Re: Fentanyl to Dick

[Guest guest]

Dick,

IMO, that's an unreasonable amount of time to be on the lower dosage

of 25 mcgs. when they aren't working. My doctor started me on 25's,

then after 2 weeks when I told him they weren't working, he

immediately upped me to 50 mcg.'s, which at that time, was sufficient

for me. I was also taking Percocet 10/325's at that time, too, up to

6 a day.

Then a month later I was hospitalized with diabetic ketoacidosis and

pancreas burn out, and stopped all narcotics completely. I remained

off of narcotics for two months, until new pains in my pancreas

developed, it was the two pseudocysts becoming enlarged again. I had

fired my old GI and found a new GI doctor, who immediately put me back

on the 50 mcg. Duragesic patches, which worked fine for about 5

months. After 5 months they weren't enough, he tried me on Oxycontin

20 mgs's., twice a day, and that still wasn't working. At that point

he said he was over his head with finding suitable analgesics for me

and sent me to a PM doctor.

After experimenting with several other narcotics at different dosages

for a month, with little success, the PM doctor put me back on

Duragesic 75 mcg.'s, and I was fine, that was the good level for me.

I'm explaining the way the whole dosing regimen became established

mainly to point out to you and others that may read this how the whole

process worked with my PM doctor, and the events that lead up to it.

I think the way my GI doctor reacted was typical of many of his peers,

that they are uncomfortable dealing with the stronger narcotics, and

a good doctor will readily admit this and send you to a PM doctor,

with their blessing. I do know that my GI doctor checked around first

to make sure that the PM doctor he referred me to was one that

regularly worked with narcotics and would write scripts for all the

schedule II drugs. He told me he didn't want me to get stuck in a

clinic where they didn't believe in narcotic administration, because

he already felt that celiac blocks would be a waste of time for me,

and he wanted to make sure that I had appropriate pain relief without

any hassles.

The PM doctor's ritual was to give each different med one week to see

whether or not it was effective. If, after a week there wasn't

noticable success, he would switch me to something else. One other

thing he has me taking in addition to the Duragesic patches with

Oxycodone, (10 mgs. as needed - 125 per month), for BT, is Neurontin.

I started on the Neurontin when I went back on the patch and have been

taking it ever since, starting at 300 mgs. per day, presently taking

1,800 mgs. per day. This medication isn't a narcotic, and was

originally prescribed as an anti-seizure medication, but has been

found to be very effective as a pain reliever, so has been used for

this purpose for a few years. There have been rare occurances of

pancreatitis in some patients who took it. I was warned of this

before I even began taking it, but Zantac has the same precaution, and

I took that for 2 years without any trouble, so I figured I'd try the

Neurontin. It has been VERY effective for me. So much so, that I've

been able to drop back to 50 mcg. patches and only use less than 50

Oxycodone per month.

If you can find another PM doctor, that's what I would do, and I would

explain to that doctor that I'd already been acclimated to the 25 mcg.

patches and that they weren't anyhere near stong enough. I would NOT

admit that you'd experimented with stronger dosages, because that's

when they lose trust in you and start thinking you're a drug seeker.

But I would tell the doctor that I FELT that with a stronger dosage

there might be some good success with the patch, and see if the doctor

would go up to 50, perhaps, as a starter, with a reevaluation in two

weeks for 75 mcgs. It takes several days for each dosage to become

fully absorbed into the bloodstream, it may be that you didn't give

each new dosage long enough of a try to see whether it truly was

enough before you jumped to the higher one.

This would certainly be better than taking 5 Lortabs each day for 8

years, that could be poison for you in the long run.

With love, hope and prayers,

Heidi

Heidi H. Griffeth

Bluffton, SC

SC State & SE Regional Representative

Pancreatitis Association, International

Note: All comments or advice are based on personal experience or

opinion only, and should not be substituted for professional medical

consultation.