prescribed fentanyl patches, worried about overdose

did your dr approve you adding another patch???? If not, you do not need to do this. After say 2 weeks on the 25 call you dr about possibly adjusting the dose, but i would never put on 2 if you were not directed to do so.

I'm guess you got into PM since your post in Oct said you could not find a dr to give you pain meds.
If you use too many patches and are short you could lose your chance and pm bc your using too many patches at once, not to mention w/d if you run out... just another problem.

Just please be careful.

Post Edited (AngMichelle) : 11/4/2014 3:36:47 PM (GMT-7)

Fentanyl gave me rashes and took 8-12 hours to work for me and even then didn't work very well and made me sick. Also it would only work for 52 hours tops so.. all in all it would only work about 40-hours for me. Norco gives me better relief than fentanyl. That is just me.

Ok thanks everybody, please dont worry I am still around lol. Well the thing is he made me surrender to pharmacy my previous prescribed percocet 20 pills in exhange for these patches because he didnt want metaking anything on top of these patches. And he did tell me to use as prescribed. So if I had percocet I could take that until this patch kicks in. But as has been my story so far, everytime a doctor has changed me to another medication, its always a substantially low dosage compared to previous one. I did use multiple opiate charts and felt it was within the safe limit.

Vicki I know you said I cant be opiate tolerant this fast but even this doctor was surprised at the amount of my usage, he said even cancer patients dont need that much daily that I need. Also even at these 2 patches my pain relief so far is minimal. He isnt pain specialist, just a new gp I saw today who understood. my situation and wants to get to bottom of why this paiN is persisting. He also ordered a mri at a private place so it can get be done quicker, and is trying to move up my pending ct pelvis urogram scan, he is open to prescribing me other pills so I will ask him for oxyneo 180 mg daily which really worked for me. He did make me sign this contract though so I cant get any of this pain meds from anybody else and only go to one pharmacy.
Before all this my situation was really dire, I had made appointment to one of these addiction clinics so at least that was my only option of getting some sort of pain managment, but I cancelled that since someone else is now willing to adjust/increase my pain medication. Seeing this pain it feels like some nerve injury from surgery or I wont be surprised if he left something inside. I have talked to a couple of surgeons overseas and they say if I come over, they can try to help me( surgically I guess), but that will be my last resort in absense of any imaging. So lets see.

It is designed to peak at the midway mark of the patches duration therefore you will see less relief first day and more on second and it will start to wane on third. That is the reason so many here are on 48 hour changes versus 72.

Please dont eve do that again because meds like Fent and methadone are ones that regardless of tolerance there can be that one time they can decrease respirations to the point of no return.

Sometimes we just have to wait things out and deal with the pain in other ways and not expect the meds to ever be enough/

I agree at this point that it would not at all surprise me to see something got left since every other test and scan has showed nothing.

Your right Rick I didnt even think about his using one of the months patches and that means running out before he should and this is one that will not fill early. I wouldnt tell it either and chalk it up to not being well informed by a GP that is not well versed in PM and not understanding the implications and strength of this med, in other words a hard lesson learned and know next time.

have you even tried the other ER meds like Morphine, Opana, oxycontin, Kadian, and the others out there? I just don't understand how your post in late Oct said you couldn't even get hydros or codeine but now you find a new PM and get Fentanyl??? And its just not smart to go against medical advice, especially adding another patch as its not the same as taking another pill if its not working.
Plus you'll be short and risk losing a dr willing to help you.
Im not saying not to the Fent patch or that you don't need an increase, but do it as directed.
Looks like i'm heading toward the patch and it scares me, too much to just add another patch...

and are you on a nerve pain med like Lyrica, neurontin, cymbalta, nortriptyline? they help nerve pain specifically. I hope you find answers, just be careful in the process

you may have sights before, but are you in USA?

Hey upjo.

Beeng "Opiate Tolerant" as we seem to call it the Fentynal maybe going to start helping a little at 75 and then at 100.

You may need more.You Doctor may be nervious about prescribing more.

I take 2 10 mg Opana and 4 2 mg Dilaudid a day.I need a raise in the Opana,I'm just trying to wait.It's getting tough.

Your an interesting "Case",lol.

There are Doctors that are comfortable writing the amount of medicine you require.Some Posters here take pretty large quantities and they require it.

I hope you find the right Doctor.Maybe this is him,maybe not.

I think all Doctors start at the bottom whem prescribing ER Pain meds.

Edit:Medical Marijuana would help you immensely,my years of experimenting guess.

Marijuana allows me to be able to get by on maybe 1/2 the Pain Meds,not to mention it's the only thing I've ever tried that makes my stomach quit hurting.Phenegran daily does not work.

But I live in Alabama.My PMD told me,laughingly,"This is Alabama".Thae PMD I was at last year didn't test for it.

I recommend you trying it.It can't hurt.

Can you not get a Pain Management to take you?

