Doc called in Fentanyl today...I'm really nervous..need advice

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Medicalkid2
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   Posted 4/3/2012 5:19 PM (GMT -6)   
So I have been on Percocet 5/325 for about 8 months now...it does not work anymore. 10mg keeps me at a reasonable level of pain for about 4-4.5 hours and 15mg lasts about 6 hours but I'm pretty tolerant. I'm 18 and in college and right now I feel like I'm dying. My Internist (Primary) on Friday wanted to put me on OxyContin 20mg 2x a day with no breakthrough meds but needed to consult a PM doc first. today I couldn't get out of bed for 2 hours...I was literally in tears. My rheumatologist's office is putting me on the Fentanyl patch 50mcg/hour...Not gonna lie I'm nervous as ever. I've heard horror stories of people OD'ing and I wouldn't touch the stuff with a 10 foot pole without an anesthesiologist baby sitting me. Is 50mcg/hour too much for someone who can handle 15mg of Oxycodone IR with ease? I'd really prefer to stay breathing during my sleep.....Can anyone offer personal insight? Worst comes to worse I'll have my mom call my aunt who's an anesthesiologist...I just am weary when regular docs prescribe fentanyl...

Post Edited (Medicalkid2) : 4/3/2012 5:22:16 PM (GMT-6)


Jim1969
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   Posted 4/3/2012 5:43 PM (GMT -6)   
Take a look at this.

www.rxlist.com/duragesic-drug.htm

It should answer your question and then some.

I think you will be fine.
2 confirmed herniated lumbar discs. Spinal Arthritis. Spinal Stenosis, diabetic peripheral nueropathy.
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sjkly
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   Posted 4/3/2012 5:55 PM (GMT -6)   
Rhuemys are often as familiar with pain management as PM doctors are. Every single patient in a rhuemys office has some degree of pain.
My rhuemy writes pain scripts for her patients.

Medicalkid2
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Date Joined Oct 2010
Total Posts : 147
   Posted 4/3/2012 6:27 PM (GMT -6)   
Ok thanks guys! When I see my Primary next she is going to prescribe something extended release...I think OxyContin will work but I'm worried about building an insane tolerance or it not lasting...I want to get back to exercise on a regular basis so idk if the fentanyl patch will work long term...my mom has the patch but she doesn't run or anything like that. I guess I'll post back tomorrow with how I feel.
C6 Herniation/Buldge (my docs debate), gen. nerve pain, ankylosing spondylitis, Crohns disease, Anxiety, Aspergers, and Mild Insomnia.
-Adderall 10mg am, Oxycodone 5-7.5mg 3-4x day,Lyrica 50mg 3x day, Klonopin 1mg night, Zoloft 200mg night. It could be worse :)

straydog
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   Posted 4/3/2012 8:02 PM (GMT -6)   
The 50mcg is a lot to start someone on I would think. When I started on them I started at 25mcg and later was increased to 50mcg. Fentanyl is a very strong drug. They even have a 12.5 mcg that they will start a new patient with. If the 50 is too strong, call your dr ASAP as they can drop you down. They work very well for most people in getting the pain under control.

Let us know how you do. Take care...Susie
Moderator, Chronic Pain Forum & Psoriasis Forum

Screaming Eagle
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   Posted 4/3/2012 11:23 PM (GMT -6)   
….I'm in agreement here with Straydog…and would think they would start with the lower dose of 25mg. This med is way more powerful that the Percocet's you have been taking, and agree if they seem too strong for you…then call and get them reduced.

Good luck!

SE wink
Moderator Chronic Pain Forum

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Blessedx8
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   Posted 4/4/2012 12:09 AM (GMT -6)   
I'm in agreement w/ the last two members.... my immediate thought when you said you were "starting" at the 50mcg was WOW. I've been on Fentanyl many, many times.... and going from what you've been on to that is really too big of a jump, just in my own personal experience.

Don't get me wrong - I personally think Fentanyl is an excellent pain medication - but it IS one of the strongest meds out there.... and it CAN have side effects - from nausea/vomiting, to breathing issues, etc. The "normal" starting dose is 25mcg... but as Stray said - they now even make a 12.5 mcg patch - for the more opiod naive patients.

Let us know how you do... Wishing you the best, Tina
Moderator - Chronic Pain Forum

My faith and family sustain me even on my worst days... as well as my wonderful friends here at HW.

Health/Pain Issues - too many to list; feel free to ask

Retired Mom
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   Posted 4/4/2012 5:57 AM (GMT -6)   
Hi,

I can certainly understand your concern about the med changes and the concern about oxycontin. That is one that I can't handle the thought of either....don't get me wrong, I know it works well for some people, but I'm scarred to try it too and always ask my PM to stay away from it, if possible, because of my fear of the med. I am very honest with him about my anxiety issues (especially where new meds are concerned).

