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monumental23mmonumental23 Posts: 2
edited 06/21/2013 - 10:19 AM in Pain Medications
Hi! I am new, but have an imperative question that I would love as much response/suggestions as ya'll can give. I will briefly say that I was in a car accident @15 that caused back problems. I was in a car accident @27, that almost cost my life. What it left me with was 2 broken femurs, broken arm, almost broken pelvis, facial damage...blah, blah. Another accident when my daughter was 5-6 months old (she wasn't in the car, thank God) that cause neck damage.
As you might imagine and have been on many types of meds. for practically ALL THESE YEARS! (I am 42 now) I've had run ins with Pain Management, you literally wouldn't believe. Ask me one day....it will blow you away!
For right now I am seeing an orthopedist who's specialty is pm. The bad thing is the medicine he started me on worked. right off! Butrans was a miracle. We went to the next highest and I started breaking out, itching half to death. They got puss in them and broke. Now, this wasn't the outside where the tape is, but where the med itself comes out. I tried cleaning the area with alcohol, lotion hydro cream on 1 hrs. before apply it never helped. With much reluctance I offered to try something else, Nucynta this last month and it's been hell. No relieve...nothing. I go to my doc tomorrow and will have to tell him this can't continue. Do any of you have suggestions for a medicine that is strong, but won't make you loopy or a mannequin?
Any help would be appreciated.


  • I have never tried Butrans, but Duragesic broke me out so bad, I couldn't stand it.

    Tried Nucynta about a year ago and I got very little pain relief with it at all.

    It was so disappointing because I had such high hopes for it.

    I have been at this for almost 20 years so I have been on just about everything out there for pain at one point.

    There are two long acting meds that have worked really well for me.

    One was Oxycodone ER and the other MS Contin.

    When tolerance becomes an issue we just kinda go back and forth between the two and it works great for me.

    I use Percocet for BT and don't have to take them very often.

    Hope you find something soon that works well for you.

    I'm sure some of the others that have been here longer, will chime in with some other ideas.

    Anyway, keep us updated on how you're doing and welcome to the forum.

    I know you will enjoy it, there are a bunch of really great folks here with so much to offer.

    Take care.
  • Thank you for your reply! Like you, I have tried just about everything. I will ask for the Duragesic again, and hopefully won't be allergic to it. If he won't go that way, I will certainly mention Oxy ER and MS Contin-those are two I had good responses with. Thanks again! Cross your fingers for me ;)
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  • terror8396tterror8396 Posts: 1,832
    edited 06/21/2013 - 4:46 AM
    i am curious as to why you had issues with your pain doctor. it seems that you had other narcotics then he put you on the butrans patch. by saying the butrans does not work or i am allergic to it is problematic especially if you suggest stronger narcotics. this might be the reason there is a conflict with your pain doctor. by saying one drug does not work and i need stronger narcotics is a problem. he gave you the butrans for a reason and by saying it is not working is a red flag. one suggestion, don't go into a pain drs office and ask for stronger meds. have him suggest to you that stronger ones would work best. just one more thing, i have not heard of orthopedic surgeons acting like pain doctors. they usually stick to surgery with bones and joints not pain management. pain guys are usually anethesiologist doctors. and they work full time as pain doctors that also do procedures like injections. i would do and take what he says is best for you and not tell him what to give you, especially when dealing with narcotics. my pain dr works in conjunction with my neurosurgeon. they work together and hand in hand. one does the surgery and the other takes care of the pain. if there is a major conflict with pain doctor, i would find another one that you could work better with.
    I have 4 fusions from L5-3, the latest last May '12 where they fixed my disc that broke.They went through my side this time. I take 40 mg of oxycontin 4x a day and 4 fenatyl lollipops 300 micro gms 4x a day.
  • I have been using the patch for almost 2 years and had a lot of discomfort from the medicine part of the patch initially. I also got a lot of small bumps/rash but they've gone away. The longer I use it the less skin reaction, still get reddish patch of skin that fades over a couple of weeks. The benefit for me far out weighs the side effect. Maybe you can give it another try.
    laminectomy c4/c5 2008, ACDF c4-c7 Jan 20 2014 sched
  • Another thought would be, if one patch was OK and you had problems going to the next strength, maybe you could try two of the smaller dose patches rather than one of the larger dose, that way it would be in 2 different places and might not cause the skin reaction. Just something to think about. Good luck!
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  • back to the issue with the pain dr, you leave us hanging when you say you would not what is going on with him, and then leaving it there. to me is makes a big deal when you say that. if you explain the issues, maybe we could help you more. it is like reading a book and ripping out the last 10 pages. it leaves us hanging wondering what happened. maybe an explanation would help us to help you more. once more, please let us know why there is this hostility or whatever with him. it seems to be a big deal to you by mentioning it to us.
    I have 4 fusions from L5-3, the latest last May '12 where they fixed my disc that broke.They went through my side this time. I take 40 mg of oxycontin 4x a day and 4 fenatyl lollipops 300 micro gms 4x a day.
  • ladymhurtslladymhurts Posts: 6
    edited 06/21/2013 - 9:57 AM
    I, too, have never heard of an ortho specializing in pm. I started seeing my current gp in 05 and he moved to a new practice in 08 after becoming a pain management specialist. His patients moved with him and we still saw him in our old capacity and I just lucked out 2 years ago when my own journey began. We work as a team (I've never had to give a urine test, which I remember reading a few days ago) but he has kept a close eye on me throughout my early days (chiro, pt, manipulative therapies and the medications he felt would help) and when the time came, he referred me to my spine neuro. My pm has medicated me through two years and two surgeries and the key has always been honesty on both parts, ie, this does/doesn't work, let's try something else. I'm very, very familiar with all sorts of long acting oral meds (even tried methadone for a month) but not so much with patches. Currently I take 30mg oxycodone 4x daily and 30mg MS Contin at night. With the exception of two weeks after my last surgery when I was taking 60 more mg of oc daily, my dosage hasn't changed in quite sometime and I still find it therapeutic and I am very clear headed.

