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How much breakthrough is normal
Hi everyone, I would first of all like to thank everyone who helped me out making my big decision on weather to try the fentanyl patch or not. Like I had mentioned I decided to go against it. I simply don't think I need that much medication seeing that my pain is well controlled on the oxycodone. I must now wait and see if I my doctor can make it happen. Getting it at little or no cost to me. Other wise I don't know what I will do. I simply hate the MS Contin and it's only a choice between the 3. Trying the fentanyl, paying for the oxycontin or the MS Contin. We shall see. So back in my other post I had also asked at one point if it is normal for me to still be having breakthrough pain two or 3 times a day. I have it every night. EVERY NIGHT. I don't even wish for a good nights sleep anymore because I just know it's not happening. So that's # 1. Then I get it every evening, after dinner, my 3 yr. olds bath and picking up the house. That's # 2. Then sometimes when I go overboard with house work or if I have lots of errands to do. My Doctor only gives me enough breakthrough meds for once a day as she say's it is not normal for me to get it so often. I asked her what we will do if I am still getting it so much after I start on the Oxy Contin again. She say's we will have to up the dose of the Oxy Contin. But the thing is... is that the 10 mg's of Oxy Contin works for me, when it's working. It takes about an hour to kick in, but when it does, it works. It's only later that I am in pain again. I asked her, "if 10's work for me, up until breakthrough kicks in, and we up the dose of the Oxy Contin, wouldn't I be getting more of the medication then I really need"? She Said, " It's no different then taking 2 or 3 doses of breakthrough medication throughout the day."
So my questions are,
#1 Would I be getting more medication then I really need if we upped the dose?
#2 Is it normal for me to be having this much breakthrough pain?
# 3 Could the reason I am getting so much breakthrough pain be because my long acting medication is too low of a dose?
#4 If I upped the dose of the long acting medication, would that really help me to have less breakthrough pain, even when I am so busy?
My feeling is if I upped the dose, my body would get so used to that dose, then the breakthrough would come back anyway. Then the domino effect comes in and I have to up the dose again, and again and again.
I would appreciate any info anyone may have on this. If possible please answer as many of the actual questions as possible. You may add anything you like, but at the same time, please stay focused on my actual questions. For they are very specific answers I am looking for. Thank you everyone ahead of time.
So my questions are,
#1 Would I be getting more medication then I really need if we upped the dose?
#2 Is it normal for me to be having this much breakthrough pain?
# 3 Could the reason I am getting so much breakthrough pain be because my long acting medication is too low of a dose?
#4 If I upped the dose of the long acting medication, would that really help me to have less breakthrough pain, even when I am so busy?
My feeling is if I upped the dose, my body would get so used to that dose, then the breakthrough would come back anyway. Then the domino effect comes in and I have to up the dose again, and again and again.
I would appreciate any info anyone may have on this. If possible please answer as many of the actual questions as possible. You may add anything you like, but at the same time, please stay focused on my actual questions. For they are very specific answers I am looking for. Thank you everyone ahead of time.
I have a love/hate relationship with my pain meds! My pain management team has tried a variety of things for me and I've found what works best with the least side effects for me is the Fentanyl patch and the oxycodone for BT pain. I tried the MS Contin and oxycontin. With the MS Contin I used oxycodone for BT, and with the oxycontin I used morphine for the BT pain. I really didn't want to use the patch. I was really frightened of it. (The only thing I think I haven't tried is methadone, which was discussed, but there is no way I'll do that due to the very difficult withdrawal process.)
For me, originally I was given a generic Fentanyl patch that had the gel in it. I don't think the release of the gel was consistent and I also had trouble with the patches falling off no matter what I did. In addition, the glue on that patch would get on my clothes (and it doesn't come out ... a lot of ruined shirts) and it was really hard to get off my skin.
Now I'm on the Duragesic brand (which I think may be similar to the Mylan brand) and I have had no trouble with it at all. I'm prescribed to change it every 48 hours, but I stretch it out, which is probably why I still have so much BT pain.
I've never really been able to get rid of my BT pain, and my prescription for BT meds is 30 to 45 mg. of oxycodone ever 4 hours and I've been encouraged to take that as scheduled rather than wait for the pain to build up.
I am scared to death of addiction and withdrawal and it comes up at every visit I have with the PM team. I've done loads of research on it, and from what I've read, only a very small percentage of people overall misuse their pain medication when they have true chronic pain. But it is a slippery slope, and I think being aware of the danger of it is wise.
