Update on fentanyl patch

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nasalady
Veteran Member


Date Joined Sep 2009
Total Posts : 1176
   Posted 3/10/2010 11:04 AM (GMT -7)   
Thanks again to all who responded to my first post asking about fentanyl.

I've now been using the patch for 10 days and am having fairly good results with pain control, although it does make me sleepier than usual. For the first couple of days, a new patch will bring my back pain down from it's normal 10 out of 10 (or 11!) to a 6 or 7, which is great, but by the end of day 2 the pain level is creeping back up and day 3 pain is generally 9 or 10 out of 10.

I remember some who commented that the 3-day patches usually only lasted 48 hours for them, so maybe this is to be expected.

But don't get me wrong....I'm grateful for any relief!! This is the first pain med that has actually been able to touch my back pain....it's amazing to have a break from the pain!

I'm on one of the lowest doses (25mcg/hour), and am contemplating asking my doctor for a higher dose patch.
Lyme Disease, AIH, Hashimoto's, lupus, fibro, RA, celiac disease, asthma, psoriasis, Raynaud's, hypertension, osteopenia, sleep apnea, RLS, GERD, DDD, L4 and L5 radiculopathy -> severe lower back pain, cubital tunnel, tarsal tunnel, Doxycycline, Prednisone, Imuran, Plaquenil, Lyrica, Cymbalta, Levothyroxine, Atenolol, Cozaar, Zyrtec, Fosamax, Albuterol, Prilosec, CPAP, Darvon, Morphine Sulfate

autoimmunediseasesgfliving.blogspot.com


skeye
Veteran Member


Date Joined Mar 2008
Total Posts : 2976
   Posted 3/10/2010 1:50 PM (GMT -7)   
Hi JoAnn,

I'm so glad to hear that you are getting some relief from the patch! Hopefully with time the side effects will decrease. If your doctor doesn't want to increase you patch or increase the frequency (every 2 vs 3 days), then maybe you can ask about breakthrough meds for that 3rd day. Hopefully you can work something out.

hugs,
Skeye

Stella Marie
Veteran Member


Date Joined May 2005
Total Posts : 601
   Posted 3/10/2010 1:54 PM (GMT -7)   
I have used the patch in the past. One warning to you - fentanyl has an extreme affect on your breathing. I mention this because I noticed in your Bio that you have asthma and sleep apnea. I had to stop using fentanyl because it had a negative impact on my central apnea.

I did change my patch every 48 hours vs the regular 72. The patch does come in 12.5 dose. You could consider half steps. Sometimes just a little extra is all you need for pain control. The problem with fentanyl is once you max out - your done. There are not many more options in pain conntrol. Tolerance build up can be a problem.

Good luck.


Stella Marie   Chronic Pain Forum Moderator

Progressive neurodegenerative disease called Multiple System Atrophy, muscle spasms, muscle pain, neuropathy, & neuropathic pain, central sleep apnea, osteoarthritis, and 2 pain implants – intrathecal pain medication pump and an SCS (spinal cord stimulator).  Extra fun little toys and gadgets; O2 generator and assorted wheelchairs, walkers, canes, and orthotic braces.  Med - too many too list or even care about!

 

 


Post Edited (Stella Marie) : 3/11/2010 10:54:55 AM (GMT-7)


nasalady
Veteran Member


Date Joined Sep 2009
Total Posts : 1176
   Posted 3/10/2010 2:04 PM (GMT -7)   
Thanks for the hugs skeye! You're right that maybe I need something for BT pain. I'll talk to my doctor about that.

Stella Marie, I appreciate any info from experienced users of the patch. Yes, I've been worried that I would build up a tolerance and so that's one reason maybe I shouldn't ask for a higher dose. My back pain doesn't usually become unbearable unless I stand or walk for more than a couple of minutes....then it hits hard. So it's been wonderful to be able to take a shower that lasts more than a couple of minutes! :)

I am worried about the breathing thing too....a couple of times it almost seemed as though I was having to remind myself to breathe! Very weird! Probably worth mentioning to my doctor.

