Pain Medications
February 1, 2012 - 2:12pm
Fentanyl patches anyone?
My doc agreed to restart a pain management regimen with me last week after being clean since June. I got stuck on Percocets and Oxycontin after my second surgeries. Had to detox for 3 days at a local hospital, which was my choice vs the slow dr weening process just putting my body through hell. I decided to do it the quick and painless way which was actually great!
Anyway... I'm seeing the same doc and I feel fortunate to be able to have him as my doctor. He prescribed me #25 fentanyl patches, changing them every 72 hours. I'm just wondering what everyone's experiences with these have been? So far I can say they are better than any pill i've ever taken (pain decreasing). I feel a little dopey every once in a while.. it comes and goes. I don't get that euphoric feeling like when you take a 10 mg Perc but the amount that the fentanyl has decreased my pain is pretty amazing.
I'm wondering what dose everyone is on and where is the most effective place to stick the patch. I'm on #3 today and quite happy.
Thanks!!
BTW, i'm looking at a double level fusion which I have my consultation with the same NS which has been doing my Facet blocks on the 21st of this month. I'm trying to bide my time as I am a business owner and the winter is a busy time for us.
_____________
DDD
L2-L3 mild disc bulge
L3-L4 slightly greater but still mild disc bulge
L4-L5 Broad based disc herniation, Thecal sac impression, Edema/granulation tissue where disc should be.
5/12/10 L5 / S1 discectomy
1/11/11 L5 / S1 Discectomy revision
L5-S1 Transitional
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..meds messing you up a bit and Congratulations on staying clean since June!
My doc has me alternate between the oxycontin...then the next year the patch..continue for a year then back to oxycontin...so I don't breakthrough the maintaining med.
Presently, I'm on the patch. Doc told me to put on upper arms, chest or back. But I read the packet accompaning the patch for locations to apply, also.
Good luck to you!
My profile lists my spinal issues and other conditions that I navigate around daily.
Doing my best to be getting around and hanging on to this ride called life!
Hello Salty, glad to hear you are getting some releif from the patch. I was on the 100 mcg patch for 6 weeks. It was pure hell for me, sooo many side effects...hot flashes, sweats, made me sleep alot,shakes, withdrawl symptoms and a few more. I have since been switched to opanaer 40mg,3 times a day. I still dont get the pain releif I'd like but I have very few side effects.
I would be Interested to know more about your hospital detox. Could you give more details about that.I fear the thought of ever being weened of of my pain meds because I have a very hard time with withdrawl. For some reason I start feeling some symptoms even if I go an hour without, after my dosage time. I even landed in the hospital when my PM dr. made the switch from the fentinyl patch to The regular 12 dose of Opana, thats when he increased me to an 8 hr dose. Again I would appreciate if you could give the details of your hospital detox
thank you and I hope you continue with the pain releif you are getting and wish all pain free days ahead.
Back issues for 20 + years...numerous facet injections...a few radio freq injections..discogram(OUCH)..bi-lat linginual hernia surgery(with nerve damage),Jan 2010..Dynesys stabilization surgery(aug 2010)..tens unit..percocets,oxycodone, morphine ms...currently on the Fentinyl patch 75mcg, oxymorphone 10mg, neurontin and zanaflex
The hospital detox (medically) works very well. Although you are looked upon as a street adict. You WILL be living with hardcore crack addicts, Herois addicts and every other drug you can think of.. But remember.. YOU and I are and addict as well. The difference is we are using for a reason and that is to make our lives better by lowering the pain level in our bodies to a suitable level.
If I had to do it all over again I would never have gone. I should have just sucked it up with the DR and showed him that it was no big deal and just ween myself off, even if it did suck hard. Because once you tell your DR you are going to Detox, or he or she finds out you will have a label on you forever with that particular Dr. I am fortunate to have a Dr that understands and I feel thankful for that.
If your wanting off the meds, Try to find a doc that prescribes suboxone. Get into that program. Don't go the route I went unless its so out of control its your only option. I had no idea it was one step down from jail until I got in there. And once your there, Your there. No leaving and if you try to leave they will make your life hell and make you wait 15 hours for your stuff that they confiscated upon arrival.
DDD
L2-L3 mild disc bulge
L3-L4 slightly greater but still mild disc bulge
L4-L5 Broad based disc herniation, Thecal sac impression, Edema/granulation tissue where disc should be.
5/12/10 L5 / S1 discectomy
1/11/11 L5 / S1 Discectomy revision
L5-S1 Transitional
I have been on and off the patch over the past 5 years. I have also gone through complete opiod medical detox twice.