I do take breaks from my medication. I never take a break from the Fentanyl but at times I do stop the oxycodone, even though the pain will escalate. It's helped me to keep at this same dosage for a long time now. (I started with 5 mg. Percocet 3 times a day about 7 years ago, and after 9 surgeries and the development of RSD, along with other pain issues, my dosage now seems so high it scares me.)
I trust my doctors implicitly but I also learn so much from this board. I just find that the support I get here helps me as much as my medication does.
In addition to the medications, I also use lidoderm patches, 800 mg. of Advil several times a day, and I have a lotion from a compounding pharmacy. In the past I've tried Lyrica, Neurontin and Cymbalta for nerve pain, but none of those seemed to help. Every couple of months I get a stellate ganglion block for the nerve pain. The results on that varies, and though it never takes all the pain away, I usually get a fairly good reduction in some of the pain. I also have a prescription for Ambien for sleep but I rarely take it as I find melatonin works equally well for me most of the time.
JayBay made a good point on pain management. For so many years I was searching for a cure and zero pain ... or at least maybe a pain level of 2 or 3, but I now realize I have to be more realistic and accepting of what my baseline pain is and go from there.
It's definitely hard to deal with pain when you have small kids. My youngest is now 11 but I remember how much trouble I would have changing diapers after he was born. My hands just had so much pain that it was an ordeal. These days I have trouble driving at times, parallel parking is out of the question; I just can't turn the steering wheel. You'll find shortcuts for yourself as you go along.
Hopefully, at some point you'll be referred to a pain specialist. I do think they offer more options for chronic pain, though many primary care doctors are up on treating chronic pain and ordering the right medications and treatments.
I hope your BT pain eases up.
For me, originally I was given a generic Fentanyl patch that had the gel in it. I don't think the release of the gel was consistent and I also had trouble with the patches falling off no matter what I did. In addition, the glue on that patch would get on my clothes (and it doesn't come out ... a lot of ruined shirts) and it was really hard to get off my skin.
Now I'm on the Duragesic brand (which I think may be similar to the Mylan brand) and I have had no trouble with it at all. I'm prescribed to change it every 48 hours, but I stretch it out, which is probably why I still have so much BT pain.
I've never really been able to get rid of my BT pain, and my prescription for BT meds is 30 to 45 mg. of oxycodone ever 4 hours and I've been encouraged to take that as scheduled rather than wait for the pain to build up.
I am scared to death of addiction and withdrawal and it comes up at every visit I have with the PM team. I've done loads of research on it, and from what I've read, only a very small percentage of people overall misuse their pain medication when they have true chronic pain. But it is a slippery slope, and I think being aware of the danger of it is wise.
I do take breaks from my medication. I never take a break from the Fentanyl but at times I do stop the oxycodone, even though the pain will escalate. It's helped me to keep at this same dosage for a long time now. (I started with 5 mg. Percocet 3 times a day about 7 years ago, and after 9 surgeries and the development of RSD, along with other pain issues, my dosage now seems so high it scares me.)
I trust my doctors implicitly but I also learn so much from this board. I just find that the support I get here helps me as much as my medication does.
In addition to the medications, I also use lidoderm patches, 800 mg. of Advil several times a day, and I have a lotion from a compounding pharmacy. In the past I've tried Lyrica, Neurontin and Cymbalta for nerve pain, but none of those seemed to help. Every couple of months I get a stellate ganglion block for the nerve pain. The results on that varies, and though it never takes all the pain away, I usually get a fairly good reduction in some of the pain. I also have a prescription for Ambien for sleep but I rarely take it as I find melatonin works equally well for me most of the time.
JayBay made a good point on pain management. For so many years I was searching for a cure and zero pain ... or at least maybe a pain level of 2 or 3, but I now realize I have to be more realistic and accepting of what my baseline pain is and go from there.
It's definitely hard to deal with pain when you have small kids. My youngest is now 11 but I remember how much trouble I would have changing diapers after he was born. My hands just had so much pain that it was an ordeal. These days I have trouble driving at times, parallel parking is out of the question; I just can't turn the steering wheel. You'll find shortcuts for yourself as you go along.
Hopefully, at some point you'll be referred to a pain specialist. I do think they offer more options for chronic pain, though many primary care doctors are up on treating chronic pain and ordering the right medications and treatments.
I hope your BT pain eases up.
