Another question: Fentanyl users, please!

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gangsterkathryn
Regular Member


Date Joined May 2012
Total Posts : 44
   Posted 6/17/2012 7:34 PM (GMT -6)   
Currently I am on the 50 mcg/h generic patch. I alternate 1000mg Tylenol and 800mg ibuprofen every four hours (so I take each one every eight hours) as what I would think are breakthrough meds... I'm curious to know what strength patch others are using and what breakthrough meds. I want to see what is normal so when I'm at the doctor, I can ask about increasing the strength and adding a breakthrough med.

Also, if anyone is on an anti-depressant, can you tell me what one and, again, the strength. I also feel the need to add that into my regime because of how bad the depression is getting.

Thanks in advanced everyone. I hope everyone had a good weekend. Mine was okay. I got some Toms shoes, which I desperately needed (the shoes, not the brand but I'm sure it will help) because I was walking on the backs of my flats. These new shoes have better arch support and I can't wait to go on my walk tomorrow!

Thanks for listening to me blabber on, again...
Kathryn - 22 years old.
Mommy to Baby Scott - May 18th, 2011.

Accidents: Jan. and Oct. 2008, Nov. 2009.
Surgeries: Eye - 1995, Lumbar Laminectomy L4-5 - Feb. 2008, Cesarean Section - May 2011 and Gallbladder Removal - June 2011.
Current Medication: Generic Fentanyl 50 mcg/h patch every 72 hours (feels ineffective after 48), Meloxicam 15mg once a day and Generic Tylenol for breakthrough.

momtofourangels
Veteran Member


Date Joined Apr 2010
Total Posts : 2265
   Posted 6/17/2012 7:59 PM (GMT -6)   
Hi Kathryn I'm also on the 50mcg fentanyl patch. I also take 5mg oxycodone twice a day if needed for breakthrough pain. I would advise you not to ask for a certain medication because the doctor may get the wrong idea, and think that you're asking for the wrong reason. I advise that you go in and explain that the fentanyl patch isn't covering your pain very well, and see if he/she will prescribe you an additional med for the breakthrough pain.

I wish you the best with getting your pain under control.

hugs
Loretta
Dx: osteoarthritis, bursitis in left hip, Osteoarthrits in right hip, compression fracture in thoracic spine due to falling on frozen ground March 2001 , ddd, spinal stenosis, bone spurs, osteoarthritis in spine, osteoarthritis in both knees
Meds: Fentanyl patch, oxycodone, otc: BenGay, Tylenol Arthritis on occasion

gangsterkathryn
Regular Member


Date Joined May 2012
Total Posts : 44
   Posted 6/17/2012 8:34 PM (GMT -6)   
Thanks Loretta!

Don't think I'd ask for something specific, just let them know that I feel the dosage needs to be changed and that I might need something better for breakthrough meds... I guess I'm more asking to see what I would possibly get placed on, as in what is normal..

How do you feel in the morning when getting out of bed?
Kathryn - 22 years old.
Mommy to Baby Scott - May 18th, 2011.

Accidents: Jan. and Oct. 2008, Nov. 2009.
Surgeries: Eye - 1995, Lumbar Laminectomy L4-5 - Feb. 2008, Cesarean Section - May 2011 and Gallbladder Removal - June 2011.
Current Medication: Generic Fentanyl 50 mcg/h patch every 72 hours (feels ineffective after 48), Meloxicam 15mg once a day and Generic Tylenol for breakthrough.

Screaming Eagle
Veteran Member


Date Joined Sep 2009
Total Posts : 5005
   Posted 6/17/2012 8:54 PM (GMT -6)   
Hello Kathryn!

Im just into my 2nd month of the Fentanyl patch, and so far not getting decent results. Were trying different brand names first, but I have a feeling the Fentanyl itself is not working or not a big enough dosage. That being said, it makes my BT med's seem like they are not effective either.

I think one needs to make sure their baseline med's are dosed correctly first, ….and one way to check that process is to see if your taking your BT med's on a regular schedule. I'm a firm believer that if you are doing this, and not using them as true BT med's then you will be chasing a black cat in a pitch dark room.

I use Percocet as my current BT med..7.5mg, ..and my patch strength is 25mcg.

Good luck in your visit with your PM/PCD

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."

Post Edited (Screaming Eagle) : 6/17/2012 7:57:53 PM (GMT-6)


gangsterkathryn
Regular Member


Date Joined May 2012
Total Posts : 44
   Posted 6/17/2012 9:57 PM (GMT -6)   
SE,

Thanks. I definitely need to get the baseline med situated. I am hoping that, somehow or eventually, I can get back on the BuTrans... The fentanyl is making the depression much, much worse.

Thanks for your response!
Kathryn - 22 years old.
Mommy to Baby Scott - May 18th, 2011.

Accidents: Jan. and Oct. 2008, Nov. 2009.
Surgeries: Eye - 1995, Lumbar Laminectomy L4-5 - Feb. 2008, Cesarean Section - May 2011 and Gallbladder Removal - June 2011.
Current Medication: Generic Fentanyl 50 mcg/h patch every 72 hours (feels ineffective after 48), Meloxicam 15mg once a day and Generic Tylenol for breakthrough.

straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 16793
   Posted 6/17/2012 10:25 PM (GMT -6)   
Kathryn, there really is no way to compare your meds to anyones because every one reacts differently to medications. What dose may help me may not have any effect on your pain at all. Some people take oxycodone or percocet for BT pain, but again this is going to be whatever your dr decides because there are a lot of different meds used for BT.