First things first ... I wear my patch just above my beltline alternating sides ... Its one of the few hairless places on my body that also has a little bit of fat. I have had difficulty with differant brands of patches and I find that only the Sandoz works for me ... I just restarted 100mc/hr and stopped 180 MSContin per day .... Feeling better already!!
Medical detox ... Basically in my case they kept me knocked out on Librium for 3-4 days after which I emerged without the habitual use of opiate pain meds. Unfortunately I also was back in severe pain ... so within several weeks of trying this and that .... it was agreed by all to put me back on opiate based medications (though at lesser doseages)
I also tried suboxone but the whole sublingual approach gave me swallowing issues .... In general - yuk.
Hope something in the above helped,
Warm Regards,
d
I discovered that Sandoz brand fentanyl patches contain more actual medicine than other brands. For example, the 12 mcg patch from Sandoz contains 2.1 mg of fentanyl in the entire patch, but a 12 mcg patch from Mylan (for instance) contains approx 1.6 mg of fentanyl - even though it's labeled as being the same dosage. This information is printed on the package. I found this out the hard way, and was having withdrawal symptoms when I noticed the difference in the amount of medicine in the Sandoz patch vs. other brands. I took the different patch wrappers to my doctor, and he couldn't believe it... he was quite angry that the manufacturers can get away with putting less of the active ingredient in a generic medication. It has something to do with the Hatch-Waxman act. None of my local pharmacies could get Sandoz patches from their wholesalers, so the only way to alleviate this problem was to have my doctor basically double my patch doseage - which he did - and I got better immediately. Anyway, the amount of fentanyl in a patch can vary, depending on the manufacturer... check the labels!
Having been on both Fentanyl patches and MS-Contin as long acting medications, I can definitely say the fentanyl patches are excellent at maintaining pain levels to minimize the use of breakthrough medications.
Make sure you are applying the patches to hairless areas as applying them anywhere else lowers the absorption rate.
As far as detoxifacation, I've had to do it twice...once after my hemi-laminectomy in '08 and after my posterior interbody fusion last march. The usage of suboxone/subutext makes the process simple and relatively painless.
My only negative point would be the detox after being on the patches last year (as after the hemi-laminectomoy I was on Oxycontin, not Fent) that the application of suboxone to someone on fentanyl is very tricky as the medicine lasts a long time even after the removal of the patch. I was put on suboxone too soon after the patch was removed and immediately went into precipitated withdrawals.
For 48 hours I shivered and was sweating terribly. I was dosed with valium every hour for 2 days straight and I still could not sleep or function.
Just a food for thought. Good luck with your fent meds!
Mike
L4-5 hemi laminectomy 3/08
L4-5 PLIF w/ BMP 3/2011
L4-5 ALIF 1/31/2012 (revision 1)
L4-5 PLIF 5/1/12
im on the 100 every 48 hrs, and have found the only hairless spot that they will stick(i sweat alot and have an oily complexion) is on each side below the waist line alternating sides, kinda about where you pockets are, but more to the side. i am tired ALOT, thats the only thing i have seen with them. great level of pain releif without the fluctuations as compared to pills is the definate plus. i also had a problem with brands, the mylan is the best ive found, some are huge and like a packet of gel with just adhesive around the outside, not only did they not stick well, they like burned my skin and iched terribly. my 2 cents hope it helps
it all started when i was 29 and picked up something i shouldnt have! after that,4 lumbar surgeries in the last 8 yrs, 2003, laminectomy l5s1, 2004,laminectomy l4-5, 2008, fusion, l4-5 through l5s1 with 1 bone graft and spacer at l5s1,6 screws and flexable rods to l4-5. nov.20,2010, add on to fusion, 2 more bone grafts,2 more screws, 2 solid rods, Between surgeries, too many injections to count,including rf nerve burning, pulsed rf, facet block,steroid, caudle epiderals,etc.Ive got- ddd, djd, arthritis,mid level levoscoliosis and alot more i dont understand. constant pain still. taking fentanyl 100 every 2 days, 10 mg oxycodone 5xdaily, xanax 1 mg as needed, 100mg zoloft daily, and ambien to sleep a couple hrs a nite.
Hello! I take 50 mcg/hr of the Mylan Pharmaceuticals patch. It has been a life saver for me. I have been on the fentanyl patch for about four months so far. I started on the 25 mcg/hr first. It wasn't enough so my PM doctor bumped it up. I change mine every 48 hours. I didnt do well on the 72 hour change. I hope they work as well for you as they do me.
Jim