Are you dealing with Specialists here because the pain is a Post-Surgery result?

God Bless,

Rick

The idea that there is some magic number with fentanyl after which you overdose isn't necessarily true. I overdosed while taking 25mcg/hr patch AS PRESCRIBED (and yes, I was already opioid tolerant). So now they've got me on 12.5mcg patches and even those I usually only change every 4 days. I have a very low tolerance for medications. But yes, 25mcg/hr is on the low side. The point of starting there is to be sure that the patient tolerates it okay for a bit before upping it (and 25mcg/hr works for some people). They do take time to build up in your system. If I don't change mine on schedule, it usually takes close to 24 hours before I start to feel any relief from the patches.

You may want to check out the ACPA resource guide www.theacpa.org/uploads/ACPA_Resource_Guide_2014_FINAL.pdf. It lists dozens of alternatives to opioid pain medication. Surely there is something out there besides narcotics that would help you (even if it's not enough on its own). It took me more than 2 years working with my PM to find a decent combination, but eventually we figured it out. There are many categories of "pain medicine" -- anticonvulsants, anxiolytics, tricyclics, muscle relaxants, NSAIDs, acetaminophen, etc. Plus, various delivery systems -- topical, IM injection, oral, nasal, transdermal, transmucosal. Plus interventional medicine -- injections, rhizotomies, neuromodulation, pain pumps. And physical medicine -- PT, acupuncture, chiropractic care, massage, and other alternative therapies. And lastly there is pain (behavioral) psychology to work on behavioral modification, setting reasonable goals/limits for yourself, distracting techniques, relaxation techniques and so forth.

Believe me when I say that I understand how frustrating it is to be in pain while the doctors try to figure something out, but self-adjusting a new medicine after only a few hours -- especially a C2 -- is crazy dangerous. I'm glad you are okay but please don't try that again, ok?

It is possible to get rebound pain. My PM deals with that in new patients all the time -- people who truly weren't addicts but had irresponsible former PM's that just kept upping their dose again and again. He started working with them and got them down to 1/10th of their former dose AND with better pain control than ever. Even I am dealing with this now since I was up a lot on my pain meds because of a massive infection in my back. Cutting back was brutal at first, but at week 3 now, my body is starting to re-adjust and the lower dose is starting to be sufficient again. Keep trying to find a PM -- maybe now that you are only on patches, it will be easier. Have you talked to anyone about an epidural? They are designed to block out a good portion of the pain in a specific area. It wouldn't make it completely numb, but maybe could bring the pain down from an 8 or 9 down to a 5 or 6 & I always consider that a huge win! I just got an epidural last week for pain that went from low back to iliac crest (those bony parts of your pelvis that stick out in the front of your body) and down my legs to my knees. Pain went from a 9 to a 5. I went from crying and screaming in pain, barely able to move at all, to being able to resume my normal life (albeit still with noticeable pain). :) There are also topical treatments like Lidoderm patches that might offer some relief.

Take care

Everybody's body handles medicine and procedures differently. It also depends what you're trying to fix. It seems you are pretty much at the end of your rope, so maybe give the blocks a try.

You haven't been on the Fentanyl patches very long. Maybe the Fent in combo with your other meds and other non-medical routes will give you some relief. If your Dr thinks your pain situation is to complicated, then you definitely need a new Dr. He really shouldn't of prescribed the Fentanyl if he was that uncomfortable. He might need to watch his back if he prescribes those "Big Gun" pain meds. That is a VERY powerful drug. It really worries me when people treat it like taking and extra Motrin or Advil, or even an extra Oxy. Please please please don't fool around with the dosages.

I've been on varying doses of Fentanyl over the past 5yrs, along with other pain meds. Also receiving dry needling, lymphoma, PT, and other relaxing techniques. I'm definitely not pain free-I don't think any of us are. I was actually admitted last week for pain control and had meds tweaked. If you are going to be seeing the addiction dr regularly, maybe keep a pain journal. Help your Dr see when you have pain, if there are any triggers, what level is acceptable for you, and at what level are you ready to curl up and cry. The "Pain Scale" is so subjective with the number system, it can be hard to convey to the Dr how pain affects your daily life. Descriptions in a journal form might get the point across. Ex: I'm happy with a pain level of 4. I have been in pain every moment of my life that I can remember. I'll never be pain-free or even close to pain-free. Childbirth is an 8 for me, TMJ replacement surgery a 9. I've never said 10 and I hope that I never have to. Telling your Dr a rating of 7 won't be helpful without a comparison.

I hope your appointment goes well tomorrow so you can get some sort of pain relief. While you are getting some relief from your current Dr, I hope you are quickly able to get in with a pain management specialist. A family Dr should not be writing scripts for pain patches since they are only to be used on patients that need long term pain control.

You deserve better treatment than a primary dr can prescribe. Let us know how the appointment goes.