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    #31
    You're welcome - I hope it helps.

    Sever chronic non-cancer pain should basically be treated the same as cancer pain. The same protocols are used.

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      #32
      Originally posted by alan View Post
      All my pains do is get worse, and my negative attitude with them. Doctors are useless with regard to this.
      Alan, I'm sorry. I hope you one day find a doctor, and something, that will help.

      Comment


        #33
        50 isn;t very high. The next step would be 75. And you should definitely have something for breakthrough pain, even if it is jut percocet. (Personally, I would say if you NEVER had pain break through, you were on too high a dose, so the logic that you don;t need other pain meds with a patch is faulty.)
        T7-8 since Feb 2005

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          #34
          Originally posted by sjean423 View Post
          50 isn;t very high. The next step would be 75. And you should definitely have something for breakthrough pain, even if it is jut percocet. (Personally, I would say if you NEVER had pain break through, you were on too high a dose, so the logic that you don;t need other pain meds with a patch is faulty.)
          I am not even sure what the max dose would be. I am not a big person either, not sure if that has any effect on dosing. Im thinking it might.
          I wouldn't mind on being on to high of a dose. The idea of NO PAIN is fantastic!!!!

          Becky
          T8-9 according to latest scoring.......
          since 1/3/04

          I am the best at being me. No matter how that happens to be!!

          Comment


            #35
            There really isn't a max. But don't worry about a max, you're nowhere near it.

            The deal with opioids is "titrate to effect". i.e. gradually increase the dose until you reach the desired effect, with the minimum amount you need to achieve that.

            Opioids, like any drugs, can have side effects - you don't want to have more than you need.

            If they can find a dose of long-acting meds that control your pain, in general, and then give you breakthrough meds that stop pain if it occurs "breaks through" you would have optimal pain control.

            Also, if pain has been uncontrolled for a while, sometimes it takes a higher dose to subdue it - which can then be cut down some (without increased pain) once the pain has been controlled for a while.

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              #36
              Becky, you might try seeing if they would keep you at the 50 and change every 48 to 60 hrs...you do need something for break through...as far as you not getting proper sleep, my son tried every thing out there and doc gave him 25 mgs of seraquil (sp) at such a low dose because the side effect of the drug is sleep...I think your lack of sleep and proper rest causes the body to hurt more too. I am so sorry you hurt so much...and thank you for your kind comments and support as we deal with my son's current crisis...he got off the vent today and I'm still doing the happy dance! would give anything if you could be pain free and dance too!

              Comment


                #37
                Originally posted by bcsimpsons View Post
                I am not even sure what the max dose would be. I am not a big person either, not sure if that has any effect on dosing. Im thinking it might.
                I wouldn't mind on being on to high of a dose. The idea of NO PAIN is fantastic!!!!

                Becky
                I guess what I am trying to say is that pain goes up and down, you want something that is high enough to control it MOST of the time, but if it shoots up b.c it is cold and rainy, or in the late afternoon if you have been out all day, then you use the breakththrough meds. But if you had it high enough to control the peaks too, you would be overmedicated too much of the time.

                But yea, pain free would be great.
                T7-8 since Feb 2005

                Comment


                  #38
                  Originally posted by bcsimpsons View Post
                  David,
                  I didnt mean to make you upset. I wanted to just know if anyone else had experienced this. When it happens to me it just really freaks me out. I just wanted to make sure that it wasnt just me .
                  Becky, don't worry, you're not upsetting me. It's just frustrating to know that there's something vey simple out there that can help a number of people, perhaps even you to some extent, and it's forbidden due to politics.

                  Comment


                    #39
                    Originally posted by sjean423 View Post
                    I guess what I am trying to say is that pain goes up and down, you want something that is high enough to control it MOST of the time, but if it shoots up b.c it is cold and rainy, or in the late afternoon if you have been out all day, then you use the breakththrough meds. But if you had it high enough to control the peaks too, you would be overmedicated too much of the time.

                    But yea, pain free would be great.

                    I wish I didn't need anything at all! . People shouldn't have to deal with pain at all. It should just be wiped off the face of the planet!!! . I know just wishful thinking.......

                    Becky
                    T8-9 according to latest scoring.......
                    since 1/3/04

                    I am the best at being me. No matter how that happens to be!!

                    Comment


                      #40
                      Originally posted by David Berg View Post
                      Becky, don't worry, you're not upsetting me. It's just frustrating to know that there's something vey simple out there that can help a number of people, perhaps even you to some extent, and it's forbidden due to politics.

                      David,
                      Thanks for explaining. That is very frusterating . I hate politics so much!!!!

                      Becky
                      T8-9 according to latest scoring.......
                      since 1/3/04

                      I am the best at being me. No matter how that happens to be!!

                      Comment


                        #41
                        Becky, you've gotten some excellent advice by my wise friends, and I don't have a thing to add.

                        I'm not recommending you do this, but if I were in your place, I'd be very tempted to go to the 48 hour patch change right away, before your doc appointments, or even try wearing two patches at once to increase the dose.

                        As I said, I am not suggesting you do this. But wearing two patches at once is not an uncommon thing for physicians to prescribe to get the desired dose. If I were to do this, I'd just make sure that I only tried this when there was someone around who knew what I was going to do, and try it at a time when it wouldn't matter if the increased dose caused me to be sleepy, especially on day one of the three day cycle. I'd also only try this if/when I knew that I could get a refill before running out so that using one extra patch for this one time experiment (just so I could get a break and some real rest) wouldn't leave me short.

