Fentayl patch lasting issues

[mommabear50]

My husband and I are both on 75mg patch. I find it equal to oxycotin meds I was on for years.  However, my husband has a hard time, after 48 hrs, with being hot and cold. Also increasing pain and being unable to stay awake. As soon as he makes it to 72 hrs within two hrs of changing his patch he is fine. We are having a hard time convincing his PM doc about this. He says his symptoms don't make sense. I don't think he believes him. It was hell just getting him to give him BT meds. So, my question is-does anyone else have these issues with the patch not lasting longer then 2 days? As well as the other symptoms he is having.
I have a wonderful PM doc that really listens to me. I have been with pain management for over 10 yrs. My PM doc won't take my husband as a patient due to us being a married couple. But I'm just trying to get some feedback on this issue to take to his PM doc. Thanks for your help.  

[namnam46]

Hi mommabear,

First I want to welcome you to the Pain Management Forum and let you know that we are glad you found this Forum. I want to let you know that there are NO Doctors on this Forum only CP - Chronic Pain - Patients that help each other with our OWN expertise and experiences that we have developed through our OWN CP Issues.

I'm sorry that you Husband is having this problem with his Doctor!! I, too, am on the Fentanyl Patches and change them every 48 hours, just as you do.  HOWEVER, after my Hip Implant Surgery 5 months ago, the Doctor in the Hospital REFUSED to write the order to change them every 48 hours and I had to tell my surgeon that he wouldn't do it and my SURGEON wrote an order to OVERRIDE the OTHER Doctor's order so that I could have my pain patches changed every 48 hours.  There are SOME Doctor's that JUST DON'T believe that the patches should be changed more often than every 72 hours.  

The FIRST appointment I had with my PM Doctor he ASKED me how the patches were working and I told him that the FIRST 2 days I didn't need very much BT {Break Through} Meds BUT by the 3rd day I'm having to take ALL of my BT meds and I'm STILL in pain.  He IMMEDIATELY changed my prescription to read "change every 48 hours".  He said that my body is metabolizing my medication FASTER than normal and that's what is causing me to be in so much pain the last day.  THAT'S what you need to talk to your Husband's PM Doctor about.  

I would "Google" about the Fentanyl and having to change it every 48 hours and see what you can get off of the internet.  ALSO, you could call YOUR Doctor and explain the problem and ask HIM/HER to give you some information on this problem that you and your Husband can give to his PM Doctor.

I HOPE that this has helped you in SOME way!!! I wish you the VERY best!!

PLEASE keep us updated on how this goes.............Sherry  :)

[monsterjam2]

Everyone reacts differently to pain medicine.  What works for you will most likely not work for him, and what works for him most likely won't work for the next guy.  It sounds like the patch is not working well for your husband.  The doc is not going to want to increase the dose if it is making him sleepy, and if it is not controlling his pain (keep in mind it takes a number of doses till it is working its best), he is either going to need non-narcotic BT meds or something different all together. (A narcotic BT med could be life-threatening if he is having trouble staying awake with the patch.) His doc may want him to stay on the patch for a little while to see if the hot & cold sensations go away, too(they are not common side effects of Fentanyl).  They may just be some temporary annoying side effects, or they may be related to something else.  I would suggest that he continue to follow up with this doc, as it may take some trial and error to find the right combination for him.  Best of luck to both of you.