Well, have 3 Oxycodone 5 mg. to last me a week

[Cindylou]

I just received the return call from Pain Management Clinic about my request to have more than 3 remaining Oxycodone to last me for a week, along with the 25 mg Fentanyl Patch. The nurse said no. My procedure is exactly a week from today. They must think I am an addict. That's all I can think. Do they think that I really don't want the upgrade in patch mg. to work?! How can they call themselves a pain management clinic when they are not managing my pain?! I was up every hour last night, sweating profusely, rolling around in pain. Must have changed my pj's 3 times from being drenched in sweat. I just feel so helpless. And angry and frustrated. Can they not "read me" by now to know that I am a legitimate pain sufferer? Honestly. And why isn't the 25 mg. patch not taking my pain away?! Or even giving me moderate relief? I just don't get it and want to cry. Sorry I am so upset and have to vent. It's just not right.

[KBear]

That sucks! I hate it when they act as if we are addicts, especially when we have a well documented history of pain and have done every therapy, procedure, and surgery known to man, to get better. I told my doctor this at my last visit. I said "I have done EVERYTHING you and all my other doctors have asked of me. I NEVER run out of pain meds early. I take and pass with flying colors all the drug tests I have been given (which cost me $200 a pop, btw). I have been the biggest advocate to getting better and off of these meds. So, it really bothers me when I get treated this way! I would rather die than live like this, PERIOD." It apparently hit a nerve with him and he changed my meds.

I have found that on the phone it is harder to get anywhere with them; but face to face works alot better. I will also make it a point to not take any medication before going in, so they can 'see' what I go through. I usually will take extra meds before an appointment to keep me comfortable and then end up suffering that evening when I am out of my allotted meds for the day, not doing that anymore.

[Fuzzy]

It really is too bad that they are so dam paranoid about the pain med prescriptions that the true pain patients have to suffer. They should know you well enough to prescribe you whatever you need for the week. No, Justin??

I hope you make it through this week ok

[Justin]

I just received the return call from Pain Management Clinic about my request to have more than 3 remaining Oxycodone to last me for a week, along with the 25 mg Fentanyl Patch. The nurse said no. My procedure is exactly a week from today. They must think I am an addict. That's all I can think. Do they think that I really don't want the upgrade in patch mg. to work?! How can they call themselves a pain management clinic when they are not managing my pain?! I was up every hour last night, sweating profusely, rolling around in pain. Must have changed my pj's 3 times from being drenched in sweat. I just feel so helpless. And angry and frustrated. Can they not "read me" by now to know that I am a legitimate pain sufferer? Honestly. And why isn't the 25 mg. patch not taking my pain away?! Or even giving me moderate relief? I just don't get it and want to cry. Sorry I am so upset and have to vent. It's just not right.

CL, I am sorry that you are going through this. The 25 mcg/hr of Fentanyl is the equivalent of 30-70 mg of oral oxycodone a day. How much oral medication where you on before your switch to Fentanyl?

The 25 mcg/hr Fentanyl patch is a substantial amount of narcotic released continuously. How long have you been on the 25 mcg/hr patch?

[Cindylou]

Well, in August and September I was on 1 tab Oxycontin (10 mg) 2 x day, plus Percocet 1 every 6 hours for breakthru; in mid to late September I was on 1 tab Oxycontin (10 mg) at bedtime and the Oxycodone 2 x day for breakthru; Then early October I was on Oxycodone 5 mg w/ instructions of 1 tab 3 x day for 3 days, then 1 tab 2 x day after that. On October 5 the 12.5 patch was introduced with Oxycodone 5 mg 1 x day. Did that one week and then for the past few days I have had on 2 12.5 mg patches to equal 25 mg, w/ just my 3 remaining 5 mg for breakthru (Oxycodone) to last me a week....till next Wednesday. I almost collapsed from pain in the grocery store, consulting w/ my pharmacist a couple of hours ago. Not good.

[Katie]

I often break out in bad sweats when I get behind on my short acting morph. I assume it is a sign of withdrawal, and that plus the pain lets me know I am behind. It gives me a feeling of what this will be like when I have to taper off after surgery. Is it pure pain or the lessening of the medication that is causing the sweats with you, do you think?

You went through this just a little while ago. I thought we were finished of this crap!

Kathy has a good point about going in to see them in person. Are you doing more too, CL that would increase your pain level?

Hang in there girlfriend. I'm praying for a suitable, permanent solution for you...and no, not that kind of permanent

Would you like a phone call so you can vent?

