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
Be VERY VERY strong in your attitude about pain relief for him. He doesn't have to use it if he doesn't need it. Amy
Guila, make a scene if you have to. I am SO anti meds that I actually went into shock from the pain of rad burns during the final week. That was stupid. The pain is real and your dad is entitled to relief. Get loud and pushy if that is what it takes, but do not let anyone tell him he does not need it -- the pain just gets worse and having made it this far does not mean a thing. I am angry on his behalf!
The pain was the worst for my husband two to three weeks after. That is unacceptable and I would tell them that you have educated yourself and that you are aware that this is the time he will need it most. Is this his RO or MO that is refusing you? My husbands RO and MO were always so concerned with the pain management and made sure he did not have to suffer anymore than he had to. Even with the proper pain relief it is misery...do not take no for an answer.
When we went to Hopkins we were given a page with "Patient's Rights" and among them was "right to adequate pain management." So I think you need to go to the person at your hospital who deals with patient issues (they all have someone) if your dad's doctors continue to fail him. Because that's what it appears they're doing.
Gail
Just in case someone missed my other post on Duragesic or Fentanyl:
W A R N I N G:
DO NOT CUT A PATCH IN HALF - A FATAL DOSE OF FENTANYL CAN BE RELEASED.
Do not used damaged packages either. Wash your hands after application. Follow the instructions very carefully.
This is a very safe and effective drug when used properly and one of the strongest pain relievers on the market.
Dammmn,
I should have read this post earlier. My brother suffrered so much because of the radiation and the I am keep on asking the doc about cortico steroids for the pain. I should have asked about this patch.
At lease his mucositis is under control now and he has pain from the last chemo they gave him 10 days ago.
Does it help in chemo as well?
If so, I need to find out out if at all this is available in India.
thanks guys for the great tip,
Praveen
Praveen,
corticosteroids do nothing for pain. If Duragesic AKA Fentanyl is not available then ask for Oxycontin for long term pain relief. Please note that these drugs are only indicated when long term pain relief is required. There are different meds for short term use.
These are both extremely powerful and effective drugs. Fentanyl is 40X more potent than Heroin.
Ir is very safe and effective if used accodring the manufacturers instructions.
While I would never try to argue with Gary, I might strike up a dialogue. And since we have been "intimately" involved with fentanyl patches for the last few weeks, I am going to venture forth here. I do not doubt that they are safe for many people. In our case, my husband started on a 50 mcg dose a week before he had his 1st Erbitox injection. As a prelude to the Erbitux he got a dose of Benedryl and Ativan and within 30 minutes was having a very bad reaction--to what we are not sure.[ The chemo Doc say it was the Ativan] After 5 days of his being on another planet, I jerked the fentanyl patch when he had a 101.5 temp early in the am.[because the dosage can be excelerated by heat]. He got Erbitux #2 that same day, but no Benedryl or Ativan. Within 24 hrs. of the patch being off, he rejoined us on earth and has been lucid and coherent ever since. So how much did the patch contribute to his craziness? Don't know- I just know he is back with me now and the patch is gone. Amy
Post Script: I was the instigator for John using the patches. I had read here about the good pain relief fentanyl provided and I wanted something that would stop the debilitating headaches he was having and help with the mouth pain. Interestingly, the headaches disappeared while he was on the patch,and to date, have not come back. My uneducated guess is that the patch stopped a cycle of pain that was maybe tension and stress related. Am keeping my fingers crossed. amy
I used the patch for a little over a year. It was great a lot better than the narcotics i used for break through pain. I found that the further out of treatment I was the more that the patch seemed ot put a film between me and the world. I opted to quit using them because I wanted to be as present as possible for my life. Not everyone is the same. I also was only 36 y.o. and was afraid if I got into pain again and was still on the patch what were they going to use then??
Thank you all so much for the great info on these patches.
I had a little chat with my brother yesterday over the phone and he is doing OK now. He is not in great pain that requires these patches. I am so happy after a long time since I was able to talk to him and his voice is better. I can understand him completely and I hope he will lead his normal life soon.
thanks
Praveen