Re: Duragesic Fentanyl patches to Donna

[Guest guest]

Donna,

It certainly a possibility that your doctor could move you up to a 50 mgs.

duragesic patch. Unless they have had considerable previous experience

with strong opiate medications, the warnings on the dosing requirements for

this therapy strongly advise that patients be iniated with no more than the 25

mgs. fentanyl patch. It takes a few days-week for the drug to build up a

reservoir underneath the skin and begin to be distributed through the

bloodstream, so they advise patients to allow enough time for the medication

to be distributed before they will begin to feel the full effect. Since you've

only

been wearing the patch for five days, and should be only on your second

patch, you may need a few more days before you can expect full coverage.

Your doctor's only following wise medical practice by starting you on 25mgs.

as he did. I have heard of some patients getting very dizzy and disoriented,

and feeling woozy when they first began, obviously they weren't used to that

much narcotics in their system. Plus, we all have different tolerances to

drugs, and the physician needs to allow for this when the patches are started.

When I started the 25 mg. duragesic I'd been taking Percocet 10's every 4-6

hours on an as-needed basis for about a year. I used the 25 mgs.

successfully for about 7 months, only upgrading to 50 mgs. last October when

I had my last acute attack. The 50 mgs. worked well until about two months

ago, so it was only 3 months before I needed an upgrade. My doctor feels

that I have a high drug tolerance, since none of these medications or

upgraded dosages have ever made me feel disoriented, dizzy, or fuzzy, and I

have always responded better to a higher dose than many people can initially

tolerate. Sad commentary for someone who never had anything stronger

than aspirin until three years ago!!

When is your next appointment with the new doctor? If you aren't doing this

already, I suggest that you start a pain/medication diary today, writing down

how you feel, if you have pain, when it started, what level it is, what you took

to relieve it, how long it lasted, etc. This would be most helpful for the

doctor

in determining how well the medication is working, or not working, etc., and

can even pinpoint whether it's the duragesic or the BT meds that aren't doing

their job. I do this now, and I've never had any trouble getting my doctor to

understand my complaints when I feel my medication needs adjustment. I

think that anyone who is trying to convince their doctors that they need an

increase or a different pain medication should keep one of these diaries. It

shows that you are serious about your health and pain management, and not

just a drug seeker.

Good luck, and start that diary today!

With hope and prayers,

Heidi

Heidi H. Griffeth

http://www.pancassociation.org/anthology.htm#Heidi

South Carolina

SC & SE Regional Rep.

PAI, Intl.

Note: All comments or advice are my personal opinion only, and should

never be substituted for consultation with a medical professional.

Donna wrote:

> I have been on the Duragesic Fentanyl patches since Monday March 1,

2004. They do help, but I am having quit abit of pain. Maybe the doctor can

up the dose to 50mg. rather than the 25mg. Is that a possibility!!!!