As far as they patch...obviously it works great for some, but I did not feel any relief from it. I do agree that you should start at the lowest dose possible to make sure you can tollerate it and to see how much your body needs or even can handle taking.

I may have read your post somewhat off, but it sounded to me like you have more than one Dr prescribing pain meds....if that is the case and you are seeing a pain mgt dr, you could easily get dropped from the practice....especially if they do urine drug screens. I would try to go through only one Dr for all of my pain med needs and stick to the same pharmacy too. The complications can be too much to deal with and you don't want to end up with no pain meds at all.

I hope you find great relief with the patch! Good luck!
Failed TLIF L5-S1, Miltiple Bulges/Herniations, Scoliosis, Pituatary Disorder, Fibro, Failed Bladder Surgery, Failed Nissen, GERD, OCPD, GAD, MDD, CFS, TMJ, Migraines, HBP, Idiopatic Reactive Hypoglycemia w/Diabetic reaction to HGH, Bi-lateral CTS (now trigger finger), Edema, Tarsal Tunnel Syndrome, Peripheral Neuropathy, Plantar Fascitis, Tibular Tendonitis, Adult Onset Flat Feet, & Vision Issues

Medicalkid2
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Date Joined Oct 2010
Total Posts : 147
   Posted 4/4/2012 7:48 AM (GMT -6)   
Thanks for the support guys!. I told my roommate who is an early riser and my other roommate who was working late to see if I was still breathing...they looked at me with a strange look until I explained that I was on some new medication thats like 1000x more potent than morphine and understood. They also understand that if they ever are caught looking through my stuff for pain killers they won't find because they are in my pocket 100% of the time I will break all of their fingers and make it look like a bloody accident, haha only partially kidding with that one but my roommates are all very focused students and most of them didn't even no what Oxycodone was. One of them said he didn't know how to swallow pills! I laughed inside thinking "As if I could get away with saying that!".

As for the dose...my mom was taken Lortab 7.5mg 4-6times a day and her physician switched her to 50mcg/hour and at the time I was thinking wondering if the doctor was trying to kill her! Luckily she's fine and that little tid bit did make me more reassured that I would be fine. I did some brief research before I put the thing on and apparently the starting dose for opioid tolerant persons like me can varry greatly... this article talked about a gentimen on 1000mcg/hour: http://www.medscape.com/viewarticle/576398 . I read the entire packet insert, they defined opioid tolerance required for the patch as "over 2 weeks on a potent opioid narcotic such as Oxycodone or Morphine", interesting.

As for how I feel, I put the patch on at 9PM and was up tell 1AM writing a paper, I wanted a few hours to make sure I didn't just fall out on the stuff. I take Ambien to sleep and I reduced the dose by half and still couldn't sleep so I took about 75% of my usual dose and slept pretty well, I woke up sore but thats because I actually slept on my neck wrong but no severe pain, I actually hopped out of bed rather energetically once I hit the snooze button about two times :D. But WOW its 9:30AM and I feel like a rockstar! I don't feel stoned, sedated, and only a hint of euphoria but nothing distracting, still very sore but its always like that now. This fentanyl is really kicking the crap out of my pain, I'm at like a 4/10 right now and sitting in a chair with perfect posture and no increased pain. Definitely going to be taking Ibuprofen today but don't think I'll need to take Percocet today, in fact I'd probably only bring one with me if I weren't paranoid about people stealing it.

As for more than one doc prescribing...no that is really not the case. My pain management doctor is one of nicest Physicians I have ever met, hands down best bed side manner and she is considered to be the top Physiatrist in the area working with professional athletes too, BUT when she switched practices everything went FUBAR, the practice is sketchy, I call for a refill and they don't respond right away and when they ask what medication they make mistakes....they gave me 180 Percocet instead of 120, I was honest at my next appointment and told my physician I had enough for X amount of days thanks to their error. They never drug screened me which I guess is a reflection on how the doc viewed me but I thought this was inconsistent. I heard rumors that the DEA hit them hard and after that they adopted a new contract too. They are blatantly disrespectful as well, I have had nurses just give me the rudest rants on a regular basis so I explained to my PM doc that I could no longer go to her practice and that I liked her as a physician but hated the practice...she's a friend of my mom so its ok.

Now with that behind I explained to my Internist that I did not like the practice's sketchy, rude, and unprofessional operation and she agreed it would probably be easier for her and my Rheumatologist to coordinate my pain management. Only reason I had to have my Rheumy prescribe is because my Internist wasn't in so the nurse told me to call the Rheumy. My Internists nurse said she'd make sure my doctor called ASAP, I'm going to have to see if I want to do the OxyContin or HydromorphContin vs the Fentanyl as fentanyl is the king tiger of opiates and I seriously do not want to piss it off! That said I really don't feel too sedated or anything. Anyways I am going to go stretch before class and I will update later on whether I needed to take the Percocet and how I feel.

