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Posted 12/29/2007 7:05 PM (GMT 0)
My pain doc finally rx'd me fentanyl patches. He was gonna rx me Methodone, but I heard somewhere that if I start taking Methodone nothing else would work for me anymore. I also don't like the stigma associated with the Methodone. I don't want people to think I am a Heroin addict trying to get clean. Um...no thanks! So I asked for Fentanyl instead.

So, any advice or information I should know?

I've already started wearing the patch as of yesterday evening.

I'm on 12 mcg/hr.

My pain hasn't completely gone away, my hips still hurt and so does my lower back.

Thanks in advance!
Posted 12/29/2007 8:27 PM (GMT 0)
Does the pain ever "completely go away"?
Posted 12/29/2007 9:45 PM (GMT 0)
I think Methadone is fabulous for pain . But I had to quit due to swelling of legs . And also I was taking Tramadol with it . Dr. said it was ok .

Lucia did you see the warning about the PATCHES


Posted 12/29/2007 9:55 PM (GMT 0)
Lucia - be very careful with any of the pain patches. there are quite a few threads on here that you can search about them. There are quite a few different things that can cause the patches to release the medication more quickly than it is supposed to such as a fever, taking a hot shower, hot tubs, being out in high heat, and things like that. I would definately go to their website and read, and also read the warnings posted on this site. Make sure that until you are used to them that you do not drive, or do anything that requires you to have you brain all there.

I've heard great things about the patches - but there are also side effects, and things that you might have to differently.
Posted 12/31/2007 3:44 AM (GMT 0)
I have been using fentanyl (100 mcg) patches since 2002. I've had chronic back pain for YEARS, starting with scoliosis, then a fall off a cliff while hiking in CO, causing several smashed vertebrae, then falls, t-bone accidents, rear-end collisions, etc., all conspiring to increase my pain level to a point where it began going down my legs.

Since 2004, I've been plagued with multiple pneumonias (inspite of vaccine), causing fevers ranging from 101 to 104 with no problems with the patch. The medical personnel were more concerned about how the fever was affecting ME not the patch! One 8-month period, I had high fevers once/month for 8 months, yet I never had a problem with the patch. I prefer the Mylan brand, since it's smaller and sticks better.

I'm not saying there haven't been problems with the patch, and that warnings are not in order...I am simply stating that in the 5 years I've used it, I haven't had any problems with too much med, or high fevers creating problems with it, etc. And...it has up until recently, been a God-send. However, it's no longer as effective, so I'm being evaluated for a medtronic pain pump. So far, so good. The tests have been successful, at least as far as I'm concerned. They gave me 3 shots. The 1st one was good...I was able to run some errands, and even organize my bedroom (even Fibber McGee's closet would look better than my bedroom! <G>). The 2nd one wasn't as effective, and the 3rd was hard to evaluate...I'd just gotten out the hospital - again - with pneumonia, and was rather weak, so couldn't do too much.]

I hope this helps!

Happy New Year!
Posted 12/31/2007 12:18 PM (GMT 0)
I am not sure that I would recommend someone starting the patch without trying all of the other oral pain medications. I have been on the patch for 4 years. I started at 25 mcg and am now up to 75 mcg and about to start the 100 mcgs. I have had problems with the patch falling off. I miss not having a hot bath or shower in 4 years. On very hot days, if you perspire the patched often have problems sticking. Then you have to add up the cost of a covering bandage, like a tegaderm if you find you need one. I certaining do and since I have too change my patch every two days the cost really adds up. Once the dressings fall off, trying to get them to restick is a (pain in the behind). If you don't restick the old one then you will be short dressings. In hind sight, I wish I had continued using either the methadone or the dilaudid. Either on would have beend less expensive and easier to use in the long run. You are only on the 12.5 mcg = please research your options carefully. You may be on the patch a very long time. Consider the experse should your insurance ever change. Patches are very expensive ocer the long run. Good luck with what ever you choose.
Posted 12/31/2007 12:18 PM (GMT 0)
I am not sure that I would recommend someone starting the patch without trying all of the other oral pain medications. I have been on the patch for 4 years. I started at 25 mcg and am now up to 75 mcg and about to start the 100 mcgs. I have had problems with the patch falling off. I miss not having a hot bath or shower in 4 years. On very hot days, if you perspire the patched often have problems sticking. Then you have to add up the cost of a covering bandage, like a tegaderm if you find you need one. I certaining do and since I have too change my patch every two days the cost really adds up. Once the dressings fall off, trying to get them to restick is a (pain in the behind). If you don't restick the old one then you will be short dressings. In hind sight, I wish I had continued using either the methadone or the dilaudid. Either on would have beend less expensive and easier to use in the long run. You are only on the 12.5 mcg = please research your options carefully. You may be on the patch a very long time. Consider the experse should your insurance ever change. Patches are very expensive ocer the long run. Good luck with what ever you choose.
Posted 12/31/2007 4:29 PM (GMT 0)

