DON"T CUT FENTANYL PATCHES IN HALF!! (And yes, I AM shouting!) This could cause a release of a dangerous overdose (per warnings on the package)

And it is almost certain that Charlie's problems are withdrawal, our MO tapers off in 25 mcg increments and if that is too much, in 12 mcg increments (the new dose patch, note it is 12 mcg. and not 12.5 -- which would seem logical but...) This is at Hopkins so I have to think they have a LOT of experience with this issue. The MO and RO both say that while withdrawal symptoms are rare (if it's done right) but they do occur, and the ones they told us to look out for are nausea, sweating, dizziness and stomach cramps. Sound familar?

Keep Charlie on the pain killers he needs to avoid pain. Anything other than this borders on malpractice, per top pain management specialist who spoke at recent HNC symposium in this area.

And for what it's worth, standard practice at Hopkins is a PET/CT at 3 and 6 months and again at a year, though Barry's ENT felt the latter was optional based on physical exams -- the RO was a bit more pro doing this. They might just do an MRI.

Gail