Switch from Fentanyl 50mic's/hour to OxyContin input please!

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Medicalkid2
Regular Member


Date Joined Oct 2010
Total Posts : 147
   Posted 4/14/2012 2:58 AM (GMT -6)   
So I was taking Percocet 5-325 4 times a day for about 9months....good pain relief for about the 6months my tolerance wasn't up but never covered the whole day like I needed...I'd either purposefully plan on filling the script and taking half the dose for a week or two so I could take more later in the month..I found 4.5-6 a day worked and after a explaining this my doc put me on Fentanyl saying I needed to be on a long acting opioid (something I had said 9999milion times for the past months!)...well I like some things about Fentanyl but the negatives outweigh the positives....it only lasts 2 days and I feel like the dose is dumped in the first day, I get good pain relief the second day and the 3rd day is usually withdrawal...Ugh I 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... Even on the Fentanyl I just don't feel "right" even with pain relief...sometimes I feel so sedated..I haven't gotten to class really at all this week between being in the bathroom and basically being knocked out by the fentanyl in my sleep. Its hard to win with this pain...the Oxycodone for me was as close as I got...Hydrocodone made me sleepy but not as bad as Fentanyl so I switched to Oxycodone...Oxycodone was way less sedating and I could function but eventually I needed more...I know docs don't like OxyContin for the stigma and all the addiction facts but I really think its perfect...other options are MS Contin, HydromorphContin and some others but I really don't want to try those because I know what Morphine and Hydromorphone feels like compared to Oxy already...

Advise on how to tell my doctor this? Does anyone have experience with both OxyContin and the Fentanyl patch? Im going to be working in the hot sun all day this summer (if I have pain relief) and I won't even bother trying to get the patch to stick when Im jumping in and out of water or lifting weights or going on my long hour long runs....I hear people stay on it even through stuff like this...whats wrong with OxyContin over Fentanyl?

Blessedx8
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Date Joined Aug 2008
Total Posts : 3193
   Posted 4/14/2012 3:16 AM (GMT -6)   
Hey Medicalkid,

Sorry the fentanyl gave you these issues :( Fentanyl works great for my pain; just can't use it in patch form. Yes, I've been on both - fentanyl and oxycontin (which I'm currently on) - as well as most opiods.

Are you going to give your doc a call about the fentanyl side effects or do you have an upcoming appointment? It sounds like you really need to let the doc know what's going on. That basically is what the patch does for me - I have fevers and other stuff w/ my health issues - so I don't even make it 48 hours w/ the patch. I just gave it another try and it was unsuccessful. (The patch can be written to be changed every 48 hours, just harder to get insurance to approve, but mine did).

But, regardless, it sounds w/ the side effects (sedation, being in school, pain relief, etc) - it's not the right med for you?

All I can say is that I advocate very strongly in being open and direct w/ doctors. I think what you wrote is basically what you need to say. You gave the fentanyl a try... it's too sedating and you are going into withdrawal on day three.... etc etc. That you get the best pain control w/ the oxycodone... by the way, are you in Canada? (I saw you mention hydromorphcontin - I don't think we have that here in the US)... anyway, have you been on the 7.5mg or 10mg percocet?

I don't think anything is wrong w/ oxycontin over fentanyl... if that's what is best for your pain control and your doctor is willing to prescribe it. But has he said he won't?

Finally, I can't remember what your pain issues are... but have you tried a muscle relaxer? nerve meds? Anything else, med wise, for pain control? I need these as part of my med combo.

(Sorry for the questions, just trying to help, lol). Hope you get this figured out! --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

Blessedx8
Veteran Member


Date Joined Aug 2008
Total Posts : 3193
   Posted 4/14/2012 3:21 AM (GMT -6)   
Just read your other post and saw you have a call in to your doctor, w/ no return call....

I also read your doctors' thoughts on oxycontin. I don't understand how doctors have this thought, if they are willing to prescribe fentanyl... but I know all doctors have their own viewpoints.

