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    Butrans patch
    Cautiouslyoptomistic posted:
    Is there anyone that can recommend a way to approach my spine specialist/pain management doctor on butrans patches? I don't have much on my MRI but some wear and tear on my L-5 S-1 facet joints. I have been on Tramadol 100mg 4 times a day, and 5/500mg Vicodin PRN and I want to get off pills all together. I have new back pain now and pain all through out my legs. My Primary Care Doctor thinks I might have Fibromayagia as well. On a bad day I'm at about a 8. I'm stiff in the morning, can't stand for longer than 5 minutes without needing to sit down, and can walk for only about 20 minutes before needing to sit. My concern is these days if you "ASK" anything, I'm hearing that could be looked at as "drug seeking", and I'm frustrated because I just want to get pain relief to haver a good normal life.
    bj1208 responded:
    hi and welcome to the support group -

    this is hard to do - the best way to approach your physician is to let them know what is not working and how it's not working - your physician will let you know what he/she believes may help - and you can let them know your concern bout taking oral meds - let them do the asking and you can explain -

    also - testing should be done at both physicians (or your pain doc may do both) but tests should be done to see if you do have Fibro -

    also your pain doc should do a test on ur legs: EMG test WITH NERVE CONDUCTION TEST as this will determine if there is any nerve damage in the legs (I have same problems and have nerve damage in both legs).

    please keep us posted - take care - Joy
    Cautiouslyoptomistic replied to bj1208's response:
    Joy, thank you so much for replying. It means a lot! I have been dealing with my back since 2007, and I'm going on 32 now. It has been a very frustrating road, which I'm sure you can understand..hence why we are on here. Can I ask your opinion on the patch..have you heard about it yet? I have done tons of research, and I feel this is the only thing I haven't tried. The FDA approved it last January.

    Thank you so much for your advice, that sounds great. I have never had tests done on my legs. I just recently went on gabapentain and my pain has gone from a 8 to a 3 on a good day.
    bj1208 replied to Cautiouslyoptomistic's response:
    hi again -

    i've only hear of the fentanyl patch - so this is new to me -

    i've never tried any patch - just have heard too many horror stories -.

    i am looking at having the spinal cord stimulator implant done - it will, hopefully, take care of about 80% of my pains - and then i can reduce pain meds (ms contin 60mg 4 day; oxycodone 30mg 4 day; neurontin 600 mg 6 day; muscle relaxers 4mg 5 day) so i'm hoping this will help. if not then it will be the pain pump implant.

    they have asked if I wanted the patch and told them NO - so I would do all the research you can before accepting it.

    keep us posted - take care - Joy
    Cautiouslyoptomistic replied to bj1208's response:
    Hi Joy!

    I have great news!!! My appointment went perfect!! He was wonderful..I went in with a list of my problems, what i don't like, and what I want to change.

    I finally have a diagnosis!!! I have what's called Lumbar Facet Arthropothy. As well as Lumbar degenerative disease, and a bulging disc on my L4-5.

    It feels sooooo good to have validation on my pain, it is bittersweet though. I explained how I wanna get off tramadol and not take any pills. He is going to do a facet injection, see how that does and we will go from there.

    We then discussed pain management options..he brought up the Butrans patch. Says that it's a great alternative to people with moderate constant 24 hr pain. You wear it for 7 days, then replace it. It comes in 3 levels of the meds. 5, 10, and 20mg. He started me on 5, and we will go from there. I put it on Monday afternoon and am not getting any relief yet, and don't feel dizzy, or sick, I feel completely normal. Apparently it can take a few days to absorb in the body.

    What I have heard is that people say it's a miracle. They have thrown away there pills. One guy said that he can finally work again because he is not so loopy from the narcotics. I have read alot of similar stories. That it doesn't give you that euphoric feeling or get you high. I will let you know how I'm doing
    bj1208 replied to Cautiouslyoptomistic's response:
    thats great! keep us updated as to how u are doing - take care - Joy
    dmw70 replied to Cautiouslyoptomistic's response:
    How has it been with the Butrans? I just started last week. Had L5/S1 fusion in 8/07. Recurring pain since. Been on many types of meds, in PT, modalities, you name it. Can't even remember how many injections I've had over the years.

    New PM doc put me on the Butrans, and after 4 days I feel minimal pain relief, dizziness ("cloudiness"), take 1 or 2 perch 7.5/325 for BT pain.

    It's nearing year 6 of back problems for me. I'd like to hear about your experience with the patches, your injections and overall progress.
    Ashbroco replied to Cautiouslyoptomistic's response:
    I wanted to know how your progress is going since you were put on the Butrans patch. Can you give me an update?

    I was diagnosed with Lupus & Rheumatoid Arthritis about 10 years ago and have been battling ever since with various pain. A few years ago, my GP & Specialist put me on Lortab, then Percocets, then Oxycontin. After a while I started to gain a tolerance for whatever I was on, then they would put me on something stronger. I'm only 31, so I don't want to burn out ALL of my opiod receptors so quickly (also, I was sick of taking pills every few hours). Because of the Lupus, I already have to take many pills every day, so the way I see it...the fewer the better. My GP finally saw how frustrated I was getting about all the pills, so he recommended a pain patch. I thought that he was referring to Fentynal at first, so I initially said NO, but he told me about Butrans. Because of my extensive use of pain medication, he put me on 20mcg/hour.

    So far, I've been on it for about a day, but I'd like to hear some other opinions on it's use. Any obective/subjective criticism?
    Cautiouslyoptomistic replied to dmw70's response:
    Hi there, sorry it took me a while to get back to you! Well I started with the 5mcg. I did not feel any pain relief and after a few days I felt really tired. I work from home and If I sat down for a while in front of the TV I fell asleep.

