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Posted 6/26/2012 3:56 AM (GMT 0)
I am so glad to find this board. I've lurked on others but never really wanted to post till now. I have been on lortab 10/500 for a very long time. I moved and had to find a new pm and my new doc took me off the pills and put me on 25mg fen patch. I'll put on my third patch in the morning. I'm getting pain relief pretty good but I just don't feel happy for some reason. I'm not sad, just kind of blah...it's hard to explain really. Tomorrow, I have the choice to put two patches on if I feel like I need an extra one but I just really don't want to, but to be honest, I was wondering if it might not help my feelings. I don't get the "high" from pain meds that I did when I first started taking them eight years ago but something is just different and I can't figure it out. Has anyone else been through anything like this? I've never abused my meds and putting on an extra patch when I'm not really sure if I need it or not seems kind of stupid to be honest.

By the way, I've got chronic neck problems. I've had injections, pt, and a second opinion and now I'm looking at a bunch of more procedures from my new doc. I know I've left a lot of information out but like I said, I'm new at this posting.

Thanks for any advice you might have.

Annie

Posted 6/26/2012 4:14 AM (GMT 0)
Hi Annie...

Welcome to the board.

I do think that different medications can affect our moods. I suffer from depression (relating to my health issues) - and I've had medications make me feel worse... etc.

Did this "blah" feeling started after you started the fentanyl? Or were you already feeling this way beforehand?

Anyway - I personally would only put the extra patch on if needed for pain. Since you are saying that you are getting good pain relief... I wouldn't increase. Trying to stay on the lowest possible doses of medications is important if you have chronic pain.

In addition - if you continue to have mood issues - I would encourage you to go in and see your doctor - and let them know what's going on....

Let us know how you are doing... and, again, welcome to the board. --Tina
Posted 6/26/2012 6:35 AM (GMT 0)
Annie,

Welcome to the forum. I am glad you decided to post on the site, but sorry for the pain that brought you here.

I am on the fentanyl patch as well, and have had successful relief for the last 2 years in August. I am happy with it now, but my first two months were rough. I had dizziness and vomiting and got the blah feeling you are describing, but mine tending more toward depression. I have a history of depression and anxiety, and my doctors were aware of this and ready to help me when I informed them.

As Momto8 asked, have you ever had depression before? Have you called your doctor to tell them of the new blah feeling? Are you on an antidepressant now?

I can tell you that I choose to stay on the  lowest dose of medications possible because tolerance to the medications can happen. My medical issues are expected to be life-long, so I want to keep tolerance at bay for as long as I can. If you are unsure about putting on another patch, I would follow your instincts. You know your body best.

These are just my experiences. Some people wear the patch and have no side effects. Everyone reacts to medications and procedures differently. You must work with your doctor to find what is best for you. I urge you to call your doctor if the blah feeling continues or gets worse.

I hope that the blah feeling lifts and you get the pain control you are looking for. Please keep us posted. I would like to see how you are doing.

Mindy

Posted 6/26/2012 12:48 PM (GMT 0)
Hi Tina and Mindy! Until I was put on the patch, I was just fine. I'm on Zoloft for depression and I had my meds working just right for me so why did this doc think he needed to do this? He says he doesn't like giving out pills. It just doesn't make sense to me why he would put me on the patch knowing it was so much more potent than the lortab. I'm going to call them today and I'll let you know what they say.
Thanks for the advice!
Annie
Posted 6/26/2012 1:38 PM (GMT 0)
       Hello Lovencis!...and Good Morning!          I wanted to Welcome you to the "Chronic Pain Forum"....and say that I agree with both Tina and Mindy here. I too wear the Fentanyl patch, but have not recieved the relief I was hoping for. However, I just started these about a month ago, and am at the starting dose of 25mcg. I had trouble with the Matrix type tape, and got no if little relief from them, so I switched to the Gel type, and it has been effective to a small degree.     I too find it odd that your PM has jumped from the Hydrocone to the Fentanyl, and I fear that it may set you up for problems down the road, as this is the most powerful pain med out there. What will be his plan,... once the tolerence has built up, to where they are no longer effective?     I also agree with Tina, that if you are doing fine, as far as pain relief with the single patch, than it may not be a good idea to add a second one.       Depression can go hand in hand with Chronic Pain, but as Tina says, you need to let your Dr know, and he may be able to offer a script for that.      I'm curious  as to what he will do for you, once you let him know what is going on?... so please do come back and update us. The information you provide us here may help others, and visitors that are reading these post on a daily bases. Kind of like when you were watching this forum for a while,... before joining us.         Take care, ...Welcome!.. and enjoy the forum and it's wonderful members!           SE
Posted 6/26/2012 1:45 PM (GMT 0)
Some doctors believe the patches are harder abuse that pills. Others believe that the patches deliver more consistent dosing than is possible than pills. It usually comes down to one or both of these reasons why some prefer to prescribe the patches more than pills.