Thank you everyone for your input. There has been many comments on addiction and reaching for the bottle as soon as I anticipate the pain. # 1 Yes I do reach for the bottle when I know it's coming. # 2 Yes I do worry about being Chemically dependant, which I know I already am. I have been on percocet now for 16 months, and I know that if I had them pulled right from under me I would be in a lot of trouble. I absolutely need them for the pain, but I am having an injection coming up in March, and if this works out for me I know I will have to taper very gradually. I have never taken a break from the medication. But please don't miss understand what I am saying. Although the oxycodone doesn't leave me feeling very sleepy like the MS contin does, I absolutely don't go reaching for them just for an energy boost. My doctor doesn't give me enough to have the leisure to do that even if I wanted to do that, which I don't want to do that. The only time I take my short acting medication is when I KNOW I will need them. Because my doctor gives me so few, I used to try not to take them most times when I really should have. More times then I can count I ended up on my hands and knees crying, praying for the pain to go away. I was forced to take the meds anyway, and since I waited for the pain to get so bad, It took me having to take more of them to relieve the pain. During those experiences it took 3 or 4 5/325 percocets to relieve the pain that had already gotten to it's worst, when usually it would take 2 of them if I had taken them at the onset of the pain. As for taking a break from the medication, I know everyone's pain is different so all I can comment on is my own. Honestly, I would be scared to death to even try it. When this first began in my life, I had to go 2 months with no pain relief. I was in the ER 3 times during that time and was given vicodin. Needless to say the vicodin did NOTHING for the pain. Finally when I found my doctor ( the one I have now ) she wanted to put me on Vicodin too at first. When she told me this I just about had a panic attack. I told her it didn't work, but I had to leave there that day with only vicodin anyway. It was hell that I had to continue living until my doctor soon after agreed to put me on something stronger. I don't want to be weak and I envy all the people who have taken breaks from their meds, but with the amount of pain I experience I just don't see how it's possible. LIke I said, if I don't take them right at the onset of the pain, it gets to a point that my body just CANT handle. I have 2 kids. The last thing I wan't to do is pop pills all day, but when I don't take my pain medication I can't even concentrate enough to answer simple questions. As for trusting my doctor, I do for the most part. The thing is is she is not a PM. She is my General practitioner. I have asked her time and time again about seeing a PM, but she won't refer me until we have exhausted all out other options. She said that most PM's don't see Chronic pain patients until they have already gone through all other options. I still have 2 injections to go before she will refer me. I love my doctor. She's great. I appreciate her soooo much. She listens to me, and it seems like she really cares about my well being and pain control. It's not that I don't trust her, it's just that PM's specialize in this sort of thing. They have seen so many patients with the same medical problems I have. They have had so much trial and error, because they do this all day long. I just don't think my doctor is quite as experienced with pain management as I wish she was. But I know she is doing her best, and I do appreciate all she does do for me. I have heard so many stories about people not getting anything for breakthrough, and other horror stories about non understanding doctors. And I am giving her the benefit of the doubt. I didn't even want to try the MS Contin. I am still pretty new at all this myself, and the word MORPHINE freaked me out a bit. But I tried it.
From MZ33
I understand what you are saying and just wanted to
let you know that it is available.
I think if you will look you will find lawsuits against
some of these patches for overdose problems.
But they are on the market and sold as safe.
And best of all they do work to relieve pain.
I understand what you are saying and just wanted to
let you know that it is available.
I think if you will look you will find lawsuits against
some of these patches for overdose problems.
But they are on the market and sold as safe.
And best of all they do work to relieve pain.
So how does that work? I get that a compounding pharmacist puts together the gel, but are you responsible for pumping it into a "blank" patch? How do you control the dose? Just curious.
I live in one of the largest cities in the nation and compounding pharmacists are few and far between. I personally know of two within 25 miles of my house. My brother used one out in the suburbs for his son who has serious epilepsy. The only way he could take one medication was as a syrup which had to be mixed by a compounding pharmacist since it wasn't made commercially. All was well for about year until they nearly killed the boy. The pharmacist grabbed the wrong bottle and the medication was 10 times the strength it should have been. I understand that medical errors happen all the time, but I trust the big pharma companies to at least program their computers correctly over the greater probability of human error with a compounding pharmacy.
I'm glad to hear you found something that works for you and a pharmacist you're comfortable with. It's also good to know there are alternatives available if we look hard enough and think outside the box.
