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Fentanyl patch not working that great...Any advice?
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StacieElaine posted:
Hello everyone.
I am new to these boards. I guess in order to ask advice I will give a background history of my back condition. I currently am dealing with DDD, Spinal stenosis, Osteoarthritis, scoliosis, herniated L3/L4, and I had a lumbar spinal fusion 5 years ago for my L4/L5/S1. In 2008 I had a total of three surgeries for my back and all within 7 months so the scar tissue can be quite annoying at times. First was the Microdiscectomy the end of April 2008, then my disc completely blew a few months after surgery so I had my fusion the end of October 2008. Well, within a week I ended up with staff infection in my wound and they had to open me back up and clean out my hardware and staple me back up & I was back to work in 2-3 weeks wearing my back brace

Since all of that, I had to leave my job and I ended up on disability almost 3 years ago. I am remarried, have 3 kids now (14, 7 and 1) and they keep me on my toes most of the time. I have been in pain management for 4 years and have recently started a new pain doctor. My PREVIOUS pain doctor had me on: Roxicodone 30mg x 5 a day, Methadone 10mg x 12 a day and Ambien for sleeping.

My NEW pain doctor has weened me off the Methadone completely as of last month, changed my Roxicodone strength and now I take: Oxycodone/Ketamine compound 60mg/40mg x 4 a day and 100 mcg of the Fentanyl patch every 72 hours plus my Ambien to help me sleep.

Last month I couldn't really tell if the patch was helping because I was completing my final month of weeing off the Methadone so I spent most of the month withdrawing. However, the first couple of days once I started taking the Fentanyl patch it almost seemed too much as I would nod off so I WAS going to talk to my doctor about reducing the mcg's but that all went away so I thought I my body adjusted to the dose. NOW, this month is a whole new story. My Roxi/ketamine compound 60/40mg work great but they last only about 3 hours until I start hurting like mad crazy again.

I put a new patch on yesterday around 10am. I took the kids school shopping from 2-4pm and I had to come home in the middle of us shopping so I could sit down and take a pain pill. My lower back was in so much pain that I was about in tears. My husband thinks maybe I didn't give the patch long enough to kick in so maybe that is what happen. To be honest with all of you, I have the tolerance of an elephant. I never nod off unless tired, I still am active (as one can be in chronic pain,) so most people never even know I take so much pain medication.

I don't know if I need to talk to my doctor about possibly adding a 2nd patch, like a 25mcg in addition to the 100mcg or if he will think I'm crazy? I know that I am applying them correctly. I have done so much research online trying to find anyone or anything that can help or relate. Everyone seems to say that Fentanyl is the best medication for severe chronic pain but I can't seem to find relief. My doctor did offer me another medication alternative when I was starting the Fentanyl. He said I could choose between the Fentanyl patch or Oxycontin 60mg or 80mg (can't remember which it was) and everyone tells me that I'm better off with the patch. I sure wish I felt that way.

Any advice? Am I expecting too much from these patches? Should I ask for the additional 25mcg patch? Would the Oxycontin be a better option for me? I just want to be happy and it's hard to be in so much pain, I want to do things with my kids, my husband. I'm too young to feel so old! It's starting to seem hopeless.

Thank you for your time,
Stacie
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ctbeth responded:
Hi Stacie,

I have about one minute to write.

I suggest that you tell your prescribing MD exactly what you've told us.

IMHO, it would be better to tell your MD about your pain rather than suggest a pain med increase.

Whether Fentanyl or Oxycontin is "better", what helps you the most is what is better, or best, for you.

Best wishes,

Beth


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