My best guess is that it is the Fent patch that is giving you the "blahs". This medication, when used in small doses does make a good pain reliever but in larger doses it is used and an anesthetic. It may be that you are more sensitive to its sedating qualities. Not enough to make you sleepy but enough to bring you down a bit.
Posted 6/26/2012 2:19 PM (GMT 0)
       Jim that may be, however from what I have read the Patches are very easy to abuse, and I find that they are a safety concern around children. There have been cases where children have pulled them off of their parent or grandparent, and stuck them to themselves to mimic and or out of curiositie ...or have picked them out of the trash, and died as a result. I have more of a safty concern, and respect for this med over any other that I have taken to date.   Many of us lock up our med's until they need to be taken, and as with pills they can be Immediately swallowed, but the patch,.. o bviously is different, and a real concern. We just saw a warning from the FDA on this a while back with the same warnings.      So, it seems that there is an abuse concern as with most all pain med's and also a saftey concern as well.       I think you have a good therory and comment on the sedating qualities, and may be a possibility in Lovencis case.    SE               
Posted 6/26/2012 10:59 PM (GMT 0)
Thanks SE and Jim,
I really appreciate the good advice and everyone is so friendly and helpful! I agree that safety is a major concern. I keep my meds locked up tight and have no small children living in the house. Believe me, I dispose of the used patches where there is NO CHANCE of anything happening with a child or animal! I will keep you all updated!
Thanks again for all the help!
Annie
Posted 6/27/2012 12:11 AM (GMT 0)
Never said the patches couldn't be abused. Just said they are deemed by the medical community as harder to abuse.
Posted 6/27/2012 1:52 AM (GMT 0)
Hello. I have been on Fentanyl patches for nearly a year now. Started at 12.5, then 25, then 50, and have been on the 75's for about 3 months now. I switch every 48 hours vs. the more normal 72. They never make me feel one way or the other, I definitely don't get any kind of "high" feeling from them. They simply cut the bulk of my cancer related pain. I still take on the average, of (6) Loratab 10/500's a day for breakthrough pain.

The Loratabs don't make me feel anything either, other than pain relief, but I have been on them for 2 full years now.

Different people do react to different meds. My dr. recently switched me to Dilaud, and I didn't like the feeling, the dizzyness associate with it, etc, so he switched me right back.

Everyone is different with meds, for sure.

Hope you get use to them

David in SC
Posted 6/27/2012 2:00 AM (GMT 0)
Hey David, I agree, everyone reacts differently to different meds. Hopefully I will get things smoothed out with the patches. Take care!
Annie
Posted 6/27/2012 4:06 AM (GMT 0)
Thanks, Annie. For me, dealing with Severe Pernament Nerve Damage caused by faulty Salvage Radiation after having failed surgery for Prostate Cancer, the Fentanyl Patches have been the best thing I have ever been on for getting rid of the bulk of the 24/7 pain. Once we found the right dose, which right now is at 75 micrograms. At first, we swtiched every 3 days, but within the first month, discovered that every 3rd day right on schedule, I would have a bad pain day (well worse than the others), so my oncologist who is also my pain manager, wrote the prescription to switch the patches every 48 hours, or 2 days. I go through 15 a month this way, and never had an automatic bad 3rd day. For some odd reason, at the CVS drug store I have used for years, it cost me less money to buy 15 patches than it did when I was buying 10 patches. No reason given, but saves me a little. Under my medicare prescription plan, I pay $41 a month for the 15 patches, which I find very reasonable, especially if you ever see the list price for them.

Hope you get things straightened out, being on the right mix of pain meds at the right doses, is half the battle to me.

David
Posted 6/27/2012 4:12 AM (GMT 0)
P.S.

Most doctors won't just put a person on Fentanyl. Typically, you have to be considered "opiate" tolerate for a good period of time before using Fentanyl. It is not used for short term pain relief, i.e, like if you just come home from the hospital. My dr. felt I was safe, since I had already been on heavy daily doses of Loratab for over a year before he started me on the Fentanyl.

