doc switched me to fentanyl 2wweks ago, can I switch back?

[maddie22]

My pain doc switched me from 4 percs to fentanyl, gradually have gone up to 60mcg's-can I switch back to per before it's too late?

[cin333]

Hi maddie..Just been scrolling through these pages of chronic pain I also am a chronic pain pt. I have been through steroid injections in my lower back due to DDD and fibro.and OA. Had a right knee replacement inAug of 08,,which it did help. Also had numerous cervical steroid injections a few years ago(Dr. stated that in the future will probable need surg) I am now experiencing severve lower back pain which I did receive steroid injection and one nerve ablation of  L4 and L5 and S1. this did help until 9 months ago. In the meantime my Dr. started me on Fentanyl 12mcg now I'm up to 100mcg I would love to get off this stuff because now I think this pain in my back is more nerve pain. Going to see a Chiropracter will discuss his plans next week. Im afraid of titratiog off my fentanyl patches..but I don,t want to become addicted. This is the reason I'm writing you because I red your article on titrating 12mcg at a time  Will discuss with my dr. at my next appt. would appreciate your answer or anyones advice  thank you and god bless to you and everone..Cindi Try and keep a smile

[maddie22]

I am now reducing my fentanyl dose to find if there is even a level of support fentanyl can give. My nerve pain was horrible yesterday-but it is always so cool when you can have a good day, in spite of such pain. I have a 16 year old boy who plays hockey, his team has been playing great and we've had a lot of fun because of it. My daughter is 18, a senior and making the big college decision. And then there's my amazing husband, who would love to see me get some relief.  So, if I understand what you all are saying and what i am experiencing-the fentanyl will do nothing for the nerve or muscle pain. Do you know, is it a problem or should I say contraindicated to continue to get rhizotomies, which help tremendously with the nerve pain.  Yesterday, at the end of the day, I read this quote, from a newly cannonized saint, and I thought to myself, wow-that says it all, "People who suffer, have something to offer to God.  When they succeed in enduring their suffering, that is a daily miracle." St. Andre Bessette

[flower12345]

Maddie,

I totally understand what you're saying about your spiritual journey. I feel like I've gotten much closer to God as a direct result of my accident. I depend on the Lord so much more now, I read the Bible every day, and it's wonderful. For me, that is something that I would never trade--even for this pain. It's hard to put into words.

That said, I hope that your doctor listens and tries something that helps!

Hugs,

Flower

[maddie22]

Yes, I have learned so much on this road of pain.   The pain went from neck pain which was "covered" pretty well by tramadol for the first four years. But quickly, in the course of four short months, exploded to this headache/migraine spiral, due in large part to the nerve at c2/3 which I think is a huge contributer to the muscle spasms.
And yes, the nature of chronic pain, is that it gets worse. In short after my second dr. appointment after starting the fentanyl and trying to find the correct dossage-(my husband is a physician and came with me for these last two appointments as I think I have a believability issue with my doc-Mike, my husband,  was a godsend and the doc gave my pain more credibility with Mike's input)-anyway, he said at the second appointment that the fentanyl patch would do nothing for my nerve pain and nothing for the muscle spasms. So I couldn't help but ask myself-then why am I on it?  We jumped from a class 1 med, 4 x's a day to 12.8 mcg.-100 mcg.'s option as we find the right dossage.  That's went I when online and found your sight.
I'm smart, I have been on this road a long time and do think fentanyl may offer some pain management support in conjuction with "other" support meds for the muscle spasms.  When the muscle spasms have med support the nerve isn't as intolerable.
I also, can't help but touch on the spiritual journey this has brought me to.  Afterall, we are spiritual beings, as well as physical, mental and emotional.  If you want to hear more about that part of the journey, I am happy to share.  God has taught me so much and as "painful" as the last three years, specifically, have been.  I wouldn't trade them for what I have gained on the spiritual part of my journey.
Medically speeking, I am trying to find a dossage of fentanyl that supports my pain management.  Right now, this is what I seek.  I know all about the bodies tolerance and the pain cycle.  So I'm on a quest to find the lowest dose of "the patch" that can be a support to my pain management and then we will move to the "other" meds that can support the muscle and nerve issues. So, thank you again for taking the time to respond.  I really appreciate it. you asked what kind of doc he is-his speciality is proceedures that support pain management, he also does the medication part.  So, he is a specialist and not a pcp.  Thanks again-happy to have your input. Peace, M

[namnam46]

Hi maddie,

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.

Wow, Maddie, you've really been through the mill with your pain.  I think one of the MAIN problems is that the Fenatnyl won't ever START to touch Nerve pain. For the nerve pain you need to talk with your Doctor about th possibility of Gabapentin and other meds in that class of Drugs.  As far as the muscle spasms go there's ALSO better thing out their for that too.  Things such as Baclofen and Flexerill things along that line.

