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Pain Patches
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Debsbears posted:
Hi I have a few questions regarding pain patches.

I have used the lidocin patches in the past - but one needs to place it where the pain is. That is not possible now due to the location and I live alone so no one can help me.

My PM Dr just gave me a script for Butrans patch - however my insurance does not cover it and I do not qualify for the trial because of my insurance.

If you have used a pain patch what kind did/do you use? How did/does it work? Is it covered by your insurance? Thanks for your help.
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bj1208 responded:
Hi Debsbears -

sorry no one has responded but I don't remember if any members are currently using pain patches - I know we had a couple of "fly by night members" (ones who ask question and never hear from again).

question for you: did you ask why your insurance won't cover it?? sometimes a 'PRE-CERTIFICATION needs to be done where the doctor has to submit this to the insurance company in order for them to approve the medication. and if still not covered then don't buy it but let your doctor know and see if there is another pain patch that maybe your insurance will cover.

let us know what you find out - take care - Joy
 
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Debsbears replied to bj1208's response:
Hi Joy thanks for replying.

I have called the Dr. because Butrans is not covered by my insurance. At 140.00 a month I will not be purchasing them. I have asked for the Pre-authorization saying it is medically necessary for me to use them so I will see what happens. They are suppose to call me back today.

Apparently Butrans is fairly new - and my insurance whats me to try Fentanyl or morphine patches first. But I can't use either of them Morphine due to allergic reasons and Fentanyl my Dr said no because of all the side effects.

I'll let you know what happens next.

I saw my Neurosurgeon yesterday and doesn't think any pain patch will work. It is a hardware problem and he thinks that is one reason I have so much pain in the neck. I have been rejecting the hardware since day one and now that my 7 vertebrae fusion is completely fused I will be having the hardware removed on the 13th of Sept.
 
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Debsbears replied to Debsbears's response:
Hi Joy, Deb again, I just got a call from the PA at my Drs office they already put in the request for "Medically Necessary" to get the pain patches she really feels this will at least take the edge off without the major side effects.

She doesn't want me to use the Fentanyl patches because of my Pulmonary Fibrosis - my lungs are already compromised and could get worse.

They will get in touch with me when they hear back from the insurance co.
 
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bj1208 replied to Debsbears's response:
hi Deb - that's great - keep us posted how you are doing with the patch -

take care - Joy
 
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bj1208 replied to Debsbears's response:
hi Deb - just saw this post on the hardware issues - gosh sorry you are having to go thru this - I have a single fusion L5-S1 and sometimes i wonder if my pains would be better if the hardware was removed - but I had one Spine Specialist go thru the entire process and retracted my thought completely! LOL

Good luck and keep us posted - take care - Joy
 
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Debsbears replied to bj1208's response:
Hi Joy My fusion was from C3 to T1 and I only have about 4 screws that are causing a problem. I asked him if he could just leave in the left side and take out the necessary hardware from the right. It doesn't work that way.

So I will add to my collection 2 more rods and 10 screws. I am not going to ask him for the T2 and T3 when takes them out, although he might give them to me as well. Not sure about that - it would be nice to see what the spinous process looks like up close. I'll keep you posted. Deb
 
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Debsbears replied to bj1208's response:
Hi Joy it's me again, I couldn't sleep last night so I went online and looked up Butrans pain patch to see the info on it. To my shock a Warning as big as an 8 x11 sheet of paper - who should not be using it.

It states clearly that I am one that should not be using it for many reasons - so I called the Drs office to tell them there is no need to get it approved I would not be giving it a try.

The strange thing to this is when they called me yesterday to tell me why I shouldn't use the Fentanyl or Morphine patch one would think they would have checked into this one before saying I should try it.

So I will not be using it - I'll have the surgery and therapy as usual and see what happens.
 
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bj1208 replied to Debsbears's response:
it's good that you double checked this before using it and finding out that way.

keep us posted on ur surgery - and see if someone can post how ur doing etc.

take care - Joy
 
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trs1960 replied to Debsbears's response:
Harware removal is just as tough as installation. I would go for the all or nothing approach anyway. I had all of my hardware from T4-T12 removed and while it was a tough recovery, It did help. Since that time I've also had new hardware installed from T12-L3. This hardware doesn't bother me at all like the thoracic hardware did...sounds familiar eh?

As for patches. The lidocain patches didn't help me. They just didn't penetate deep enough and I've cut open so much everything topical is already numb!

I've never been on the butrans patches, but I know I've read stories about them in here...?

I did go on the Fentynal and those damn things nearly killed me...twice. I had horrible reactions as my body became overly sensitive to the drug. A sreies of psycosis, I could tase and smell the drug in my system.

I know everyone is differant, but after what happened to me I could never recomened Fentynal for pain regulation...unless it was end of life treatmeant, but not for someone who wants to live.

In my decade plus of fighting the fight with pain. I've found that sans a mal chemical reactino almost all of the pain meds work to help you tolerate the pain. Working to teach your mind to focus on something good helps tolerating the pain. Don't get hung up on anyone medication if you can't get. No medication by itself (at this time) is a miracle drug. All opiads work pretty much the same way. Each of us may tolerate them differently and we must be careful about side effects, but in the end your mind is the most powerful tool you have.
I know it's frustrating to get denied something that your doctor says will help. I would ask him how different it is from other drugs that you won't be denied? If he tells you why Butrans is so much better than you have more ammunition to battle your insurance. If he says, well, we could also use drug X. The try that.
Our pain is certainly real, but the placebo effect we get from these drugs is sometimes as powerful as the somatic relief.
This is when a PM that comes from anesthesiaology is better suited to help you. He has a much better understanding of the pharmacology and can help you understand the drugs. The stronger the opiad the more respsitory system depression. This is likely why they steered you away from Fentynal...it's over 100 tiimes more powerful than morphine.

I also went on Opana ER which was about $800 a month (my insurance paid all bu co pay) It was nothing more than a new synthetic time release opiad. I get better results from straight morphine which is a few dollars per bottle.

I'm not telling you what to do, I'm just telling you to talk to your doctor about alternatives or about ammunition to get the Butrans paid for.



Good luck.

Tim
 
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Debsbears replied to trs1960's response:
Tim thanks for your reply.

I can not use the Fentanyl or Morphine patches. As for the Butrans patch that one is more of a red flag to me than the others.

I am having all the hardware removed as my Dr. said he can not remove parts of it, it has to be all or nothing. It is scheduled for the 13th of Sept. and we are hopeful that most of the pain will go with it if not oh well it's back to taking the Norco.
 
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trs1960 replied to Debsbears's response:
Don't expect too much too soon. I took me 18 months to recover from my hardware removal. Eventually it did feel better and it was worth it!
Just don't expect miracles in a few months. Patience is key.
I got a little depressed about 9-12 months post op as I was expecting things to be better and I was second gueesing my decision to remove the hardware. Well eventually it did get better. Not 100%, but a lot better.

Hang in there.

Tim
 
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Debsbears replied to trs1960's response:
Thanks Tim - I plan on taking it easy for a long time. My biggest concern is after the hardware is removed and I am missing the center parts of my neck (cervical) with the laminectomy how strong will my neck be?
The Drs all say it is completely fused together or they couldn't take it out. I am just a little concerned about the stability I will have.
 
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trs1960 replied to Debsbears's response:
Theyre right. It looks weird in an MRI, but fused us fused,

You'll be fine
 
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Debsbears replied to trs1960's response:
Thanks


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