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Transitioning to Fentynal patch from Norco

Started by lisap7 on 07/11/2010 9:52pm

I am changing from oral Norco(70mg+ per day) to Fentynal patch-25mcg keeping the Norco for BT pain.
How soon should I notice pain relief from the patch? I am wearing the second one and find I still am needing 3-5 Norco for better pain control. Which leads to my next question...Should I still be needing THAT much Norco with the patch? I was under the understanding that my main pain control was supposed to come from the patch.
I have called my PM doc and she wants me to "try" it for a couple weeks then we will discuss how things are going. She didn't seem concerned about the Norco I am taking-as long as I take no more than 7 per day. I thought the patch was going to mostly replace the Norco, not be in addition to...

Peace,
Lisa

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Lisa,

Normally you would begin to notice some relief from the Fentynal patch about 24 hours after first applying it. One thing that can make a difference in absorption is the location where the patch is placed. Are you wearing it on your chest or abdomen?

I'm kind of shocked that your doc would transition you from Norco to Fentynal. That's quite a leap in the narcotics chain. Norco is a short acting immediate release drug combined with acetaminophen. Have you been on any other extended release opioid, or just the Norco?

In the grand scheme of things, when using the Fentynal patch, your need for breakthrough meds should go down significantly. 25mcg is a very small dose, and you may not even notice any significant relief from it if you are used to taking 70mg of Norco. Once you find the right dose of Fentynal, then your pain relief should be fairly consistent because you won't be bouncing up and down on your level of medication throughout the day.

Let us know how it goes.

Bacaumi

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I have been all over the place in regards to oral pain meds...oxycontin, percocet, tramadol...you name it I have been prescribed it!
My pharmacist told me that I need to contact my PM doc because the strength of my patch is weaker than my daily consumption of Norco...which explains all the BT pain!
This is my first experience with this type of pain relief and I just wasn't sure WHAT to expect. I also take 2400mg of Neurontin and 4500mg of Robaxin perday-I had adjusted to all the meds and was able to be somewhat functional. Now when I take the Norco and everything else- I am sooo stoned, I have trouble tying my shoes-let alone have a rational thought!
I just hope the adjust period isn't too long!

Peace,
Lisa

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UPDATE: My PM doc has upped the patch to 50mcg Q* 72 and the change is unbelievable!! I applied the 50mcg about 5pm on Tues eve...by Wed am I have had 2-count'em-2 Norco!! I am still a bit more tired than normal,but I figured that that will pass.
Pain is about 3-4 still(I can live with that!) and the couple times I needed the Norco it didn't go over a 7-again I can live with that.
I am so grateful to have found something that helps...still on a boat load of meds, but for the first time in over 4 years, I can walk to and from the barn without needing to stop!! Praise be to God!!

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Lisa, You don't know me from Adam, however I want to help you! STOP, STOP NOW !

Seriously, you need to do all the research you can on the Fentanyl patch, just Google it and be amazed at what you read. You will never trust your PM doc again.

I know this from experience, I have had 3 low back surgeries, {L-5,S-1 x 2; then L4-5,L3-4} also two cervical spine surgeries at C3-4, C4-5 & C5-6 {Discotrectomy, where they removed the disc and the vertebrae. They cut the vertebrae into pieces to use as fusion material and placed it within a titanium cage with bars and screws where the vertebrae and disc were.}

I tried everything I could to get back to some sense of relieve and normalcy, only to have my disc above and below collapse, due to Degenerative Disc Disease. At this point, (20 years of struggling, pain, comebacks, setbacks, and finally failure) , my doctors gave up and sent me to a PM Doc who was suppose to be the best! All the experience, credentials, reputation, etc.

He also started me on Norco 10, four times a day for break through pain and Fentanyl 25mg/hr every 72 hours/3 days. No difference, so he increased the patch to 50mg / 72 hrs. Helped but not relieved, No problem increased to 75mg, after 3 months, increased again to 100mg, & change every 48 hrs, & leave the other one on until third day. I was in a mess. He gave me more meds, One to wake up and get going, 2 to stop the pain, 3 to get ready, and 4 to go, and then 5 to stop and sleep.