I live in one of the largest cities in the nation and compounding pharmacists are few and far between. I personally know of two within 25 miles of my house. My brother used one out in the suburbs for his son who has serious epilepsy. The only way he could take one medication was as a syrup which had to be mixed by a compounding pharmacist since it wasn't made commercially. All was well for about year until they nearly killed the boy. The pharmacist grabbed the wrong bottle and the medication was 10 times the strength it should have been. I understand that medical errors happen all the time, but I trust the big pharma companies to at least program their computers correctly over the greater probability of human error with a compounding pharmacy.
I'm glad to hear you found something that works for you and a pharmacist you're comfortable with. It's also good to know there are alternatives available if we look hard enough and think outside the box.
From MZ33
Anyone who is interested in compound drugs should talk
with your doctor about your options.I have used a
Compounding pharmacy for years.This was not for any reason
other than I refuse to go to a big box pharmacy.The reason
for me to go to compound was not price alone it's only
About 10% less.I was talking with my doctor about different
options and taking so many meds.My PM doctor wrote the
script to include an additional med in the compound.
I can tell to that the factory patches are easier to use because
I have add gel to patch then apply.
I also get a delivered pain gel that is compounded by
a different pharmacy because it's in a pump container.
My regular pharmacy does not have the pump containers
and would simply give me a jar of gel.
I hope people that are on Internet trying to copy and paste
some garbage will simply ask a Doctor these things.
A good pharmacist will work with you and your doctor.
You also must make sure you have a compounding pharmacy
to work with.
Anyone who is interested in compound drugs should talk
with your doctor about your options.I have used a
Compounding pharmacy for years.This was not for any reason
other than I refuse to go to a big box pharmacy.The reason
for me to go to compound was not price alone it's only
About 10% less.I was talking with my doctor about different
options and taking so many meds.My PM doctor wrote the
script to include an additional med in the compound.
I can tell to that the factory patches are easier to use because
I have add gel to patch then apply.
I also get a delivered pain gel that is compounded by
a different pharmacy because it's in a pump container.
My regular pharmacy does not have the pump containers
and would simply give me a jar of gel.
I hope people that are on Internet trying to copy and paste
some garbage will simply ask a Doctor these things.
A good pharmacist will work with you and your doctor.
You also must make sure you have a compounding pharmacy
to work with.
I'm kinda in a hurry so I just wanted to comment on one thing - I agree that tolerance can be controlled if you're willing (and able) to do what it takes to lower your tolerance once in awhile. I've been on Lortab/Norco 10's for the past 3-4 years, and they still do just as much for me as they used to. there are times when they don't, when my pain levels are higher, but my RESPONSE to them is adequate because I've taken breaks. I've switched to lower dose narcotics, quit taking them all together, switched to the same dose of a different opiate, etc.....and after so many years I can still take a 10/325 and experience the same relief I experienced 4 years ago.
In fact, today I took one and instead of getting worse like I thought it was about to, the pain got better right before the pill kicked in so I got a "high" for the first time in about 2 years...I HATE that feeling. I was calling my husband "keep an eye on me if I fall asleep wake me up...I need some caffeine. I'm going to take a cold shower" lol...I really really really hate that "high" feeling. Not to down on anyone who was a drug addict but I don't understand how people can enjoy it, it scares the crap out of me...but then, I"m a control freak and it makes me feel out of control.
anyway sorry for the tangent.
so being on strong meds at a young age is difficult, but with proper management and attention it can be done effectively.
sorry I can't comment on anything else, I was only on Ms Contin for awhile (15mgx3 a day) and if you want to message me to ask anything about it I'd be happy to share, but like I said I"m in a hurry at the moment.
Best wishes :-).
In fact, today I took one and instead of getting worse like I thought it was about to, the pain got better right before the pill kicked in so I got a "high" for the first time in about 2 years...I HATE that feeling. I was calling my husband "keep an eye on me if I fall asleep wake me up...I need some caffeine. I'm going to take a cold shower" lol...I really really really hate that "high" feeling. Not to down on anyone who was a drug addict but I don't understand how people can enjoy it, it scares the crap out of me...but then, I"m a control freak and it makes me feel out of control.
anyway sorry for the tangent.
so being on strong meds at a young age is difficult, but with proper management and attention it can be done effectively.
sorry I can't comment on anything else, I was only on Ms Contin for awhile (15mgx3 a day) and if you want to message me to ask anything about it I'd be happy to share, but like I said I"m in a hurry at the moment.
Best wishes :-).
Jenny, I suspect you're overthinking the whole long-term and breakthrough pain thing. Like you, I was pretty confused when I first began opiate therapy and could have avoided a whole lot of problems had my doctor fully explained exactly what pain management is all about.