    Was there a particular reason that he switched you to a patch as opposed to oral meds? That's something that is important to know. It is so, so important to keep the lines of communication clear between the patient and the doctor that is prescribing the kinds of meds that most of us take.
    with courage to endure...
  • n2bravesnn2braves Posts: 341
    edited 06/22/2013 - 12:17 AM
    Since the Butrans didn't seem to cause the same irritation at the lower dose paininohio might be correct that you could just put on two of the them instead of one at the higher dose, something you could ask your doctor.

    I totally understand that the irritation from the patch was too much for you, the Duragesic was the same for me and there was no way that I could make it work, no way!

    As far as going in and asking your Doctor for stronger meds, I didn't get that impression from your post at all.

    It is just that the Nucynta did not work for you as it didn't work for me either, and you are just gathering up ideas on what might be the next logical step.

    Jon, my MD was always open to my ideas about what I wanted to try and this last time we did a med switch at my PM, the Doctor asked me if I had a preference when it came to LA drugs, so it won't hurt for Monumental23 to be prepared just in case.

    Totally understand that you don't want to go in "asking" for stronger meds, but one should always be prepared.

    Hopefully he will have some good suggestions for you or ask for your input.

    As far as it being a "red flag" to let your Doc know about that Butrans patch causing severe irritation like that, when I went back to my Doc with my complaints about Duragesic, I took a pic with my cell phone of just how bad the irritation looked so he could understand.

    I know what you are probably thinking, isn't that taking it a little too far?

    Maybe so, but that is just me, better safe than sorry!

    Take care Monumental and let us know how things go for you.

    Will keep you in my prayers that you find something soon that works well.

  • oberlin_patientooberlin_patient Posts: 58
    edited 06/23/2013 - 5:22 AM
    Ask your doctor for an Rx for flector patches. They work great.
    **EDIT to remove link. Please do not post links to outside websites. Review the forum rules.
    Thank you for your cooperation.
    The Spine Health Moderation Team
  • may come from the rubbing alcohol and the hydrocortisone cream you are putting on your skin where you place the patch. You are not supposed to do that, and you are supposed to rotate the sites where you place the patches, so that you don't develop a rash from the medication/adhesive.
    Rubbing alcohol irritates the area and the hydrocortisone cream will cause the patches not to stick.
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