Chronic pain and depression go hand in hand. I did not know until a few months ago that not all pain meds and antidepressants mix together. My pain mgt dr had to take me off what my PCP had me on because it did not mix well with my pain medication.

You may want to make a list of what pain meds you have taken in the past and how well it did or did not help your pain and include your current pain meds.

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

mrsm123
Veteran Member


Date Joined Dec 2007
Total Posts : 1235
   Posted 6/17/2012 11:21 PM (GMT -6)   
As Susie said, you can not compare your pain medication needs to someone else's. What works in what dosage for one person may not work as well for another. If you experiencing worsening of your depression symptoms, and believe that the fentanyl is the major contributor to worsening symptoms of depression, then increasing the dosage is the worst thing you can do.
Talk with your doctor and see what he or she recommends as far as changing your meds back to the butrans patch if you felt better pain relief and lessing of the depression symptoms on that than you are on the fentanyl.
Good luck
Sandi
Motorcycle accident 1992, Back problems from 92 to 2005. August 2005- early 2006- Chiropractor care
March 2006- consult with surgeon -PLIF/TLIF L4-5, spondylolysthesis, canal and foraminal stenosis, multiple herniations
Post Op Cauda Equina Syndrome
Revision August 2007- salvage op
March 2011- 2nd onset of Cauda Equina Syndrome
Needs surgery to prevent paralysis

kelsrox
Regular Member


Date Joined Dec 2011
Total Posts : 108
   Posted 6/18/2012 2:33 AM (GMT -6)   
Kathryn, I have not used the patches yet (new to pain management and they gave me a choice of Morphine ER or patches and I chose the former). But I can tell you, you need not take so much Tylenol. Though the maximum daily dosage is 4000mg (after that, liver damage is likely occurring) the use of Tylenol in such abundance over time can cause damage. I don't mean it to scare you. I mean it to tell you that you do need to seek another alternative. Ibuprofen can cause issues as well, but I think you get the point. I had to be scared for my liver to decide to choose a long acting medication and use the one I was taking before as a breakthrough medication (it contained 325mg of Tylenol per dose). I fear I haven't helped you much but please tell the doctor you feel strongly about other options. Not just for pain control but for the health of your liver. God bless.

Kels
Kelsey; 25 year old lady suffering from a slew: Depression, Anxiety, Irritable Bowel Syndrome (IBS), Polycystic Ovarian Syndrome (PCOS), Chronic Pain (CP).

Fusiongirl
Veteran Member


Date Joined Apr 2012
Total Posts : 608
   Posted 6/18/2012 10:32 AM (GMT -6)   
Hi Kathryn

I am on 75 mug fentanyl patch and use sevredol for breakthrough, 30 mg as required. The combination works well for me. Having said that we are all different and respond differently to pain meds. Also at your age don't want to be taking anything that might cause damage to your body.

I was always told that breakthrough meds should not be required constantly, they are there for bad periods. It sounds like your base level is maybe too low or that fentanyl is not the drug for you. You have to be honest with your pain doctor re what you are taking and your pain levels and maybe ask if there is something else you could try. Fentanyl has been my savior but from tis forum it's obvious it doesn't suit everyone

Hope you manage to find a solution. Good luck.

Jane

iloveoliver
Regular Member


Date Joined Jun 2012
Total Posts : 156
   Posted 6/18/2012 5:13 PM (GMT -6)   
I agree with Jane. Fentanyl has been a lifesaver for me. It truly is the best pain med out there. You aren't gonna get any euphoria from it which is why some people don't like it. I defiantly am NOT referring to anyone who posted here in this thread. I read a lot of bad forums before I found this great place here! Anyways so I am glad I gave it a chance but since it's not working for you not sure what your doctor will suggest since fentanyl is about as strong as it gets. But like everyone else said, what works for someone may not work for someone else. I am on 200mcg but that's not really a normal dosage for most people. 100mcg seems to be the norm. Good luck and please give it a try. I almost let the bad stories I read about the patch on other forums stop be from trying it.

Post Edited (iloveoliver) : 6/18/2012 4:18:29 PM (GMT-6)


gangsterkathryn
Regular Member


Date Joined May 2012
Total Posts : 44
   Posted 6/19/2012 4:58 AM (GMT -6)   
Thanks everyone for all your advice!

I went to a urgent/primary doctor yesterday. Plastered all over the lobby are certifications for pain management and buprenorphine (medication in BuTrans)... they told me they want me to get another MRI because mine is too old (three months isn't but they want more money, I'm sure, since they do the MRIs there) so I'm supposed to do that today, then hopefully get something new. I told them I needed new; the fentanyl just isn't doing anything. I feel as if I don't have any pain medication. The baby woke up for a bottle, doesn't happen often, making it and then sitting there giving it to him, killed me. I hobble-ran back to bed to lay down. I put the heating pad on and hopefully will fall back asleep very soon.
Kathryn - 22 years old.
Mommy to Baby Scott - May 18th, 2011.

Accidents: Jan. and Oct. 2008, Nov. 2009.
Surgeries: Eye - 1995, Lumbar Laminectomy L4-5 - Feb. 2008, Cesarean Section - May 2011 and Gallbladder Removal - June 2011.
Current Medication: Generic Fentanyl 50 mcg/h patch every 72 hours (feels ineffective after 48), Meloxicam 15mg once a day and Generic Tylenol for breakthrough.
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