(No Subject)

hi I'm new to this sit and happy I found it.... I just started the Butrans Patch 2 20mcg due to really bad Endometriosis I've had surgery and a DNC and have been in so much pain it's crazy this might be TMI but I can't even have " ALONE TIME " w my husband cause it hurts and I bleed.... So my Doc to me on the Patch and I'm almost on week 2 starting tomorrow and I still have pain and this thing itches sooooo bad!!! But I wanted to know what would be the best place to put it? I work at a school and would like it not to be showing I have both on my hips.... And they itch like crazy!!, what do I do? And do to all stuff I'm on I get really bad hot flashes and sweat like crazy!!! Help!!!!

no! Not really they went in and found that my intestines, bladder, and Uterus was super glued with Endometriosis.. I didn't even know I had this till a year ago!!! now I'm waiting for a Histaroctomy!!!!....

Hi Marie and welcome to the chronic pain forum. I am sorry to read that you are suffering so but it appears you have a dr that is listening to you and wants to help you. I do not know much about the patches you are using. You should have an insert that came with the patches and it should say on the insert where they can be applied. If the itching becomes too much of a problem you may want to give your dr a call. Some times this happens with patches.

Any way, I wanted to pop on and tell you hello and welcome aboard. Take care....Susie

Hi there...

As Straydog mentioned, there is literature that comes with the patch that specifically states the 8 sites, 4 on each side of the body, of where to apply the patch and they are to be rotated every 7 days so that you do not have a patch on the same area within 21 days. The sites are the upper outer arm, upper chest, upper back or the side of the chest.

Both this or the Fentanyl patch are supposed to stay above the waist and not applied to the legs so please make sure you are following directions.

I have to say I'm concerned that they have you started on such a high dosage and that you are on 2 of the 20mcgh.

The usual dosage to start is a 5mcgh patch for those that haven't been on high dosages of other meds. 5mcgh is for those that have been on less than the equivalent of 80mg of Morphine per day.

This is directly from the Butrans patch website information:

The maximum BUTRANS dose is 20 mcg/hour. Do not exceed a dose of one 20 mcg/hour BUTRANS system due to the risk of QTc interval prolongation.

Obviously I am not a Dr., just stating my own thoughts based on my experience with pain management and everything that I have read. One of the main reasons to always start on a low dosage of a new med is to minimize any of the side effects.

So, being on 40mcgh is probably one of the reasons you are having such severe itching as well as developing such strong headaches. Many people will add Benadryl to help with the itching as it usually subsides within a few weeks to a month. However, there are a certain few that just can't tolerate this type of application (transdermal).

It's VERY important to stay well hydrated when on high dosages of opiates. I drink about 12-14 glasses of water a day to keep headaches at bay.

You mention only Percocet or Norco. Is that all that you tried before as far as opiates go? Did they not try any other type of long acting medication like Oxycontin, Opana, Nucynta, or MSContin?

Many people with Endo are also on a nerve pain medication which can be helpful. These are either Lyrica, Neurontin, or Cymbalta. I was diagnosed with Endo many years ago as well as adhesions in so many places in my abdomen as I had cysts rupturing each month they even removed my appendix in one surgery as they were worried about this as well. My OB/GYN said that it was the millions of nerve endings that were affected by the adhesion's movement as well as the ruptured cysts so this is why that particular type of medication is a good addition.

Another helpful med can be an actual muscle relaxer like Flexeril or Amrix, Robaxin, Skelaxin, Baclofen, or Zanaflex.

Other treatments are acupuncture, massage, and daily walking and stretching to help the adhesions.

May I ask what surgery they are considering next for you? I certainly hope that you can get some help by it. I know quite a few people have had success from a hysterectomy but obviously this is the last resort and done when someone is ready for this.

Please make sure you are telling the Dr. about the side effects you are having so they can adjust things as needed.

Keep us posted..

 

Post Edited (Snowbunny21) : 12/19/2012 5:00:41 PM (GMT-7)

Thanks for sharing more...if you have bladder issues then yes, please be careful about the water intake to stay at the level they suggest.