((((hugs))))
JoAnn
Lyme Disease, AIH, Hashimoto's, lupus, fibro, RA, celiac disease, asthma, psoriasis, Raynaud's, hypertension, osteopenia, sleep apnea, RLS, GERD, DDD, L4 and L5 radiculopathy -> severe lower back pain, cubital tunnel, tarsal tunnel, Doxycycline, Prednisone, Imuran, Plaquenil, Lyrica, Cymbalta, Levothyroxine, Atenolol, Cozaar, Zyrtec, Fosamax, Albuterol, Prilosec, CPAP, Darvon, Morphine Sulfate

autoimmunediseasesgfliving.blogspot.com


mrsm123
Veteran Member


Date Joined Dec 2007
Total Posts : 1228
   Posted 3/11/2010 12:20 AM (GMT -7)   
Hi Joanne,
I also use the fentanyl patch and have COPD on top of it, brought on by years of asthma. Fentanyl does interfere with respiratory problems, so make sure that you and your spouse are both aware in the event that you have trouble with your asthma or apnea to watch your breathing.
As far as increasing the fentanyl goes, you are on a very, very low dose of fentanyl so maybe a small increase might not be a bad idea, as Stella Marie suggested, the 12.5 mcg patch might be just enough to cover the increased pain from standing or walking for more than a few minutes. And a breakthrough med if you start experiencing pain during the 48 or 72 hours that your doctor has you changing the patch. It is not uncommon for chronic pain patients to need something for those times.
You could also talk about how the patch doesn't seem to last for the 72 hours intended for it to last for. Are you using the gel based patches or the ones that are tape? The gel ones are well known for seeming to not last as long as the tape versions.
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.
Avascular necrosis of left wrist- maybe hips too


Stella Marie
Veteran Member


Date Joined May 2005
Total Posts : 601
   Posted 3/11/2010 5:48 AM (GMT -7)   
If in the back of your mind you have to remind yourself to breathe then it s time to make an appointment with your Pulmonary Specialist ASAP. You need another sleep study now that you are using fentanyl. Are you using mechancial help at night, either O2 or one of the PAP's (C, Bi, and/or V)?

I had a dramaic increase in non breathing events when I started fentanyl. This is a warning that Pain Management Specialists do a very poor job of reviewing with their patients.


Stella Marie   Chronic Pain Forum Moderator

Progressive neurodegenerative disease called Multiple System Atrophy, muscle spasms, muscle pain, neuropathy, & neuropathic pain, central sleep apnea, osteoarthritis, and 2 pain implants – intrathecal pain medication pump and an SCS (spinal cord stimulator).  Extra fun little toys and gadgets; O2 generator and assorted wheelchairs, walkers, canes, and orthotic braces.  Med - too many too list or even care about!

 

 


Post Edited (Stella Marie) : 3/11/2010 10:56:48 AM (GMT-7)


nasalady
Veteran Member


Date Joined Sep 2009
Total Posts : 1176
   Posted 3/11/2010 8:18 AM (GMT -7)   
Sandi, thanks for your reply....I appreciate your suggestions. I'm using the gel type of patch.

Stella Marie, you're probably correct that I should have another sleep study done now that I'm using fentanyl. I use a CPAP machine.

I appreciate your concern and your warnings....

P.S. Has anyone ever noticed that they had trouble swallowing on the patch?
Lyme Disease, AIH, Hashimoto's, lupus, fibro, RA, celiac disease, asthma, psoriasis, Raynaud's, hypertension, osteopenia, sleep apnea, RLS, GERD, DDD, L4 and L5 radiculopathy -> severe lower back pain, cubital tunnel, tarsal tunnel, Doxycycline, Prednisone, Imuran, Plaquenil, Lyrica, Cymbalta, Levothyroxine, Atenolol, Cozaar, Zyrtec, Fosamax, Albuterol, Prilosec, CPAP, fentanyl patch 25mcg/hr

autoimmunediseasesgfliving.blogspot.com

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