I literally lost about six to eight months of my life, I have no recall of anything, but when my 12 year old daughter showed me a report she did for school called, "If I Had One Wish" and her's was titled ;
"I'd wish that the Doctors could put my Daddy back together Again." In it she mentioned the worst thing she ever saw was her Dad, who was a Giant and a Survivalist only three years ago, in bed unable to get up for four days! I think he is dying, fast."

I went look at the mirror and she was 100% correct, I was DYING, QUICKLY. Being poisoned by a highly regarded Doctor and former Hospital Administrator.

I requested, & received my records from his office and started skipping doses of meds. and throwing others away. First thing that glared out was I went from 6'3 ~ 212 lbs. to 6'2 ~165 lbs. in five months, I continued to lose this weight until I was down to 143 lbs.

Can you imagine a 6'3" 212 lb. Man who came back from two severe back surgeries and was still working 50-60 hrs per week, Hunting, riding four wheelers, fishing, drive boats, tractors, building sheds, camps, walking 1/2 mile in waist deep water to go duck hunting, realizing what was happing to me? I wanted to ring his neck, but I was too weak & confused, and in so much pain. So I turned to what I did best before, computer research. I was shocked! Over 3000 deaths each year in America alone are linked to these patches. It just gets worse, but YOU have to read it yourself to get the full impact of just what this Doc is getting you into.

I just spent the past seven days, going through the worst withdrawals I could ever imagine, up for 28 hrs. without being able to sit or lay still for more than 30 seconds. I was a HEROIN JUNKIE, period.

Thanks to a so called Doctor, who when I told him I wanted off these patches told me ~ through his PA, and secretaries, He would no longer treat me if I would not take the medication he said at the doses he said. :0 I told his secretary, and PA, to tell him THANKS but I didn't plan on seeing you again, since I only saw you 4 times in 5 years anyhow, until I see you in front of the Medical Licensing Board at your hearing from "Gross Patient Negligence."

Doctors are Medical Practitioners, { Meaning they are Practicing Medications on YOU!}, not GOD.
Stand Up for yourself and do yourself a favor, stop the patches now. TODAY! You will have some withdrawals but nothing compared to what a few years on them will do.

These patches will kill you or change the structure of your Brain, nervous system, and internal organs if you stay on them, research for yourself.

GOD BLESS YOU & I PRAY YOU HEED THIS WARNING! I have been off all Opioids for a week today, I just walked at a brisk pace for 1 hr. 30 min ~ non stop. My pain level is down from 8-9, always to 4-5 occasionally. I could barely walk or stand for five minutes last week. Clean and healthy, w/o all those chemicals are your best chance! PLEASE, PLEASE, PLEASE!
For yourself and everyone who loves you STOP THE PATCHES! THEY are DEATH IN A BAND AID !

****ALSO; Don't get HOT, they dump all three days worth of medicine in you if they get above 105*
Reply if you need more help. Sincerely, CajunMan

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Lisa

It's great to hear that you are getting some much needed relief. Fantastic! I don't know if the doc advised you about keeping a pain log, but it certainly helps especially for someone using a transdermal system. Depending upon the brand/type of transdermal system and the individual using it, the patch can fall short of the 72 hour window. So tracking your pain patterns along with your patch changes, is a smart thing to do, especially if you wind up needing to show your doc that the 72 hour window is too long for the effectiveness of the patch. So track your baseline pain and your break through pain and meds.

Also if you have small children or pets, be vary careful how you dispose of the used patches. They come with disposal instructions, I highly recommend following those instructions so that no one or no critter accidentally gets a hold of one.

Best wishes to you and enjoy the pain relief.

Bacaumi

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I've taken fentayl patches for 3 years, increasing from 50 mcg/hr to 200 mcg/hl. Thank God I had successful back surgery last fall and started weaning from that dose--now I'm taking 50 mcg/hr.

Dr. Daniel Bennett (your doctor can read his reports and speak with him about this) did 2 things that made me much more comfortable: first, change the patch EVERY 2 days (not every 3 days per drug instructions), AND to put the patch somewhere the skin vessels are close to the surface, i.e., on the CHEST.

In my opinion (I'm not a doctor but an over-experienced patient) it's time to increase your dose of fentanyl. It's is a very strong medication (40 times stronger than morphine) which makes a lot of MDs very nervous and weak in their deetermination to not have a patient die of an overdose, but for heaven's sake, treating your pain has nothing to do that. She already precribes another narcotic--what's the problem.