While I feel it's a safe and effective drug if used 100% properly, its also very potentially dangerous. It is synthetic morphine, and is said to be 100x stronger than herion dose for dose. You also have to be careful being in the sun or getting to hot while on the patches. My doctor forbids me to use our Hot Tub, or even to take a tub path while on the patches. Just something to think about. There are too many accidental Fentanyl deaths every year in this country, most could have been avoided.

I mark all the days I switch patches down in my Daytimer. My rule, is I always take the old one off first, dispose of it properly, then put the new one on. I wear my along the front of my shoulder, and switch arms every time I switch the patch. My wife is a very experienced nurse, and she sometimes double-checks me, to make sure that I haven't forgotten to take off the old patch first. I wouldn't want to accidently overdose because I get forgetful. Sorry, don't mean to preach here, lol.

david
Posted 6/27/2012 5:08 AM (GMT 0)
I was switched to butran after years of hydrocodone and percocet. At first I felt a little down to, but the pain went away and stayed awaay. I think our brains do get some sort of high from the pills, now not all brains but some, also with the pills I would get this weird amount of energy I thought it was just because I felt better, but now I realize it was probably Euphoria. I am glad to be on the patch now, it helps me so much and finally I just feel normal again.

I hope you get yours working right soon!

Posted 6/27/2012 12:45 PM (GMT 0)
 

        David, I agree with your information on the Fentanyl patches, and am very glad to see you sharing your experience here on the CP forum with us. We appreciate it! wink

       SE

Posted 6/27/2012 1:23 PM (GMT 0)
SE - thanks, i am going to devote more time here, as on the prostate cancer side, there is nothing that can be done at the moment to slow down the cancer, it is what it is. however, i have been living with severe chronic pain for 2 years now, and been dealing with cancer related chronic faitgue for 12 years (had been through major radiation 2x in the past 12 years, had 3 bouts of another serious cancer prior to the prostate cancer. so i can relate to the good folks here at HW CP community

Kate - I agree with you. My oncologist put me on the 12.5 at first, and we have slowly incresed to the current 75 over a period of a year, I have to save something for later, when my cancer progresses further. I don't have any problems with adhesion, as I am one that barely if ever sweats. dr's nurse said you can put one layer of what they call "pink" tape over the patch, but not to cover it entirely if adhesion is a problem. when i shower, i make a point of not aiming the water directly over the patch, then i pat dry the patch as i am drying. so far, never have had one come loose.

david in sc
Posted 6/27/2012 2:27 PM (GMT 0)
           Kate, I found that the Matrix tape type of patch stuck very well!...however it did not release the med into me much at all, and I had to revert back to the gel pack type for better coverage of my pain.    One thing I did on one of them was to shave a small area, because I a very hairy man...and that was a big mistake, as the body oil on the razor c ontaminated the surface of the patch and the sticky ediging around it...and would not stay on. Even after I reapplied it with TegaDerm...it was ineffective for pain reduction...and I had to remove it and apply a new one.      It is very improtant that the surface of your skin is very clean for best results. Now last night while taking a shower, I happedned to see a Pumice stone that my wife uses on her feet, and thought I would use to it to help remove some of the adhesive! I can tell you now...Don't Do That! I got an instant road-rash..and that hurts!  LOL!     I will assume that Micropore is about the same as the TegaDerm, and it work the best for me. David mentioned the placement of his patch...and I use the same places as well. I also raise my arm to relax the skin and apply the patch as tightly as I can...and them when I lower my arm, it makes it even tighter and gives full coverage to the surface of the patch.       I have found that when you place it on a rounding surface it seems to work better...and you want to avoid any fatty tissue if possible. I also tried it on the torso area under my arm, and found that I seem to sweat more there...so on top op the shoulder seems to work better for me. I have heard of patients putting them right over the place of the injury...but not sure if that is more effective or not.      I do have a question for anyone here using the gel type!...when you remove the patch, have you checked to see if any is left over in the reservoir? I have looked at mine that last couple of times, and after stripping it with my fingers, found a small amount left in it. I figured it would be all gone, as I can feel my pain getting worse late into the second day. I change mine out every 72hrs (3days)..and still not happy with the results.       Good luck, and I really appreciate this post, as many of us use this type of pain med.      SE  
Posted 6/27/2012 6:01 PM (GMT 0)
SE, my pharmacist had me try one round of the Gel-type patches, I didn't care for them too much. For me, it seemed to quickly drain the "med" too fast, and found the resivoir empty by the end of the first day, plus I had a bit of a hard time getting it to smooth out right. I agree with you, putting it directly over a damaged area really wouldn't prove much, as the med is abosrbed through the skin, then distributed through out the body. I have heard of some folks talking about itching and mild burning, but I have never experienced either sympton.