I'd probably put a call in tomorrow to your doctor, to let him know the side effects you are having... if not tomorrow, for sure on Monday.

--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

straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 16788
   Posted 4/14/2012 4:21 AM (GMT -6)   
MedicalKid if you plan on being in the heat this summer you may as well forget about using the Fentanyl patch. The insert advises not to be in the heat, take hot showers, anything that increases the body temp. The heat causes the patch to release too much medication, which results in the patient getting too much and then you have to deal with withdrawals because too much of the medication was released. I had heard something about this problem was going to be addressed but nothing was set in concrete.

From what you have described since being on Fentanyl it does not sound like it has been a good match for you at all and thats a shame because it can be an excellent pain reliever for some. Hopefully your dr can come up with something else that will help you out. I was on Fentanyl patches and that was some of the best pain control I had in a long time. I had no peaks or valleys with it. Take care...Susie
Moderator, Chronic Pain Forum & Psoriasis Forum

Snowbunny21
Veteran Member


Date Joined Jan 2010
Total Posts : 3557
   Posted 4/14/2012 9:36 AM (GMT -6)   
I just think the best way to speak to Drs. is to just tell them the truth...but let them decide from there...

As in..not saying, "I want to be on Oxycontin"....But...letting them know the issues with the Fentanyl patch....and then letting them know that you had good success with Percocet before..

I also wouldn't rule out taking Opana, Nucynta, or MSContin.....these are all good medicines that provide good pain relief...

I've been on MSContin for years...

The other key is making sure that you are working with your Dr. to do many other things besides opiates to help keep your pain levels low...

Things like exercise, PT, yoga/stretching, massage, acupuncture, injections, TENS unit, muscle relaxers, nerve pain meds, counseling, eating healthy, not smoking, etc...

Just to name some things...

Everything is like a building block...one on top of the other...so the narcotic is not meant to provide all the pain relief...

It is hard many times unfortunately getting a hold of Drs. on a Friday afternoon....but there is always an on call Dr. if you do have emergent symptoms with the Fentanyl and need to talk to them...

I hope you can get an appt. next week and start on something else....
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 4/14/2012 2:44 PM (GMT -6)   
Thanks guys! I have an appointment on the 17th of this month thank God.

As a reminder of my pain issues, I have had Crohns disease for about 4 years now...its in remission now but I still always have a baseline of pain from it that the maximum dose of Ibuprofen and tylenol combined doesn't touch not to mention bouts of severe sharp pain....I've seen about 5 GI's (horrible experience in the past but thats another story) and everyone is saying its Crohns...I had such sharp pain at times I went to the ER because I was seriously afraid something was wrong but each time it was just a spike in pain and nothing serious...script for Vicodin call your GI :/ . My body temperature is usually all over the place from the Crohns so I have to stay hydrated, no big deal.

about a month ago I was diagnosed with Ankylosing Spondylitis after I had severe neck pain for a little over a year, I always had muscle tension in my neck so I thought it was nothing until it got worse and worse on top of a bulging disk in my neck. Today I live in constant pain I probably couldn't even fathom a while ago, I never thought hell on earth was real. I was a competitive athlete all through out high school rowing pretty much all year long, I ate a very good selection of food and made sure I stretched, TENS unit after a rough practice with lots of muscle tension following, regular massages, and counseling. I still do all of those and make a point to stretch every morning...I loose track of conditions, medicines, treatments, etc. these days now as I'm trying to focus my energy on other things, I still do them I just have trouble recalling them thats all :p I'll update my signature too. (EDIT: I also have degenerative disc disease...its inevitable for every person in my family, literally the whole side of my dads family has it and my moms side all has AS or RA...as if I could notice the degenerative disc disease above everything else!).

