Pharmaceutical Switch question

[Inspektahdek]

I'm currently on Fentanyl 75mcg patches, Percocet 10s X 4 a day and valium for back spasms. Recently I've been having some really bad reactions to the Fentanyl and it caused me to get really light headed, dizzy, sweat profusely and gave me a really bad rash that was almost blistery where I had the patches so I stopped wearing them.

My surgeon is on a small stint of a vacation so there was no way for me to talk to her about that but I did see my primary care physician and told him about that and that I've been taking the percocets alot more to placate or make up for my main medicine the Fentanyl and he supplied me with another bottle of the same quantity. I was even due for a refill in 3 days anyhow so it wasn't that much of a hassle.

Initially right after my surgery I was put on Fentanyl, percocet, valium, and oxycontin but later on which was the last time I saw my surgeon she kept everything the same except upped my fentanyl to 75mcg from 50mcgs but took away the OXY. What are the chances due to my reaction to the patch that I can get put back on the oxy or even something similar. I'm even willing to take the shitty MScontin as long as it relieves pain as well.


I would really like to ask her if I could try methadone since it's now used alot for pain relief more than it used to be used to treat addicts plus the fact that it lasts all day. Would I be too forward to ask her about methadone if I told her I went online and did research on long lasting medication? I know she'll supply me with something to replace it but what do you guys think that might be to replace fentanyl? The percocet is nice and it helps when I have immediate spikes in my pain but from my experience the main pain relief from percocet only lasts about an hour for me and my pain is literally 24/7.


anyways thanks for the replies beforehand, peace

[greenfox]

I'm currently on Fentanyl 75mcg patches, Percocet 10s X 4 a day and valium for back spasms. Recently I've been having some really bad reactions to the Fentanyl and it caused me to get really light headed, dizzy, sweat profusely and gave me a really bad rash that was almost blistery where I had the patches so I stopped wearing them.

GIVE ME SOME moving along


My surgeon is on a small stint of a vacation so there was no way for me to talk to her about that but I did see my primary care physician and told him about that and that I've been taking the percocets alot more to placate or make up for my main medicine the Fentanyl and he supplied me with another bottle of the same quantity. I was even due for a refill in 3 days anyhow so it wasn't that much of a hassle.

Initially right after my surgery I was put on Fentanyl, percocet, valium, and oxycontin but later on which was the last time I saw my surgeon she kept everything the same except upped my fentanyl to 75mcg from 50mcgs but took away the OXY. What are the chances due to my reaction to the patch that I can get put back on the oxy or even something similar. I'm even willing to take the shitty MScontin as long as it relieves pain as well.


I would really like to ask her if I could try methadone since it's now used alot for pain relief more than it used to be used to treat addicts plus the fact that it lasts all day. Would I be too forward to ask her about methadone if I told her I went online and did research on long lasting medication? I know she'll supply me with something to replace it but what do you guys think that might be to replace fentanyl? The percocet is nice and it helps when I have immediate spikes in my pain but from my experience the main pain relief from percocet only lasts about an hour for me and my pain is literally 24/7.


anyways thanks for the replies beforehand, peace

Be very careful when you ask questions like this. Unfortunately there really is no golden rule to this, but there are a few pointers":

1) Don't diagnose yourself; don't recommend OTHER meds.
2) DO say "This isn't working for me for my pain

when you try to diagnose yourself, that is a RED LIGHT in a doctors head as to what the fuck is up.

my $00.00000000000000002

[Inspektahdek]

GIVE ME SOME moving along



Be very careful when you ask questions like this. Unfortunately there really is no golden rule to this, but there are a few pointers":

1) Don't diagnose yourself; don't recommend OTHER meds.
2) DO say "This isn't working for me for my pain

when you try to diagnose yourself, that is a RED LIGHT in a doctors head as to what the fuck is up.

my $00.00000000000000002




ok ok, I'm aware of all that but the main thing is that I'm having an allergic reaction to the patches im not trying to get more medicine or a different medicine for it to be stronger or to fuck me up more I'm trying to get something equal to it or maybe a little better that doesn't give me the allergy problems. I checked fentanyl side effects on a site and it described some of what I was feeling

light headed dizziness
feeling cold, sweating alot,
and rash and blistering where patch has been or where it is worn



My main thing is to switch meds because of the problems not because its not working for the pain, the patch was actually working excellently for the pain.