ElizaJane said...
I am not sure that I would recommend someone starting the patch without trying all of the other oral pain medications. I have been on the patch for 4 years. I started at 25 mcg and am now up to 75 mcg and about to start the 100 mcgs. I have had problems with the patch falling off. I miss not having a hot bath or shower in 4 years. On very hot days, if you perspire the patched often have problems sticking. Then you have to add up the cost of a covering bandage, like a tegaderm if you find you need one. I certaining do and since I have too change my patch every two days the cost really adds up. Once the dressings fall off, trying to get them to restick is a (pain in the behind). If you don't restick the old one then you will be short dressings. In hind sight, I wish I had continued using either the methadone or the dilaudid. Either on would have beend less expensive and easier to use in the long run. You are only on the 12.5 mcg = please research your options carefully. You may be on the patch a very long time. Consider the experse should your insurance ever change. Patches are very expensive ocer the long run. Good luck with what ever you choose.

Are you criticizing me for going on the patch? I'm sorry if you don't approve of me being on the patch. Vicodin, Lortab, Norco, and Percocet didn't do crap for me. The epidural injections in my back didn't help at all. The patch has been a godsend for me. I am no longer in agony. I still do have some pain, but MUCH less than what I used to have while on the oral medications. I feel so much better.

I have not have had any problems with my patch falling off so far (it is made by Mylan). My Medicare plan D covers the patch. The co-pay is only $1. No problem there.

And I'll get some bandages to keep the patch on in the summer time. I can find them at Walmart. Shouldn't be hard to find.

And anyway, once your patch falls off you aren't supposed to restick it, as it will send more medication into you and you could OD. You're supposed to put on a new patch instead. At least, that's what I read in the instructions that came with the patches.

Anyway, have a wonderful New Year!
Posted 12/31/2007 7:10 PM (GMT 0)
Lucia - I don't think ElizaJane was criticizing you, that's not how I took it anyway. I have been on the patch about 2 years and understand what she is saying about them not always sticking well. The Mylan one you have worked best for me as far as sticking, too. It is a smaller patch and you don't see a gel in it, the medicine is mixed into the adhesive. The ones I have problems with sticking are the larger ones that have a pocket that holds the medicine that is a gel. If you put them in a place of movement (even if the skin would just move when you changed positions) then they don't stick well. I have found putting them on my hip/upper buttock works best although I do sometimes need a Tegaderm over it. The problem lies in when you've just put a patch on and later that night or next day it starts coming off...you don't want to put a new patch on because you still have days worth of medicine left in that patch, so you try putting something over it to make it stay! At any rate, I can't find that smaller patch at the pharmacies here as of last month, I guess another company is cheaper for the pharmacies to use, but they just don't stick as well. I've read here that people have had better luck with the name brand, but it costs a lot more with my insurance, so I will stay with purchasing the Tegaderm bandages.

That is absolutely wonderful that yours cost you $1. I had a period of no insurance and had to pay $100 per box, now I have insurance again and it is only $15. The Tegaderm patches are around $7 for a box of 5-6, so you need at least 2 boxes a month....I think these costs is where ElizaJane was saying to weigh the costs of being on this medication. It sounds like you have tried everything else under the sun and that the patch is going to be good for you. Like you said, it sure can be a godsend.
Posted 1/1/2008 12:36 AM (GMT 0)

ElizaJane said...
I am not sure that I would recommend someone starting the patch without trying all of the other oral pain medications. I have been on the patch for 4 years. I started at 25 mcg and am now up to 75 mcg and about to start the 100 mcgs. I have had problems with the patch falling off. I miss not having a hot bath or shower in 4 years. On very hot days, if you perspire the patched often have problems sticking. Then you have to add up the cost of a covering bandage, like a tegaderm if you find you need one. I certaining do and since I have too change my patch every two days the cost really adds up. Once the dressings fall off, trying to get them to restick is a (pain in the behind). If you don't restick the old one then you will be short dressings. In hind sight, I wish I had continued using either the methadone or the dilaudid. Either on would have beend less expensive and easier to use in the long run. You are only on the 12.5 mcg = please research your options carefully. You may be on the patch a very long time. Consider the experse should your insurance ever change. Patches are very expensive ocer the long run. Good luck with what ever you choose.

