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



Pain Management Message Board

Patch Alternatives?


Post New Thread   Closed Thread
LinkBack Thread Tools Search this Thread
Old 06-22-2012, 09:37 AM   #1
jet12581
Newbie
(female)
 
Join Date: Jun 2012
Location: KY
Posts: 3
jet12581 HB User
Patch Alternatives?

Hello-Newbie here, this is my first post
I have been battling Chronic Pelvic and low back pain for the last 2 years.
After seeing a host of different practioners, I was finally referred to Pain Management.
My first visit went well, and I was prescribed Percocet 7.5/325 every four hours for pain. It helped, but I have a desk job and some days with all of the sitting for long periods I am miserable after a few hours, and the percocet does not help much.
At my second appontment I was put on the Butrans Patch 10 mcg/hr, with percocet for breakthrough pain. After 3 days on the Butrans, I started breaking out in a blistery rash at the site of the patch, with red itchy skin. I also did not feel as I was getting any additional relief, and taking the percocet with it didn't help. I called my PM doc and they took me off the patch and scheduled me to come back in.

I did like the idea of an extended release patch, the Butrans just didnt agree with me. I know of fentynal(sp?) but are there any other long acting narcotic patches prescribed for chronic pain? Are there longer acting medications avaiable? Just curious what my nest med may be or what I should say at my appointment next week without looking like a drug seeker.
This has been a hard long road so far and I have dealt with very uncompassionate drs that would not help my pain. I just dont want to say the wrong thing and get kicked out of the practice!!
Any insight would help!

 
Sponsors Lightbulb
   
Old 06-22-2012, 10:31 PM   #2
tortoisegirl
Senior Veteran
(female)
 
Join Date: Mar 2012
Location: Washington
Posts: 1,187
tortoisegirl HB Usertortoisegirl HB Usertortoisegirl HB Usertortoisegirl HB Usertortoisegirl HB Usertortoisegirl HB Usertortoisegirl HB Usertortoisegirl HB Usertortoisegirl HB Usertortoisegirl HB Usertortoisegirl HB User
Re: Patch Alternatives?

As far as I know Butrans and Fentanyl are the only ones that come in a patch (besides Lidocaine, but that isn't a long acting pain med). In my opinion Fentanyl would not be appropriate for you (its not a first line opiate). There are however many pill options. For example, Morphine, Oxycontin, Opana, Exalgo/Dilaudid, etc. Is there a reason you would be opposed to pills? Personally I don't have a problem taking my pain meds several times a day as they help my pain...I just make it part of my routine (I also take several other meds).

The patch was almost more of a nuisance for me as I was anxious about it falling off, so I'd check it was still sticking several times a day. Also, its easier for me to take pills a couple times a day than to remember what day of the week to change a patch. There is also the issue of where to put it so that its hidden, skin irritation, I know Fentanyl patches can't be exposed to heat (not sure about Butrans), etc.

If I had an issue remembering it I would set an alarm, but I associate my med schedule with certain activities, like when I brush my teeth in the morning or when I eat my lunch (but my schedule is very predictable). I would think if your doctor was willing to put you on the Butrans patch they will have some ideas for you at your next appointment. If you have chronic pain which hasn't responded to other treatments, a long acting med is going to be a much better fit than a short acting med where you have the yo-yo relief.

I'd just be very honest with what happened with the Butrans patch. You may not even need to say a thing as they will already have your phone call in the file. They will likely take the conversation from there, as in discussing another med option. If the doctor doesn't, you could ask what alternative idea they have.

If you were to ask by a medication by name that would be more of a drug seeking behavior, but discussing your pain and what is and isn't working for you is necessary. Another example would be saying your dose needs to be increased to X mg/day, instead of explaining you've had increased pain and letting the doctor take it from there.

I think if you are honest and observant of any contract you may have signed you don't have a reason to be worried. I hope seeing a pain specialist is beneficial for you, as I know if has been quite helpful for me already, and we're still tweaking with my meds. Best wishes.
__________________
Kate
constant headache since 2006

 
Old 06-25-2012, 08:36 AM   #3
jet12581
Newbie
(female)
 
Join Date: Jun 2012
Location: KY
Posts: 3
jet12581 HB User
Smile Re: Patch Alternatives?