                        Of course, this is just me, and I'm pretty adventurous, but SAFE, when it comes to home pharmacology. My experiments have led to some very effective discoveries, including many my docs/pharmacists had never heard of. (E.g. taking 260 mg of quinine sulfate plus one Darvocet -- in addition to my regular dose of oral baclofen -- would keep my legs loose and spasm/pain free for 8-12 hours. Was a lifesaver before long plane or car trips).

                        Maddmother is right -- the lack of rest will greatly exacerbate your pain/reduce your ability to cope. Perhaps you could call your physiatrist and ask him if it's okay for you to try an OTC sleep aid just so you can get some quality sleep. (I take 12.5 mg of Ambien CR on top of way more opioids than your dose of Fentanyl with no problem.)

                        We have to get you a break from that pain!
                        Last edited by thehipcrip; 20 Jan 2010, 2:37 AM.
                        It is easier to find men who will volunteer to die, than to find those who are willing to endure pain with patience.

                        ~Julius Caesar

                        Comment


                          #42
                          Hang in becky, all I can say

                          hope it gets better. Need to go chuck breakfast bad pain run, 10 since sunday night
                          Kindly,

                          The Ketamine Kitty

                          All the tears, all the pain, all the rage through the night (apolgies to the rewrite) RR

                          Next time I die make sure I'm gone,
                          don't leave 'em nothing to work on JT

                          And I ain't nothin but a dream JM

                          Comment


                            #43
                            Originally posted by thehipcrip View Post

                            I'm not recommending you do this, but if I were in your place, I'd be very tempted to go to the 48 hour patch change right away, before your doc appointments, or even try wearing two patches at once to increase the dose.

                            As I said, I am not suggesting you do this. But wearing two patches at once is not an uncommon thing for physicians to prescribe to get the desired dose. If I were to do this, I'd just make sure that I only tried this when there was someone around who knew what I was going to do, and try it at a time when it wouldn't matter if the increased dose caused me to be sleepy, especially on day one of the three day cycle. I'd also only try this if/when I knew that I could get a refill before running out so that using one extra patch for this one time experiment (just so I could get a break and some real rest) wouldn't leave me short.
                            Good thought, if you are sure it won;t leave you stuck w/o any patches at all before a refill. Do they work better the first day or two, then slack off? Your doctor may even recommend it if you call. Occasionally I have had to change my patch a day early because it isn;t sticking properly. Again of course,
                            Originally posted by thehipcrip View Post

                            I'm not recommending you do this, but if I were in your place .........
                            Doubling up at the 50mg might be too big a jump, as he will go to 75mg next not 100mg.

                            But if they help at all in the beginning, I would personally go to 48 hours before upping the dose. I didn;t do that, and still ended up with it running down on the 3rd day after upping the dose. Just my metabolism.
                            Last edited by sjean423; 20 Jan 2010, 5:15 PM.
                            T7-8 since Feb 2005

                            Comment


                              #44
                              Originally posted by thehipcrip View Post
                              Becky, you've gotten some excellent advice by my wise friends, and I don't have a thing to add.

                              I'm not recommending you do this, but if I were in your place, I'd be very tempted to go to the 48 hour patch change right away, before your doc appointments, or even try wearing two patches at once to increase the dose.

                              As I said, I am not suggesting you do this. But wearing two patches at once is not an uncommon thing for physicians to prescribe to get the desired dose. If I were to do this, I'd just make sure that I only tried this when there was someone around who knew what I was going to do, and try it at a time when it wouldn't matter if the increased dose caused me to be sleepy, especially on day one of the three day cycle. I'd also only try this if/when I knew that I could get a refill before running out so that using one extra patch for this one time experiment (just so I could get a break and some real rest) wouldn't leave me short.

                              Of course, this is just me, and I'm pretty adventurous, but SAFE, when it comes to home pharmacology. My experiments have led to some very effective discoveries, including many my docs/pharmacists had never heard of. (E.g. taking 260 mg of quinine sulfate plus one Darvocet -- in addition to my regular dose of oral baclofen -- would keep my legs loose and spasm/pain free for 8-12 hours. Was a lifesaver before long plane or car trips).

                              Maddmother is right -- the lack of rest will greatly exacerbate your pain/reduce your ability to cope. Perhaps you could call your physiatrist and ask him if it's okay for you to try an OTC sleep aid just so you can get some quality sleep. (I take 12.5 mg of Ambien CR on top of way more opioids than your dose of Fentanyl with no problem.)

                              We have to get you a break from that pain!
                              using two patches would be deadly. changing it every 48 hours is ok, but not without a letter of autharization from the dr to her insurance. or she will have to pay out of pocket for the extra patches she will need. those patches do not last 72 hours, However becky you have breathing problems, and fentanyl is a thousand times stronger than morphine. using too much will kill you. I have friends missing from my life because they either doubled up or the patch was defective and gave too big a dose. There are hundreds of o.d deaths every year from using this medication not as prescribed. please do not double up, please.

                              Comment


                                #45
                                Originally posted by bcsimpsons View Post
                                Its ok, I am on a fentanyl patch (50micg/hr). I also take ativan for anxiety. Sometimes the combo work slightly. By slightly I mean instead of a 10 or 11 on the pain scale it'll register as a 9 or 10 respectively. The have never given me anything for break through pain since its a patch. At least thats their logic . I personally don't like it. I will take OTC's like advil etc but it does absolutely nothing so why I take it, I have no idea .

                                Becky
                                you should have something for breakthrough pain. It may be a concern with the ativan, which can depress breathing as well as fentanyl, so adding more pain meds may be really bad for you in that you could stop breathing. I am so sorry about this pain you are in. I know you must be sick of everyone saying they are so sorry, when sorry does nothing to help you. dont give up on getting through to the doctor about this pain. there has to be something to give you relief.

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