I am sorry to say I took offense to this.   I am a close personal friend of Lucia's, and I can attest to the fact that she HAS tried all the oral medications available to her and NOTHING worked long term.  As she already stated, she also tried injections to relieve the pain she was in, and they also DID NOT work.  Before she was Rx'ed Duragesic, she was in agony despite the meds she was taking. It was NOT uncommon for her pain levels to be upwards of 7-10 WITH oral opiates in her system. She also tried a TENS unit, and that wasn't helping much, either. 

 

It was her own personal choice to go with the patch, and I frankly do not see a difference between it and Dilaudid, Ms-Contin, or Oxy-Contin, with  the exception of the route of administration.

 

As for the other problems the patch may create, she read the literature that came with the prescription and has educated herself about the medication.  I am sure if she has any problems with it, she will ask her Dr how to remedy the problem.  As of now, she is pleased with the pain relief she is getting, and I am pleased for her.  It's the first time in MONTHS that she is able to manage her pain effectively.

Posted 1/1/2008 12:56 AM (GMT 0)
I can see where you could take offense to the post, I guess I didn't read it the same way though. Your doctor isn't just going to jump right to the patch without having tried everything else possible. Whatever the case, I am SO happy that the patches work well for Lucia. They started out doing well for me, but I think it is time to up the amount of the patch because I am having to use all of my alloted breakthrough meds each day. The subject of methadone had never been brought up with me, but I don't think I would have taken it either. The epidural injections are a joke, IMO, the first one lasted 1 week and by the third injection it was a day or two. But, we all know it is one of the first things tried along with physical therapy. Only you and your doctor can make the right choices for you. The only thing I would caution is that the generic patches with gel in them do not stick as well, and Lucia may not get the same brand patches each month (even from the same pharmacy), so keep track of how each kind works for you.
Posted 1/1/2008 2:24 AM (GMT 0)

Mochiah said...
 Your doctor isn't just going to jump right to the patch without having tried everything else possible. Whatever the case, I am SO happy that the patches work well for Lucia. They started out doing well for me, but I think it is time to up the amount of the patch because I am having to use all of my alloted breakthrough meds each day. The subject of methadone had never been brought up with me, but I don't think I would have taken it either. The epidural injections are a joke, IMO, the first one lasted 1 week and by the third injection it was a day or two.

 I guess I should consider myself lucky.  I have'nt progressed to the point of needing analgesia such as duragesic yet.  I am able to maintain adequate pain relief with anti-inflammatories, muscle relaxers, and when the pain is really excruciating, lorcet.

You raise a good point that a good Dr won't jump straight to the patch without trying everything else first.  But, I honestly believe other pain relief measures were honestly tried before the patch was Rx'ed.   In fact, he wanted to put her on methadone, but she suggested the patch and he OK'ed it.  I guess I had a problem because the DOCTOR authorized the prescription.  He would NOT have done so if he had a problem with it, but he didn't, and he's the one with the medical degree.

 

Posted 1/1/2008 2:34 AM (GMT 0)
You said you take a muscle relaxer, if you don't mind me asking, what is it and does it work well for you? I don't see a muscle relaxer that I know by name listed in your meds.
Posted 1/1/2008 2:52 AM (GMT 0)

Mochiah said...
You said you take a muscle relaxer, if you don't mind me asking, what is it and does it work well for you? I don't see a muscle relaxer that I know by name listed in your meds.

I forgot to mention it, sorry...  As you can see, I take SO many darned meds! tongue

In addition to the above, I'm also on flexeril 10mgs and I love it! It works really well for me most of the time.  There are times when I am in alot of pain, and I resort to lorcet, but only when I absolutely need it.

 

Posted 1/1/2008 3:33 PM (GMT 0)
I am on Flexerill 10 mg 3 times aday and it works well for me too.

Posted 1/4/2008 1:01 PM (GMT 0)
Hi There: I started the patch a few months ago, around 5. At first I thought, wow, pretty good, but I coninued to take percocet with the patches I stopped using the patch, I posted somewhere else about this, and now I am starting to wean of the percocoet. My experience on this first day is that the patch definitly increased my tolerance and withdrawls are much more severe. Definitly committed to kicking these meds but worried I have way too much tolerance now.