I hope that will help to clarify that for you. :)  Now as far as changing back from the Fentanyl then you MUST TALK WITH YOUR DOCTOR!!!  Don't attempt to do this without getting the OK from your Doctor.  He will then HELP you taper back off and switch to whatever is the correct medication for you.  When you taper off you need to REQUEST that he do it at 12 mcg's at a time.  Then you shouldn't have ANY problems at all.  :)

I've been on the Fenatnyl Patch for over a year and it gives me a GREAT deal of pain relief. I have SEVERE DDD and Osteoarthritis in EVERY joint of my body.  It's not fun but the Fentanyl certainly makes it MORE than liveable!!  :)

It very well may be the support med that you need.  ONLY you and your Doctor will know that.  :)

I wish you the VERY best and HOPE that you will keep us updated on how you are doing and what you and your Doctor decide to do.

We will be looking forward to your updates..............Sherry :)

[Melissa_1982]

TY for clarifying.  I'm sorry to hear that you have been suffering from chronic pain for so long. Sadly it's usually a long battle to find something that works for you. I am by no means a doctor & won't claim to have the knowledge they do, but have been on pain meds for almost 8 years & Fentanyl for several years. If you found that the percs weren't covering it then the doctor may think that Fentanyl would help with your pain. It is better for long term pain because you don't have to try to remember to take the pills every 4-6 hours & it does do a decent job at helping with pain as long as you know what to expect & don't expect miracles.  You will NEVER be pain free, but pain meds can help make it tolerable so that you can try to live comfortably.  Over time you will develop a tolerance to it & it may need to be increased to provide the same effect that a lower dose use to provide much that same as any pain pills do.  You may or may not continue to feel break through pain, but if you do I encourage you to mention it to your doctor so you can have something there for breakthrough pain.  I don't think it would do anything to help with the muscle spasms though as it it a pain medication. You may need a muscle relaxer to help with them.  

Are you seeing a PM doctor or receiving your meds from your PCP?

I suffer from severe stenosis in my lumbar spine & possible stenosis through my cervical & thoracic areas (currently pregnant & can't have MRI until after the baby is born). I've done everything & was finally prescribed Fentanyl a few years ago after my others medications weren't helping with my pain as well as I needed. Fentanyl has made things a little easier for me, but I've found that you build up a tolerance after awhile & IF you ever decide to decrease your dose because the pain isn't as bad anymore it does offer it's own challenges with tapering & withdrawals.

I hope I was of some help
Melissa

[maddie22]

Let me clarify. I have gone up to a 50mcg and a 12.8 mcg. I have been a chronic pain patient for 10 years since a whiplash accident in 2000.  The pain has gotten progressively worse and has gone from very specific neck pain, where the whiplaash occured to a headache tthat has lasted a year and four months to date.  When I first started with my doc 3 and a half years ago-I was homebound, my pain was so bad.  He did a rhizotomy at c2/3 on the L and R-which pretty much saved my life..but..the nerve continues to grow back on the L side, every three months and the R side, every 6 months.  A year and a half ago he put in an occipital stimulator which has cut my multisympton pain by a fourth.  I just had botox done 3 months ago to my traps, occipatals and jaw-it helped, but is now gone.  So, I needed to clarify, I have been on this train, a very long time.  He has had me on 3-4 perc which has not been effective for quite awhile. So, two months ago, when it was clear that the migraine nerve was now growing back and the botox, which has been sechuduled for late february was wearing off to go to something more long term. So, I have been trying to find the correct dose and after doing much reading have come to the conclusion that possible at 25mcg's it could be a support med, but will never be cover the nerve pain or the severe muscle spasms.  So, I don't want you to think any of this has been taken lightly. But, am very interested in input from those of you who are finding help or atleast a livable pain level.
Thank you, M

[Melissa_1982]

That is a possibility BUT Fentanyl only comes as a patch, injection or a sucker which is known as Actiq or something close to that. It's not offered as pills, as far as I'm aware. I could be wrong though

[flower12345]

Melissa, maybe she also has Fentanyl for breakthrough pain...??

Maddie,

Why the switch? Did your condition progress?

[Melissa_1982]

How are you receiving 60mcg's? The patch comes in 12.5mcg, 25mcg, 50mcg & 100mcg.  Why are you looking to switch back?  Fentanyl is usually ONLY prescribed for terminal patients or people with severe chronic pain. How often were you taking your percs? I ask because Dr's usually turn to fentanyl when high doses of other meds aren't sufficient at treating your pain. It is a VERY strong medication that has it's own pro's & cons, but is by no means a medication to be played with.

With those answers I can try to help. I'm on 100mcg Fentanyl every 48hrs & have been on varying doses for several years.