Side note: Only other time I've had Fentanyl was for a colonoscopy where I recall nearly everything and the CRNA saying I became extremely talkative and not really loopy until she completely knocked me out with Propofol.

Post Edited (Medicalkid2) : 4/4/2012 7:59:48 AM (GMT-6)


Blessedx8
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   Posted 4/4/2012 9:00 AM (GMT -6)   
I'm glad it seems like the patch is working, with no side effects. That's great.... :)

Re: the article you referenced... I read it... and they were talking about someone w/ end of life rectal cancer wearing 10 100mcg patches. This is extremely atypical and would never happen w/ a "functioning" chronic pain person.

You are right, though... people's reaction and tolerance vary greatly. I'm the most opiod tolerant person that I know and can handle enough meds to put 3 grown men under. That being said, I still keep my meds at the lowest possible and know that anyone can have a reaction w/ these meds.

Take good care - and I hope this continues to help you w/ your pain...!

--Tina
Moderator - Chronic Pain Forum

My faith and family sustain me even on my worst days... as well as my wonderful friends here at HW.

Health/Pain Issues - too many to list; feel free to ask

Screaming Eagle
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Date Joined Sep 2009
Total Posts : 5005
   Posted 4/4/2012 9:15 AM (GMT -6)   
 
 ...again!...I will agree with Tina on this. It's great that you are getting relief....but if you can get it at the lower dose of 25mg....it may be worth a try. Then it will give you more room to go up later if needed. It sounds like you have a good PM...so discuss it with her and see what she thinks.
 
  SE wink
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Snowbunny21
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   Posted 4/4/2012 11:56 AM (GMT -6)   
I'm still a bit confused....Does your internist know that you are now on the Fentanyl patch? It would be very unusual that they would prescribe OxyContin, another long acting medication ON TOP OF the Fentanyl....

Most people are on a long acting medicine and than a medicine for breakthrough....which would be either Percocet or regular Oxycodone, Vicodin, or anything short acting....Only needing to be taken IF there is breakthrough pain...

Unless you are saying that you would rather substitute and switch from the Fentanyl over to OxyContin.....that would make more sense...

If you are getting a 4 with just the Fentanyl....that is fantastic and sounds like you don't need a BT med....

To add another medication like OxyContin to this....that just seems strange...the goal is to keep our pain in the 5 range....not to be pain free.....

As well as you mentioned....tolerance is very important to watch....so that is why most of us take the least amount of medicine we can...

Along with doing numerous other things besides medication to help our pain....One should never just rely soley on a narcotic to keep their pain levels low...

I'm glad you are getting pain relief as yes...the 50mcg is a pretty high dose to start you on......


I know it's already too late that you've told your roommates about your narcotics....but you will now have to be EXTREMELY careful as I can bet they have told others and the word is now out to many that you are on these medications...

I can't imagine carrying around all your patches with you as that in itself is very dangerous.....What would be best is getting a safe that is bolted to the floor.....and then ONLY you should have the combination...

Again...these are just suggestions to help you....I think many of us were just concerned in making sure ALL your Drs. know about one another and getting narcotics from more than one Dr...

Keep us posted...
SB and "the pup who snores loudly" 
 
ACDF C5-C7, (no hardware), with autograft bone Nov. 2001
(reabsorption of bone 2 years later...still lost in body..expect to burp it out at anytime..haha")) 
ACDF with hardware, allograft bone Nov. 2005 
Anterior and Posterior CDF, allograft bone with BMP, removal of old hardware, use of titanium plates, rods, screws, & kitchen sink (lol) Oct 2006
 
 

Medicalkid2
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Date Joined Oct 2010
Total Posts : 147
   Posted 4/4/2012 1:08 PM (GMT -6)   
Snowbunny21 said...
I'm still a bit confused....Does your internist know that you are now on the Fentanyl patch? It would be very unusual that they would prescribe OxyContin, another long acting medication ON TOP OF the Fentanyl....

Most people are on a long acting medicine and than a medicine for breakthrough....which would be either Percocet or regular Oxycodone, Vicodin, or anything short acting....Only needing to be taken IF there is breakthrough pain...

Unless you are saying that you would rather substitute and switch from the Fentanyl over to OxyContin.....that would make more sense...

If you are getting a 4 with just the Fentanyl....that is fantastic and sounds like you don't need a BT med....

To add another medication like OxyContin to this....that just seems strange...the goal is to keep our pain in the 5 range....not to be pain free.....

As well as you mentioned....tolerance is very important to watch....so that is why most of us take the least amount of medicine we can...