-inspektah

[greenfox]

ok ok, I'm aware of all that but the main thing is that I'm having an allergic reaction to the patches im not trying to get more medicine or a different medicine for it to be stronger or to fuck me up more I'm trying to get something equal to it or maybe a little better that doesn't give me the allergy problems. I checked fentanyl side effects on a site and it described some of what I was feeling

light headed dizziness
feeling cold, sweating alot,
and rash and blistering where patch has been or where it is worn



My main thing is to switch meds because of the problems not because its not working for the pain, the patch was actually working excellently for the pain.



-inspektah

ive done fent in every way except sticking it up my arse and I ahte to say it but that's a pretty normal reaction. Now on the other hand, you could tell your doctor all this. Whatever you do, don't ask for OCs.. if they're offered you're golden. Just dress really nice to go to the appt. and just play `em like a fiddle. Yoyu just gotta be careful that's the main thing; fent or nothing at all, that's the thing isn't it?

[Inspektahdek]

ive done fent in every way except sticking it up my arse and I ahte to say it but that's a pretty normal reaction. Now on the other hand, you could tell your doctor all this. Whatever you do, don't ask for OCs.. if they're offered you're golden. Just dress really nice to go to the appt. and just play `em like a fiddle. Yoyu just gotta be careful that's the main thing; fent or nothing at all, that's the thing isn't it?


Oh I wouldn't even dare come out and ask straight up for OCs but my surgeon is really cool and respectful to her patients when it comes to pain so I'm just going to tell her I guess that it leaves me a little bit of a rash and that is there a chance I can switch to pill form which would be (MScontin)? or what else would a pill form equivalent be from a doctors perspective if I told her I was having some rashes and sweating alot from wearing them?

What's the most likely thing I'm going to get? I really need a long acting medication as well as my breakthrough meds which are percs which do well but like I said don't last long and the pain is all day.

[greenfox]

Oh I wouldn't even dare come out and ask straight up for OCs but my surgeon is really cool and respectful to her patients when it comes to pain so I'm just going to tell her I guess that it leaves me a little bit of a rash and that is there a chance I can switch to pill form which would be (MScontin)? or what else would a pill form equivalent be from a doctors perspective if I told her I was having some rashes and sweating alot from wearing them?

What's the most likely thing I'm going to get? I really need a long acting medication as well as my breakthrough meds which are percs which do well but like I said don't last long and the pain is all day.

you could end up with something sweet like a dilly you could get fucked with a perc 10 or maybe even a (UGH) demerol. That's the thing about it; it's all a game of chance. and when they switch you and if it's something crappy you can't be like Uhh I don't want that...

hell you could even get a kadian (ew)

[halfalien_s4]

in my opinion ms contin is good (i take it), oxy is better i f u can get it but just be hoest with ur doc about what ur feeling....for me, methadone worked somewhat for my around the clock pain, but i noticed my BT meds working less...just something to consider. u might ask her what u said and ask is there anything in pill form i can take in place of the patches? hopes r, she'll switch u to one of the contins...

[rroberts161]

On the other hand, in the ED (Emergency Department), patients show up all the time in pain with known disorders. About three months ago I saw a case in point. A patient presented at the ED with head pain and vomiting. At triage (by a nurse), the patient indicated she had a "sinus infection". On examination by the physician, the patient provided a presentation FULLY IN ACCORD with the claimed disorder. This included head pain, purulent discharge from one sinus and a sensation that the other was blocked. The patient indicated that the pain had begun about four days earlier, and that she had come to the ED only after the pain became unbearable. The patient's history was significant for sinus surgery eight years earlier (quote: "Well, I did have bilateral ethmoidotomies, with windowing of the maxillaries and planning of the turbinate processes.") and also for pain management that was current (methadone 100mg. in. d., oxycodone IR 10mg. b.i.d. and doxepin 150mg. a.m. and p.c.). Asking for medication, she stated, I am on pain management, so I doubt you are going to be able administer adequate opioids to accomplish pain control."