First, it's about "management" and not "cure." The goal is to make your pain manageable enough that you aren't laid out on the couch all day. Many patients never reach that goal and not one of us has zero pain.
Second, long-acting meds like fentanyl aren't necessarily "stronger" meds. Think of them more as time-released meds to give you a baseline of pain control. Breakthrough meds should only be used if the pain gets out of control. It takes a lot of mental work to not reach for that pill bottle every time you experience or anticipate a pain spike. Ultimately, you're better off if you can deal with your pain with primarily long-acting medication.
Three, tolerance is a real problem with any opiate therapy no matter what drug is used. It can be dealt with through changing medications every few months or taking an outright opiate vacation for a few weeks. Yes, there is a certain amount of short-term suffering with both techniques, but it helps you avoid reaching a drug ceiling sooner rather than later.
One thing I'm somewhat concerned about is that you automatically turn to the breakthrough meds to get the housework done or chase after the kids. Please don't take this the wrong way, but this is how people get into trouble with pain meds. Take a look at the Substance Abuse forum and see how many people's addiction began in just this way. I'm not saying you're addicted, but want you to keep this in mind as you go forward. If you find yourself reaching for those breakthrough meds for an "energy boost" or in anticipation of some activity, that's the beginning of a problem.
There are certain lifestyle changes we all have to make to accommodate our chronic pain. It interferes with everything we do as well as relationships with family and friends. You can't expect any medication to allow you to function at 100% of what you did before chronic pain came into your life. These are all good reasons to at least try a few weeks of therapy with a pain psychologist. You can learn different mental skills to cope with your pain and keep your relationships on good footing as you adjust your life to something you can reasonably manage. The mental AND physical side of chronic pain should be treated for the best outcome.
MZ33 - did your compounding pharmacy make your patches for you or did you have adhesive and release problems with commercially-made patches? I suppose a compounding pharmacist can make anything - but this is a new one on me. I had the most trouble with the gel pouch patches. Even going outside on a hot day released too much and they rarely lasted the full three days. I'd sweat them off or they'd fall off in the shower. What a pain. I've used the Mylan pharmaceuticals generics for years and had far less trouble keeping them on and less trouble with heat. I wouldn't soak in a hot bathtub with one one, but normal showers aren't a problem.
First, it's about "management" and not "cure." The goal is to make your pain manageable enough that you aren't laid out on the couch all day. Many patients never reach that goal and not one of us has zero pain.
Second, long-acting meds like fentanyl aren't necessarily "stronger" meds. Think of them more as time-released meds to give you a baseline of pain control. Breakthrough meds should only be used if the pain gets out of control. It takes a lot of mental work to not reach for that pill bottle every time you experience or anticipate a pain spike. Ultimately, you're better off if you can deal with your pain with primarily long-acting medication.
Three, tolerance is a real problem with any opiate therapy no matter what drug is used. It can be dealt with through changing medications every few months or taking an outright opiate vacation for a few weeks. Yes, there is a certain amount of short-term suffering with both techniques, but it helps you avoid reaching a drug ceiling sooner rather than later.
One thing I'm somewhat concerned about is that you automatically turn to the breakthrough meds to get the housework done or chase after the kids. Please don't take this the wrong way, but this is how people get into trouble with pain meds. Take a look at the Substance Abuse forum and see how many people's addiction began in just this way. I'm not saying you're addicted, but want you to keep this in mind as you go forward. If you find yourself reaching for those breakthrough meds for an "energy boost" or in anticipation of some activity, that's the beginning of a problem.
There are certain lifestyle changes we all have to make to accommodate our chronic pain. It interferes with everything we do as well as relationships with family and friends. You can't expect any medication to allow you to function at 100% of what you did before chronic pain came into your life. These are all good reasons to at least try a few weeks of therapy with a pain psychologist. You can learn different mental skills to cope with your pain and keep your relationships on good footing as you adjust your life to something you can reasonably manage. The mental AND physical side of chronic pain should be treated for the best outcome.
MZ33 - did your compounding pharmacy make your patches for you or did you have adhesive and release problems with commercially-made patches? I suppose a compounding pharmacist can make anything - but this is a new one on me. I had the most trouble with the gel pouch patches. Even going outside on a hot day released too much and they rarely lasted the full three days. I'd sweat them off or they'd fall off in the shower. What a pain. I've used the Mylan pharmaceuticals generics for years and had far less trouble keeping them on and less trouble with heat. I wouldn't soak in a hot bathtub with one one, but normal showers aren't a problem.