Along with doing numerous other things besides medication to help our pain....One should never just rely soley on a narcotic to keep their pain levels low...

I'm glad you are getting pain relief as yes...the 50mcg is a pretty high dose to start you on......


I know it's already too late that you've told your roommates about your narcotics....but you will now have to be EXTREMELY careful as I can bet they have told others and the word is now out to many that you are on these medications...

I can't imagine carrying around all your patches with you as that in itself is very dangerous.....What would be best is getting a safe that is bolted to the floor.....and then ONLY you should have the combination...

Again...these are just suggestions to help you....I think many of us were just concerned in making sure ALL your Drs. know about one another and getting narcotics from more than one Dr...

Keep us posted...

I am not taking OxyContin AND Fentanyl. God that would be asking for an overdose not to mention a massive tolerance beyond my imagination. My Internist is out playing golf or whatever and my Rheumy is called in the Fentanyl as an emergency thing since my Internist can't write the script if she's not in the office, but they communicate. I want to switch to OxyContin for my long acting med and have 5mg Percocet or Hydromorphone for breakthrough pain....my doctors always comment on how long acting meds do not last as long in me as other patients most likely from the Crohns (absorption issues)...I do not want to continue the patch because being pain free means I am not going to sit around, I am going to be back to running and what not and while the patch is supposed to hold up to those things I don't want to test fentanyl patches on a 90º day while sweating and running for >60 minutes...it sounds like a dangerous plan. Also I don't expect to be pain free, that is as ridiculous as expecting to one day grow wings and fly, I have always had pain and delt with it, but when it gets in the way of simple tasks in life that is when I will see to have it taken care of it with discriminate force (aka narcotics). I do not take more medication than I need because physical tolerance is no different than drug seekers increasing the dose as far as most every physician I've ever seen is concerned. If I could be comfortable on Ibuprofen I would be comfortable on Ibuprofen.

As I said my roommates have known...its not like a secret when you have to take short acting meds every 4 hours, I know you guys know this because we've all been on short acting meds at one point and if its for >8months eventually you'll be as about as discrete as House MD. I am not the trusting type at all, I don't even let people use my computer under my direct supervision unless its urgent nor do I leave ANYTHING in an area not locked or in my visual field, heck I don't even sit in a room with my back towards the door, I don't leave my phone on the table when I got to the bathroom it stays in my pocket, people do not "hold stuff for a second" for me I personally carry it with me. I notice everything the second I enter a room. I don't know how to put it but I'm not exactly the type of person who doesn't see someone coming from a mile away. I'm a nice person don't get me wrong and I always do my best to make sure everyone is comfortable but if you touch my stuff, or anything important or so much as forget to return my air freshener on time I'm going to be on your case tell the end of time. Like I said I sleep with the pills in my pocket and keep track of how many I have. If I care about it, I'm responsible about it, end of story. I'm really a straight shooter about every aspect of life (which is why my posts are rather aggressive, and sometimes a tad arrogant blush blush ) and don't need to make things more high profile than they already are, thats just way more stress than I need :)

ANYWAYS I feel like I am ranting/verbally assaulting you guys on a nice day (Sorry, I talk with allot of conviction, so everyone tells me at least :D ) so I will switch to a positive note! :) My Rheumy confirmed the Ankylosing Spondylitis so all my doctors know what we are actually shooting at here, my Rheumy is starting me on weaker immunosuppressants and then moving on to Humira if these ones don't work and I'm hopeful that I won't have to be on OxyContin by this time next year and just have say 30 Percocets over 3 months for as needed severe pain, maybe more depends on which is more realistic and "less sketchy". Whatever works for me is what I think is the best, EVERYONE is entitled to live at a good standard of life and anyone who deprives someone of this from ignorance or malice intention is not the type of person that should be sucking away our air longer than needed (thats not a suggestion either, don't let people take away your life).

But to update I am feeling pretty good, the pain level is up and down and the medication seams to be holding up a consistent fight against the pain but I'd agree and say 50mcg is strong but not heavy (at least for me, your experience may vary :p). Haven't even thought of needing the Percocet today and just grab my Ibuprofen :) I'm in a very good mood because I am not stopped by pain, the sun is out, other than this post I have not been laying around, and I can get back to my school work like any other pain free kid.

I really appreciate the advice, its really difficult dealing with pain when you have no one that can possibly relate but then I come on here and I see all different kinds of people and all of you guys have character and experience with the issue and put your time aside to help an abrasive occasionally arrogant guy like me :D :D :) Anyways everyone enjoy their day and I sincerely hope your doing as well as I am pain wise.

Post Edited By Moderator (Momto8kids) : 4/4/2012 1:23:31 PM (GMT-6)


Blessedx8
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Date Joined Aug 2008
Total Posts : 3193
   Posted 4/4/2012 1:26 PM (GMT -6)   
Hey Medicalkid...