I've always had pain, I never expect it to be a consistent below a 4/10 but I do expect to have a much higher quality of life than I currently do know when I KNOW its possible...my conditions may be bad but their are people that have it MUCH MUCH worse that live much better, yes everyone is different but I KNOW If doctors instill a little trust in me and stay consistent, stop playing around with medications without warning, and actually collaborate I can live well. I take honesty and openness very serious in everything about life, I'm not going to say Ive not told a lie but I'm pretty darn honest lol. I tell my doctors everything and I tell them I believe the best patient-physician relationship is built on honesty on both ends which is why its frustrating when they make assumptions about my honesty or intentions, I do not sleep with a dirty conscience and allot of the assumptions and guilt from other things still haunt me in my sleep every night...I think the guilt of letting people down, missing school, and distrust from doctors has got to be tied or a close second to the actual physical pain. If I say Im going to do something I usually mean it from the heart, breaking that hurts allot I'm not sure if you guys have similar trouble with that or not.

My whole goal is to be active again. I know a few people who have severe chronic pain that requires 24/7 opioid management and you would never know because they are so active. I don't want to be a couch potato....that to me is not a fair way to treat your body if you can get up :D

Post Edited (Medicalkid2) : 4/14/2012 3:33:27 PM (GMT-6)


straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 16788
   Posted 4/14/2012 3:58 PM (GMT -6)   
MedicalKid I also have crohns and have done the resection bit and still have not achieved remission whatever that is. I am on Humira, Lialda, Entocorte & Imuran. What meds does your dr have you on? Even with you being in remission you should be on a maintenance medication like Imuran, never know what is being done to the insides, going drug free because they sy remission is not a good plan. You said you were dx'd with AS last year, are you doing Remicade infusions? By doing Remicade for the AS it can also help with your crohns. I was on it for three and a half years before building up antibodies to it. Last of all, if this were me I would stay totally away from Ibuprophen.

Take care....Susie
Moderator, Chronic Pain Forum & Psoriasis Forum

Medicalkid2
Regular Member


Date Joined Oct 2010
Total Posts : 147
   Posted 4/14/2012 4:28 PM (GMT -6)   
straydog said...
MedicalKid I also have crohns and have done the resection bit and still have not achieved remission whatever that is. I am on Humira, Lialda, Entocorte & Imuran. What meds does your dr have you on? Even with you being in remission you should be on a maintenance medication like Imuran, never know what is being done to the insides, going drug free because they sy remission is not a good plan. You said you were dx'd with AS last year, are you doing Remicade infusions? By doing Remicade for the AS it can also help with your crohns. I was on it for three and a half years before building up antibodies to it. Last of all, if this were me I would stay totally away from Ibuprophen.

Take care....Susie


I was only on Pentasa but my rheumy is going to do Humira this summer. I just can risk getting sick as I live on campus in college around other kids and a compromised immune system is no good for me. I've been in the hospital from random serious infections like scarlet fever, etc. :O My doctors used to say stay away from Ibuprofen but now they advocate it...?..I guess they must be overwelhmed with all that is going on I'm not sure...I told my Internist that I was having severe heartburn from Ibuprofen and she gave me some strong antacids but I'm not sure how to explain to her that its just a bad idea....exact same thing happened with my mom and now she has stomach ulcers...you would think we could apply some critical thinking in the cause and effect department here :O ! I'm concerned about cost too...I mean my family is upper middle class but with my mom being sick with Lupus & RA two people on Humira seams like allot...I don't want to tax my family anymore money (which is another reason I don't like the Fentanyl, expensive and if you loose a patch its like loosing a piece of gold!)

straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 16788
   Posted 4/14/2012 4:40 PM (GMT -6)   
I would not worry much about compromising the immune system, I have been on the biologics for years and have been healthier. Thats another possible side effect they have to list. Its really odd how a lot of have wondered why we were getting fewer infections after being on them, lol. Eating right and getting plenty of rest seems to do the trick.

My gi says no to Ibuprophen. There companies out there that offer cards to help with the cost of the co-pays for Humira, I have one and it costs $10 a month for my Humira. Your dr should have these cards in his office so ask for one....Susie
Moderator, Chronic Pain Forum & Psoriasis Forum
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