Saw My New Pain Management Doc Today

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skrape
Regular Member


Date Joined Feb 2009
Total Posts : 141
   Posted 8/20/2009 2:08 PM (GMT -7)   
Well, I had an appointment scheduled for September 14th with this new Pain Management doc but they called today and asked if I could come in. I told them that yes, I could and I went to see him. I told him about the low back pain and these Fentanyl patches and about how they are ruining my life. He wants to do a test tomorrow to see if a procedure will help and if that looks like it will, he wants to do another epidural on me. Those of you that know me know that the last epidural pretty much incapacitated me. I will wait to see what the test shows and we shall see.

As for the patches, he still wants me on them but he doubled the dose to 2 100mcgs patches a time to be changed every 48 hours (vs 1 100mcgs patch every 72 hours). So he, in effect, doubled my dose of pain meds and removed that whole pesky last 24 hour problem I have with the patches not working right (Yay!). I will have to wait and see but THAT should help the pain a bit.

I'll update everyone on the whole situation as I find out what the test reveals.


Skrape
Fentanyl Patch - 100mcgs x 72 hours
Baclofen - 10mg x 8 hours


skrape
Regular Member


Date Joined Feb 2009
Total Posts : 141
   Posted 8/20/2009 9:28 PM (GMT -7)   
I do, however, find it scary that I am on 200mcgs of Fentanyl every 2 days. That is a ton of pain meds from what I understand.


Skrape
Fentanyl Patch - 100mcgs x 72 hours
Baclofen - 10mg x 8 hours


PAlady
Veteran Member


Date Joined Nov 2007
Total Posts : 6795
   Posted 8/20/2009 9:37 PM (GMT -7)   
Skrape,
I don't have any experience with fentanyl but I just hope it all works out for you. Certainly if it feels like it's too much, well, maybe others here who have the patch can offer suggestions!

Good luck!

PaLady

skrape
Regular Member


Date Joined Feb 2009
Total Posts : 141
   Posted 8/20/2009 9:44 PM (GMT -7)   
Thanks. It has been a pretty bad year and I have done 9 months of pure hell being in tons of pain and in WD half the time. I really think I was a breath away from my breaking point for a long, long time. I was up onto my 48 hour mark on this patch when I got back home today so I was able to slap on two of these patches and know, really know, for sure that I was not going to have to go through 36 hours of ungodly pain and sickness before I could change them again. I put these on about eight hours ago and they are really starting to kick in now. It is the first time that my back has been back down below a 5 that I can remember. It is fantastic!


Skrape
Fentanyl Patch - 100mcgs x 72 hours
Baclofen - 10mg x 8 hours


Mrs. Dani
Veteran Member


Date Joined Jun 2009
Total Posts : 2787
   Posted 8/20/2009 11:26 PM (GMT -7)   

 

   Dear Skrape,

     Hey there! *huggs* I am glad they got you in sooner! Even better you pain subsiding has got to be like a breath of fresh air. *huggs* It must be really hard thou, to go through with another procedure! I sure do hope it helps to bring your pain level down even lower.

*huggs*

   dani


TWO roads diverged in a yellow wood,  
And sorry I could not travel both  
And be one traveler, long I stood


LLPLUV
Veteran Member


Date Joined Mar 2009
Total Posts : 1158
   Posted 8/24/2009 6:36 AM (GMT -7)   
I have heard of the 2 100 mgs patches. My father was on that dose for about two years then he moved down to 150 then to 125 finally finishing off at 25's. I'm so glad someone finally noticed that you need to change them at 48 hours. That has to come as a HUGE relief for you.

Keep us posted
Laurie
Kidney Diseases and Disorders
              Moderator
 
39 yr young female with,
Chronic Kidney Stones, PKD (Polycystic Kidney Disease), Chronic Kidney Failure, Severe Hypertension, Urological RSD

Also CHF (Congestive Heart Failure) and Sleep Apnea

Hopefully NO MORE........


skrape
Regular Member


Date Joined Feb 2009
Total Posts : 141
   Posted 8/24/2009 6:46 AM (GMT -7)   
I don't know that I am going to be on the two patches for long. I started these on Thursday and was up all night (all night, no sleep at all) Thursday with another migraine. I was then up again most of the night Friday fighting the same (it never really went away; just got a little less severe) and only got about 3 hours of sleep. On Saturday I changed them again and within 5 hours the migraine was back full swing again. I took the second patch off and was up again until 5:00am battling the headaches. I left that patch off and was able to sleep a little better Sunday night (only up until 3:00am so I got about 4.5 hours).

I talked with my Pain Management doc's nurse about the headaches on Friday and she said she would get back to me but never did. I need to call again today and find out what I need to do. I will take the changing every 48 hours but I don't think my head can withstand the 200mcgs, it is just too much. I have had headaches almost daily since being on Fentanyl; I used to only get a headache once maybe every 2 or 3 weeks (if that) but I have had the every single day while on Fentanyl. These have even gotten to the extent that I had to go to the ER for IV fluids and such.


