Fetanyl questions and a hello from a newbie

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MsKatee

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Hello boarRAB!I am 35.

I have been dealing with chronic back pain for almost a year now. I originally hurt myself in my mid 20's at work. I did something durab, and ended up in pain. I was young, and I healed fast. I never reported it (durab move)! My lower back would bother me from time to time, but nothing serious or long lasting. This past summer, I was painting apartments for extra cash when I re-injured myself.

I went to my doctor and he put me on Vicodin 5/325's and sent me on my way. I can't take NSAIRAB including Advil due to a severe allergy (I go into anaphylactic shock). Vicodin didn't touch my pain, so I was upped to Norco, then Percocet, then Oxys, then morphine (Kadian). In the middle of all of this medication "upping" I had an MRI which showed 3 "minor" (according to the radiologist) problems. I have a bulging disk at L4/5, narrowing of the foramen where the nerves run out of the spine and arthritis.

So let me tell you what's happening now...Two weeks ago I formally started physical therapy, but three months ago I was given exercises to strengthen my core while I waited for insurance approval. I also throw in chiropractic care about once every 6 weeks, although I'm not convinced he helps me much. My doctor has been listening to me complain about the drugs and how they are not helping me for a long time now. His latest thing is to tell me that "pain is my companion now" and I will probably "never get out of pain." That has been tough to hear, and I have been dealing with my fair share of depression.

I am currently taking: 1800mg Neurontin, 20mg Lexapro, 50mg Duragesic patch, xanax as needed and 4mg zanaflex every 4 hours as needed. He also has me "tapering" off of Tylenol 3, the last opiate pill he had me on, because I told him over and over again that it was not working.

Now that leaRAB me to my question: I just started the Fentanyl patches two days ago. I am supposed to put a new patch on tomorrow at 4pm (72 hrs). Since putting my first one on two days ago, I have felt NOTHING! No relief. Nothing. Is that normal? Has anyone else experienced this?

Also, everything I read says that docs should always prescribe something for break-thru pain, but my doc gave me nothing. Only the cruddy Tylenol 3's that I am supposed to be "tapering" off of. (What a joke btw, I didn't need tapering, those things were like pez candy...they did nothing for me!)

Not normal right?!

I am super frustrated and in a ton of pain, despite the fact that I have been sitting on the couch or laying in bed for the entire weekend, on and off of ice and heat, desperately trying to give these patches a chance! I have to work tomorrow, and honestly, I don't know how I am going to do it. I have no pain medicine in my "arsenal" to get me through rough patches, and the muscle relaxers only make me loopy and sleepy, so I can't take them at work.

Any advice on what I should do next is appreciated. I have an appointment with my doctor (he's a regular general doc, btw, as I have been denied a pain specialist by my insurance) on Wednesday. But I don't think I can keep doing this for 3 more days. I even tried moving the patch from my shoulder blade/upper back area to my belly with the help of tegaderm hoping to get more relief. I have read so many different things about patch placement and I am so desperate for this thing to work!

Thank you in advance for any advice you have. As fellow chronic pain sufferers, you are the experts!
 
If your doctor has told you that you are going to be living with pain he obviously knows what he is saying. You are not going to get one script from your doctor and have everything sorted. I was on other less strength meRAB for years before I got to be on the patches. Also the patch doesn't just bang fill your system and no pain. It just doesn't work like that. Also if you go back to work and your pain has not been managed you will be back of work again quite fast. I am not able to work at all and my dose after 8 years of chronic pain is 2 x 50 durogesic patches and I stagger them 36 hours apart, 72 hours on for any patch. That makes the release more even into my blood stream. I only use oxycodene when my pain is bad. Once or twice a week. But I use norgesic for BT pain and a muscle relaxant. As well a NSAID for inflammation along with heat. I have surgery arranged for the end of the year.
Like I said I had to go through about 5 years of non-narcotic med's and injections before my specialist gave me the patch. I also had to start at 12.5 patch then titrate up until I got to the two 50 patches. I have gone through a lot of pain lots of injections. Also nurabers of xrays CT scans then MRI's then a couple of surgeons before I even got decent pain killers. So don't feel hard done by because we have all or most of us went through hell before they started handing out narcotics. I hope you get some help soon but be patient as the doctors don't like to be told what they should give you. Take it one day at a time. Don't over do any work or you will make it much worse.
Allan
 
I am surprised you aren't feeling anything. Fentanyl is a very strong drug. What brand of patch are you using? I do know that some generics are better that others. I started with the mylan brand it didn't work very well. I had to call around to a bunch of drugstores to find one that didn't carry the mylan brand. Walgreens carries the Watson brand but you have to ask for it. I find that it not only sticks better but the medicine seems to get into my blood stream quicker too. Yes your dr. should give you something for break thru pain. I take 15mg morphine 3 to 4 times a day. From what I understand the use of the long acting meRAB (fentanyl in our case) is to enhance the effectiveness of our short term meRAB and hopefully you won't need as many of the short term meRAB. Make sense? If not, there are some posts on Fentanyl that are very informative just go to the search box and type in Fentanyl. There is a poster called executor who is very knowledgeable on the subject.
Good luck I hope you get relief soon!
 