You should have felt better by now. Ask her to call Dr. Daniel Bennett and ask him about fetanyl.

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An idea for you folks who feel tired all of the time from your meds: ask your doctors about prescribing "Provigil."

It's a drug that stimulates the nervous system, but is NOT RELATED TO AMPHETAMINES. It is a safe and effective and has really helped me to have good days those times when I've awakened tired because I needed sleep meds.

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mr CajunMan you said it all just as it really is it ----I wish I had read this before july 23rd I lost my husband he was on all that and was acting strange far over a year ARE MOREGOD TOOK HIM HOME THE DOCTOR TRYED TO SAY CARDIAC ARREST IM GETTING ALL HIS RECORDS THIS WEEK BUT GOT HIS MEDICINE LIST AND OH MY WAS I SHOCKED.HE WAS ON SO MUCH MEDICINE HE DIDNT KNOW WHAT HE WAS DOING WE HAD BEEN APART BECAUSE HE WASNT THE SAME I COULDNT DO ANYTHING WITH HIM MY DAUGHTER AND MYSELF WAS TRYING TO KEEP A EYE ON HIM BUT THEY FOUND 4 FENTANYL 75MG ON HIM I DIDNT NO ALL THIS TELL LAST NIGHT HE HAD BEEN IN THE HEAT FAR A FULL DAY NUMEROURS OTHER MEDS NORCO 1O MG 6 A DAY XANAX AND MORE DUE TO A HIP REPLACEMENT THAT WENT BAD BUT YOU KNOW WHAT THEY NEVER SAYED ANYTHING ABOUT IT AT THE HOSPITAL MY DAUGHTER TOLD ME LAST NIGHT SO NOW I KNOW IT WAS A ACCIDENT OVER DOSE HE COULDNT REMEMBER NOTHING HE WAS TRYING TO GET IT TOGETHER WE THOUGHT BUT I COULD WRITE A BOOK ON IT BUT IM REALLY UPSET THAT THEY DIDNT TELL ME AND UPSET THE DOCTOR GAVE HIM ALL THAT I DONT NO WHAT TO DO THESE DOCTOR HAVE TO STOP ALL THIS IM SO GLAD U MADE IT HE HAD A
LITTLE GRANDDAUGHTER 13 THAT BEGGED HIM TO GET HELP BUT HE WAS TO FAR GONE KEEP YOUR STORY UP IT COULD SAVE A LIFE GOD BLESS YOU I DIDNT POST THIS TO SCARE ANYONE JUST TO LET YOU KNOW IT CAN HAPPENED IF YOU R NOT CAREFUL SO PLEASE LISTEN TO WHAT CajunMan SAID PLEASE---- IF U NOTIFY BY FACE BOOK DO IT IN PRIVATE CONVESATION BECAUSE AS OF NOW ONLY ME AND MY DAUGHTER ARE AWARE OF THIS THE GRAND KIDS AND DOCTOR DOENT KNOW WE KNOW WHAT HAPPENED YET

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I am having spinal surgery L4-S-1 in 6 weeks and am very anxious about getting off Fentanyl patch (50 mcg every 48 hours). I am told by most MD's (pain and shrink) to wait till post-surgery but I can't figure how one can distinguish pain experience AFTER surgery if I am still on the Fentanyl which masks pain. I would like to get off patch previous to surgery but I know this is very difficult (I tried once when I was on a lower dose and it was hell - black depression and horrible restlessness -- so I gave up going it alone). Can someone comment on their experience prior and post with spinal surgery and how it affected withdrawing from Fentanyl? It's the only med I am on for back pain.

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I am having spinal surgery L4-S-1 in 6 weeks and am very anxious about getting off Fentanyl patch (50 mcg every 48 hours). I am told by most MD's (pain and shrink) to wait till post-surgery but I can't figure how one can distinguish pain experience AFTER surgery if I am still on the Fentanyl which masks pain. I would like to get off patch previous to surgery but I know this is very difficult (I tried once when I was on a lower dose and it was hell - black depression and horrible restlessness -- so I gave up going it alone). Can someone comment on their experience prior and post with spinal surgery and how it affected withdrawing from Fentanyl? It's the only med I am on for back pain.

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