No worries... I can be a bit aggressive, lol, myself.... so it's ok (not that I thought you were being that way...). I think most of us were just wanting to help you and were concerned. Many of us have been lots of experiences - and that's the point of this board - to share those various viewpoints.

Also, I don't think anyone was saying the 50mcg is a "strong" dose of fentanyl; but it IS a "bigger than normal" starting dose - especially for a person that was not on long-lasting meds.

Okie, dokie - enough said by me. Take care... and glad it's helping!
--Tina
Moderator - Chronic Pain Forum

My faith and family sustain me even on my worst days... as well as my wonderful friends here at HW.

Health/Pain Issues - too many to list; feel free to ask

Screaming Eagle
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Date Joined Sep 2009
Total Posts : 5005
   Posted 4/4/2012 1:40 PM (GMT -6)   

 

    ...well shoot! rolleyes ...I always seem to be in agreement with Tina...and I am again this time as well. My only concern was the amount that your PM started you out on....however, she has a better idea of your medical history, plus they are the professional as well. wink

    If you are aware of our concerns, and it seems you are, and well educiated in that area,...then we are happy for you...just stay cautious as possible, and always question your PM's direction.

 I remember the first time my Dr scripted out Oxycontin to me...it was #40"s X2....and I think I took around 2 days worth....and called him up and said "Hey!...let's lower the dose here"...we went down to #20"s and that worked fine for a while....but at least I had room to go up when it was needed.

   Good luck, and keep in touch with us!

       SE wink


Moderator Chronic Pain Forum

Weekly Quote!

"Getting over a painful experience is much like crossing monkey bars. You have to let go at some point in order to move forward."

Medicalkid2
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Date Joined Oct 2010
Total Posts : 147
   Posted 4/4/2012 2:59 PM (GMT -6)   
So my Internist, PM doc, AND Rheumy communicated! My PM doc called and apologized for the communication issues and said her and my Primary wanted to go with the 50mcg/hour Fentanyl (Yeah...too many doctors if you ask me)....they both cited that OxyContin is the most abused narcotic out there and while I could have argued about the fact that I know I would be anymore "addicted" to OxyContin over Percocet, I can't say I'm complaining about the pain relief I currently have! She is mailing the script and it should arrive by tomorrow or the next day just in time for when the patch I currently have on wears off. I'm really pleased that at least for today I don't have to take anything additional other than Ibuprofen for inflammation of course. If I do have additional pain though she said to just call! This is great though, I don't feel sedated, stoned, just strong pain relief.
C6 Herniation/Buldge (my docs debate), gen. nerve pain, ankylosing spondylitis, Crohns disease, Anxiety, Aspergers, and Mild Insomnia.
-Adderall 10mg am, Oxycodone 5-7.5mg 3-4x day,Lyrica 50mg 3x day, Klonopin 1mg night, Zoloft 200mg night. It could be worse :)

Snowbunny21
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Date Joined Jan 2010
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   Posted 4/4/2012 3:06 PM (GMT -6)   
Thanks for expounding more on your response to me in the other post....

As well as providing us with an update...it sounds like you are doing really well on the Fentanyl and glad everyone is all on the same page..

Just be careful of taking long hot showers..That is what landed me in the ER when I was first prescribed the Fentanyl patches....It released too much medication into my system at once...

Same thing with a hot tub being a no-no....and just be careful when being out in the sun this summer...

For me...I was happy to switch over to MSContin for my long acting med and OxyIR for BT pain....I have more control in taking less medication on some days and more on others (still as prescribed)....so being on the patch didn't give me that leeway...

But again...I'm glad that it's working so well for you...

Thanks for updating us!
SB and "the pup who snores loudly" 
 
ACDF C5-C7, (no hardware), with autograft bone Nov. 2001
(reabsorption of bone 2 years later...still lost in body..expect to burp it out at anytime..haha")) 
ACDF with hardware, allograft bone Nov. 2005 
Anterior and Posterior CDF, allograft bone with BMP, removal of old hardware, use of titanium plates, rods, screws, & kitchen sink (lol) Oct 2006
 
 

Medicalkid2
Regular Member


Date Joined Oct 2010
Total Posts : 147
   Posted 4/4/2012 3:55 PM (GMT -6)   
Snowbunny21 said...
Thanks for expounding more on your response to me in the other post....

As well as providing us with an update...it sounds like you are doing really well on the Fentanyl and glad everyone is all on the same page..

Just be careful of taking long hot showers..That is what landed me in the ER when I was first prescribed the Fentanyl patches....It released too much medication into my system at once...

Same thing with a hot tub being a no-no....and just be careful when being out in the sun this summer...

