It is not unusual for ppl to go to a 48 hour schedule for patch changes. It's better in my opinion that increasing the dosage. Discuss that possibility with your physician.
And yes you will have to be very careful in the sun. The patch releases more medication than intended once your body temp reaches above 103 or the sun beats on it. Being in the sun for even a short time can produce some life threatening complications. The patch is not something you can wear to the beach or pool in your swimsuit on an exposed area. Taking the patch on and off is never recommended.
You'll have to make some difficult choices. As long as the patch is so effective I would hate to see you go to something that may not be as effective. However sun bathing is not an option with the patch on. Our member "expert" on the Fentanyl Patch should be along shortly and provide you some better information.
Unfortunately chronic pain requires that we make some pretty difficult choices. If going to the pool or sun bathing with your daughter is not one you are willing to give up than you may have no choice but to try an alternative pain management medication. How often do you plan on to the pool? In my opinion if this is a weekly trip or every other week you may be able to juggle your patch changes. However if this will be several times a week I think it may be next to impossible to manage.
What ever you decide make an informed and educated decision. Please let us know how you are doing.
Take Care and Good Luck to You,
I had great results w/ the patch, and was on it for 6 yrs until I had the choice of adding another patch to the 100 mcg one, or going back to pills (oxy,etc). The patch is EXTEMELY POWERFUL, and while it stinks that feeling you had when you up'ed your dosage it's uncommon- at least not the way I remember it. I didn't start at 100 I started at 75, then 100. Because of it's power there a few things I learned that may help you, at least I hope so. I love this forum and wish I would of had 'something' to help me during my 1st 14 yrs of pain management - I gave been on a lot of forums and most are just a outlet for abusers, pushers, & others who make it EXTREMELY difficult for legitimate PM patients to get what they need.
Where do you live? If you live in FL, or whereever with the summer coming up, you'll have to adjust yourself. My patches kept falling off, even when I lived in MA. if they fall off, it's pretty close to useless to get them back on. They make a full size 'overlay clear sticky bandage' that will save you TONS of aggreviation. First things 1st, they always start you lower on ANY medication change, because different meds act differently, most of the time you'll go thru several 'adjystments' before you get the right dose FOR YOU. Next is I would sincerely reccomebd starting a 'log' of time, date. Pain level of when you put the patch on, when you notice you pain increasing, etc - thus will help your Dr. You might have 'over done it' while you were feeling really good, just something to consider. If you live in a state like FL that let's you get name brand without the Dr writting 'NO SUBSTITUTIONS' on your script, I have always found the name brand works the best. It's tough to get a 'beat' on how well it's working right off, it took me 3 weeks before I figured it out, then the best places to put it, etc. If you don't feel the need to go to a higher dose then don't, I was at every 72, then went to 48 hrs. As I say in almost every post I write you need to have a good relationship with your Dr, that's key. If you dont trust or respect him and ge doesn't trust or respect you the relationship doesn't do ANYONE any good, your not allowing him tondo his job and your short chafing yourself as to the quality of your care, so if somethings not working, talk to the dr - even if you need to make a special appointment. If your having that sick feeling you could be going through a tad of wuthdrawls, but since it's been a week or more i doubt it. While this will seem silly, the patches worked lousy FOR ME on my chest or back, just because I would perspire and the thing wouldcurl up, even under tape, and those Clear bandages that you put over the patch help, but not alot. There a manfactur that makes a smaller 'patch' all I can remember is the box is white, blue stripes and yellow. The size per patch also is smaller for a 25mcg then a 100 mcg, I wish I could remeber the company as that patch seemed to stick the best out of all of them. I got into the habit of using waterproof WIDE medical tape, cuttiing it into 'stripes' so it would over lap the patch by 1/2" - 3/4" on each side, top and bottom, overlapping the stripes by about 1/4" of a inch per stripe, running them side to side (horizontally) after I would take a shower in the morning, dry off, put my fresh patch on, after I had applied pressure to it as the directions stated, then I would take a raquet ball or a wide highlighter and roll it over the patch for a minute or so making sure I got the corners, ends, etc. Put