Thanks so much for the response! I am not opposed to a longer acting pill at all, I just kinda liked the idea of sticking a patch on and not have to drag a pill bottle around all day. But the more I think about it the patch is not a good option for me. I swim and spend a lot of time in the sun and pool in the summer and you cannot expose modt patches to heat. I know they are supposed to stay on during swimming but I went to the pool the 2nd day I had it on and it started getting loose.
My PM appointment is tomorrow. I dont know if it's my imagination or what but since I stopped Butrans my pain has been harder to control with oral meds. My PM doc seems a lot more compassionate and I hope I wont run into any trouble with needing to switch meds. I am in KY and drs here are so quick to label people on pain meds and accuse people of pill seeking, because opiate abuse of people taking meds for fun is an epidemic around here. I have also heard some horror stories of doctors dropping PM patients for no reason or if they are not in agreement with or sticking to their treatment plan. It sucks but without proper medication I have 0 quality of life, I can barely work, take care of my 2 year old or be imtimate with my husband due to the pain I have that so far I can only control with opiates.

I have been keeping a pain diary I will take in tomorrow as well. Hpoing all goes well. Again thanks for the response, I am so glad I found this forum. Everyone seems so nice and helpful!

 
Old 06-25-2012, 09:39 PM   #4
tortoisegirl
Senior Veteran
(female)
 
Join Date: Mar 2012
Location: Washington
Posts: 1,187
tortoisegirl HB Usertortoisegirl HB Usertortoisegirl HB Usertortoisegirl HB Usertortoisegirl HB Usertortoisegirl HB Usertortoisegirl HB Usertortoisegirl HB Usertortoisegirl HB Usertortoisegirl HB Usertortoisegirl HB User
Re: Patch Alternatives?

Hope you have a good appointment! I really try to not let myself start to stress about something until I know its a problem. Once they called me in same day for an appointment instead of me just picking up my prescriptions and I was so freaked out that something was wrong...they couldn't even give me an answer of why they had me come in or answer what would have happened if I couldn't have made it in at that time (I had been planning to run in there right before they closed), but I figured it must have been them wanting to fill an open appointment slot and I was the newest patient (they had wanted to schedule me anyways but were full).

I really haven't found taking pills several times a day to be an issue. It might take some getting used to if you aren't on other meds, but most of us are. Even if its three times a day, I just do when I wake up, 8 hours later, and when I go to bed, so only one dose is away from home and might need an alarm. I did have problems with the patch as far as skin irritation, and although it stuck, I was always anxious about it falling off and I'd be short some and whatever. The only thing I don't like about oral meds vs. a patch is they never last even close to as long as they are stated for me, so I end up doing some clock watching...that shouldn't happen with a long acting me though (I'm special!). Best wishes.
__________________
Kate
constant headache since 2006

 
Old 06-27-2012, 02:50 AM   #5
luvinmusiq
Senior Member
(female)
 
luvinmusiq's Avatar
 
Join Date: Jun 2012
Location: Illinois
Posts: 161
Blog Entries: 1
luvinmusiq HB Userluvinmusiq HB Userluvinmusiq HB Userluvinmusiq HB Userluvinmusiq HB Userluvinmusiq HB Userluvinmusiq HB User
Re: Patch Alternatives?

Hey!!! Welcome! I agree with what was said about asking for meds by name and what regiment you should be on. That will not look good to a doctor. I have seen it happen so many times at the PMP that I know when they are going to get let go. But For me Fentanyl patches were great. Most people I talk to tell me how it was the answer to their prayers. Now don't mistake it there is many people like Kate who say they really hate it. They had problems. I personally tell everyone who ask questions like that, you have to find what works best for you. Just be honest with your pmp and they should work with you in finding a combination of a long acting and something for breakthrough pain. I do agree that Fentanyl is a very powerful narcotic. So depending on your tolerance and your pain you might want to try other meds. Only you know how your pain is and what will work for you. The patches I have also learned that different brands may break your skin out and some brands don't. Another thing is some will start to peel off if you are sweating too bad or if you keep rubbing on it. I personally leave it alone. I have never had one come off. In the beginning I was nervous because of the horror stories of them coming off so I ask the doctor. He told me what to use. To tape it down and NO PROB! After a while I just stop using the tape and realized I didn't need it. Go Figure!!! But I really want you to have a heart to heart with you doctor and number one thing is be honest. Do not keep using anything that is not helping and tell him what your goals is. Tell him around what time a day the pain starts to get worst and what you are doing when that happen. That will help. Good luck and I will be waiting to hear what happen.
__________________
Dx Lupus (SLE) 1996
Dx Tumor (pituitary) 2010
Dx Pancreatitis 2011
Pancreatic Stent
Osteoarthritis
Stroke
Leukopenia
Migraines
Power Port implant 2010
Total Right Hip Replacement

 
Closed Thread




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 09:07 PM.



Site owned and operated by HealthBoards.comô
Terms of Use © 1998-2017 HealthBoards.comô All rights reserved.
Do not copy or redistribute in any form!