There is a way to get around this w/ the insurance and dosing instructions, if your PM doctor is willing to try different things. My brain is fuzzy because I haven't been on the patch in a few years (I'm on oral fentanyl now, though); but - anyway - the same thing happened w/ me - the patch would not make it the whole 72 hours.... and my insurance was balking at paying for it to be changed at the 48 hour interval.
Like I said, my mind is fuzzy on the exact way we did it - but it was something to the extent that on that last day, I would have two patches on. One patch would be put on, on day 3....and the other patch would be coming off on Day 3.
Another thought is having a different kind of breakthrough medication (be it the oral fentanyl, dilaudid, etc) for Day 3 to get you through.
It took me many, many years - and MANY combos of things (and a great doctor willing to try various combos) to come up with something that works.... I hate to see anyone suffering -- especially when you ARE getting good relief 2/3 of the month.
Good luck to you! --Tina
Main Health Issues: Dysautonomia/POTS; CFS/Fibro; Chronic Pain (back issues, migraines, carpal tunnel, among other things); Chronic Hypertension; Hypothyroidism and Hypoadrenalism; Mixed Sleep Apnea (on BiPap); Depression/Anxiety; Vitamin D Deficiency.