Question regarding getting my pain med dose lowered

That is great that you want to try and be more natural in your approach to pain relief as it was only a month or two ago that you were talking about needing to go up to the 100mcgh...The only part I don't understand is the "urgency" part of it?

I would just explain your plan with your Dr. and they can just write a post-dated prescription for the 50mcgh to be filled in two weeks. I don't see how finishing out the month would be a big deal.

He may choose to start you right away but many Drs. don't want a patient to have extra Fentanyl patches sitting around so I would bring in your patches to see what he wants you to do with them.

Why not just start using the patch back at 72 hours so that will start getting you more used to things and help with any withdrawal? This is what I would do for the next few weeks until the regular monthly prescription would be filled, but certainly up to you and your Dr.

Good luck!

You may "think" that the medication has worn off after 48 hours but there really is medication that is still being released during the last 24 if you extend it the regular 3 days. It will help with any withdrawals and the Dr. will probably suggest this if they don't end up giving you the new prescription on Tuesday.

And I was just thinking that if you did this the next two weeks until the regular prescription would be filled, then you will be in a much better place to move to the 50mcgh patch.

Obviously all your choice:) Just sharing some thoughts...

I guess I just don't understand then because if you are saying you can't even handle the 75mcgh at the regular 3 days, then don't see how you are going to go down to the 50mcgh patch? By moving to the 3 days for now with this patch, you would be tirating down more slowly instead of making the large jump which may cause more withdrawals.

So I don't know what you mean when you say you "can't" keep it on for 3 days?

And is your goal to go off opiates all together or just go down to only the 50mcgh?

 

Post Edited (Snowbunny21) : 4/15/2013 7:17:13 AM (GMT-6)

So just an update. I went in for my appt, and talked with my doctor about this for almost 2 hours (well and other things too). We spoke about the pros and cons of reducing the dose, and in the end he felt that if I wanted to try a lower dose for a month and report back next month then that was fine with him.

He simply asked me to bring back the remaining patches I had of the 75mcg ones, which I did. They told me to call in if my pain went back up or got worse before next month and they would "re-evaluate" my pain regimen (probably just put me back on the 75 patch if I can't handle the pain with the 50s).

I told him that I would like to stay on a lower dose if possible and lose weight/eat right to be healthier and such. He agreed that it was a good idea. However, if the lower dose does not allow me to function as well even with the excercise then I will go back to the higher dose. He briefly talked about going from 2 days to 3 days on the 75s but did not want to do that since he knew they did not last that long anyway.

So right now I am trying the 50 patch every 48 hours. I just started my 2nd patch today and so far its not too bad. I plan on going to the gym tomorrow and this weekend. The pain is a bit worse than before but nothing too bad. The only thing that my doctor wanted to check was my testosterone levels, just to make sure that is not the reason I have low energy and motivation (instead of the patches being the reason).

I hope I can keep up with this lowered dose but I am optimistic that I can. The real test will be how I feel after going to the gym and when I have my son. Wish me luck.

Thanks for the update!

I think it's a great idea for all of us to try and be on the least amount of medication we can handle as most of us are in this for the long haul.

It's good to hear that your Dr. is ready and able to help and see what happens and go from there:)

Just another quick update.

I just spoke with my doctor on the phone and he wants me to give him a 24 hour urine test to check my cortisol levels. He said I may have Cushings Syndrome (I think thats what its called), as well as low testosterone. He asked about my pain levels since I went down to 50 mcg/hour patch, and how my energy/motivation levels were as well. I told him that my pain levels are higher than before and it does not seem to help my energy or motivation to exercise. He said that my low testosterone levels are more likely to be the reason for this and not the dose of fentanyl that I am on.

So I scheduled my next follow up appointment for May 8 (thats the soonest I can get in), and will get my pain regimen re-evaluated and probably go back to the 75 patches again and address the issue of my low testosterone. Any advice from anyone who has either Cushings or low-T, I would appreciate it. I don't know what to expect on that front.

Quincy: I believe it is not allowed to "cut" any patches for any reason. It says so in the paperwork info with my patches, and online as well. I don't want to OD. Thanks anyway for the advice though.

Brett, I am thinking some of the guys have discussed low T levels previously, so you may want to use the search feature and see what you can pull up....Susie