they list specific temp ranges. I just know that there is a very clear warning about high fevers. I would read the information myself...There may be cutoff point. The white prescribing paper comes in the box with your patches....i would read it and see what it says.


    Quote:
    Am I nuts? Am I being a "cry baby" for asking such questions?
    I don't think you're "nuts" at all. Fentanyl is serious medicine and isn't too be taken lightly. You have every right to ask good educated questions. Docs like this seem to have the "God" complex....Don't ask any questions and just do as I say. Good bedside manners are important today, I think.


    Quote:
    Or.....is it time to start finding a new PM Doc?
    That's a tough one. I would try his new method first and see what happens. I would be very concerned about cutting my med in half. Otherwise, it seems to be a very good plan. Not many Docs would support a patient on a patch a day regimen....The manufacturer says one every 72 hours. I was lucky when mine did the same thing. However, mine didn't cut my strength.

    Is it possible he cut your strength back because you're exercising so much and he wonders if you're truly in as much pain as he once thought?

    If you're really worried about the fever thing, I would identify exactly what is says in the white prescribing paper and take it in to see him and see what he says.

    Best of luck with this,

    Regards,

    Ex

     
    Old 06-01-2009, 11:54 PM   #8
    silentwarrior
    Member
    (female)
     
    silentwarrior's Avatar
     
    Join Date: Apr 2009
    Location: USA
    Posts: 65
    silentwarrior HB User
    Re: Patch and Exercise

    Hi Thanks again for responding so quickly. :0) I am very tired so gonna keep this quick and perhaps add more later.

    My Doc wanted to keep me on two patches and switch them daily but this kinda freaked me out. So he said ok well we can try one patch and see how it goes. Since then however I have agreed to stay on two patches.

    He and I butt heads a tad bit about exercise. It took me a long time to admit to myself and to him that I am in more pain than I can handle. The patches do help quite a bit so I am eager to work out although thus far I have not done much at all at least not by my standards. He knows that for years I was brainwashed to work through the pain, suck it up, pop 12 Aleve and get my rear into the game...that kinda thing. (Thus all these years later me not being able to use oral NSAIDS but anyways...)

    So its a mental block with me. I know that the patches mask the pain and I know my body is going down hill with the lupus and MS...not to mention my other health issues. But because the patches take me down to about a 4 out of 10 (with flares of BT pain reaching an 8) I feel like I need and want to exercise....to coach my teen step kids soccer...take long walks on beach with my Hubby...that kinda thing.

    Its a great reminder that you both write about.....the cutting my dose in half if I go from 2 patches to 1. To answer your question Brian I am 2 25mcg patches because I use Mylan and my pharmacy only holds 50mcg patches in Sandoz which I tried but had a reaction too.

    I have a well respected Pain Doc who is known to think outside the box so to speak and I know that I am lucky to have him. I guess I am pretty new to patches (few months) and just have a lot of questions is all. Plus my Mom who is a nurse hates patches and is constantly giving her opinion on them. I do not share my med history with many people at all as it is not their business. Me (obviously), Hubby, Docs (I have a team of 6 Docs), and my Mom know all of my health issues/risks/concerns and my med regimine. My baby sis and a handful of my friends know about my Lupus and MS and they assume that I am on meds but they have never heard that from my mouth.

    I spoke with my Rheumy and my Neuro today and both said to be careful going from 2 patches down to one. They liked the change it daily idea but worry going to one patch will put my body which has enough issues through WDs.

    So, I am gonna try the TWO patches but switch them every 24 hours with mild exercise in between patches.

    Ok so this wasn't as short as I thought it would be. Please forgive typos as I am falling asleep as I write this.

    Thanks again so very much for your input.

    Peace.
    __________________
    SW

    Last edited by silentwarrior; 06-02-2009 at 12:04 AM. Reason: rewording

     
    Old 06-02-2009, 07:56 AM   #9
    Executor
    Inactive
    (male)
     
    Join Date: Jan 2008
    Posts: 3,998
    Executor HB UserExecutor HB UserExecutor HB UserExecutor HB UserExecutor HB UserExecutor HB User
    Re: Patch and Exercise

    Quote:
    Originally Posted by silentwarrior View Post

    So, I am gonna try the TWO patches but switch them every 24 hours with mild exercise in between patches.
    Yes, that sounds like a good plan....This way you can get your exercise in without worrying about the patches sliding around, falling off and etc. Also, because you are still an active person, your metabolism is probably higher than average, thus, you will burn through more med than average.....Another good reason to change every day.

    The patches were originally developed for cancer patients and those hospice people at the end of life. Thus, the test group was mainly bedridden and not very mobile to say the least. As a result, the original test data recommended 72 hour dosing.

    However, the manufacturers have since applied for, and been granted, a much broader label, thus the patch is now prescribed for all sorts of pain. However, the same test data accompanies the patch, and thus, the prescribing recommendations are the same.....When a med is approved for a broader label, they must use the same test data & etc. The white prescribing paper does say, however, that some patients do need more frequent dosing. As I said previously, you are fortunate to have such a progressive Doc as many wouldn't go for 24hr dosing.

    I would still check into the fever thing as it's important. The white prescribing paper comes in the box with your patches.

    Best of luck to you. Feel free to Pm me or ask any questions you may have.

    Regards,

    Ex

     
    Closed Thread

    Related Topics
    Thread Thread Starter Board Replies Last Post
    fentanyl patch not lasting 72 hrs.. due to menopause noescape Chronic Pain 52 02-14-2012 04:12 PM
    Ortho Evra patch help needed CruiseMomInSC Birth Control 3 08-10-2005 11:43 AM




    Thread Tools Search this Thread
    Search this Thread:

    Advanced Search

    Posting Rules
    You may not post new threads
    You may not post replies
    You may not post attachments
    You may not edit your posts

    BB code is On
    Smilies are On
    [IMG] code is Off
    HTML code is Off
    Trackbacks are Off
    Pingbacks are Off
    Refbacks are Off




    Sign Up Today!

    Ask our community of thousands of members your health questions, and learn from others experiences. Join the conversation!

    I want my free account

    All times are GMT -7. The time now is 05:59 AM.





    © 2022 MH Sub I, LLC dba Internet Brands. All rights reserved.
    Do not copy or redistribute in any form!