Hi Jenny,
Once again, I DON'T mean to contradict MZ33, but the compounding pharmacies CANNOT make you a custom patch. What the compounding pharmacies can do is to make a compound Fentanyl tablet that goes under your tongue such as Actiq is.
The following paragraph was copied from forresttennant.com about compound pharmacies and what they can do with Fentanyl.
START:
"A "compounding" pharmacy can make an under-the-tongue fentanyl product often called "troche". Likely, your physician will know of a compounding pharmacy near you. Lately, I've observed that many compounding pharmacies only reduce their prices or costs slightly less than ACTIQ® or Fentora®, because they know that fentanyl is the very best pain reliever for many patients, and so they want to gouge the patient."
END
MZ33 if you have some sort of proof that these pharmacies CAN produce a patch can you please give us the link to it? I could find NO SUCH information ANYWHERE that ANY compounding pharmacy can produce a PATCH. Thank you. :) The reason that I ask you to show us this is that we try VERY hard to keep incorrect information from getting put out on the MH site. Thank you.
I hope that this information will help to clarify EXACTLY what the compounding pharmacies CAN do. :)..............Sherry
Once again, I DON'T mean to contradict MZ33, but the compounding pharmacies CANNOT make you a custom patch. What the compounding pharmacies can do is to make a compound Fentanyl tablet that goes under your tongue such as Actiq is.
The following paragraph was copied from forresttennant.com about compound pharmacies and what they can do with Fentanyl.
START:
"A "compounding" pharmacy can make an under-the-tongue fentanyl product often called "troche". Likely, your physician will know of a compounding pharmacy near you. Lately, I've observed that many compounding pharmacies only reduce their prices or costs slightly less than ACTIQ® or Fentora®, because they know that fentanyl is the very best pain reliever for many patients, and so they want to gouge the patient."
END
MZ33 if you have some sort of proof that these pharmacies CAN produce a patch can you please give us the link to it? I could find NO SUCH information ANYWHERE that ANY compounding pharmacy can produce a PATCH. Thank you. :) The reason that I ask you to show us this is that we try VERY hard to keep incorrect information from getting put out on the MH site. Thank you.
I hope that this information will help to clarify EXACTLY what the compounding pharmacies CAN do. :)..............Sherry
From MZ33
I want everyone to know that I said Hot and Cold are problems
for me! I'm am not a doctor but I want to make sure that everyone knows
that I experienced extra realease of med from fentanyl patch.
The first time I was driving and was so sleepy I didn't remember
the whole drive. I called my doctor and the nurse told me about how
careful some people have to be with them.Also if you have a compounding
pharmacy,with your doctor you can have it made in custom patches!
MZ33
I want everyone to know that I said Hot and Cold are problems
for me! I'm am not a doctor but I want to make sure that everyone knows
that I experienced extra realease of med from fentanyl patch.
The first time I was driving and was so sleepy I didn't remember
the whole drive. I called my doctor and the nurse told me about how
careful some people have to be with them.Also if you have a compounding
pharmacy,with your doctor you can have it made in custom patches!
MZ33
Hi Jenny,
I don't mean to contradict MZ33 but I want to clarify a couple of things here.
Not EVERYONE has to have the coverings for the patches to hold them on.In fact MOST people DO NOT have to have them. That's why I told you that IF you should choose the patch to be sure that it is the Mylan Brand. The ones that have the MOST trouble with them sticking are the ones that DON'T have the Fentanyl in the adhesive and have it in the reservoir. The one that I told you was so dangerous.
The other thing is that the cold does NOT effect how fast OR slow the Fentanyl comes out. The HEAT DOES effect it and you need to be careful - as it is stated in the insert - to be careful with your Hairdryer, electric blankets, Hot Showers - it will tell you the temperature of the water in the insert and IF it doesn't then ask your pharmacist as they will have ALL the information - and of course the IDEAL thing is to be SURE that you take a nice HOT Shower when you are CHANGING your patches and have it off ready to put on a new patch. At that time you can JUMP in the shower and enjoy a LONG leisurely HOT shower OR bath while the patch is OFF. I get to do that every 2 days as I change mine every 48 hours. The other day I can take a nice warm shower with NO problems. I stand with the water hitting the other shoulder where the patch isn't BUT it ALSO hits the shoulder with the patch also. I just don't stand there for long periods as I don't want to take any unnecessary chances. :)
I KNOW that you aren't going the route of the patches BUT I needed to clarify a couple of statements that weren't consistent with what you need to be concerned about with the patches. :)
Good luck getting the OxyContin!!!........Sherry
I don't mean to contradict MZ33 but I want to clarify a couple of things here.
