I was just wondering if anyone has used or are using them. My mom is under pain managment and they are trying to get her off all the pain meds that have been perscribed to her. Right now they have her on the patches and morphine. She has been cancer free for two years but not pain free. The combination is working wonderfully, she is like her old self again ( driving her daughter nuts ) Just curiosity about what other people are doing or useing.

Hi, Annabel, could you please be more specific about the feyntenal and morphine? We are trying to find a pain med. combo that will allow John to spend more time "out of bed" while controling his pain. What kind of pain has she been having? Amy

Annabel,
I used Fentanyl for months, and it worked great. 72 hour time release patches from 15mg up to 300 mg dose rate. (I only got up to 75mg).

Fentanyl is a "long term" opioid pain management narcotic, similar to heroin. It is almost perfect in that it retains it's pain management qualities for a very long time and the patch is an easy way to administer the dose. It does take 24 hours before a full therapuetic level is achieved in the bloodstream. It is hard to overdose (although not impossible) because you would have to physically place more than one patch at a time.

Morphine Sulfate is a "short term", fast acting opioid, typically prescribed for "breaththrough pain" and it takes about 30 minutes for full effect if taken orally in pill form. You would typically use morphine prior to eating and some types of exams, etc.

I was never high when taking the pain meds. They are very potent and require medical supervision or at least a plan to wean off of them. Abruptly stopping them can cause convulsions and/or death.

Constipation is also a serious matter when taking these, or any narcotics, so talk to your nutritionist, stay well hydrated, eat foods with fiber, eat fruit if you can and use stool softeners, like Colace.

I, too, used and loved Fentanyl patches and used one, then up to three at a time for the worst of the burns. I just backed them off and went on my happy way. I was definitely not high because of them, but they sure zapped pain that had me going into shock without them. Once they took full effect, I did not need anything else for pain. Amy, this might be all that John needs, as they sure took care of truly terrible burn pain like it was nothing.

Annabel,
Fentanyl patches were an excellent tool for managing pain during my treatment. I started with a 25 mg patch and ended up at 175 mg. for the 2 weeks following the end of treatment. Those were the worst weeks of the whole process. I also used oxycodeine in liguid form for breakthrough pain, putting it through my PEG to get quick relief.

As Gary mentions, it is very important to have someone managing your Mom's pain and I think, equally important, managing the tapering off process when reducing the amont of pain killers. The patches can come in 25 or 50 mg increments, as I recall, and you want your Mom to taper off gradually. I did it in 25 mg. doses. If that becomes too uncomfortable, you can cut a patch in half and come down more slowly in 12.5 mg doses.

Best, Sheldon

Annabel,

My spouse was under the care of pain management team. She started with a 25 microgram per hour fentynal patch and worked up to 50 than 75 and than 100. Morphine was prescribed for breakthrough pain.

She was on the 100 microgram patch for several months and we justed started going in reverse down to a 75 microgram patch again under the care of the pain management team.

As others have said, these are potent painkillers and require the a medical team supervison. Also the process to get the off these pain killer must be gradual to avoid nasty complications.

In our case both the patch and the liquid morphine worked well in controlling the pain/

Vin

I agree the morphine and the patches are a god send. I feel worried because she has been on the patches for about a year now..there seems no end in sight to the pain. the morphine has given her back more of her life.. but how long can she stay on meds.

That's a LONG time - my doctors had me phase out after a certain period. I would be asking some hard questions about why she is pain that long of a time.

I agree with Gary -- most of the HNC patients we met at Hopkins got off their fentanyl patches within 3 months but I know of one who did not and who, in fact, had a lot of trouble weaning off -- he'd drop down and have the pain come back, plus other symptoms (sleep disturbance, sweats) so more was going on. I am not sure how it resolved, we have lost touch. But I think a candid discussion with your mom's doctors is in order.

Gail

hi all,
I am very interested in this topic because my dad in in his last week of radiation and asked for a patch to help with his pain and he was told that he didn't need it if he's made it this far without it. I am so upset at how we have had to fight for every little bit of help regarding his pain management. I am going with him tomorrow to try one more time for pain medication because i've read on this board that the two weeks after radiation is finished is horrible. any word of advice on what to say tomorrow?
thanks