My Medication Mistake

Wow Shell, what a mess! I've experienced that misery myself a few times over the years. It feels like the worst flu you've ever had - times 2! The fentanyl withdrawal is actually worse than the oxycodone, but you were withdrawing from both - UGH! And here you were trying to do the right thing - bet you won't do that again! Lol

I used the Duragesic patch for about a year and a half, many years ago. I was allowed to use my hot tub (part of my P/T), as long as I covered my patch with the Tegaderm (which I used anyway) and didn't submerge the area of my patch - not too hard, as I put mine on my upper arm. I was told to only stay in for 15-20 mins. at a time and then get out for 10 mins. or so. Of course I wasn't allowed to use the sauna or the steam bath. I used the hot tub a couple dozen times and never had a problem. But please ask your doctor what he thinks, if you want to do this. Oh, to answer your question about the patch 're-sticking' to your skin? No. With the ones that I used, the adhesive was pretty much gone once I removed it. And if I remember correctly, once the drug delivery process is interrupted like that, it doesn't work properly if re-applied. Well, I hope that helps. And DON'T try and do the right thing again! (jk!)

I was always told not to use a hot tub when wearing a patch as it heats up your body temperature too high and can release too much medication. It may be different in a medical setting or when instructed by the Dr. as in Splash's case but the one's that are at resorts and other places you can't control the temp yourself, I would be too scared to chance it.

The black box warning actually reads:

*Avoid exposing the Fentanyl patch application site and surrounding area to direct external heat sources, such as heating pads or electric blankets, heat or tanning lamps, saunas, hot tubs and heated water beds, while wearing the system.

*Avoid taking hot baths or sunbathing. There is a potential for temperature-dependant increases in fentanyl released from the system resulting in possible overdose and death. Patients wearing the Fentanyl patch who develop fever or increased core body temperature due to strenuous exertion should be monitored for opioid side effects and the Fentanyl dose should be adjusted if necessary.




The only time I had to go without meds was during the worst bout of stomach flu in my life and couldn't hold down anything for close to a week. I was on 75mg of MSContin and about 35mg of Oxycodone and it was horrible and I considered it a lot of meds...

So I can only imagine how you felt with 50mcgh Fentanyl which is very strong and then the Oxycodone....

The main reason I stopped the Fentanyl patch and it was just the 25mcgh was that at the time, I was only on about 15mg of Oxycodone a day and my Primary at the time was trying to help as she knew I was in terrible pain...But she just didn't know enough about pain meds and how strong the Fentanyl was so I had put mine on that afternoon and the next morning took my long hot shower, it released too much medication in my system and I would up passed out and took a trip to the ER! It was quite scary....

I'm glad you got things straightened out and shared your story as it's a good learning lesson for many of us on here:)

Post Edited (Snowbunny21) : 1/14/2013 8:44:31 PM (GMT-7)

Hi Shell,

I'm sorry to hear about your recent experience. It sounds awful, and I can totally relate.

The patch was the only med that I ever had any trouble with in terms of withdrawals. I was on it for a few months several years ago, but it didn't work well for me, so my doc and I decided to change meds. I was on 150 or 175 mcg/h, and because of the 3 day schedule I was on, the taper lasted about 3 wks. A good part of those three weeks was torture for me. It was the summer, and very hot out, but I was freezing, yet sweating buckets. I had bad muscle aches, and was very restless. It felt kind of like the flu -- very uncomfortable. Unfortunately, because the patches only come in certain sizes, and you can't cut them in half or anything, there was't any way to stretch out and slow down the taper. I've never ever experienced withdrawal like this from any other taper or missed dose (including both short acting and long acting oral opioids).

As for the hot tub situation, the best thing to do is just avoid them completely. I had to do that while on the patch. It was frustrating because we have a hot tub in our backyard (got it 7 or 8 yrs ago -- it had been my mom's dream to get one for many many years), and my family went in it often. Instead of joining them, I had to stay on land and just hang out with them at, but not in the tub. That was one of the things that I really didn't like about the patch (not to mention that it did not help my pain much) -- not just the hot tub, but the whole heat thing in general. As I said, it was the summer. I was afraid that my body would get overheated if it was a hot day, or if I was in the sun. I was afraid to exercise for the same reason, and I had to be careful not to take long or really hot showers. I'm also always freezing at night, especially (even in the summer), so I normally sleep with a heated mattress pad, but I couldn't use it with the patch. You really do have to be very careful. There is so much medication in those patches that if you were to overheat & absorb the meds too faster you could die. It's a scary thought & I just didn't want to take any risks.

Anyways, glad to hear that you are feeling better now that you are back on the patch. Hopefully now that you went through this experience once you'll know what to do, and can avoid repeating it in the future!

Skeye


ps - as the others said, you cannot reapply a patch afte you take it off. As soon as they make contact with your skin, the patches pick up oils and debris from your skin & loose their stickiness. So, unfortunately, it is a one-shot deal.

Post Edited (skeye) : 1/14/2013 10:15:06 PM (GMT-7)

Well, after all of the comments following mine about the hot tub, I thought I should clarify what I said so there would be no misunderstanding. Lol

I was only relating my experience with the Duragesic patch and using a hot tub - and I immediately followed that with the directive to speak to ones physician before using one. At the time, I was receiving care at a practice where we took part in a comprehensive program, using various 'modalities', while recovering from surgery and/or receiving treatment for CP. At any given time, there were 5 or 6 of us who were using the Duragesic patch (or similar) and also used the hot tubs as part of out P/T. We were all given the instructions that I mentioned above and as far as I know no one had any problems. We were a fairly close group and did our best to laugh our way through the pain and tears!

Anyway, I just wanted to make clear that I wasn't recommending the patch/hot tub combo - just relaying a personal (positive) experience. I would hope that most CP patients would know to speak with their doctor first, before trying something that wasn't ordered/prescribed by them.

Have a peaceful day!

Shell

I know exactly how you felt, it's happened to me as well. Took one patch off, got distracted, and forgot to replace it. Feelings were to the letter as you described. Horrible. I have been using a patch for many years now, and I have sunbathed with it, had long soaks in the bath and never once has it fallen off or caused me any type of problem.

I know the has been debated several times but what type of patch do you use? I am always given the 'Duragesic' brand, they are the very thin plasticky ones if you get my meaning. They have never come off. I was once given the reservoir type. I had a rash very quickly and they just kept falling off. Luckily my GP now always prescribes Duragesic. Off ourse I am lucky in that I don't pay anything for my prescriptions, I would imagine for you they could be pricey which is a shame as they are good.

Whilst I wouldn't advocate using hot tubs etc regularlly, I think if you are careful, keep a close eye on how you are feeling, then you should be fine. Just don't do without, especially overnight. I hope you had a good weekend, great to hear you getting out and enjoying yourself. You deserve that!!

Jane

Shell,

I'm so glad that you are alright, what a scary thing to go through. It sounds though that you and your friends had a great time.

I hope you have a good weekend and low pain days. I will be gone for a few days. I'm going into the hospital on Thursday and they said I should be there 2-3 days. I'm assuming that is IF I don't have any of the serious side effects.

Take care and I wish you low pain days. If your pain gets to bad just pull up your thoughts of the male dancers, I'm sure it would send some of the pain away, LOL

Hugs,
Barbara