Attention Patch Wearers; Don't Do What I Did!!

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gtrplayer
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I will get straight to the point with this post.

I am, unfortunately, prescribed Butrans 20mcg patches for pain management after being forced out of my previous pain management group. I have been on them for 3 months now, and every month, I had the same issues: patch falling off, patch failing to adhere to my skin despite wiping it with rubbing alcohol (as directed), and drying the area where the patch was to be placed. The constant removal, and re-application of the patch led to less that desirable pain management.

I remembered Goat had posted about the Tegaderm covers, so I went and bought a box of those huge sized things. I had the same issue with the Tegaderm; it just would not stay sealed on my skin. So, I took things into my own hands, and things got dicey, quickly.

Last night, after getting fed up with the patch and Tegaderm falling off my skin for the 10th time in 3 months, I decided to reapply the Butrans pouch to my chest (as suggested by the Dr, and the directions that come in the Butrans box). I then applied a new Tegaderm adhesive over the patch, and held it in place firmly for 30 seconds. All is fine, until I did the following, which is NOT recommended, and probably advised against.

I noticed the Tegaderm had begun pulling away from my skin, so I broke out the old liquid bandage. You know, the stuff that stings like all get out when you put it over a cut? This was far from one of my "better choices" I've ever made. Almost immediately, the Tegaderm not only bonded to my skin, as intended, but it seemed to actually "melt" the Tegaderm into my skin. I only applied the liquid bandage along the outer edges of the Tegaderm, but it turned my skin into what looked like 2nd degree burns- or old man scar tissue skin (for those of you who have seen that leathery skin look). So now, I am stuck with this Tegaderm, more or less, melted into my skin. A reaction caused by the liquid bandage and Tegaderm itself. It looks horrible, and itches/burns like crazy. While I did achieve my goal of getting the patch to stay on, I dread the day I need to take this thing off.

I am posting this just as a cautionary tale to hopefully prevent others from making the same mistake I made. I had told the Dr that these patches do not stick to my skin, and he advised taping the Tegaderm along the edges. I had already done this, with no effect. So remember, even those of us who have been around medicine our entire lives can really muck things up when we think we have a good idea. I really thought this was going to be a sure-fire fix, but instead, it just created more of a burden. Just to re-iterate, as if I need to after posting this story of my most moronic idea ever, I am not a Dr, or a qualified medical professional. I do not work in the medical industry despite being forced to be around it my entire life. So, take this for what it's worth.

Regards,

Josh

P.S. Still haven't found my "auto-dictionary" function on this computer, so I probably have some misspelled words. I'm working on it.

goat
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Missed this earlier

 I have ended up asking for mylan brand only but still have bad

Application at times.  I need to read the instructions again..you said use alcohol to prep it and I thought it read soap and water only. I like using the inside of my bicep also as my chest not an option.

sandi123
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Try applying the patch

With tegaderm on the inside calf and using nasachrome spray first, letting it completely dry, then apply the patch, hold in place for 30 -60 seconds, then the tegaderm.

gtrplayer
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Alcohol vs. Soap and water

I thought it was strange, too, regarding the instructions to "cleanse the area with rubbing alcohol, and let dry before attempting to place patch onto skin." The instructions that come in the box, which is about the size of a small book by the way, actually say to avoid using Soap, as soap could potentially effect the release rate of the patch.

I started with my left bicep, then my right bicep; both times the patch fell off as though there were no adhesive put on the patch. So I got frustrated, and read the packaging again, and it actually says to "place one patch on back or upper chest for one week, remove after one week, and apply new patch at different site. Dispose of patch using provided container."

