need help new dr wont provide breakthrough meds

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nhm
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Hey guys its been a whille.I switched drs and due to pain havnt been on computer but I realy need your help,advice and input. I was previously on oxycodone 20mg IR 4x daily which worked great. Then I switched Drs and she put me on the fentanyl patch 50mcg an hour. It takes forever to kick in and about the time it does its time for a new patch change.Then comes more problems because I feel pain and withdrawl for 24-36 hours till the new one kicks in.Plus Ive tried different brands and NONE of them stick.I follow the patient insert and dr advice and clean and dry the area 1st and even tape it and it still doesnt stick..Last month I ran out early from losing 3 patches! So theres some of my problems. Heres my biggest problem.My dr doesnt believe in breakthru meds! And this patch DOESNT cover my pain unless Im sitting still like a vegetable.My house is a wreck and my 80 year old grandpa has to help get kids ready for school in the mornings and help with meals because Im in to much pain to do just about anything.For such a strong opiate, it sure x*#&s for pain! Thats another thhing Im only 31. If she  puts me on fentanyl now what will I do when Im 50? Im trying to get into a dr with a good reputation for pain patients but hes a gp.Id like to avoid pain management as Ive already done that because they want to do injections and Ive already had them and they didnt help and caused bad reactions.What do I do?How do I find a decent dr to either take me off this patch and provide shortacting meds or leave me on it and provide breakthru meds without sounding like a drug seeker?Im at the end of my rope Im sick of crying everyday and staying in bed.Im in so much pain Ive considered taking my life to end this pain.Ineed help guys please respond as soon as possible.All advice is greatly appreciated.And btw no I cant go back to the dr who provided the oxycodone I wish I could.

love, melinda

portlandia
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That seems very odd! fentnyl

That seems very odd! fentnyl patches are good for 72 hours and can take up to 6 hours for them to start working. I would get a doctor who knows what they are doing. If you use a fentnyl patch leav it on for 3 days they should be 72 hour patches. the only fentnyl that works fast are the lollypops and actiq pills. what worked good for me was using the 100mcg fentnyl patches along with 80mg oxycontin and 30mg oxycodone IR four times a day but only one 80mg oxycontinb tab a day so basically per day my regimen was this

1- fentnyl- patch 100mcg that laste 3 days before I changed it

1x80mg oxycontin tablet

4x 30mg roxicodone tablets

 

I don;t know what your tolerance is like so adjust your dose accodingly and get a new dr. nobody should take off a 

72 hour fentnyl patch after a hour. That is crazy!

nhm
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no portlandia you

no portlandia you misunderstood me. I know they stay on for 72 hours and that theyre SUPPOSED to begin working in 6-12 hours.However, in my case for whatever reason it takes a LOT longer for them to work, I timed it once and it took 34 hours to get out of withdrawl after putting on a new patch. And they dont seem to last the 72 hours, more like 50. I think this could work if she'd rx breakthrough meds for when I have breakthru pain and during patch changes..I asked her for breakthru meds for my daughters birthday I said I didnt want to be in bed in pain I wanted to enjoy it.She called in 5  5mg lortabs! A week later I called again and said Ive been in bed 2 days can you please call in some breakthru meds.She said "I callled you in 5 lortabs 7 days ago that should be sufficient"!!!! Now Im greatful for any pain relief I get but seriously how long are 5 5mg lortabs supposed to last? And I was on 20mg oxycodone IR 4x daily and now on 50mcg ftd patch does she really think a 5mg lortab makes a dent in my pain?Again Im grateful for any pain relief she provides but I feel Im undermedicated.At least before when my pain reared its ugly head I could take a pill and get relief. I dont have that option now. The patch does not cover all my pain(and nothing ever will but we can do better than this I know because I did better than this on oxycodone) and the patch does NOTHING absolutely nothing for flare ups or spikes in pain.I even talked to my long time pharmacist and he said in general yes when on a long acting med the dr provides breakthru meds for flare ups I hope that explained it a little better and yes I do wear them for 72 hours although the last 24 are very rough as its already wearing off by hour 50.Please help! I have a dr appt on the 4th and I want to be able to talk to her about my need for breakthru meds, in an intelligent manner.Maybe there is an article written by a dr or the american pain society i could bring to her showing the need for breakthru meds with longacting meds? I do not want to have to go to pain management..I need help!

Melinda      P.S. Portlandia thats part of what Im asking HOW do I find a dr who knows what theyre doing?I live in a town of about 200 people the nearest towns are 12-25 miles away..I can handle driving that far but I dont have a reliable car to drive to the city and have no clue how to find the right dr. If I ask over the phone hey do you do opiate therepy they automatically think drugseeker and say no we dont do that here.And theres limited drs that take soonercare.

celticgreenman
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Function vs Pain level

nhm,

Sorry you are having problems again.  Not knowing what your physician type is (pain management, primary care provider, specialty such as anesthesia or orthopedics. etc) when searching for articles on pain management, I went with Family Practice.  The following is an article from the AAFP.

 

“Treatment of Nonmalignant Chronic Pain”

Dawn A. Marcus, M.D., University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania

Am Fam Physician. 2000 Mar 1;61(5):1331-1338.

