Pithy -- I empathize, as I used patches for 2 years, and had to deal with increased tolerance, skin rashes, and patches falling off. I learned to use a large, 3x2" bandaid over the patch to keep it adhered to the skin.
After so many years on opiates, you are probably dependent. I would imagine you'll experience withdrawal symptoms long before you have an appointment.
Chewing or eating used patches is not recommended -- who knows what's in there besides Fentanyl, which metabolizes very quickly. There is also the danger of dose dumping -- getting a large bolus of F. from chewing the patch.
Wouldn't it be better for you to come clean re: problems with patch falling off? Perhaps you'd also be better off to use another long acting opiate, or have your doc write for Duragesic, do not substitute?
Sorry to read about your difficulties. In addition to the frustration of dealing with patches not adhering to your skin properly, I agree with Philnoir's suggestion using a 3 x 2 inch bandaid. I wore two patches during the hot and humid summer and had a challenge keeping them in place.
Please do not open patches to take the contents orally or have contact with your hands/skin. This could be very dangerous.
Bottom line: 25mcg/hr may not be adequate especially after 5 weeks of use. My suggestion is to be as honest as possible with your MD. Best wishes.
After rereading your post, I realise you have been at 25mcg/hr for 5 months. By this time, you are most likely tolerant and experiencing w/d.
Hopefully you and your MD can sort this out quickly.
yeah...coming clean seemed best to me. I called and explained and they said, we'll talk at next appt. So, I'm wearing old patches (so glad I didn't toss them all!). I do wear bandaides over them frequently but still on search for perfect cover that does not cause sweat and rashes. I've had the bandaide WITH the freaking patch roll off, onto my shirt, and into the laundry it went. Wasn't til shower that I realized, patch and cover are in the washer.
Yes, I did call and they said we'll talk at next visit. I'm wearing old patches that didn't get tossed. I'll show them and hopefully, if my urine doesn't show a significant or any fentanyl, it will be the evidence of non-abuse.
I had a lot of problems with them falling off also. I now place them on the flat part of my breast and the patch I use does NOT have the gel in a reservoir. It has helped a lot. Just make sure you change breast and spot you put them on.
Hope this helps.
Tegaderm. Kinda expensive. But works alot better then oversized band-aids. You can find them at Walgreens or other pharmacies near the bandaids. The tegaderm (get the large pieces) are the clear VERY VERY sticky and very very thin coverings for wounds and such. Its the same stuff the use to cover the spot you get an IV in when in the ER or during a surgery. It's very sticky like I was saying so be careful too touch it as little as possible and leave out as many air bubbles as possble and it can stay on even while your in the bath! Make sure your skin is clean and dry and oil/debri free as well before you apply the patch and then the tegaderm over the patch and cover the patch completely. You get the point though, I'm sure. :) Take care and luck on all your pain!
Oh! And they come in packs of 10 (you can usually find the generic brands, too). So I hope this may help you out so no more patches are wasted and you don't have to go though any extra pain. Tegaderm is about as thin as your own skin, its really the best! Pass the news on to anyone having trouble keeping their FP staying on! :)