I hate to contibute polluting our water systems, but even the doctor said to flush the old patches down the toilet. As a nurse, my wife said that people will dig through trash cans to find and even eat the used Fentanyl patches. Hard to believe. Where she works, they have to account for every single used patch from the patients, and even have to log them in for DHEC purposes.

I really don't get that obsession with the drug seekers, I get nothing from them except for discrete pain relief.

As far as addiction, both my oncologist and urologist/surgeon have repeatedly told me, that if the body is really in severe chronic pain, the chances of becoming addicted in the normal sense usually doesn't happen. But if they were used for any recreational purpose, you could be hooked as quick as someone trying heroin even once. Not an issue for me, I don't take anything I don't need, don't do any recreational drugs, and only take what I take to the letter of the prescription. Gee, this is a guy that hasn't even had a sip of beer or wine in nearly 40 years. If a miracle happened (and that is what it would take) and I woke up without pain, I would be more than happy to end my use of these meds in a heartbeat. But right now, without them, my life would be a living hell, much worse than it is right now. Couldn't imagine what the pain would be like without the meds, too scared to think about that.

david
Posted 6/28/2012 7:15 AM (GMT 0)
Michael,

When I was on the patches, like David, I used to flush them too (sorry water system, lol). But I felt that was the safest thing to do w/ so many kids in the house.

Re: the gel patches... as I said before, those were definitely the ones that worked best for me... but, 99% of the time, they were "dry" by 48 hours - which is why I would always get it scripted to change after 2 days.

LOL - the mental image of your using the pumice stone on the "rectangle adhesive leftovers" makes me laugh, lol. Ummm, yeah - that probably hurt!! Instant road rash, lol... But yes - that adhesive gunk is HARD to get off, isn't it? I found some success w/ rubbing alcohol.

:) --Tina
Posted 6/28/2012 9:07 AM (GMT 0)
LOL! Tina!…I got no sympathy from my wife after such a foolish stunt either! tongue I have to laugh at myself as well..just wasn't thinking, but ever so glad that I didn't try a blowtorch to burn it off! shocked

I have used the rubbing alcohol , but felt like some of it was still there….I will have to be more careful I suppose! tongue

SE wink
Posted 6/28/2012 12:43 PM (GMT 0)
There are special wipes to remove adhesive from the skin.  You can find this at medical supply businesses in your area.

 

Mom, by flushing the patches down the toilet, you are putting the medication in everyone's water source!  You should never flush any medications down the toilet.  You could buy a lock box and put the patches in a zip loc bag and in the lock box until garbage night.  That's what I would do.

 

http://www.usatoday.com/money/industries/environment/2011-03-03-1Apurewater03_CV_N.htm

 

Sherrine

Posted 6/28/2012 12:48 PM (GMT 0)
        Sherrine, I wondered the same thing, but right there on the box..it states how to disgard them..."by flushing them down the toilet" ....I don't do that at our house as we are on our own sewage system out in the country. You would not think a Medical company would tell it's customers to do this, but again it's right there on the box of instructions.       I forgot to mention that you are not supposed to clean your skin with rubbing alcohol before applying the patch, as it will leave a residue. If you do use it for cleaning the skin, you are to then wash the area with a mild soap and rinse thoroughly    with water.   SE
Posted 6/28/2012 2:05 PM (GMT 0)
good old fashioned witch hazel is great for getting rid of too much adhesive goo. you can still buy it at most drug stores.
Posted 6/28/2012 2:15 PM (GMT 0)
 

      ...now that is some slickery stuff! tongue   I have not heard of that product since I was a kid,...way back in the Brill Cream and Asorbine Jr days! smilewinkgrin

      Thanks for the tip David!

   SE wink

    

Posted 6/28/2012 3:59 PM (GMT 0)
For me, flushing the patch is the best option.... first, that's even what the drug manufacture says to do....as well as the FDA. The FDA says the risks of the patch being in the garbage outweigh the patch being flushed - due to the fact that the drug, in the wrong hands, can be fatal.


--Tina
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