I am afraid to ask my drs about my fentanyl dose

I dont know how to get across my complete sufferring around the meds..and try to get some answers without writing a book .....the main question is how do you go to your pain clinic doctors and tell them that you are coming off your fentanyl patch 50 mcg every 34 hours and then go through hell till you can get another patch on to alleviate the dependence that has developed...same with my tramadol......and ativan.....I feel horrible that i have become dependent on what i need for chronic back(ddd) pain...and yet its poisoning me ...my memory has become seriously impaired and i am tortured from 34 to 48 hours, until i get another patch on...when i speak with them i get very little .....they say it cant be the meds...maybe your depressed.....ive lost 45 pounds in 5 months ,have no appetite , afraid to watch movies or listen to music...my life has gone down so fast it scares me ...in dec I was a retired happy ex-psychotherapist with a wife and son.......I simply cannot believe this has happened to me ...I am ashamed and fearful......how can i get help if i am afraid they will take the meds away and then ill go into those dreaded panic attacks ...so i stay frozen knowing by the day i am deteriating horrifically and yet feel frozen to seek help.....I have been trying to reduce off the tramadol by myself and have gone from three to two 50mg tabs a day......but as soon as that patch hits 34 hours i go into a solid radical depression thats so fearful.....and yet noone seems to be doing anything about it .....including me.....how do i make my first step...towards talking to someone that understands how a chronic pain meds can be a situiation of dependence and why is there no response.......if a diabetic was not receiving the right dose , wouldnt they find the right dose......i just get ignored as if its something else ...i know its coming off the fentanyl........its horrific....and if i ask for more ill be drug seeking ...how could that be ?..I thought these drugs caused dependence.....I look around and all i see is detox centers....how could that be the answer when underneath the meds is a terrible pain condition that is real.....how do i find the right combination without having to go to a detox center.......how do i start this conversation with the pain clinic...and get past my fear that they will just treat me like an addict.......i have only always taken what they have prescribed.....and yet i have so many fears.......about it.....any help in this area would be greatly appreciated....sorry about the redundancy but ..memory and its functions are going by the day.......this feels dangerous .....and very biochemical.......I want to get off the meds and i am afraid too.....how do you get to the next step ?

The best thing you can do is to discuss it with your doctor and work with him to help get off these meds and onto new ones.

You have a pain management doc, yes? They're the best ones to handle this sort of thing. They can also provide you with various meds to help with the withdrawals that occur, which they will naturally, regardless of what meds we're tapering off of (even A/D's can cause symptoms)!

If they're not working, explain *this* to your doctor and ask for help,...openly and honestly.











M.

Yeah, A/Ds can cause horrible withdrawals!

The best thing you can do is be HONEST with your PM doc. They've been around the block and seen everything if they're experienced. They will NOT shame you for where you're at. It's such a hard thing ... you need the meds because you're in terrible pain, but then your body becomes dependent on them and your mind plays tricks on you too. If you ARE "addicted" and drug seeking instead of "dependent" (which I am for sure, dependency is a physical state), your PM can help you figure that out. In my experience they're kind and compassionate people and you shouldn't be afraid at ALL to tell them what's going on exactly. That's a very common thing that I've heard about Fentanyl (never been on it myself), that it wears off before it's time to change it, so you're not crazy.

I wear a butrans patch, take percocet for BT meds and also consume quite a bit of (legal) medical marijuana and I still never, ever am pain-free. The best I can hope for is to get my pain down to the level where I can do normal activities like clean the house, go for short walks, etc. Good luck, and again, I think there's no reason you can't be completely honest with your pain doc.

Oh - edited - I think it's kind of weird that your doc has you on tramadol and fentanyl. That's like giving someone a piece of sugar-free gum and then a huge pixie stick. Tramadol is like NOTHING, and Fentanyl is one of the strongest, if not the strongest, meds out there. So ... it doesn't surprise me that the tramadol doesn't seem to help. You may need something stronger to get you through those days where the fent patch doesn't work. Everyone has different metabolism, yours just may be faster and that's how your body processes the fentanyl. Don't give up.

Post Edited (Backtolife) : 9/2/2014 4:56:02 AM (GMT-6)

Hi Yama and welcome to my world and HW. I wish your story was not so hauntingly familiar but unfortunately it is. Almost a year ago now I was in the same place as you and yea it looked alot like I had imagined #*#* was. I was sick and tired of just being sick and tired! !!. I had over a decade of pain, drs, surgeries, injections, and depression that naturally comes with a chronic issue. Add insult to injury and also a decade of narcotics with the last 12 or so being methadone.

