Today, Richard started the Fentanyl 72hr 25mcg dosage. I know he's in pain if he agrees to start the patch. Neither one of us has ever needed medications for health issues so we are in uncharted territory. Of course, having cancer is a different world and the old ways are gone for the time being. I like the term "new normal." There is no reason to suffer and the motrin only took the edge off.
I'd love some feedback on pain relief from the patches. Please no horror stories because I'd be totally freaked out and paranoid. Cautionary advice would be fine and positive feedback about the patches would be great. Richard has a good appetite and I want to keep him eating as long as possible. It's just so painful and we are supplementing with protein drinks, ensure+, Peg tube and ice cream. You all give such good advice and I value all your opinions. Geri

I didn't have the patches but from other posts I know they had to be weaned off when the pain subsided.

David, What did you use for the pain? Richard reacted that first night to the chemo and has had one side effect after another since then. Now with the mouth sores starting in the third week, It seems as if he is going to need all the help he can get. The results of the first set of blood work after the chemo has come in and is perfectly normal. The numbers are all about the same as before treatment. This is good news, but that will probably change within the next few weeks. The only break we've had so far is an excellent prognosis. We need to cling to that info and have faith that this will pass. Geri

I am currently on Fentanyl patches, 100mcg every 3 days. They are wonderful. They work great, they're easy to apply, and they keep their 'stick' pretty well. The 100's are fairly large but if after 48 hrs or so one side starts to lose it's stick, I apply a large bandaid over it that keeps it anchored down to the skin and that works great.
I've also got Oxycodone for 'breakthrough pain' but haven't needed that in some time, the patch does just fine.
It's normal to develop the narcotic addiction to them and I don't know of anybody who's used them long term and NOT had that. But for me, this is my third round of using them in 3 years and I love them. You just have to know that at some point you'll have to go through the process of getting back off them.
Feel free to holler if you have any more questions about them.
-Steve

Steve, Did you start out on the 25mcg dose and then move up to 100mcg? I guess they try you at the lowest dose possible. The nurse said it could 18hrs or so for the med to start to work and then it will be in your blood stream continuously. How long did it take for yours to work? Thanks for the feedback. Geri

Hi Geri,
At first, yes it took maybe 8-12 hrs for me to kick in, but once you're on it and replacing the patches on schedule, it provides a pretty consistent dose. For me anyhow, at the end of 72 hrs it's not like it's all worn off. I can sometimes feel that it's not full strength any longer, but not completely gone. So if you stick with the schedule it's pretty consistent in my opinion. I know in some cases if the pt. feels the patch is not lasting the full 72 hrs, the doctor will have them replace the patch every 48 hrs instead of going to the next higher dose (they've done that with me on a couple of occasions) but of course you would ONLY do this if directed by your doctor to do so.

Yes I started with 25's, then 50's, then 75's, then 100's. I've had a lot of pain from the 5-FU and the other chemo drugs causing severe mouth sores where I already have significant radiation damage. So the pain gets pretty severe for me and the patch is necessary. It's SOOOO much better than taking Oxycontin every 12 hrs or Oxycodone every 4-6 (again, in my opinion).
-Steve

I thought I'd mention again too just to be clear, when I say you develop the addiction, that's really no different than any of these other narcotics like the Oxycodone (and Oxycontin), etc. If you're on these drugs continually you will get dependent on them over time. It's one of those things they don't really tell you about in the beginning, but even if they did, you'd probably take them anyhow because of the pain, and deal with 'coming down' off them in the future once you're at a spot where you can.

There may be others not crazy about the patch. I don't recall seeing any but they may exist. I'm just telling you my opinion based on my experience with it, and actually being on it right now.

If you have other concerns or questions feel free here on this string or you can shoot me a PM too.

-Steve

Steve, Thanks so much for your info. It means everything to get some reassurance that the patch will help. Did they ever prescribe oral morphine sulfate for break through pain for you? Morphine has such a scary sound and we haven't used it yet. The nurse said it is quick acting and only lasts up to 4 hrs. Did you ever take any motrin while on the patch or was the patch enough? This is all so foreign to us and to Richard who wouldn't even take an aspirin before this all started. Thanks again, Geri

I used the fetanyl patch and it worked great for me. I started with 25 and at the highest was at 150. That was only for about a week then gradually back down. The dose I stayed at the longest was 75. It was easy to use, but remember it takes about 24 hours to get regulated so make sure you know when to change it. I used to write it in my calendar where I kept my appointments when I put a new one on so I could remember.

He should also be given something for breakthru pain. As always ask the doc about taking something like motrin. I was given Lortab liquid which went in the peg tube only on a very rare occassion. Morphine is used very often with cancer patients and it works great, Ive taken that many times when in the hospital. Fentanyl is actually stronger than morphine.

Tell your husband not to feel bad about taking the patch. I am not and never was one for meds, but fighting cancer kinda makes you do everything differently.

Yes in previous rounds of treatment I was given morphine also and had no problems with it. Currently I have Oxycodone in liquid form (20 grams/ml) and in pill form for breakthrough pain. But my doc reduced my 5-FU a bit so I've been able to stick with just the patch alone for the most part. I have taken Motrin and Extra Strength Tylenol at times as well in treatment but make sure you talk to your doc to make sure there's no conflict with what you're on and what you want to take. You should be able to get by for the most part with the patch and whatever they give you for breakthrough pain.

I think if he gets on the patch he'll find it an easy and effective transition and I'd be really, really surprised if he didn't come to like it after a dose or two. Great stuff IMHO....
-Steve

Thanks so much to both of you for posting your info. Christine, do you remember how long it took for the patch to first take effect? I put the time and date on a designated piece of paper on my frig. and will use that to keep track. Thanks, Geri