    A few weeks later, I had another injection done and went up to the 10mcg. I can honestly say that after 2 weeks on that dose I realized my back pain in the morning had changed. Usually when I wake up, I don't wanna get out of bed because my back hurts so bad...but then I DO wanna get out of bed because my back hurts so bad. It's usually a no win situation. But now, I only feel a little stiff. It's a different feeling. Instead of it being pain, it's slightly uncomfortable.

    I have also noticed though on day 5 or 6, it's hurts in the morning again. I don't believe for me it's lasting the full 7 days. So I have been changing it every 6, or 5.

    As my overall pain goes, I feel it has helped me. My only issue which I constantly come across is, any activity small to large. I haven't found anything that helps with the break through pain besides the norco. So my pain specialist has me on the patch, then vicodin for the BTP.
    The crazy thing is there is NO euphoric feeling what so's as if I have a advil patch on.

    Which patch are you taking? If your doc started you on the low dose, and it's not working after 2 weeks, I would try the 10, but give it a little bit before you go tot the next step.

    As far as the injections go..I have ha them before as well and decided to give them another shot, haha...I don't think they do anything. I believe my patch has given me the pain relief.

    Please let me know how you are doing, and take care. I hope you find some relief in whatever your being given. If not there's something else out there we can find!
    Cautiouslyoptomistic replied to Ashbroco's response:
    Hi there! How's the patch going? Any relief?

    I can relate to your pill situation. I'm 31as well, and my tolerance was that of horse, and I'm 5'3 115 pounds. So I had to find something else. I believe this has helped me enough to not have to take pills all day. Now your on the 20, which I have not gotten to yet, but am thinking maybe next round. I thought after 2 weeks is when I either felt it didn't work, or then when I went to the 10, after 2 weeks is when I started to pick up on the changes.

    What I like about it, is it doesn't get me "high". There are no euphoric effects like the pills. So I believe they have found something that you won't get addicted to like the pills.
    I have never had a problem with it staying on. In fact, it hurts to rip it off!!

    I hope it will be able to help you cut back on your pills! I feel it has helped me in a lot of ways, by means is my pain all gone, but it has helped with the everyday aspect of it. PLEASE let me know if you have any questions!!! Or anyone who is reading this! Look forward to hearing about your progress and take care;-)
    dmw70 replied to Cautiouslyoptomistic's response:
    I am glad to read that so far your pain is in check. For me, the Butrans at 5 mcg started working. Put the patch on a Thursday. By Friday I noticed lowering of pain. Same with Saturday and part of Sunday. I also noticed my sleep was better. And mornings weren't torture as well. By Sunday night I started feeling nervous. Monday, anxiety grew worse. And by Tuesday I was completely spacey, nervous, found myself staring at the TV without completely comprehending what I was watching. Now...I did do some mild exercise Friday & Saturday, which raised my body temp. I don't know if it caused more of the drug to be released. All I know is that I was a basket case about 4 days into the patch. As you know, prescriptions come with the warning "Consult your physician if experiencing any of the following symptoms". Well, I've been on many different meds at different times over the years, and this was the 1st time I ever had to call my doctor. I was advised to promptly remove the patch. That said, I did, however, like the fact that it was not a "high" and it evened me out. I'm now completely off the patches. Overall, not a good experience for me. Just last week I had my 2nd round of injections. Still a little sore. If all goes well, I'll have the ablations done.

    By the way, it seems to be a common complaint that the patches are NOT lasting the full 7 days. Maybe the powers that be are looking into this, but every 5 days (or 6 patches per prescription instead of 4 may remedy this. Who knows...?)

    Good luck with everything!
    mrspremo responded:
    I know you say that you don't feel "high", but please keep in mind, Butrans IS a schedule II narcotic. That's very strong. I was on the 10MCG patch, and when we lost our health insurance after the Army I could no longer afford pain management. So abruptly, the use of my pain management regime went out the window. No more Butrans or Savella. And it was the worst withdrawal. Sounds like you have a good dr though!
    dmw70 replied to mrspremo's response:
    Butrans (and other buprenorphine meds) is a Class III drug. But that doesn't mean there isn't a withdrawal. I was only on it for less than a week and experienced withdrawal.
    mrspremo replied to dmw70's response:
    That's kind of what I said. My dr told me that buprenorphine, including the Butrans patch, was a schedule II narcotic. Naturally, a powerful narcotic will produce withdrawal. Mine was severe. It may be a schedule III where you are, but in the county of Muscogee, in Georgia, it's a schedule II.
    Cautiouslyoptomistic replied to mrspremo's response:
    They seem to be going back and forth with the class II class III. From what I have been told and the research I have done, it's a class III.
    Personally though, the classes don't matter. I was on tramadol (considered a non-narcotic) for a year. 50mg, 4 times a day and the first 3 days of tapering, was just as painful, if not worse then tapering off of a true narcotic, which I have done a few different times. It took me about a month and half to get off those things. It was awful.
    All of our bodies are different, and are going to react to different things in different ways...hence why we all come on here asking for others opinions on pain relief.
    dmw70, I'm sorry that you had a rough experience on it. But I think it's great that you tried something new.
    With that said, one of the reasons that I have been excited about the patch is it means there turning new leaves out there. The way that I look at it is, in 10 years, even 5 years...there are going to be many choices out there for all of us. So for me, I will try new things, listen to my doc and keep doing my own research to see if there are things that can help me live a better life.

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