I started slowly at some point noticing my memory decline, lack of interest in well life. Staying close to home, begging off family outings, my wardrobe looking more like it consisted of all sleepwear and endless hours and days of letting things go, paying bills, family birthdays, cleaning, mailing things, hitting the normal yet important deadlines life consists of. Pain was my excuse, crutch, reliable reliance and I used it freely! !

I spent endless hours staring at the ceiling in fog but sometimes thought and somehow some of my thinking got through and I did some serious soul searching delving into my dark corners of my mind, looking back at the end of a decade and into another I knew I didn't have a desire for it to be a replica of the last. I tried to assure myself my early days and weeks on this CP journey were long behind and I somehow survived those "Kevorkian " years as I think of them now. Had to figure out how I got here to this place.

I spoke with my PM of 5 awesome years and simply together we decided to take a look at my basic pain levels unaided or masked by meds, reset all the pain receptors, evaluate exactly what if any effect 12 years of methadone, totalling 15 on daily opiates of some degree. We had a plan and I had tried numerous times the last few years to get off of my own accord. I had small success, lowered my intake a few mgs but just couldn't get any lower on my own.

Methadone like fent is not easy to back off of and I knew the panic of withdrawal was going to win if we didnt approach this correctly. Not to mention the pain was going to hit me like a wall of fire. I was determined though that I was not going to allow the medicine to take anything else from me. At 56 I should remember my children's birthday's without concentration, my childhood friend, my first dog, dance, and the day my parents passed away. Unless I had some medical issues causing chronic constipation, memory loss, lack of interest in my life and all the things that were making me feel hopeless and useless then the meds had to do it and that meant they were robbing me of more than giving.

I was put on butrans, lowered off the rest of my methadone, given clonidine to control my b /p, and aide in the symptoms of w /d. Ativan for restless legs, a few hydrocodone if it got unbearable and I am not going to lie to you here, entered the gates of Hades such as I have never known. The first week was a nightmare, I didn't sleep, eat or sit still for more than one minute. I paced, cried, pulled out hair and broke a few things along the way but then one day I didn't.

I could eat, hear noises without the background of rushing water, listened to hours of music with my teenager and reminisced of events I thought I had long forgotten. My world became clearer each day and I felt better than I had since the whole chronic pain thing started. I used every modality known for pain relief but I was managing no worse than on the methadone.

I did about 3 months of the butrans and that schedule of other stuff and went back for an eval to discuss my now options. We tossed around meds, eliminating for this or that and settled on morphine or specifically MS Contin 15mgs twice a day with the hydro 10 three times if I really needed to. The first week was a blur and I slept way too much so I cut back to one 15mg MS and eventually stayed there and now use no bt med at all.

I am so grateful for this forum and the people here that didn't let me give it up and pushed me when I could not go another step. They carried me! !

It was the best thing I have done for my pain, family, my life and I will never regret the methadone as it saved me at the time but it should have been changed long ago. We need to not spend years and especially decades on one type of med. I'm a firm believer in resetting those pain receptors whether by cleansing or shuffling meds to hit different ways and that you never allow your body to depend on chemical means only to attack pain.

I had a great therapist who taught distraction technique an I use it faithfully. I get good results out of hydrotherapy an old heat /ice alternating. I use all the things I can first and the meds last now and I will be forever glad that I had a great team of drs on my side.

My story is here archived and if you use the forum search at the top of the page you can visit with my nightmare and into another realm as I came out of the stupor and fog of that decade of narcotics such as methadone.

Your at a point where you can find a way back and still not be doomed to suffer. I'm not sure how long the relationship between your Dr and you is or if he is a great one but if he's not willing to work you off and onto something that will give you help not take away from you then my first piece of advice is find one who will.

Hey Yama...My PM doctor wants me on Fentanyl or Butrans patch, but I refuse for now, based on past experience.  I tried Fent back in 2005-06 and got actual relief...but not with 72 hour intervals.  Back then I was called an "enigma".  I could not remain on my hands and knees, crawling to the toilet, so I lay in the floor of the bathroom.  I needed to change patch every 2 days, but doctor would not allow me to do that.  I could not see the benefit ratio of relief vs. withdrawal.  That experience 9 years ago scarred me towards the patches, although it had potential to give me my life back.

You simply must have the conversation with your doctor, if you choose to continue with the patches.  I agree with others that Tramadol is "small catch" for pain relief.  It's a major contradiction.  Please talk with your doctor sooner, rather than later.

Dixie

Yama, it's great that you've found courage to act through this site, this is one of the best due to Vickie , Susie, WB, and so many other of the mods. They do a great job of keeping this site CLEAN AND ACCURATE. I'm sure that we will be in touch . . . Q