Not EVERYONE has to have the coverings for the patches to hold them on.In fact MOST people DO NOT have to have them. That's why I told you that IF you should choose the patch to be sure that it is the Mylan Brand. The ones that have the MOST trouble with them sticking are the ones that DON'T have the Fentanyl in the adhesive and have it in the reservoir. The one that I told you was so dangerous.
The other thing is that the cold does NOT effect how fast OR slow the Fentanyl comes out. The HEAT DOES effect it and you need to be careful - as it is stated in the insert - to be careful with your Hairdryer, electric blankets, Hot Showers - it will tell you the temperature of the water in the insert and IF it doesn't then ask your pharmacist as they will have ALL the information - and of course the IDEAL thing is to be SURE that you take a nice HOT Shower when you are CHANGING your patches and have it off ready to put on a new patch. At that time you can JUMP in the shower and enjoy a LONG leisurely HOT shower OR bath while the patch is OFF. I get to do that every 2 days as I change mine every 48 hours. The other day I can take a nice warm shower with NO problems. I stand with the water hitting the other shoulder where the patch isn't BUT it ALSO hits the shoulder with the patch also. I just don't stand there for long periods as I don't want to take any unnecessary chances. :)
I KNOW that you aren't going the route of the patches BUT I needed to clarify a couple of statements that weren't consistent with what you need to be concerned about with the patches. :)
Good luck getting the OxyContin!!!........Sherry
From MZ33
I suffer from chronic pain from cervical spine surgeries.I have tried about every drug out there.Then my doctor started me with 125mg Fentanyl patch every 3 days.I will say that after we went to every 2 days, it works great for me.However it is very expensive and you still need breakthrough meds.Also if you like hot showers and its cold outside and you need to drive ///DO NOT DRIVE//! The hot and cold is it big problem for me,it will release more meds into you.Oh and you will have to buy a transdermal bandage to go over each one.This is a must,they will come off without them and the will help with temp changes.I hope I have helped in some way.
MZ33
I suffer from chronic pain from cervical spine surgeries.I have tried about every drug out there.Then my doctor started me with 125mg Fentanyl patch every 3 days.I will say that after we went to every 2 days, it works great for me.However it is very expensive and you still need breakthrough meds.Also if you like hot showers and its cold outside and you need to drive ///DO NOT DRIVE//! The hot and cold is it big problem for me,it will release more meds into you.Oh and you will have to buy a transdermal bandage to go over each one.This is a must,they will come off without them and the will help with temp changes.I hope I have helped in some way.
MZ33
Sorry, I forgot to answer question 4. :{
Yes, upping the dose of the Long Acting med could DEFINITELY help you have less BT pain as it will keep more medicine in your body. The higher the dose the less pain you will have for a longer period of time. That's just the way that it works. :)
I realize that I didn't really address the first question. IF you are wanting to get less BT pain then upping the dose would NOT give you more medicine than you need as you are wanting to get more meds in your body to keep the BT pain at a minimum.
At some point you HAVE to trust your Doctor. I REALLY feel that she is doing her best to try to help you. IF after you TRY what she asks you to try and you DON'T like it you can ALWAYS change to something else. IF you don't feel comfortable trusting her then YOU need to CHANGE DOCTORS. I have TOTAL trust in ALL of my Doctor's and I have no reason to doubt ANY of their choices for me. So far they have ALWAYS recommended meds that have helped me.
We can sit here and answer your questions BUT it comes down to the fact that YOU MUST put your trust in your Doctor. It's alright to question SOME things but IF you want pain control then you need take a leap of faith that she knows what she is talking about.
I wish you the best and I hope that you will give her ideas a try and if you do I REALLY think that you will get the pain control that you are seeking.........Sherry :)
Yes, upping the dose of the Long Acting med could DEFINITELY help you have less BT pain as it will keep more medicine in your body. The higher the dose the less pain you will have for a longer period of time. That's just the way that it works. :)
I realize that I didn't really address the first question. IF you are wanting to get less BT pain then upping the dose would NOT give you more medicine than you need as you are wanting to get more meds in your body to keep the BT pain at a minimum.
