Hi Nicki,
My sister started on the Duragesic patch about 6 weeks ago at 25mg and it was increased by 25mg every week or so because of so much "break through" pain until she got to 125mg. (She is allergic to morphine she takes liguid Ibuprofen for break through pain. When she's taking the Ibuprofen 3 - 4X's a day they increase the patch.) so Last Friday they increased it to 175mg and yesterday she was throwing up and had dry heaves, feeling faint, dizzy, etc. (We think it was just too much, too fast.)The hospice nurse said to use a supository for nausea and thank goodness that worked great. Today she is fine. Hope this helps.... good luck to you.
DenverSis

Actually that is not the a way it works. They always start Duragesic at 25mg and increase it 25mg at a time. There is a formula for the ratio between the breakthrough pain meds which are "short term, fast acting" opioids vs. the "long term opioids" such as Duragesic. When the intake of short term meds exceeds a certain amount, they will increase the Duragesic. You will still need breakthrough pain medication at times. The Duragesic is supposed to control the overall pain threshold but there will still be breakthrough pain during certain times, such as eating, drinking or some exam procedures.

A 50mg jump is not recommended by the manufacturer according to their warnings, precautions, contraindications and indications for use.

The NCCN pain management guidelines I posted earlier cover all of this in great detail.

At this stage nausea could could caused by a lot of different things. If it can controlled by compazine suppositories you're pretty fortunate. I puked so much in the late and post Tx I polished my teeth like glass from the stomach acid.

Antacids may help as well since chemo does a number on the stomach lining.

Nikki,
I took liquid vicodin for pain during radiation. I started taking it about week three and stopped the last day of treatment. The pain wasn't horrible for me. Good luck with it all.
Minnie

Nikki, for the surgery I was given Oxycodone which was wondeful with no side effects and no problem stopping, then in my final week of rad when my neck was burned to a crisp and weeping, I decided to stop being tough and was given Fentinyl patches which worked wonders, I believe I was up to three or four and after about three weeks of those, just stopped, again with no problem or side effects. I really like the patches because they work for three days. Takes a little time to get started, but from then on, no pain at all. It is wonderful that the philosophy now is the patient should not be in pain. It was not always so.

Geez, people! I would not have realized how many options there were and that I'd almost need a medical degree to get through this mess!

.....and Gary, you are just soooooo descriptive that I can literally "feel your pain!"

I do find it most interesting that there are so many different reactions/tolerances/experiences with the same treatments. WE are truly unique individuals, are we not? I'm telling Tom that I would think that since his body obviously HATES the chemo, that the radiation might be a 'friend.' We can only hope...

This Xeloda causes his skin to turn splotchy-red...face/chest/feet/top of his head. He says his fingertips are tingly, too. Tomorrow is the last dose of the stuff for a week.........and radiation starts tomorrow, too...

Hope you all had a good day - Tom spent more money today - and I tell him I do believe this disease has moved to his brain!!!!!!!
Nicki