In this context, the patient asked for and eventually received a 30mg IM bolus of MS, after being titrated to analgesia with fentanyl first. In the ED fentanyl offers several advantages. It is very short acting, so that an unintentional overdose is of short duration and easily reversed with antagonists. Most doctors only have trouble with self diagnosis if the presentation of symptoms or patient responses to symptoms fail to fit within normal parameters for the proposed diagnosis. Patients almost always enter the examination room with an idea of what is wrong with them, with a tentative diagnosis.

Perhaps the single greatest error made by patients who are in need of opioids is patient reliance on the physician to sense the need and order the drugs without explicit patient request. THIS ALMOST NEVER HAPPENS. Physicians get very poor pain management education in med school, and it simply does not happen that doctors decide to prescribe Schedule II opioids to a patient exclusively on the basis of the diagnosed disorder.

People who are in true pain do not often wait for the doctor to ask about pain medication, they speak right up! In the ED, pain medication is probably the most demanded treatment we have to offer. In fact, ED visits are almost exclusively driven by pain. In the absence of pain, most patients will make an appointment with their PCP (primary care physician) no matter what the problem. Unless there is significant bleeding. Bloody people nearly always come to the ED.

In short, if you do not like the patches because they cause allergic dermatitis, this is legitimate. If you mention your light headedness though, many doctors are going to consider lowering the dose of medication in the view that this is a sign of very mild overdose. Unless you want your medication dose reduced, avoid mention of minor problems that will sound like opioid intoxication.

Guess that is it. If you are direct with your doctor, ask for what you want and give good reasons for your request, you should do alright. If you act as if you have an appreciation of the doctor's reluctance to order strong opioids by evasively hinting that you want other pain killers than you have, alarms are going to go off. Normal patients ask for what they want without apology. Only so-called "addicts" act all mushy and ignorant of their wants. Perhaps the worst thing you can do to yourself is act vague and needy, prolonging the interview artificially until the doctor gets around in frustration to reciting names of various opioids until he mentions the one you really want. When this happens, nearly all doctors recognize this as the presentation of a hidden agenda for a specific drug. This makes for an uneasy physician.

DISCLAIMER: I m not suggesting any person act on the basis of the remarks I make above. I am not establishing or intending to establish a doctor-patient relationship by anything written above. I do not accept responsibility for any actions or outcomes by intervals or groups acting upon their understandings of my remarks.

[Inspektahdek]

Wow, I kinda fucked myself on this one. She told me to take something that she gave me before which worked for side effects like itching and as well as muscle spasms. The medicine started with an A and is a hypnotic, I forget the name but she told me to take that and continue the fent.

So on to how I fucked myself, I come in to pick up a refill, I was called be the nurse that morning that a refill was put in. I go and get my percocet which was lowered and now the fent is 25mcg, from 75mcg!!! What happened here? Is she starting to taper me from post op surgery? I had surgery at the end of January btw.


Agh!

[roxi*stardust]

Wow, I kinda fucked myself on this one. She told me to take something that she gave me before which worked for side effects like itching and as well as muscle spasms. The medicine started with an A and is a hypnotic, I forget the name but she told me to take that and continue the fent.

So on to how I fucked myself, I come in to pick up a refill, I was called be the nurse that morning that a refill was put in. I go and get my percocet which was lowered and now the fent is 25mcg, from 75mcg!!! What happened here? Is she starting to taper me from post op surgery? I had surgery at the end of January btw.


Agh!
About 6 weeks, that's all they give after surgery. Been there done that!! Sorry hun, next time expect much less

[Hammilton]

Well, if she didn't say anything, I dunno. It may be that they're tapering you, or that for some reason she now suspects you're a drug seeker, then again, she put you on Alprazolam, generic Xanax (I'm sure that's what you're Hypnotic begining with an A is), which is definitely a drug of abuse.

Same thing happened to me this week, and I have as much idea as you do. I'm just gonna taper off completely, though.

I figure I can life with the pain if I keep doing the excercises and try Lyrica some more.

[Curio]

Wow, I kinda fucked myself on this one. She told me to take something that she gave me before which worked for side effects like itching and as well as muscle spasms. The medicine started with an A and is a hypnotic, I forget the name but she told me to take that and continue the fent.

