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What's up with Fentenyl Patches?

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Posted 8/30/2007 4:18 AM (GMT 0)

Hey folks,

I've had chronic back and knee pain for many years.  My pain management doctor won't prescribe any medication for me, just an ongoing series of epidurals and nerve blocks.  They do me no good.  I've played by the rules with these shots for over three years.  Still, I am in constant pain and have no quality of life.  I can barely take care of myself, and am not able to do even the most basic housecleaning or laundry.  I really think Fentenyl patches would greatly improve my quality of life, but I think I have a snowball's chance in hell to get my pain management doctor to prescribe them for me.  I was wondering if anyone has used, or is using the patches.  Also, what conditions are you on them for? 

I'm just so tired of not being able to do anything, and more fed-up that I'm still in pain when I'm sitting still.

I would appreciate any information or recommendations you all might have.

Thanks,

Leigh Ann cool

Posted 8/30/2007 7:08 AM (GMT 0)
I have been through all those shots and therapy, have had back trouble for 20 years, no one would treat it when I first injured it because I was 25 years old, now I finally get to a pain management doc who prescribed me the patch, was on 50's for 2 months I felt like they were working but needed a little more strength to them so I asked him for it  and he got all *issy with me so I went to my PCP doc and she gave me the 75's with change every 48 hours and I have never felt this good in years, I would definately recommend getting them if possible, it has changed my life. Hope that helps you. Oh I have been diagnosed with DDD, Tarsal tunnel in my ankle, Plantar fascia (which I had surgery on, didnt help) I also have a SCS unit in, Take Neurontin, Relafen also. :)

Posted 8/30/2007 1:47 PM (GMT 0)
From the information you're providing, your condition is simply not being treated properly. Of course, that makes NO sense.

Some PM docs just don't believe in prescribing opiates. No matter what the reason is, they ARE robbing you of quality of life. It should be fairly easy to find a doctor who will prescribe what you need to get your pain down to a level where you can function. There are more options than just Fentanyl, but in my opinion it is one of the best choices for chronic pain. I wouldn't get too hung up on a "Pain Management" doctor either. A general practitioner can prescribe it and they generally know as much as a "Pain Management" doc about the drug.

Good luck. Find a doctor who will treat you!

extreme
Posted 8/30/2007 8:02 PM (GMT 0)
Ya, to get the patches I believe that you generally have to have been on some sort of opiate for a while before them and be opiate tolerant, because fentanyl is such a powerful drug and I belief it has a lower therapeutic index than some of the other opioids (the therapeutic index is the difference between the dose that controls pain and an overdose). Remember that there are a lot of other options other than fentanyl patches for pain and I have heard that a significant number of people do not get very good relief from fentanyl.

Good luck finding a solution for your pain,
Circa
Posted 8/31/2007 1:38 AM (GMT 0)
Hi,I'm on the pain patches and they have helped me alot,in fact I know how I ever made it through before being put on the patches.I was started out on the 25's but was upped to the 50's.I also have oxycodone for break through pain and they are 30mg's and I'm allowed 4 aday.have you thought about seeing anothe pain specalist(sp)because you are by far not getting the help you need and no one should have to suffer from being in pain.Please le us know how you are doing and let us know if you see another doctor.
Posted 10/3/2007 1:18 PM (GMT 0)

Hi...

My suggestion to you would be that if your pain doctor is no longer helping you, seek a new one!  That's what I had to end up doing.  I was seeing him for over two years, and he gave me nerve blocks which of course didn't work for me, along with trigger point injections (which he wasn't doing correctly).  I would see him once a month to get my scripts and he would spend all of 5 minutes with me, ask me how I felt (which was the same every time I saw him) and said he'd see me in 4 weeks.  I was getting nowhere.  He didn't suggest anything new. 

There has to be a valid reason your doc isn't giving you these patches.  Maybe they'd react to your other meds?  If not, find out why he won't give them to you.  I've been on the patches for over two years and started with 25mcg, then he moved me up to 50mcg.  My new pain doc, on my first visit with him bumped me up to 75mcg.  Unfortunately for my pain, they still don't help.  My problem is Occipital Neuralgia and the pain is really deep into the base of my skull.  The patches might work for you, though. 

 

The best of luck to you.  Remember though, if you're not getting anywhere with this doctor, seek a new one.  That was the best thing I could have done.  After four years of suffering, he is the first one to give me a diagnosis.   :-)

Posted 10/3/2007 2:48 PM (GMT 0)
I'm with the others, find a new doctor. 3 years is WAY to long to wait to find someone that will LISTEN to you and help you have a quality of life that you are comfortable with. Can you pcp recommend another PM doc?

Keep us up to date...

Rob

Posted 10/3/2007 4:24 PM (GMT 0)
I'm not sure if your primary doc can or not.  I honestly don't see any reason why not, though.  If you have someone new in mind, bring your pcp the information and see what they say.  I got referred to my new pain doc through another doctor I was seeing for Prolotherapy. 

 

Believe me, I know what it's like to suffer for so long (4 years plus) and have no one undertand/believe/help you.  Nobody should have to go through that.  Talk to your PCP and see what he says. 

 

Keep me updated. If there's any other information I can offer, I'd be glad to help.   :-)

Posted 10/4/2007 2:16 PM (GMT 0)
Sounds to me like you have a Shot Jockey for a PM doc. These docs just love to push the shots because they make lots of money from them. On the other hand, he may just be one of the breed who is anti-narcotic for all but terminal patients. Plenty of those out there too. By now, I think it's been proven that the shots have been nothing short of a spectacular failure for you, and it's past time to try something else.