Really, these things are becoming a pain in the rear.

gtrplayer
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Hey Sandi

Thank you for the suggestion, I appreciate it. I will give it a try on the next patch I must wear (in 4 days). I really, really hate these things. I dislike taking oral pain medication even more because I only get 3 hrs, max, of relief when prescribed Vicoprofen or Norco. I used to be on Suboxone for pain (an off-label usage of buprenorphine/naloxone), and I swear by it. However, this Butrans is nothing like Suboxone. 

goat
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what i use sometimes

 mylan will send you askina derm overlays for free if you call mylan.  

gtrplayer
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I may do that. Tegaderm is

I may do that. Tegaderm is running me 17.00 for four adhesives. 

goat
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Askina derm overlay

 anyone that is on the Fentanyl Patches by Mylan instead of paying for the tegaderm covers (which can get very costly) you can call Mylan at 1(800) 446-9526 or 1(800) 796-9526 and let them know that you are on the patches and you are having trouble with them staying on. They will ask you some questions about what you have tried to keep the Fentanyl patch on, dosage, Dr and the pharmacy you use plus the lot number of the last prescription you filled (will be at bottom of the box) and they will send you Askina Derm patch covers for free. You will have to call when you get your new prescription filled or changed to re-order the Askina covers every month (they do send a re-order form but I have been told by mylan to call to make sure that I receive the covers on time) so they will be delivered on time but I have used Tegaderm (which are expensive and they dont give enough in one box), medical tape when the tegaderm would peel up, medical tape on every side, medical tape over the whole patch and then I found out about the Askina patch cover and I have not had ANY problems with the patch falling off now and its FREE. 

sandi123
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When I was on the patches

I went on auction sites and found boxes of 100 covers for about 10.00.....I would order them in the size I needed and then saved the billing info for my medical expenses at tax time.
If you search the auction sites, you can search under the different brand names to get the best prices....opsite, bioclusive bandage covers, tegaderm, nexcare, etc.

goat
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where ??

 were you putting the patch on the inside of your bicep?  i angle it on the inside of mine to where the muscle isnt flexing around it.  I like being able to see the patch and cant imagine wearing it elsewhere

gtrplayer
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I swear I answered this- probably didn't though

Hey, Goat, I always wore the patch (except for the few days on my chest) on the outter part of my bicep. I know I am smart enough I should know which muscles are which in the arms, but right where the two muscles meet, I would always put the patch on just above where the two muscles meet, and it seemed to work, ok'ish. My pain dr makes me get my pain meds at a pharmacy that I would never, in a million years, choose to go to on my own, but he doesn't like using paper scripts and somehow, he e-prescribes my vicoprofen to said pharmacy,even though it's a schedule 2 now. Anyways, the pharmacy he made me use was never of any help about them falling off. When I went back to my mom and pop pharmacy I;ve been using for over 30 years (since I was a child, and my mom had to take my to get that nasty amoxicillin liquid), I told him how bad the patches were treating me because they would either fall off, and become unable to readhere to my skin, or they would fall off, and I'd have to tape it on like I was going out for Friday night football. My "Real" pharmacist actually had the closest "fix" for this problem, and as odd as it seems, he suggested after I shower, I rub some "Antacid Liquid" (generic name) over the spot where I would put the patch. Oddly enough, it seemed to work, along with the Tegaderm, but ultimately I had to discontinue the patches and go back on vicoprofen. My new dog, the beagle, seemed to always scratch at my arm where the patch was at, and the one time I had my mother put the patch on my back (per his instructions), the thing fell off, and I woke up seeing the patch right next to my dog. That was the breaking point for me. I've talked to you about how important dogs are for me and stress, and if I would have lost her to these patches that I was beginning to hate anyhow, I probably would have had a mental breakdown. 

Sorry it took so long for me to post this- I honestly thought I had already replied to this question on my mobile phone, but, obviously I did not.

Take care, brother!

PS- Great new topic you started regarding OTC naloxone.I hope more people weigh in with their thoughts on it. I can almost feel the hate I'm sure to catch because of my view on the whole thing- I just hope all the posters remember that we are adults, and reardless of whether you agree or disagree with an opinion, we can all abstain from name calling.