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Posted 7/4/2012 4:59 AM (GMT 0)
Hi Guys

Just feeling down lately and I know you all will listen and that way I dont have to complain to my husband. With the heat I live in Kansas the butran patch is not doint well even with the tegaderm it still lifts away from my skin with sweat. So I have been dealing with more pain. I see my doctor on July 10, and I dont know what to say because I do not want to go on all pills again. I have loratab for BT, but that patch keeps me more even , and normally works with the pain. So should I even mention it at all or just deal with it through the heat its only 2 more months really. I have had to take more of the loratab and together they make me so sleepy, but I think when its not hot I do great with the patch. What do you all think?

Thanks!

Posted 7/4/2012 5:12 AM (GMT 0)
Ryobi can you put your patch on your upper arm and then just wrap gauze or something around it to keep it in place? I know I sweat allot and when it is hot my skin gets oily and I have a hard time with anything sticking to it. When I used to use the TENS unit I could never keep the electrodes on. And I am allergic to allot of the tapes, so that would not work eithe. Anyway it is just a thought, if you could put the patch on your upper arm and wrap it in something, I thought that might worlk for you during this hot weather.
Good luck to you, and try and keep cool

White Beard
Posted 7/4/2012 5:14 AM (GMT 0)
Hello Ryobi!

I too live in Kansas! Glad to meet you! wink

I also wear a patch, but is Fentanyl, and use the TegaDerm successfully. However I'm on a three day replacement and well into day two, not getting enough relief, and revert to the BT med's. I'm thinking there is a sports tape that you can use on the outer edge of the patch, and you might try using both the TegaDerm along with the sports tape, but not covering the TegaDerm, as it needs to breath I believe.

If your getting good coverage during the winter months, then I believe I would try to make it trying the tape first. I too can't stand the BT and or oral med's, and found it very odd not taking them when I started on my first patch. So in a way I do understand your problem and sympathize with you not wanting to revert back to the oral med's. White Beard also makes a good point, and I'm wondering where you are placing it? I place mine on the rounding part of my shoulder/arm, and also found that if I place it under my arm lower on the torso, I would sweat more there, and have problems. You might try rubbing alcohol, but even then you are to wash that area as it will leave an oily base believe it or not.

I'm thinking your patch may be a 7day patch?….maybe they can change you over to Fentanyl, as it can be changed out every 2 to 3 days and may stick better for that length of time.

Keep checking here and lets see what other members have to say.

Good luck,

SE wink
Posted 7/4/2012 12:33 PM (GMT 0)
I do the upper arms switch each week, my upper back and chest sweat way to much I tried that and they slid off early. But the tape is something I could try, thanks guys! Now with the fentenyl, does it make you sleepy, I still have to function daily as I have three kids. Thanks
Posted 7/4/2012 1:13 PM (GMT 0)
Good morning Ryobi!

The Fentanyl is the smoothest med to date for me, and makes me feel like a normal person as long as it is working. It does not have the mountain peaks like the Oxycodone I have used in the past. It is almost silent as it takes effect, and reduces the pain without me knowing when it hits. The same on the downward cycle,…it's a smoother ride down hill. Pain wears me out, so I do sleep quite a bit, but I work a full time job as well, so it would seem logical that I'm worn out at the end of the day. If anything…I'm up at times throughout the night, but that is from a combination of things. (Stress, Pain, full bladder and so forth)

I like this med the most of all that I have tried so far, but again, as I said coverage for 72hrs has not happened yet, and I believe I need a higher dosage, and a 48hr turnaround time instead of the 72hr changeout.

It's not good to suffer if your not getting coverage, either from a dose that is too low, or the fact that the patch is not staying put for you. I myself would seek suggestions from your PCD/PM. You might also try to contact the company that makes the brand of patch you are wearing, and they might have a suggestion or two for you.

Where about in KS are you? I live close to Wichita….are you within reach? There are a few of us Kansan's here, and one of my best CP friends used to live here close to me. We used to get together all the time, until her death over a year ago. I miss her dearly! cry

Good luck!

SE wink
Posted 7/6/2012 7:22 AM (GMT 0)
Breakthrough pure-agonist pain medications used with the BuTrans patch (buprenorphine)?! That doesn't make very much sense IMHO. The "bupe" would be almost certainly blocking the Hydrocodone and you might even have the two fighting each other at your receptors with less than optimal effects. For one thing I would definitely not expect to be able to get any noticeable benefit from any dosage of hydrocodone (or any traditional opioid agonist that I'm aware of, whereas buprenorphine is a mixed/partial-agonist-antagonist and so behaves very differently -- not to mention incompatibly -- from any of the former) while taking any form of buprenorphine; that's why it's used as an addiction treatment as well as a chronic pain medication.

Generally buprenorphine is used alone -- not alongside traditional agonists for "breakthrough." I don't mean to suggest that I know better than your doctor, but at a minimum if I were you I would want to explore very carefully whether this approach is the best for you and whether you should switch to an oral/sublingual form of buprenorphine to avoid the issues with the patches, or perhaps you are experiencing something that is individual to you and your situation (you do mention that together you notice they make you sleepy, which does suggest the hydrocodone is in fact doing something even though on paper it shouldn't be able to) which I can't speak to since I don't have much first-hand experience with buprenorphine in any form.

FWIW....one way or the other I think you will probably want to consider talking to your doctor(s) about some sort of changes, but I wouldn't want to imply that I know with any certainty what the best move for you is; just that it sure sounds like a change would be warranted if I were in your shoes based on what you've said so far!
Posted 7/7/2012 4:27 PM (GMT 0)
I hope you are feeling better in that heat! I like white beard's suggestion of taping the patch on. Sounds like it is time to switch your pain management drugs, once they stop working it doesn't get better easily unless you get new drugs or try the ones you did before this treatment. I wish you well!
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