For me...I was happy to switch over to MSContin for my long acting med and OxyIR for BT pain....I have more control in taking less medication on some days and more on others (still as prescribed)....so being on the patch didn't give me that leeway...

But again...I'm glad that it's working so well for you...

Thanks for updating us!

Wow I totally neglected the thought of hot showers...thanks...I take 45 minute showers...guess I'm gonna have to change that...I've heard changing the opioid helps keep tolerance down versus say taking Morphine for years on end so if the fentanyl in the hot weather becomes an issue I could switch to HydromorphContin or OxyContin to keep the tolerance down...as for signs of overdose...I know the "depths" of opioid sedation but is fentanyl different? Is it like suddenly getting hit with a hammer or what? as I originally stated I'd prefer to stay breathing in my sleep!

Medicalkid2
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Date Joined Oct 2010
Total Posts : 147
   Posted 4/13/2012 6:22 PM (GMT -6)   
So I've been on the patches for a bit....I really like the window of pain relief but I don't think this is right for me.....The patch seams to "dump" its dose in the the first 48hours leaving me practically stoned 8 hours after I put the patch on and then having about 20-26hours of good pain relief with no sedation and then nothing...I have literally been in the bathroom or in bed ALL day today as its been a bit under 3 days since I put the thing on, lots of pain and chills...I'm gonna take the patch off now and put another on after I take a shower in a couple of hours because this is ridiculous. I called my PM doc and as usual they have not returned the phone call! >:( Man I'd love to give these people a dose of their own medicine...I think I'm just going to try Purdue Pharma's world famous OxyContin (lol, I try and be humorous despite anything)...pretty much all my doctors think OxyContin (as well as Valium and others) are the anti-christ of drugs and they make everyone addicts...I'm going to ask them to look past the stigma and stop being a bunch of illogical simple simons to realize both these drugs have high addiction potential its just that most Fentanyl abusers end up dead faster. I really thought this drug was a miracle :/
C6 Herniation/Buldge (my docs debate), gen. nerve pain, ankylosing spondylitis, Crohns disease, Anxiety, Aspergers, and Mild Insomnia.
-Adderall 10mg am, Oxycodone 5-7.5mg 3-4x day,Lyrica 50mg 3x day, Klonopin 1mg night, Zoloft 200mg night. It could be worse :)

Medicalkid2
Regular Member


Date Joined Oct 2010
Total Posts : 147
   Posted 4/14/2012 1:45 AM (GMT -6)   
Ugh still got the chills, stomach cramps, diarrhea and cold sweats...sweats are starting to disappear but as Im posting this at 3:45AM you can bet its hard to sleep. Threw on another patch at 10:00PM so Im hoping tomorrow (or today really) I will feel better...
C6 Herniation/Buldge (my docs debate), gen. nerve pain, ankylosing spondylitis, Crohns disease, Anxiety, Aspergers, and Mild Insomnia.
-Adderall 10mg am, Oxycodone 5-7.5mg 3-4x day,Lyrica 50mg 3x day, Klonopin 1mg night, Zoloft 200mg night. It could be worse :)

ReactiveConstellationNE
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Date Joined Dec 2005
Total Posts : 256
   Posted 4/14/2012 4:14 PM (GMT -6)   
Medicalkid, it's very common in my experience (depending on the brand of patch; the solid polymer ones are much worse in this regard than the gel-reservoir type) for fentanyl patches to fade in effectiveness after the second day. Personally I didn't get very good pain relief from fentanyl in general; the doses had to be very high, the patches irritated my skin severely (to the point of forming bloody lesions around the edges, particularly if I wore them for more than 2 days....at least with the solid polymer type), and they tended to block the effects of any oral pain meds taken alongside.

In general I'm not a fan.
Conditions: Reactive Arthritis (AKA Reiter Syndrome), Severe Spinal Degeneration (Ankylosing Spondylitis, Pars Defect, Neural Foraminal Stenosis, 6mm gap@L5-S1, disc issues, etc), Chronic Pelvic Inflammatory Syndrome, Sacroiliitis, Costochondritis, Epididymitis, Prostatitis, Multiple Organ Issues, Unknown MS-Like Neuropathy, digestive issues, and a partridge in a pear tree.

Medicalkid2
Regular Member


Date Joined Oct 2010
Total Posts : 147
   Posted 4/17/2012 6:13 PM (GMT -6)   
Had my appointment today... I got a lecture today because my PM doc thinks I'm an "addict" I told her I would rather be dead than pills "as needed 4x a day" because my pain is 24/7 and that the Fentanyl was just crap... can't escape it. She promptly gave me an injection, switched me to HydromorphContin 8mg (forgot the brand name but its 24hour release), the dose sounds small compared to the fentanyl (based on opioid conversion charts) I was on but the fentanyl was allot I guess. She is persistent about making sure I only have to take a pill once a day with no breakthrough meds which sort of sucks but is better than 4 tiny Percocets a day which did not cover at night.


