short answer is that the patch will NOT provide any relief until at least 24 hours. 12mcg hardly seems worth it. The insert and warnings all seemed unnecessarily scary to me as this is my second go around and never a problem. the instructions do make it clear that you can shower etc, just don't sit in a sauna or steambath as that increases the rate it is released. I just put on a patch every 48 hours and then toss the old one in the trash,
Once the patch is working, it is a relief not to have to keep timing the pills etc, Finally, be sure to have oxycodone or at least percocet on hand for breakthrough pain. Obviously from EZJim's postings, the patches do not work for everyone but I would ask for at least 25 mcg to start off. good luck