That is just plain strange then for an actual PM Dr. to prescribe such a high starting dosage for the Butrans....but he obviously knows more than I do! LOL....I just got concerned when I read you are already on 2 of the 20's and that 20 is usually the highest dosage that people go to after being on it for a period of time. And since you were only on 30mg of Percocet a day, that is really not very "strong" at all and had plenty of room to move up on that or other medications to try.

Glad you have a call into them so you can tell them what is going on and what you should do from here.

And that is great news that you are ok with having the hysterectomy. I will pray that it works as well for you as I've seen many people on here say it has done for them!

I was also diagnosed with IBS back in my early 20's but I have been able to pretty much get ahold of those symptoms by staying hydrated as well as eating healthy. I moved to eating all organic a few years ago and that has made even a bigger difference! I'm not a vegan or vegetarian...Just everything in moderation but got rid of all the additives, preservatives, artificial ingredients..

It was an eye opener when I found a video online of some Drs. that did a study with a camera pill and eating Ramen Noodles. They followed the noodles from spoonful to the end result!! LOL

And it was startling to see how the body just doesn't know how to break down all the artificial ingredients. I mean, if it's meant to stay on our shelves for years and years, it doesn't digest very well I've found!

I'm not perfect with it as I will sneak in a Twizzler once in awhile...lol. But for the most part, about 97% of what I eat is all natural or organic.

I have been on SNAP (food assistance) for the last year and have no issues budgeting out my monthly food using coupons and going on double coupon day at my grocery store. Most places now have their own version of natural/organic foods so that has really helped prices come down.

The reason I share this as many people say it's just "too expensive" to do this but it's very doable. I actual spend a little less than before since I shop once a week and only buy what I'm going to eat that week. I don't just buy things on a whim to where they sit on the shelf forever.

Anyway, just some thoughts/suggestions for the IBS.

Let us know what the Dr. says...

I noticed you said you have two patches are you on a 40mg does then? I just have one patch for my 20mg.
I also know you said you are worried about addiction to the butrans, that percocet may be better, but percocet is a schedule 2 which has more addictive qualities than butrans which is a schedule 3.
I used to be on percocet, and I actually like the new combo I am given for pain. I have RA, fibro and hypothyroidism.
Everyone has different needs for their pain, but I just wanted to make sure you understood the drug schedule and knew that butrans has less potential for addiction than percocet. Its so hard having chronic pain and finding the right combination!

Oh no I just never really had to be on pain meds till the last year and I hate the fact that I have to take them cause of my medical issues and seen what they do to people! I've tried holding off on the pills to where I'm in sooo much pain and the doc told me not to do that cause its just hurting me. I've never been an addict to know the feeling of needing something maybe coffee!!! Lol so I always thought the 2 where the same!! And reading on the patch I saw it was addicting so I got concerned. But that's just me being a worry wort!! I did notice that once the patch kicks in I get migraines and start to get hot flashes and the doc said the patch will work for the HF which I hate I'm way to young for this stuff!!! But I did move the patch to my chest but on the side by my bra strap and its not itching my on my outer arm is itching dang IT!!! So I'll get Beynadril and see if that works... I'm happy that I'm I'm off the pills thou cause I hated having to take them every 4-6 hours!! But when I talked to the doc about after sex and how I feel and how I feel when I wake up she said she was going to give me the Norco to take at night or the am if the patch don't work !!! And it's all together 20mcg of the patch not 40!!! Haha my bad I read the label wrong!!!! So I should be good!! I'm just hopping I can get my Histo ASAP!!! Cause sometimes I feel like my Oversee are going to explode!! But I'm only one week 2 so I should start seeing improvements and not need anything at all just the patch and maybe IBU or Tylenol!!

I took butrans for awhile and also had the itching issue. I also had strong drowsiness once i went above 15mcg. I echo the concerns about your high dose, particularly if that is your starting dose. Sounds very dangerous actually. all meds (particularly opiates) should be started low and titrated up. These meds can really depress the respiratory system. That aside, suboxone is a very similar med that is taken orally and can be used instead of butrans if the butrans is helping the pain, though it sounds as if it isn't. butrans is one that is usually used further down the line after many of the oral meds mentioned above. Hopefully you hear from the dr soon so you can figure it out. Hopefully they take you off the butrans slowly or you will prob have severe withdraw with that high of a dose. sorry things are so tough!