controlling pain

[hurtinkurt]

so after 2 back surgeries,still living in chronic back pain .my doctor prescribed fentenyl patch for me ,,i have never tried it before ,is there any pro's or con's of using this pain reliever.'im in chronic pain all the time.......

[sueduva]

Hi, I have also had 2 back surgeries, and still live with chronic back pain.
My experience with the fentanyl patch wasn't very good.

The first time I was on the patch, my dr gave 50mcg, and I went into respiratory failure.
I was very angry when I found out there was a 25mcg patch, that I should have started with.

After starting the 25s, I had good pain relief, but for some reason I would start going into withdrawal after 48 hours, and they are supposed to last 72 hours.  I also had extreme sweating, hot flashes, I felt like I was going into early menopause. (at least if you're sweating it wont be menopause, lol)

Seriously, be  careful with this drug. You can't go in a hot tub or use a heating pad.
Good luck, Sue

[Ccjinc]

My sister died using those patches! Whatever you do, do not use anything to help keep them stuck ! My sister taped hers on & the whole dosage went to her heart !

[Tuckamore]

Hello Fellow Wisconsinite! I am very sorry to hear that you are still in severe pain following repair surgeries. My heart goes out to you.  

There are pros and cons to every opiate. You are wise to research them before you begin this or any new medication. Geminigirl offered some good information and suggestions.

I too was prescribed Fentanyl Patches but my skin could not tolerate the adhesive. The contact allergy grew until my skin blistered and appeared burned and scalded. It also produced some debilitating headaches.... that were almost as bad as the pain. So obviously the Patch was not for me. However it has been very effective for other ppl.

Heat can effect the delivery dose of the medication. While you are wearing a fentanyl patch, protect the patch from direct heat such as heating pads, electric blankets, heat lamps, saunas, hot tubs, and heated water beds. Do not take long, hot baths or sunbathe while you are wearing the patch. If you develop a fever over 102 you should contact your physician. I've been told that your body temperature need to be above 103.8 before there is any significant increase of the dispensing of this medication but always best to safe and check with your physician.

Avoid any herbal supplements, vitamins and so forth while on the patch; that is until you discuss them with your physician and I would include your pharmacist. This is especially true of supplements containing St. John's Wort.

There are several manufacturers of these Patches. Some have a reservoir of medication while others have the medication bound in dissolving layers. If using the reservoir be sure to check the seal so you do not get a flood of this medication all at once. That is a life threatening situation. Deaths have been reported from defective reservoir patches.

If keeping them adhered to your skin is an issue some manufactures provide a free light covering that will help keep them in place. Of course you must make a written request and it takes some time to obtain them. This covering is similar to the Tegaderm Transparent Dressing. Your skin must be clean and dry before application and preferably free of hair.  

You may be prescribed break through medications in addition to the Patch. However it is the goal of a long acting opiate to reduce the use of the short acting opiates and provide more even pain control....this avoiding the peaks and valleys. Once your pain is out of control it takes more opiates to get it back under control... thus the rationale for the long acting opiate.

I wish you the best with the Fentanyl Patch. I hope you will share your experience and any additional questions you may have. I'll look forward to your updates.

Take Care,
~Tuck

[geminigirl1963]

One major advantage of the fentanyl patch (or other long-acting medication) is that you aren't constantly trying to chase the peaks and valleys of pain control like you have to with short acting meds.  I feel the other advantage that the patch has over other long acting meds is that it is LONGER acting, meaning that most long acting ORAL meds you have to take usually twice a day, whereas the patch is typically changed every 48-72 hours.

I feel one drawback of the patch is that some people do find they have trouble getting them to stay "stuck", however, there are usually some ways to help with this problem.  The other thing you really have to be careful with with the patch is watching that neither the patch nor yourself get overheated.  Because the medication in the patch is released by your body temperature, the higher your temperature (either because of fever orbecuase of an external source such as heating pad, hot shower, the sun, etc.), the more medication can be released.  So therefore, if more medication is being released that should be, you run the risk of not only increased side effects, but also possibly more serious consequences.

What medication were/are you on before the fentanyl patch?  What strength patch has your doctor prescribed and are you to change it every 48 or 72 hours?

As with all narcotics, there are side effects with the patch, however, your doctor wouldn't have prescribed it for you if he didn't feel that the benefits of using it outweigh any risks/side effects.  Some of the side effects, such as drowsiness, should lessen or go away as your body adjusts to it.

I, myself, was on the fentanyl patches for about three years until I began having a severe reaction to it and had to stop them.  For me, they did provide very good pain control.  My doctor also had me on a short acting pain med for breakthrough pain, which is not unusual for any type of long acting pain med.

I hope this information helps and I also hope that if you decide to try the patches, that they give you the pain control that you need and deserve.

Best of luck!  Let me know how it goes.