Skrape
Fentanyl Patch - 100mcgs x 72 hours
Baclofen - 10mg x 8 hours


mrsm123
Veteran Member


Date Joined Dec 2007
Total Posts : 1228
   Posted 8/24/2009 11:55 AM (GMT -7)   
Skrape,
It might be that he increased your fentanyl too much at once. The jump from 100 mcg to 200 mcg, without slowly increasing the dose is not ordinarily done. I have been on as much as 300 mcg of fentanyl at one time and when we went up that much, we went in 25 and 50 mcg increases to get there.
If you get headaches on fentanyl all of the time, it may not be the right drug for you. I hope you get somewhere with the new PM 's nurse and get an answer about what you should do.
Hang in there ,
Sandi
PLIF/TLIF Fusion w/Instrumentation L4-5 Spondololysthesis L4-5.Laminectomies L4-5, foraminal stenosis L3-4, L4-5, L5-S1, herniations L3-4, L4-5, L5-S1, central canal stenosis L3-4, L4-5 and L5-S1
POST OP CES 3/30-06
Neurogenic Bladder and Bowel, bilateral numbness legs and feet
Revision for failed Back surgery, pseudoarthrosis L4-5, hemilaminectomies L3-4, L4-5, L5-S1, bmp added to revision fusion, replaced two bent screws that were reversing out of vertebrae - August 2, 2007
On going back pain and neuropathic pain, failed back surgery, consult for scs, decided not to do that at this point.
Adhesive Arachnoiditis also......just what I didn't need..9/08- adding bilateral ulnar neuropathy with severe compression to the mix. They want me to see a surgeon for ulnar nerve surgery, but I'm not biting.
I've seen enough surgeons over the last few years.
[url=http://dragcave.net/view/xdyP][img]http://dragcave.net/image/xdyP.gif[/img][/url]


uniquelyme
Veteran Member


Date Joined Nov 2008
Total Posts : 1037
   Posted 8/24/2009 2:20 PM (GMT -7)   
 
 
Skrape,
I think he knows what he's doing about the patches...after all, they weren't doing you much good on the last day so why not double up and take them every 2 days instead of three... Sounds like this Dr. might be ahead of the game when it comes to pain relief.... Let me know how it's working...
 
Me.

I have been a spectator for so long..Now it's time to participate.......
 
Post Lamenectomy Syndrome, Spinal Stenosis, DDD....
1999 Hemi Lamenectomy/2005 Spinal Fusion(L4-S1)
Methadone 120 mg. a day/  30 mg. Oxycodone as needed(up to 4 x a day)
High Blood Pressure: Lisinopril HCTZ 10 mg. daily
Type 2 Diabetes: (March 16, 2009)
Metformin HCL ER 1000 mg. at night..Glipizide 10mg. 2X in the morning
Lantus 35 units at bedtime with Solostar Pen                                                                   

 


Blessedx8
Veteran Member


Date Joined Aug 2008
Total Posts : 3193
   Posted 8/25/2009 11:13 AM (GMT -7)   
Skrape,

I was glad to hear that you had a good PM appt... and got your meds worked out so hopefully you wouldn't have to deal w/ the withdrawal stuff... But then I read about your horrendous headaches... I'm sorry! Fentanyl works better for me than any pain med -- in terms of lessening my pain. But it has the most side effects for me than any other med...

How's your headaches doing now? Did you lower your dose? How are you doing??? I hope you've gotten some relief from your headaches.

I hope you are feeling better...
Tina
Pain Issues: Neck/back pain; migraines; carpal tunnel syndrome; widespread joint/muscle pain, nerve pain in hands, arms, feet; I also have POTS/dysautonomia; CFS/Fibromyalgia; Severe Hypertension; Hypothyroidism; Addison's Disease; Central Sleep Apnea; etc etc

Meds: MS Contin (480mg daily); MSIR (15mg/6x day); Soma (3x day); Atenolol; Midodrine; Phenergan; Effexor and on the list goes...

Future Plans: Intrathecal Pain Pump; already completed trial; awaiting my decision for implantation


BionicWoman
Regular Member


Date Joined Jul 2008
Total Posts : 243
   Posted 8/26/2009 9:11 PM (GMT -7)   
mrsm123 said...
Skrape,
It might be that he increased your fentanyl too much at once. The jump from 100 mcg to 200 mcg, without slowly increasing the dose is not ordinarily done. I have been on as much as 300 mcg of fentanyl at one time and when we went up that much, we went in 25 and 50 mcg increases to get there.


I just wanted to say ditto to that. 100mcg is a huge jump and would probably give any normal person a headache, so there's no telling what it would do to you if you have a propensity toward headaches/migraines to begin with! My doctor is very conservative when he moves my fentanyl doses around and only moves me 12.5mcg at a time, which really irks the pharmacist for some reason that I don't entirely understand. rolleyes
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