Fentanyl Trial: Genetic Testing for Metabolism/Absorption of PM Meds

Hey rocckyd...Thanks for chiming in.  I appreciate this input, as I know how full your plate is.  I wanted to ask you specifically, but couldn't find your email addy.

Firstly, good to see you.  How are you feeling?  How is Nathan?  Is he having Spring Break yet?  I often think of your ongoing battles and the grace with which you fight them.  You're an inspiration.

As for the Fentanyl, what do you think could be happening in my case?  In 2005-06 I briefly enrolled in PM.  Of course, the Fentanyl patch made the most sense.  I recall the patches were larger with a reservoir of gel in the center.  I also recall feeling like (actually) smiling when I got some relief.  It was prescribed for 72 hour dosing.  I would get violently ill by the 3rd day.  I didn't realize that I was going into WD, because I was a newby.  Ten years ago my PM team would not consider 48 hour dosing.

Fast forward to 2014...Upon enrollment in January of last year, the FIRST SUGGESTION from PM was the Fentanyl patch. I procrastinated for several reasons, but mainly fear and finances.  I spent a full year trying alternate oral methods, finding I couldn't tolerate some.  I couldn't afford others.  Although I still don't have prescription insurance, I had to take the logical step in February.  I felt I was getting nowhere fast with oral meds, wasting away physically and financially. This week is a full month.

The current patches, as you know, are smaller with medicine impregnated into adhesive. I am changing every 48 hours.

I still feel like I'm wasting away.  I don't know what needs adjusting.  The 48 hour dosing is a blessing, but do I need a higher mcg?  I don't think cognitively I could tolerate higher mcg right now, plus I wouldn't want to titrate too rapidly.  Any suggestions, Rocckyd?  I think I need to rotate my bowel regimen.  I do know that I have to change things up from time to time to reset my gut.  I also have tried Linzess, which my GI recommends.  It works wonderfully, but is WAY TOO expensive.

Thanks so much~~Dixie 

 

I've never had a problem with the patches. I also use Mallindkroft, but I've had other brands in the past. I honestly can't tell the difference. Maybe I'm just lucky:) At least I'm lucky somewhere.

This is what I'm told, and I have multiple reasons for GI issues, but I'm NOT supposed to switch up a bowel regimen without my Drs approval. Basically it just sets back the clock and everything starts over.

Dixie I don't have much to offer as to why the patch isn't bringing relief but I too went through the whole menopausal thing almost 15 years ago yet last year out of nowhere I start the hot flashes,night sweating,and my gyn says simply "your biological clock doesn't understand that you have already done this against your natural time" ok maybe? I can definitely say a 6 month round of prempro set my clock straight again so maybe she was onto something. As to dumping meds that does occur anytime with transdermal delivery methods when temperatures external or internal cause vasodialation of pores. It actually is some better with the patches that have meds integrated into the material over the reservoir type but still occurs at some rate. Many fent users swear by the reservoir type over its counterparts as to having better,smoother,coverage and all I can say about that is yet another anti-abuse deterrent causes CPers issues much like the oxy and other opiates with built-in deterrents do. It's a expensive trial and more so if your getting little-known relief. This is the part where a good relationship with a good PM plays the most importance and unfortunately it sounds like yours is lacking some.

As others have said Dixie stay on top of the bowel issues as it can turn sour rather quickly and as Roc said obstructions are no fun not to mention can be extremely dangerous. I am not nor have I ever been the healthiest eater and I do like my sweets too much but being an old country gal raised by the laws of bacon grease and gravy in and on everything well those habits and aquired tastes are difficult to break. Salads and raw veggies was a farm animal staple not human ones at our house!! Lol

I have to make a conscious effort to eat healthy and those eating habits don't help the bowel issues so I have to take meds daily without fail. I have best luck with miralax and pericolace and since I don't drink milk cereals fortified with bran don't go down well dry but I learned a really good recipe for a awesome trick from a Nursing home I use to fill in a few hours at when I was still working. It sounds nasty and is chock full of things I immensely dislike but tastes far better than mag citrate or golyte. I eat a half a cup twice a day and it helps greatly when your needing bulk,fiber,softening agents and anyone interested in the recipe give me a yell. Use to see version's talked about often here but with all the new probotics and meds like miralax folks haven't mentioned it so much.

Dixie
No clue WHY night sweats.. every once in awhile I have them too - literally dripping. Have tried to reconcile medicine or foods or something to those episodes..

I just answered your email.

Post Edited (DianeB) : 3/10/2015 11:15:29 PM (GMT-6)