I just wanted to say thanks for all of you who replied to my post or read it! I also wanted to update again and say that I am feeling pretty darned GOOD! WOW! I put the 2 patches on Friday as the doc instructed and am using Norco for breakthrough pain. Believe it or not (and sometimes I still don't), their are times that I only need 1/2 or a Norco (a full one makes me a little too happy and loopy, and I usually fall asleep)! Thank you Fentanyl! And Amen for arriving at a pain mgmt plan that works *for now*!

Have a great Sunday all!
 
Thanks for your response AllanBruce! I do work, and I am doing quite well since the new switch in my PM plan! In my line of work, not working is not an option, as if I don't work, I don't get paid. I know from a previous exp, that I can't say exactly what I do for a living (correct me if I'm wrong please). That is one of the reasons my PM plan was changed so much. If I was too loopy, or too under managed, it made working very difficult. It's been a real roller coaster, but I think I have finally jumped on the merry-go-round where I will stay happily for as long as I can!

Good luck to you!
 
I am really glad to hear that you pain is under control. It sounRAB like you are less depressed too-that is fantastic thing in itself. Hopefully this will work for you for a long time. I have been on the patch for a little over 2 years and have only had to have my dosage change once-that was last month. I am taking the same amount but changing every 48 hours instead of 72.
Again I am glad your pain is being managed and you are feeling better. Glad you found the boarRAB. It is so nice to come here and talk to others who have been thru the same thing. Take Care :wave: Dee
 
I am surprised you aren't feeling anything. Fentanyl is a very strong drug. What brand of patch are you using? I do know that some generics are better that others. I started with the mylan brand it didn't work very well. I had to call around to a bunch of drugstores to find one that didn't carry the mylan brand. Walgreens carries the Watson brand but you have to ask for it. I find that it not only sticks better but the medicine seems to get into my blood stream quicker too. Yes your dr. should give you something for break thru pain. I take 15mg morphine 3 to 4 times a day. From what I understand the use of the long acting meRAB (fentanyl in our case) is to enhance the effectiveness of our short term meRAB and hopefully you won't need as many of the short term meRAB. Make sense? If not, there are some posts on Fentanyl that are very informative just go to the search box and type in Fentanyl. There is a poster called executor who is very knowledgeable on the subject.
Good luck I hope you get relief soon!
I hope this doesn't double post but the last post seems to have landed in cyber space?:dizzy:
 
Thank you deeannek for your response! I am on the Duragesic brand patch, which according to my research is the "brand name" patch. Monday, I called my doctor and explained to him that the patch was not working and questioned why he gave me nothing for break thru pain relief. He told me to "double my patches" (up to 100) and he prescribed Norco for break thru pain.

Since then, I have done a ton of research on the patch, and was not comfortable jumping to 100mg, when I know their is a 75mg patch available. I picked up my Norco yesterday and thank goodness, that is helping much more than the patch ever did. I decided to take off all the patches and start over today at my doctor's appointment. I took them off because from what I have read my doctor has not exhausted all other options before putting me on such a strong drug. This frustrates me, and today I am going to request another referral to a pain management doctor and a neurosurgeon for a second opinion. I am ready for an expert on chronic pain to help me, instead of my local general practitioner.

I will let you know how it goes!
 
Thank you so much for your kind worRAB Dee! I am thrilled with what is happening as far as my pain is concerned. My only complaint is a some insomnia that I am experiencing. But I'll figure that out over time!

Thanks again
 
Update: Today I went back to regular family doctor with my Mom and my boyfriend in tow. LOL! It was kind of funny having my Mom there, but she is an RN, and knows my doc well from working with him at the local hospital. She was there to validate how much pain I am in, and make sure I stop being jerked around on low doses of meRAB because she sees how much pain I am in and she is worried about me.

Anyway, the doc talked to us for over an hour! Finally it was decided, through much discussion, that I would go home and put 1 patch on (Wednesday). I was to use the Norco for breakthru pain, but no more than 10 per day. Friday, am to take off the old patch and put 2 new patches on. That way, I would build up to the 100mg, which made me more comfortable. The hope is that when I go to 2 50mg patches, I will need even LESS Norco to get me through the day.

I left the office feeling satisfied, but still depressed about my general situation. I told the doc about my sadness, and he said he hopes once I'm up to 2 patches, and the pain is less, I will feel better. If I don't, we will talk about a different anti-depressant and whatever else I need to feel better mentally next week when I go back.

I feel that my doc handled my case pretty well, finally. He stopped being so worried about prescribing too many pills and agreed to get me out of pain. I think he thought I was some kind of pill seeker, which I am not. I just want to be able to go about my day like a normal person without have excruciating pain. He is calling in a new RX today (Friday) for a full month's supply of Norco. (He keeps playing around with 30 or so pills per RX, which leaves me calling his office all the time for refills and constantly going to the pharmacy, which is just plain durab for someone who would rather do something more productive than go to the pharmacy when I feel well enough to run erranRAB!)

Thanks for reading/replying/supporting me!

I know I will be on these boarRAB a lot, I'm so glad I found them!

Heather
 
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