I asked her nurse how many patients she sees and the nurse said about 33 patients a day at minimum, I can't help but think that doctors look at us as the same person after 20 or so patients complaining of pain with questionable intentions....its like a worn out teacher grading tests...after a while everyone seams to get the same treatment be it good or bad. Anyways I'm brutally honest with everyone, always have been and I told my doc if she ever has a problem with me to tell me and asked why I've never had the "mandatory drug tests", I literally said "what can I do to reassure you that I'm not some addict?", It seams that everyone thinks Opioids=No self control addiction.... I just don't get how honesty doesn't trump everything else...after being on narcotics for a while they loose their buzz in terms of pretty much every addicting aspect. My primary is even MORE paranoid (she's a mother so I'll cut her some slack). Even when the doctors hand over the script fight free I offer them ways to monitor me just for their own reassurance... Rheumy thinks its Ankylosing Spondylitis, PM doc thinks it could be, primary is afraid of the addiction monkey's flying out of the wood work after me, My Rheumy is a guy and he seams to be more aggressive, to be decisive...not trying to be sexist but could that be the issue? I've always seen female physicians for whatever reason and they take the slow painful route (literally) to treating things like this IME. I just don't see myself getting self distructive with opioids...I already hate them because they make me way to tired...I don't drink, I don't smoke...I like to be as alert as humanly possible. I don't get how people can enjoy life "high" all the time...maybe some people don't enjoy life...All I know is as the weather is getting better I refuse to be bed ridden! I've got rowing to do, biking to do, and I want to learn how to sail this summer hopefully from a really cool friend...I can't do these things if I'm in pain.

MedicalKid I had to edit your post a tad, this is a family oriented forum and we do need to watch our language, as we do not know the ages of the people that reads the posts here at the forum.

Post Edited By Moderator (straydog) : 4/18/2012 11:56:18 AM (GMT-6)


Snowbunny21
Veteran Member


Date Joined Jan 2010
Total Posts : 3557
   Posted 4/17/2012 6:45 PM (GMT -6)   
Glad they were able to switch you over to Exalgo (sounds like)....You really can't compare Fentanyl which is in MICROgrams to this med....and then this new one with other pills and their MILLIgrams....As well as Fentanyl is actually the strongest medicine if looking on a chart...

Starting with 8mg on this medicine is the standard. Again...the way this medicine hit certain brain receptors is why the milligrams are different than Percocet or something like that....So you can't pay much attention to the number...It's all about whether it works for you or not...

And a good Dr. will always start low and then tirate up as needed...This way they make sure you can tolerate the medicine and don't have bad side effects or allergic reaction....

It can go all the way up to 64 milligrams....So you have room IF needed down the line....

The best possible scenario is that you can get good pain coverage with the lowest dose possible....

Again...the goal in pain management is to not be pain free....as well as you need to use all the modalities I and others have discussed before to help with your pain....You can't rely soley on a narcotic...

They really seem to be working with you on wanting to find something that can help....

What other things do you do each day/week/month to help lower your pain? Do they have a comprehensive program set up for you?
SB and "the pup who snores loudly" 
 
ACDF C5-C7, (no hardware), with autograft bone Nov. 2001
(reabsorption of bone 2 years later...still lost in body..expect to burp it out at anytime..haha")) 
ACDF with hardware, allograft bone Nov. 2005 
Anterior and Posterior CDF, allograft bone with BMP, removal of old hardware, use of titanium plates, rods, screws, & kitchen sink (lol) Oct 2006
 
 

Medicalkid2
Regular Member


Date Joined Oct 2010
Total Posts : 147
   Posted 4/17/2012 7:02 PM (GMT -6)   
Snowbunny21 said...
Glad they were able to switch you over to Exalgo (sounds like)....You really can't compare Fentanyl which is in MICROgrams to this med....and then this new one with other pills and their MILLIgrams....As well as Fentanyl is actually the strongest medicine if looking on a chart...

Starting with 8mg on this medicine is the standard. Again...the way this medicine hit certain brain receptors is why the milligrams are different than Percocet or something like that....So you can't pay much attention to the number...It's all about whether it works for you or not...

And a good Dr. will always start low and then tirate up as needed...This way they make sure you can tolerate the medicine and don't have bad side effects or allergic reaction....

It can go all the way up to 64 milligrams....So you have room IF needed down the line....

The best possible scenario is that you can get good pain coverage with the lowest dose possible....

Again...the goal in pain management is to not be pain free....as well as you need to use all the modalities I and others have discussed before to help with your pain....You can't rely soley on a narcotic...