So on to how I fucked myself, I come in to pick up a refill, I was called be the nurse that morning that a refill was put in. I go and get my percocet which was lowered and now the fent is 25mcg, from 75mcg!!! What happened here? Is she starting to taper me from post op surgery? I had surgery at the end of January btw.


Agh!

was the drug atarax? aka hydroxyzine? it's often used to potentiate opiates and help alleviate the histamine reactions like itching...
You never filled the previous rx she gave you for the med?

[Hammilton]

ooh, I never thought of Atarax. Good one. Hypnotic and it'd get rid of the rashes.

probably had the dose dropped because of lightheadedness. That's a pretty big drop, though.

[roxi*stardust]

They will continue to taper you off those meds after surgery. Typically they will keep you on then for 6 weeks or so. Sometimes longer during physical therapy. The whole idea of surgery is the allevaite pain and the need for pain meds. This is why doctors push it so often. I would guess that when you need a refilll of those patches they will cut you back to Perc 10's or a low dose OC and continue to drop you down until physical therapy is over. For my elbow reconstruction I got Perc 10's for the first 3 weeks then Perc 5's, then Vicodin ES, then Vicodin 5, the Tylenol 3's then Ultram and Motrin. It happened just like that.

[Inspektahdek]

was the drug atarax? aka hydroxyzine? it's often used to potentiate opiates and help alleviate the histamine reactions like itching...
You never filled the previous rx she gave you for the med?

ah yes, thats the one, im also curious of her suspicion

[Inspektahdek]

They will continue to taper you off those meds after surgery. Typically they will keep you on then for 6 weeks or so. Sometimes longer during physical therapy. The whole idea of surgery is the allevaite pain and the need for pain meds. This is why doctors push it so often. I would guess that when you need a refilll of those patches they will cut you back to Perc 10's or a low dose OC and continue to drop you down until physical therapy is over. For my elbow reconstruction I got Perc 10's for the first 3 weeks then Perc 5's, then Vicodin ES,
then Vicodin 5, the Tylenol 3's then Ultram and Motrin. It happened just like that.

man thats shite

[jerets]

Screw surgery. Steroids, that's as far as they'll ever get me to go and I want those limited. I am not going to let me them make me worse and take my meds too! Hah...

Jerets

[Inspektahdek]

turns out my surgeon is just retarded and has no knowledge of giving me 75mcgs of fentanyl. hmm, i started on 50s, went to 75s and now to 25s but she said there were never any 75s even on the computer but i have this box next to me that says otherwise, what the fuck? pharmacy mistake? doubtful? I told her im bringing this shit in on the 2nd when i see her, god damn wtf conspirator bullshit i swear

[Inspektahdek]

why is it so hard for us to receive adequate care? fuck it


if you know how to spell your name and read all 26 pages of the ABC book, you must be a drug addict!

[bronyraur]

why is it so hard for us to receive adequate care?

the list is endless. I don't even know where to begin.:(

[Inspektahdek]

Wow, I kinda fucked myself on this one. She told me to take something that she gave me before which worked for side effects like itching and as well as muscle spasms. The medicine started with an A and is a hypnotic, I forget the name but she told me to take that and continue the fent.

So on to how I fucked myself, I come in to pick up a refill, I was called be the nurse that morning that a refill was put in. I go and get my percocet which was lowered and now the fent is 25mcg, from 75mcg!!! What happened here? Is she starting to taper me from post op surgery? I had surgery at the end of January btw.


Agh!


alrighty, here's the news on this shizzle

I called and she said she has no record of me being prescribed 75mcg patches. But I have an appt with her tomorrow and I'm bringing the fucking box with me with her name on it, this is absolute insanity u think this was a mess up or do you think shes just retarded/pharm problem? Anyhow, I'm currently on like I said 4 percs a day plus the patches (now 25mcg) what do u think I should say or what will be given to me upon my appt tomorrow which is the day my perc day supply runs out as well. Any info is greatly appreciated. Maybe she can up me back to 50mcg? That change from 75 to 25 fucked me pretty hardcore

anyhow,


out

[Inspektahdek]

About 6 weeks, that's all they give after surgery. Been there done that!! Sorry hun, next time expect much less


I guess I'm one of the rare fortunate ones, I just walked out with 50mcg patches and 120 more percocets? wtf