I think there are so many things that play into this decision and they all need to be looked at.
Recovery time and success rate after surgery is a biggie; quality of life now as opposed to questionable after surgery; age and lifestyle; pain relief...
Personally, if I were pain FREE after suffering so long, I'd stick with the sure thing and stay on the patch. Of course, if I were 20 years old, I might think differently...but right now that's what I would do and I'd keep the surgery in the back of my mind as a last resort.
You've got some thinking to do; all the best!
A fairly universal part of drugs, especially opioids, is the tolerance over time. I think it's great you found relief, if you are not an addict, but would use this time to find alternative healthcare. The receptors in the brain become clogged with opioids, which are very similar to the natural opiates the brain produces. They actually call them opiate receptors. Over time, the receptors begin to recess, shrink, requiring more drug for the same relief. Of coarse, this is only my opinion. Fentanyl is the strongest opioid made, there is no stronger opioid to move too once the tolerance begins. You will have to up the dose, until that stops working and then detox and find alternatives.
Thought u would throw my 2 cents in...
I have been in fentanyl (and oxycodone) for years. 20 years total of pain management for Crohn's disease and rheumatoid arthritis and I am only 38 years old.
I initially found relief and freedom from pain with fentanyl. However, as weaver mentioned, over time your body required more and more of the drug to have the same effects. I ended up on a dose of 200 mcg and although I was having symptoms if toxicity from the massive dose , my body would still experience pain and withdrawal fairly frequently. Once you are on fentanyl, there is no where else to go.
I have spent the last 2+ months trying to taper off the patch. It has been awful. Nausea, achiness, GI issues, cold sweats,restless legs, anxiety....
I f I had known then what I know now, I never would have started using fentanyl. I strongly believe it should be reserved for end of life pain only.
I do wish you the best in your decision and I hope your days are pain free.
Welcome to the forum~ I can really relate to a lot of things in your post.
I hear you on the dilemma about surgery versus staying on the fentanyl patch and a benzo (clonazepam). I'll just share some things and maybe it will help you as you process what may be right for you.
I have had successful major back surgery (2011) My husband has had a very successful back surgery (2007). My 81 yr old Aunt has too (2012). My dr's 85 yr old mother-in-law has too (2006). My son-in-law has had 2 successful surgeries, one cervical, one lumbar. (2009/2011). We ALL had surgery from the same EXCELLENT back surgeon. None of us regrets it.
The days of rumored "botched" surgeries were certainly around, but wasn't that like back in the 1960's or 70's? Technology/science and medicine have come a LONG way since then, eh?
Since Fent.patches are one of the highest strengths of opiates, as was said above....once your tolerance builds...you have no where else to go.
How will being on this opiate/benzo combo affect your health...side affects, etc. long term? Opiates work in the beginning...and some for a fairly long spell of time....but at some point....we run the risk of "opiate induced hyperalgesia" where our bodies have had opiates fed to them for so long, our pain actually increases. And as Weaver pointed out, once our opiate receptors begin receiving the drug....the tolerance builds naturally whether we want it to or not. We require more of the drug to do the same job. Then you have to deal with the w/drawals from the opiates... and the benzo w/drawals are no walk in the park either. Both are very addictive.
I did a WHOLE LOT of research on my back surgeon before I let him cut on my back. I talked to lots of his former patients, asked about him at the hospitals, read all the reviews on him. I tell you....I didn't have insurance for over a yr and a half and laid in bed praying for the day when he could operate on my back. The longer I put it off....the more nerve damage I had....and some of it is now permanent. My husband had his within 3 mos of his severe pain and he has faired much better than me overall.
Surgery can be scary, sure....but the medical world has come a LONG WAY and there are fabulous surgeons out there...it's important to find one you trust and believe in.....and have received excellent recommendations from others as well.
Hope that gives you some more ways to look at this...and some points to consider. No matter how old we are.....life is meant to be lived to the fullest....and having gotten addicted to pain meds due to my health.....I wouldn't wish that on anyone.
No matter what you decide to do....I wish you the best~
Clean_in_ks that was a great answer. I hav also had two surgeries by the dame wonderful doctor and I dont regret them 1 but. However I do regret being/having to b on the pain meds due to a car accident & the aftermath of what the car accident did to me. Good luck..my advise is ANY OPIATE ISN'T WORTH LIVING LIFE SOBER !!!! No opiate is good there all the devil.
Opiates aren't inherently bad by themselves. I agree completely that for an ADDICT, opiates just aren't an option moving forward, not if that person wants to hang onto their sobriety.
For THIS OP, it's a little trickier IMO. It sounds as though the OP isn't an addict, but rather a chronic pain patient who is concerned about the ramifications of relying on Fentanyl patches long term (which is a valid concern).
All great answers above, and I agree with vicki that there are a lot of factors that go into this decision. I'm all for trying to find a long term solution to fixing the source of the pain if possible, but with that said, it's understandable that making the decision to have major surgery isn't an easy one.
I hope it all works out for the OP. It's great that she at least has a sense of awareness of the risks. So many people go into these kinds of things with little to no knowledge about the risks.
Personally im sorry I would have to agree to disagree with u the nursegirl. For me I really needed the meds but after 7 yrs it tuned into an addiction. To each his own I kno I wouldn't wish opiate addiction/dependency on anyone. And 9 times out of 10 thats what it will turn into from being on perscribed pain meds. At least thats what I've seen. So I advise the person the find what works ...yes...but b extremely careful bc it can easily turn into addicton quickly.
Thanks for that NG- You and I have probably known many in this type of situation and we look at everything! I'm looking at the disease process of spondylosis and the fix rate, the lack of abuse and the age of the OP...the dose is fairly low right now, too. Also, non abusers can get relief from the same dose for a very long time...She/he has some decisions to make!
I'm not a fan of Fentanyl because it was a poor fit for me and for the most part I feel it should be for end of life pain. But I know some people that Fentanyl worked well for. I would just advise you to try to stay at the lowest dose possible and just be aware. I've been in pain management and haven't become addicted. But I do worry that it xould happen someday. It is a hard drug to come off, even when tapering, but if your doctor is helping get you off it if needed, then it's a bit easier.
Well, Lena...you have certainly gotten a lot of responses and hopefully it hasn't made your decision making process that much harder.
All I call tell you, is that I wasn't an addict when my chronic pain began. It happened over a period of time using narcotics to ease my pain. I later paid a huge price in many ways by not being able to get my own recommended surgery sooner.
Since your doctor has recommended it...and now you have some feedback from all of us....I pray you find some peace in your decision.
Best of the best to you~
Well put cleaninkansas. Your situations sounds erier firmilar to mine...I too was put in pain management after a serous car accident I was in pm for 7 years I wasn't addicted but def. needed it for the pain but after yeaRs of putting it into my body my body becme dependent on it and I needed it as did I also need it to control my pain. You have to find what works best for you. And sometimes that may be trial and error unfortortantly but whatever u decide to do I wouldn't recommend staying on Any opiotes for a long period of time. God Bless!!