They really seem to be working with you on wanting to find something that can help....

What other things do you do each day/week/month to help lower your pain? Do they have a comprehensive program set up for you?

Yeah its Exalgo...she just called it HydromorphContin for lack of knowing the brand name right away. Fentanyl is the strongest opioid...well aware of that which is why I really wanted to switch. She seamed to think OxyContin is the anti-christ of drugs...but whatever. The Exalgo sounds good...pretty much no pharmacies carry it so I couldn't get it filled today without driving 30 mins >:( As it is the 3rd day on the patch I just put another one on...no real choice so I figure I'll remove the Fentanyl patch in 2 days and start the hydromorphone.....I just hate the current mistrust with my doctors now basically on point of principle...I don't want people giving me things because they feel they "have to ugh" rather I would prefer they give me things based on trust instead of pressure. I explained this to her and she seamed to perk up, I was just caught off guard today when she straight up called me an addict :O I almost ripped the fentanyl patch off right then and their and said "If you've got a problem I can see another person" but she further explained why she thought this...I don't like these accusations at all...shes an excellent pain management doc but her practice is complete crap (she was part of a practice that dissolved and she was sort of forced by lack of other practices in the area into this one, I always here about how they do this wrong or that wrong on top of not returning my calls)...apparently she's a pretty big deal because I was running late and I told the secretary that my mom called her (they are friends) and the secretary said "Omg you guys know her personally?" the nurse also said I was extremely lucky to have her as a doctor and that she was jealous! I guess that's a good thing but I really want to shake this whole "addict" title, its pretty much a complete insult to my character but I realize its fueled on more than unbiased malicious intent...I'm seriously the most rational thinking person in my age group when it comes to decisions that involve health/life...I'm almost paranoid about thinking things over, impulsive is not part of my vocab unless I describe someone else.

And yes I don't expect 100% pain relief...I think I've said this about 1000x as that is completely unrealistic, I've been in pain for 4 years, I can live with a 4-5/10, I can't live with a 7-9/10 ruining my life (not an overstatement) especially knowing their is a way to reduce it. I stretch, I try different diets (my uncle often suggests things to, he's an MD) and hopefully when the pain is a 5/10 or less I will get back to exercising more than anyone can fathom...I was an athletic junky, I really don't like exercising on opioids as it "slows" me down but I guess I can learn to live with that. I used to do cardio for >2hours a day and lift for at least 12 hours a week often lifting with my gym teachers, PT's and the trainers....ALLOT of "other things to help" have rubbed off on me over the years working with coaches and a few professional athletes. I don't think anyone treatment is and end all.

(Hey Medicalkid... PLEASE don't quote more than a couple of sentences from previous posters. It adds to the cost of running this forum and so forth. Thanks....--Tina)

Post Edited By Moderator (Momto8kids) : 4/17/2012 7:13:36 PM (GMT-6)


Blessedx8
Veteran Member


Date Joined Aug 2008
Total Posts : 3193
   Posted 4/17/2012 7:26 PM (GMT -6)   
Medicalkid...

Exalgo is hydromorphone ER ... hydromorphoncontin is not avail in the US.

I know it's very hard, but I would try to not take things on such a personal level. These doctors have seen it all... and I think are hardened by much of that. Does it make their attitude right? Of course not. But it's a reality in the PM world.

Maybe you'll "cut me some slack" (lol - your words, lol)... as I, too, am a mom and this is really meant in a concerning way. But... when you say that the meds "lose their buzz" after while... I would just be really careful. You are very young... and it seems like you may be on this CP journey a long time. Just concern.

(What I'm about to say is to anyone of us in general, NOT to you).... We talk about addiction on this board and many of us defend that we taking everything 1000% "right". Addiction is NOT a bad thing (on a moral basis) and doesn't make someone a bad person. We are all taking strong narcotic medication - and I truly believe it "can happen to anyone".

Like I said, I'm NOT saying that applies to you at all. In my mid-20's, when I first started getting migraines, my doctor was loading me up on Vicodin - and I admit it gave me a sense of euphoria - in that I had super-energy and could accomplish absolutely anything. Looking back, I was very naive and I, while I don't think I was addicted per se, it was an unhealthy relationship w/ narcotics. I wasn't using them for the full intended purpose - frankly, I also liked how they made me feel.

My "punishment" (lol) to the above is... now, when I have really need medication over the last 8+ years... nothing works for me - at all.

I truly hope this new medication works for you. Please let us know how you are doing on it.... --Tina
Moderator - Chronic Pain Forum

My faith and family sustain me even on my worst days... as well as my wonderful friends here at HW.

Health/Pain Issues - too many to list; feel free to ask

Post Edited (Momto8kids) : 4/17/2012 7:33:58 PM (GMT-6)

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