the tape on - keeping the pressure on the patch through the tape and start top to bottom (helps keep water out when you shower next, swim. whatever, the the same thing over the tape with the raquet ball, etc. I also found that I had the best results when I put then just above my right ankle so it wasn't exposed to alot of dampness and it made me feel better not answering a hundre questions on 'what is that', I also got good results on the outter part of my theigh, right about the waist band. Just have to make sure it's not in a place that will stretch or flex with your body as you use your arms legs - find s spot that works for you and your activity level. You'll have to experiment but it's well worth it. The patch typically (after your on it for a couple weeks) peaks around the 30th hour, going thru the adjustment period while you become use to it is tough, if you can't use the 50 mcg you might want to see about having your Dr give you something for 'break thru pain' like vicoden, percocet, etc. The patch is a long acting agent, you might need 'something' to put you between 25 mcg & 50 mcg. BTW - if the 'patch' itches like crazy it's working as designed (when you have it on nice and tight) the reason I chimed in is because I think the 25 sounds like it's working for you - it's just like a 'bad connection - but not 'instantly' noticable when the connection is bad it's about a 6-10 lapse, then anither 6-10 once you sent it right. Like I said, if it's falling off or seems 'foggy' then it's not holding a good contact with your skin - that seemed to be ALL THE DIFFERENCE IN THE WORLD WITH ME, hopefully there be plenty of time for you until you need a higher dose. I know it's a long post and sorrry for the novel, just trying to give you a point of view that took me months to figure out. FYI - NEVER PUT THE PATCH IN THE SAME PLACE BACK TO BACK. I would change mine and have some irriatation (redness, little bumps, etc) after taking my old patch off, they would go away I. A couple of days, last but not least if I was in pain I would push down and 'massage' the area of the patch under the tape, while it took a couple hours for results it was worth it - I used a racquet ball as I've said. I honestly can't wait until I can go back on the patch again (if ever) it worked great for me for a long time - but the adjustment period was 'less then spectacular' as I said, after that it was GREAT! Hope this helps.
I don't know your expert opinion, but I NEVER had a problem swimming with the patch, while I had I wrapped as I described, of course NO SUN (noticed that one real quick) & NO HOT TUB. the only reason why I never 'stuck to ' the full skin covers is I could never find them, when I could they were $12 for a box of 3 or 4, while the Johnson & Johnson medical tape EXTRA WIDE worked great for me. As I said I couldn't keep the patches on my chest or shoulders even with the tape, so I used other spots with great effectiveness. As I also mentioned I knewvi had a 'good connection ' if it was 'itchy' !!!! After a few hours of putting a new patch on. Your obviously more qualified then I am as I only have 'patient' experience to share, not medical training, knowledge. Did you hear ABYTHING w/ respect to MY post(s) and the last entry about the 'AAMRO' 'pre- press statement' ? Are you privy to that info & would love to get YOUR thoughts on that info!
Thank you both for your helpful comments. Sorry it took me so long to get back but my father-in-law has been in the ICU since Thursday and just went home yesterday with hospice so things have been a little busy.
I had switched to wearing my patch on my arm vs. my back in the beginning and after reading your comments i switched to the back again and I think that is helping. Also they are giving me a 12.5 mcg patch to add to the 25 and see if that helps and can make it last the 3 days. I will deal with the swimming/summer issue when things calm down around here...we are still a few months away from that here in Iowa!
I have one more question for you both...if you don't mind. When you were on the patch did you have to take breakthrough medication and if so how often. I have hydrocodone for the breakthrough pain and i have been taking it about every other day or so...i know a lot of that has to do with the patch problems but if the patch is working how often should you have to take. I know this is a very subjective question but just want to compare. I feel like maybe I should get a refill for the hydrocodone but don't know if it is necessary or if adding this patch will eliminate the need for breakthrough meds. Thanks for your help!!!
My sister last week died of a heart attack in her sleep from using these patches-please be careful as she had no history of heart problems and had been using these for the past 4 months-we can only relate the attack back to the patches
if i cover the patch with waterproof tape does this mean i can be in the sun for a while. i put my patch on my breast where it is covered all the time with clothes.