By the AAFP (American Academy of Family Physicians)

http://www.aafp.org/afp/2000/0301/p1331.html

 

nhm, try to speak with your physician about the fact that your patches are not lasting as long as needed, and that you do have spikes of pain while on the patch.  Both of these conditions are affecting how you can function.  Try to emphasize the functioning, as it seems that the new word in pain management is function.  Physicians are not as concerned about pain levels as how the patient is doing in his/her functioning.

Hope you find more articles and your physician manages you pain better.  Good luck.

cgm

 

BmoneyPhilly215
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Some Dr's are partial to

Some Dr's are partial to Scripting certain meds whether it be their Success with it with paitents in the past or Dr's being sold by agents sent out to try and have said medications Rx'd more over others. Weirdly the people i knew when i was into abuse of opiods, note: these were people not trying to get rid of pain as much as they were trying to catch a buzz, which may be appart of your problem Dr's anymore seem to think everyones just trying to get high and have trouble getting breakthrough meds who really need them, so im sorry for people like me in my past and people like the people i knew but them Male and Female would be WAY over rx'ed things. Im talking 80mg Oxycontins, Then Roxi 30s Oxycodone and Still 10mg Oxycodone then given Extended Release Morphine for " My wrist hurts"   The one i knew would actually get all these Then, when the newer oxycontins came out, the girl complained about the oxy's ( because she couldn't abuse them the way she wanted) and they drastically uped her Roxi 30 dose almost using that as a Contin. Sad but true. It seems alot of these pain med dr's are either too scared to Rx people what they are Legit needed while others are OVERY given Narcotics. Maybe think of switching Dr's or Sitting your Dr down and SHOWING them that the therapy they are giving you isn't working and isn't doing anything but making it worse, if they blow you off. Switch to a better Pain Manigament Dr. Just make sure you don't end up in the opiod abuse percentage. It's no fun. Not trying to be anyones father but, just thought i'd say, think before you act, it happens so fast you dont even realize how you got to where you are. I hope i could help you in this post, and wish you the best of luck.

-B

BmoneyPhilly215
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Oh and one more thing, i'm

Oh and one more thing, i'm not saying this is for sure, but i do remember, Being so frustrated i could almost think myself into withdrawl symtoms i mean straight violently vomiting, Severe Out the other end, Skin crawls you know the feeling. When i shouldn't have even been sick for another 12-15 hours. It was straight mental, but of course if i were to do something more it'd go away, but you would be suprised the mind has on the body especially when it comes to pain. As stupid as it sounds this may help you, ever notice when you're in severe pain and would get so frustrated and spazz out... Blood Pressure would start flaring and it would actually make pain and/or withdrawl worse. I know it's hard to believe but it's true. For the most part though from my first post stick to that and just keep this in mind, try to stay as calm as possible like i said it seems the more i'd spazz the more it'd spike. Best of Luck,

- B

nhm
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Thank you Elder for finding

Thank you Elder for finding that article for me, I really appreciate you taking the time!

Melinda

quincy
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Hi Mel . . .

Good, and sorry, to see you back. I'm glad that cgm's advice was useful as I can't come up with much other than wish you the best of luck!    .  . . .Q

barrebaby
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my aunt was in a similar situation

hello NHM ,i just wanted to say that i know what your going through.my family has been seeing our general practician dr for everything from a cold to chronic pain.anyways,my AUNT was in a terrible bus accident and after all the tests and MRI'S and workups...the doctor decided on FENTANYL for pain (i dont know what dose) and like your doctor this doctor absolutely does not believe in BT medication. After a few months my aunt (who is 64) complained the fenanyl patches did not kill the pain and made her feel like a zombie. i saw her a few times and she LOOKED like a zombie.it just didnt agree with her. she told the doctor she wanted off that medication ASAP so long story short,he took her off and Rx'd her 8 percocet 10/325's instead. this worked for a while (2-3 years) then she was in pain again.Also the doctor was not comfy with writing her 240 percocets per month. SO they changed again...now she is on OPANA ER TWICE A DAY and says she is feeling MUCH,MUCH BETTER.she looks alot better too and is much more active. 

     just wondering,have you talked to your doctor about OPANA yet?? THIS may be the answer. best of luck with your treatment!

Trialmember
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Melinda

I recommend that you try the Morphine patches and/or the MsContin 60mg-100mg pending on how bad ur pain is..from what you said it seems that you're in constant pain just like me I hadda burst fracture in my cervical spine and I was paralyzed from the neck down prior to my 11hr spinal fusion surgery but by the grace of God im not paralyzed after the surgery it was truly a miracle!!!! I currently am prescribed monthly Oxycodone 20mg TID #90 MsContin 100mg TID #90 and for my ptsd I get Klonopin 1mg TID #90..I used to get the Oxycodone 30mg QID #120 for my breakthrough pain medication and it worked phenomenally along with the MsContin 100mg TID #90 OxyContin 40mg BID #60 and Klonopin 2mg BID #60 Valium 10mg BID #60 and they all worked so well I was NEVER in any pain and I was able to regain my life back!!!!! But what the idiot drs have me on now as I mentioned in the beginning of this post is a joke considering the severity of my injuries!!!! Most of the time there's no way to reason with these fn sad excuses for drs

goat
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Very old post

2013.....who else is still on board pharmer?  Quincy? Gtr? Allgood? Kirby? Miss you all