[Cindylou]

Well, I think it is (the sweating, I am referring to) a combination of the side effect from fentanyl and my menopausal symptoms. That's my best guess. I don't think it is withdrawal from the short acting one, because I would think the dose of the fentanyl would prevent that from happening. Hopefully Justin can comment on that. Again, just my best guess. Thank-you Katie for the offer to chat tonight. I'm too crabbed out and just can't "talk" tonight due to these pain levels. Perhaps tomorrow if I am feeling a little better. Hopefully, Justin will see what I wrote about the medications I have been on and comment. There is one slight correction on them: That first round of the Oxycontin in Aug and Sep I didn't take, because remember how disoriented and dizzy I got on it? I had called them about it and stopped the Oxycontin and upped the Percocet for a short time.

[Katie]

I'm here if you need me

[Justin]

Well, in August and September I was on 1 tab Oxycontin (10 mg) 2 x day, plus Percocet 1 every 6 hours for breakthru; in mid to late September I was on 1 tab Oxycontin (10 mg) at bedtime and the Oxycodone 2 x day for breakthru; Then early October I was on Oxycodone 5 mg w/ instructions of 1 tab 3 x day for 3 days, then 1 tab 2 x day after that. On October 5 the 12.5 patch was introduced with Oxycodone 5 mg 1 x day. Did that one week and then for the past few days I have had on 2 12.5 mg patches to equal 25 mg, w/ just my 3 remaining 5 mg for breakthru (Oxycodone) to last me a week....till next Wednesday. I almost collapsed from pain in the grocery store, consulting w/ my pharmacist a couple of hours ago. Not good.

Hi CL,

Sorry for the late reply. It sounds like the oral dose of oxycodone was not adequately covering your pain when you started on the 12.5 mcg/hr of Fentanyl. You are not only playing "catch up" on the pain that the oral dose was not covering, but you are also waiting for peak therapeutic levels of the 25 mcg/hr Fentanyl patch to kick in--therapeutic levels occur between 24 hrs to 72 hrs.

Do you feel any better, CL? I sure hope so. The initial switch from oral meds to Fentanyl patches can be an adjustment and usually require "breakthrough" pain meds initially.
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[mark-Perth]

Hi CL

Sorry to hear that U R still having troubles with the medication.

Opiates R a very difficult medication for doctors to prescribe properly due to the huge differences in doses that each person needs and with the risk of death if they get it wrong they will always be on the cautious side and U also R better 2 as well as U dont want to OD, its not a nice way to die. Unfortunately pain sufferers R the ones to suffer in the process and to make matters worse we also have people that have abused medications which also effects our legitimate use.

As Justin mentioned the fenanyl dose U R on now should be considerably higher than the oxcontin U were on before.

The differnce though with the patch is the slow even delivery unlike the highs of the oxycontin QR so U R less likely to feel the effects of it as much.

If they are keeping U on the 12.5mcg patch but with 2 of them instead of increasing to 1x25mcg patch I would recommend if possible to change the patches at opposite times so they over lap each other. That way if the patches arent working for the whole 3 days (like they often do) it shouldnt matter as much as you will always have a reasonably new patch on giving a decent dose.

Also if the patches R white or milky as U explained before instead of clear and blood red then they R not sticking to U properly and that may account for them not working properly. I noticed a huge difference when they were applied properly and were red so that may be part of it. They really have to be pushed on hard for over a minute to clean non oily skin.

What did your doc say about that?

Often the docs have never used the patch so really dont know exactly!

The hot sweats and lack of sleep could be from 2 things. Too much medication or withdrawls from not enough medication.
Oxycontin has been the only medication that has every given me those side effects so it may well be from that and may take several days for that to go away. I was also on Fentanyl at the same time but those symptoms have never occured since changing off oxycontin to morphine. The hard thing is everyone reacts differently to different opiates. Some I couldnt sleep on and made my hypo where others were fine or sedating.

Quick release medication is also more likely to give that effect where the slow release often doesnt have the peaks and lows that cause it. For a long time I used SR meds for breakthru pain instead of QR to avoid those problems. Maybe speak to your PS about that.

Do U take anything like Amitriptyline?

Amitriptyline is good for several reasons. It helps U with sleep, nerve pain and depression (Im not saying U R depressed at all). I take 35mg at night now but was on 25mg for many yrs which should be plenty. Amitriptyline also increases the effects of opiate as well which may be a huge help for U if they arent strong enough.
High doses can be very sedating though and my PS tried to increase my dose to 75mg at one stage to reduce my opiate dose but it was extremely sedating and made me feel dreadful.

Always make sure U remember with opiates everyone reacts differently and always take care and respect them and discuss everything with your PS first.

I hope that U make it thru this next week without 2 much suffering and next week brings some much needed pain relief.

Mark