Thx
Posted 1/5/2008 12:08 AM (GMT 0)
In no way did I mean to question your decision.  All I was trying to do is tell you a little about my persoanl experience.  For me, my knowledge is from hind-sight.  I started the 25 patch and was initally delighted with the pain relief and being free from trying to remember to take medication every 4 or 6 hours.  However, now that several years have pasted and my tolerance to this medication has required to me move up about 25 every one year.  Like I said in my original post, I began by needing 25 mcg patch and within a couple of years in required 100 mcg to get the same pain relief.  I also found that I became needing stronger break through medications.  i a glad the patch works for you.  I feel trapped on it.  Yes. I am glad I have pain relief.  But if you are like me and some others and you require stronger and stonger doses over time, you may find yourself if a place where you are uncomfortable with the amount of medications that you need.  At this rate, I worry where I will be in another 10 years.  Of course I want adequate pain controll, but I do not want to be dependant on a medication the requires me to change the patch every 48 hours and spend another $15 dollars a month on a Tegaderm type dressing.  I wish I had stuck with oral medications.  I warnings for durgeics patch and strong and I greatly miss not being able to take a hot shower or bath.   On hot days, I really have to use caution wearing the patch.  You can not just decide to spend a day in hot weather - as it may affect you patch.  I had a severe reaction when I spent the day at an amusement park - after 7 hours in the direct heat my patch began to release extra medication and I had a reaction.  Once you develop a dependant, you can not just take the patch off so that you can particpate is specific activites.  I am glad everything is working fine for you.  I was just trying share my experience with you.  I was in no way was I ever passing judgement of your decision to use the patch.  I am several years into patch use and I regret my decision.  I was just trying to provide you with addition information of the patch.  I am so sorry that I cause you any offense.  That was not me intention at all.
Posted 1/6/2008 3:08 AM (GMT 0)
I had to go look at the brand of patch I use because I've never had a problem with it falling off - ever. I do use the Mylan. I guess I'm lucky that my insurance company pays for that brand since it sticks so well.

As for using the patch, I wish that I didn't have to use any pain medicine, but unfortunately, I do. I've been really happy with the patch. One of the problems I have is that I don't digest medicine normally because I don't have all of my intestines. The patch allows my body to absorb all the medicine. I wouldn't be functioning if I didn't have it. I'm hoping someday that my pain will go away, but until then I'm so happy to get the relief that the patch offers. I did have to increase my dose to 100mcg to get relief, but I had developed a tolerance to all pain meds. I think that's just what the body does. I don't like it, but I live with it.

I'm surprised your doctor offered methadone. I would choose the patch over methadone too. Somehow, methadone just sounds scarier. Good luck managing your pain. I'm so happy that you have found some relief. I hope that it continues and you get better and better.
Posted 1/6/2008 9:34 PM (GMT 0)

Hi Lucia,

My PCP initially started me on the patch a few yrs back. I was on the 25's and they did offer me some relief at the time. I was hurting so bad at that point I really did not care if it was a pill or a patch. I just needed some relief because emotionally the pain had begun to take a toll on me. My PCP does not, I repeat does not dole out pain meds either. I was a long time patient and he knew when I told him something I was being honest. It was my gastro dr that ref me to a pain specialist. My gi was as shocked as me that the PCP would write a script for a patch because most PCP's do not want the responsibility that goes with writing a triplicate script.

I stayed on the 25's for awhile and was taking BT meds only in dire circumstances. I then had to have an increase to the 50 because 25 lost its effectiveness. I did very well on the 50's for quite awhile. My only problem was the patch made me sweat profusely, it was awful. I had the store order me Tegaderms and I could cut them in half and I had no problems with the patch sticking. I could get in my pool and they stayed dry. I still got in our jacuzzi with it set at 98 and had no problems. I cannot get in a hot jacuzzi or hot shower due to BP problems. Hot shower drive my BP up real nicely. Again, I stayed away from the BT meds as much as possible. I have a very high pain tolerance so it was not a problems for me. I can handle some pain as long as its not the unrelenting kind. I know there is no such thing as being totally pain free unless, as my pain dr says, he turned all of his patients into zombies. So, yes we must put up with some pain. I was tried on numerous oral meds and either had a full blown reaction or the side effects were too nasty. My body just does not tolerate medications well at all, thats including all medications, not just pain meds.

I needed another increase in the patch and tried the 75's. I could not handle the 75's because I was unable to urinate on them. So, I now have a Medtronic Pain Pump and it works very well. By the way, I did try Methadone and it did not like me at all. I was rather disappointment because, Methadone is a very good cheap pain medication. But, only those who are going to be on pain meds a long time should ever be put on Methadone. Methadone is very hard to get off of and you must have your drs help to do so. Also, only a responsible person should ever be prescribed Methadone because its an east drug to OD on. It builds up and stays in your system thats why most peeps OD is they don't realize how much is in their system. I wasn't worried about the stigma attached to the drug, I am more into how effective a drug is. Its no one's business but mine as to what medication I take every day. Few people even know I have a pain pump. I just think for everyone concerned it just best not to let others know about your medications, that way you cannot be asked for some, or have someone snooping in medicine cabinets looking for a little stash. 