As for jumping right on to the fentanyl patch, it is not a first-line defense for pain. You have to have already built up an opiod tolerance. Usually that means several months on a short-acting narcotic like hydrocodone (vicodin, lortab, norco, etc.). Fentanyl can be very tricky for the opiate naive. With the short-acting meds, patients usually know if they've taken too much - nausea, dizziness, that sort of thing. With fentanyl, those symptoms don't always show up and the patient doesn't realize there is a problem until breathing problems commence. I say this only to educate you. If you tell a doc straight up you want to jump on fentanyl without already having tried other meds, you may be disappointed when the answer is No. It is a very effective medication when used properly.
Posted 10/8/2007 1:03 AM (GMT 0)
I know this is a little late, but I have been on the patches (50mcg) for over a year. I noticed that you have had gastric bypass. I had gastric bypass in 2003 and I also have a genetic bleeding disorder so I too cannot take any NSAIDS EVER.

I don't know if I am allowed to do this, but I am attaching a link to a study that talks about the fact that post gastric bypass we do not absorb medication the same as before. I have taken a copy of this study to all of my doctors, now most of my meds have to be liquid. My PM says that I have the same issues that those with short gut syndrome have.

Here is the link http://www.ajhp.org/cgi/content/full/63/19/1852#SEC5
Posted 10/10/2007 12:21 AM (GMT 0)
I was prescribed fentanyl patches for migraines/fibro and I had not previously been on any narcotic medications continuously. I had a bit of a time adjusting to the constant medication flow, more nausea and fatigue than anything. After the initial adjustment phase I found that it worked very well, PROVIDED they were used exactly as directed. For example, if I forgot to change the patch exactly 72 hours as i was prescribed I would be very nauseated when I did change the patch!

Talk to your doctor, if they are not willing to help. Fire them and move on, You are the one living with the pain.

good luck

 

Posted 4/2/2008 7:31 AM (GMT 0)

CRANKY 1 said...

Hey folks,

I've had chronic back and knee pain for many years.  My pain management doctor won't prescribe any medication for me, just an ongoing series of epidurals and nerve blocks.  They do me no good.  I've played by the rules with these shots for over three years.  Still, I am in constant pain and have no quality of life.  I can barely take care of myself, and am not able to do even the most basic housecleaning or laundry.  I really think Fentenyl patches would greatly improve my quality of life, but I think I have a snowball's chance in hell to get my pain management doctor to prescribe them for me.  I was wondering if anyone has used, or is using the patches.  Also, what conditions are you on them for? 

I'm just so tired of not being able to do anything, and more fed-up that I'm still in pain when I'm sitting still.

I would appreciate any information or recommendations you all might have.

Thanks,

Leigh Ann cool

FIND ANOTHER PAIN DOCTOR,PERIOD. I went from a pain doc (I have 5 herniated disks) who would give me nothing but 100mgs. methadone,he killed him self, to a wonderful doctor that will let me try ANYTHING i want if I think it will help. He first put me on 2 40 mg. Extended release Oxy's, and 3 30 mg. quick release Roxy's for breakthrough, and 2 2 mg. klonopin. It made me depressed, so we went back to 120 mg. Meth, with the 3 30 mg. Roxy's, better. Now the DEA's got a bug up their ass about methadone, 10mg. incraments only, so thats 12 tablet a day X 30. We're fixing to try something else. There is an understanding Doc out there, just make sure he is a PAIN DOCTOR. And you take Stadol. I think that may put you in withdrwawl if you use with opiates. Ask people in the hospital,Dr's offices when you go. Anyone in pain will be GLAD TO HELP find you an understanding doc. I live in the South, and there are 2 or 3 UNDERSTANDING Dos's in my town.

Good luck.

Posted 1/16/2011 3:01 PM (GMT 0)
  My mother uses the patches,and they really help her,she could not ccook for herself without them. I would change Dr.s if I were you. If you have that much pain,there is no excuse why he won't give them to you.

  She has cronic pain from back and both knee arthritis. She is 81 and she takes the 100 MCG. Patches.  These are for older people she told me her Dr. told her.

I hope this helps

Posted 1/18/2011 9:49 PM (GMT 0)
I have the patch. I started out with 25, moved to 50 and have recently been upped to the 75's. At this point when I go back to see my pain mgmt guy, he said he will go with the name brand vs. generic. I was advised that with this type of drug, there is indeed a difference. So when I do get the name brand one, I will be sure to let you all know if there is a difference.
Posted 1/19/2011 1:06 AM (GMT 0)
I agree with the others that you really need the patches to be managed by a PM. Too much danger to be managed by a PCP. There are bt versions of fentanyl. That's how the started me b/c I would overdose on the patches. Actiq is the lollipops, Fentora is the quick dissolve tabs and Onsolis is the "listerine-strip" thingies.
I hated the Stadol, but gosh if it didn't knock those migraines out of the park. Couldn't take it every day, though. I think I got maybe one or two a week. Have you tried the Imitrex IM shots? I love those things. Work like an epi-pen. I could be in the midst of a horrible migraine, crawl into the restroom to give myself a shot & 15 minutes later be okay to sit under florescent lighting for an hour long meeting. They weren't cheap & freaked me out a bit b/c they make you feel like your throat is closing up [my neuro gave me the first one in his office so he could show me that my throat wasn't really closing] but gosh they work like a charm on my migraines. There's a limit on the Imitrex too. Still, its benefits lasted longer than the Stadol.
Fentanyl has worked well for my back pain. Never did much for migraines, though. It does help with my Chiari headaches. Are you positive that you actually have migraines? There are a lot of other types seriously debilitating headaches that can mimic migraines.
Posted 1/19/2011 5:13 AM (GMT 0)
 Hi Folks,

This thread is from 2007 , in case anyone missed it before replying.

idea   idea

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