Fentanyl is the strongest pain medication available. The 12.5 mcg fentanyl patch is the lowest strength of the patch. Most patients who take this start off with 25 or 50 mcgs and go from there. The patch is for patients who have more of a long term type of pain. Its not for temporary things like migraines, pulled muscles, etc. This type of medication is a step up and step down one. You may not notice any effects until you have the patch on for 24 hours. With the 12.5mcg dosage, you may not get very much pain relief. Call your doc if you dont notice any changes after the first 2 days. The doc will probably bump up the dose to 25 or 50mcgs, you tell you to put on another patch so you are getting 25mcgs. Change your patch every 72 hours. Mark it down somewhere the date and time you place the patch and keep track to make sure you dont get mixed up (very easy to do!). Most members who have used the fentanyl patch find its very easy to use and helps to control their pain.

Read all the directions and follow them exactly. Never cut, tear, rip, fold, or in any way alter the square or rectangle shape of the patch. Do NOT take long hot baths or showers while using the patch. Put a new patch on in a different place every time. All of the things Ive written can cause the patch to release too much medication which can cause serious medical issues. Immediately report any problems of not feeling well after putting on the patch.

The thick gunky mucous is horrible!!! You can ask the nurse to use the suction machine to help get it out. Your doc can write you a prescription to get a portable suction machine at home. I was always surprised at how much gunk the nurse was able to get. I didnt get the machine at home but many here have and it was found to be a great help.

You are doing much better than most if you are going into the last week of treatments and not been on strong over the counter pain meds. There are very few here who would report they still used Ibuprofen to control their pain at the end of their treatments. I suggest asking for a prescription for magic mouthwash (MM) on your next treatment Tuesday. Even if you dont see the doc, they can still write you a prescription if you talk to yoru nurse. Theres several variations of MM. Mine was malox, lidocaine, benedryl. Swish it around in your mouth 30-60 seconds then spit it out, do NOT swallow it. The longer you swish it around in your mouth, the better and longer the MM will work. MM will numb your mouth for at least 15 minutes so you are able to eat and drink.

The last week of rads is the hardest one. I cant stress enough how important it is to pay attention to your intake during this last week and first few weeks of recovery. Radiation treatments are progressive (continues to work even after treatments have stopped), so the further you go the more you will feel its effects. The best way to get thru the hardest weeks are to focus on the tools that make it easier to get thru it...your intake and pain management. Im very glad you have such a great medical team taking care of you. It shouldnt be a rarity for patients to consult with a pain management specialist to help them get a handle of their pain.

Many of the strongest patients have had to give in and get a temporary nasal tube. This is meant for short term use and does not require surgery like the PEG of J/G tubes do. The nasal tube will help you to easily up your intake without further irritating your sore mouth and throat. Weight loss is a sure sign of not taking in enough calories. If you find you are struggling to drink enough water ask your doc for a prescription to get extra fluids. This will instantly perk you up and make you feel better. I would drag myself in for the IV, a couple bags later Id walk out a changed patient. Intake is one of the things patients trick themselves with and quickly find themselves in a downward spiral thats very hard to pull out from. Its the "make it up game." I played this myself and it landed me in the hospital for malnutrition and dehydration. On days you dont feel well you skimp on the intake saying I'll do better tomorrow. This does not work! Tomorrow never comes as the next day patients who skimped will feel even worse and the patients finds they are in a vicious cycle of trying to catch up which is next to impossible Make sure you are honest with not only yourself but also your medical team and speak up if you are start ing to struggle with your intake. At this late stage its unlikely your medical team would bother putting you thru getting a feeding tube. Especially when the nasal tube can be inserted right there in the office and immediately start being used.

From what you have reported, you really are doing very well with your treatments. Hang in there and keep up the good work!!!