Hope everyone can have a much less painful New Year. Susie 

Posted 4/15/2008 9:19 PM (GMT 0)

My doctor put me the fentanyl patch about a month ago. 25mcg.  I was fine, thought they were wonderful until last week.  I guess I am one of the ones to have the side effects.  I started having panic attacks, rapid heart rate, high bp, just all around feeling terrible.  I took the patch off last Friday morning, was fine that day, but Sat, Sun and Mon just horrible.  I take it the withdrawels are bad.  I would not recommend them, but like I said, I have always been that Little percent that will react to meds.

Has anyone else had the effects that I described?

Deda

Posted 4/16/2008 4:10 AM (GMT 0)

Lucia,

Sorry you are into the fentanyl. I was there for four years, it REALLY did help, but watch out for mixing it with Zoloft. holy cow it can have a nasty effect. Alas, I have been off it four four years and tomorrow I know I will be back on it.  what a cruel mistress!I have been pain med free for a few months, but pain knows no logic!!!!! You can have nasty side effects on the patch  I had em all.... just stay hydrated..I found that drinking lots of water really, really helped....these meds rob our bodies of water whether we know it or not. My rheumy doc said to drink water, and lo and behold it REALLY helped, also take vitamins, as the pain meds SERIOULY ROB OUR BODIES OF NUTRIENTS!!!! Hang in there, and let me know if I can help, been in too many scenarios with the patch, all worked out for the best Overall. Be strong, Colerg

Posted 4/16/2008 6:10 PM (GMT 0)
Hi, I also use the fentanyl patches for many years. I started out low 25mcg every 72 hours and over the years and after all the back surgeries I was up to 2 100mcg. patches every 48 hours. They worked for me. I now have a pain pump and so have been going down on the patches to 50mcg every 48 hours and next month I'll be down to 25 and then none at all the month after that. The different brands that have been mentioned don't seem to change the effect they have on me but I do agree that the non pouch patches are easier to use and stay on better. As I said the patches worked for me and the reason I'm quitting them is because of the pain pump. So good luck with them and I hope they do help you. My one word of caution is that even though some dr.s prescribe them for every 3 days I personally don't feel that they work that long, I can tell after about 24 hours that they are wearing off. I'm out. Toritoo

My mistake I should of said after about 50 hours instead of 24 has to when they start to wear off.

Post Edited (Toritoo) : 4/17/2008 10:18:48 AM (GMT-6)

Posted 4/18/2008 2:09 AM (GMT 0)
Lucia,
I found these patches to be my humanity savor! I still do worry about becoming tolerant, and am coming to grips that I will be dependent on meds for the rest of my life (chron's meds at the minimum). This patch has allowed me to engage in hobbies and behaviours that allow me contact with other humans(shopping/fairs etc)

Though with the issues of recall, make sure your pharmacy has the patches in plenty of time(before you run out).

I hope you will be pain free, and if you need a higher dosage, so be it. Here's hoping for pain free days for all of us!(a dream is the wish your heart makes)
Posted 4/18/2008 3:22 PM (GMT 0)
Hi All,

I know I already posted on this site about the patches but in going over the other posts I noticed that everyone seems to react differently. Like I said I've never had a problem with my patches but not everyone is the same.

The one thing that really stood out on yours and the other posts was about the stigma attached to methodone. Methodone is not just for heroin users trying to get clean it is also a very good pain medication, I've been on it before and my Guy is on it on a regular basis for pain. It's too bad that this drug has so many negative conontations with it because it does work and if people don't take it just because they don't want to be on Methodone well I think that is just sad. There is no shame in taking any type of medication that your Dr. rx's for you but so many people say no just because of the name. I wonder if it went by another name if people would have the same problem?

I guess what I'm trying to say is methodone works well as a pain reliever for so many people and it might help a lot more if it had a different name but it doesn't and no one should be made to feel like a heroin addict by their pharmasist or family or whom ever knows you because of it. When it comes down to it methodone falls into the same catagory as most opioids(?) and we (CP'sufferers) should be able to take what ever works for us without any bad feelings. Have a tolerable day. Good luck with your patches and I'm out, Toritoo

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