At some point you HAVE to trust your Doctor. I REALLY feel that she is doing her best to try to help you. IF after you TRY what she asks you to try and you DON'T like it you can ALWAYS change to something else. IF you don't feel comfortable trusting her then YOU need to CHANGE DOCTORS. I have TOTAL trust in ALL of my Doctor's and I have no reason to doubt ANY of their choices for me. So far they have ALWAYS recommended meds that have helped me.
We can sit here and answer your questions BUT it comes down to the fact that YOU MUST put your trust in your Doctor. It's alright to question SOME things but IF you want pain control then you need take a leap of faith that she knows what she is talking about.
I wish you the best and I hope that you will give her ideas a try and if you do I REALLY think that you will get the pain control that you are seeking.........Sherry :)
Hi Jenni,
Basically, this is what I was talking about with the patch and going with something so strong that you have nothing left.
You need to stick with the LOWEST dose that you can because you WILL become immune to it and have to raise the dose. That's the way that Pain Meds work. There's NO getting around it. So the longer that you can stay on a lower dose the better off you will be. I find it a real shame that your Doctor won't allow you more than ONE DOSE of BT meds. I don't recall ever hearing that before. I'm amazed that you can manage at all. I'm allowed 3 to 4 Percocets 10/325 a day for BT meds. Even though I never have to use that many at least I KNOW that they are there If I should need them.
Yes, it's normal for you to be having that much BT pain. Whenever you are doing anything that is strenuous such as bathing the kids {having to bend over for long periods of time} will cause SIGNIFICANT pain in your back. IF you can get the OxyContin then your BT pain may lessen significantly {MAYBE} there's NO guarantee but THEORETICALLY that SHOULD happen. It's a much stronger pill than what you are on now. I know the patch made a DRASTIC change with my BT pain. So you should get the same change with your OxyContin.
It could be that your long acting is too low a dose. You will ALWAYS have to up your meds at some point in time. There's NO getting around that. Your body IS and ALWAYS WILL get used to the meds that you are on and you WILL either have to up the dose OR change to something stronger. That's WHY I was concerned about you starting the patch at this point in time. At sometime you WILL have to be on the patch as there will be NO other choice as you become immune to the meds. That's why you need to try the other things FIRST so that you will have something left when everything else has been exhausted. HOPEFULLY, you will have options for several more years!!
I REALLY hope that your Doctor can get you the financial help that you need OR maybe she can get your insurance to make an exception for you. There should be an exception that she can file for this med with your insurance. You need to check with your insurance and find out what you need to do to get an exception for you for the OxyContin.
I wish you the VERY best and PLEASE let us know how it works out!!!.......Sherry :)
Basically, this is what I was talking about with the patch and going with something so strong that you have nothing left.
You need to stick with the LOWEST dose that you can because you WILL become immune to it and have to raise the dose. That's the way that Pain Meds work. There's NO getting around it. So the longer that you can stay on a lower dose the better off you will be. I find it a real shame that your Doctor won't allow you more than ONE DOSE of BT meds. I don't recall ever hearing that before. I'm amazed that you can manage at all. I'm allowed 3 to 4 Percocets 10/325 a day for BT meds. Even though I never have to use that many at least I KNOW that they are there If I should need them.
Yes, it's normal for you to be having that much BT pain. Whenever you are doing anything that is strenuous such as bathing the kids {having to bend over for long periods of time} will cause SIGNIFICANT pain in your back. IF you can get the OxyContin then your BT pain may lessen significantly {MAYBE} there's NO guarantee but THEORETICALLY that SHOULD happen. It's a much stronger pill than what you are on now. I know the patch made a DRASTIC change with my BT pain. So you should get the same change with your OxyContin.
It could be that your long acting is too low a dose. You will ALWAYS have to up your meds at some point in time. There's NO getting around that. Your body IS and ALWAYS WILL get used to the meds that you are on and you WILL either have to up the dose OR change to something stronger. That's WHY I was concerned about you starting the patch at this point in time. At sometime you WILL have to be on the patch as there will be NO other choice as you become immune to the meds. That's why you need to try the other things FIRST so that you will have something left when everything else has been exhausted. HOPEFULLY, you will have options for several more years!!
I REALLY hope that your Doctor can get you the financial help that you need OR maybe she can get your insurance to make an exception for you. There should be an exception that she can file for this med with your insurance. You need to check with your insurance and find out what you need to do to get an exception for you for the OxyContin.
I wish you the VERY best and PLEASE let us know how it works out!!!.......Sherry :)
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