Duragesic Patch

Hello Friends:

You have been a godsend of resources to me for my husband (stage four nasopharyngeal - nasopharynx tumors, neck tumors both sides)

Week two has yeilded some pain for him.  So far, he is managing with Wygesic at night and 800mg ibuprofen during the day.

But he discussed this with the rad doc today and was given a Duragesic (fetanyl) patch.  I know pp have taken this successfully for pain mgmt.  I also know it has great potential side effects. They'll taper him off it when completed with treatment but I'm still concerned about withdrawl.

Any advice or experience with pain patches and their withdrawl would be appreciated.

Thank you as always for your words of wisdom. 

 

 

My radiologist started me on a 25mcg/hr patch.  When that wasn't enough he referred to a Pain Management Doctor. And I'm not talking about a strip mall methadone clinic. He was a God send. He kept upping my dose till it became effective. 

Along with the patch I had Oxycodone.  The combination of the two worked well. While I wasn't able to eat, I managed to swallow a little bit of water every day. It's VERY important to do that. I've retained 100% of my ability to swallow. 16 months post treatment and I can eat anything I want. 

Back to the point. The use of the Duragesic Patch is very common with cancer patients. I'd do it again in a heart beat. I read stories about how much people suffer and I don't get it. There's no reason for it. A good pain management doctor can control most of the pain that comes from radiation of the neck. The key is to find a good doc that will up the dose until you get to a level that works for you. At one point I was on 100mch/hr patch and 25mg/5 times a day of Oxycodone. Yes, that's a lot, but again, not uncommon. Check out the Oral Cancer Foundation's Web site at http://www.oralcancerfoundation.org You'll find lots of info and stories of people on more drugs than me :)

As hard as it is to believe, I never really felt like I was on drugs. Your body has a way of dealing with things. 

There is a down side, but I think it's worth it. Withdrawal. It can be ugly. You WILL become dependent on it, no way around it. One of the reasons I was on so much Oxy was that I built up a tolerance to the Fentanyl.

When it was time to get off the pain drugs, I was weaned slowly. It took about two months and was relatively painless. There were times I did suffer the classic heroin type withdraw symptoms. You learn not to be afraid of them and deal with it. A little Xanax helps :)

Another side effect is BAD constipation. I don't mean take a pill every now and then type constipation. I mean do everything you can and still struggle to go 3 times a week. It's one of the most talked about topics on pain boards. 

All that being said, if I have to go through this again, I'd try to use a little less, but my pain doc would be one of the first people I'd call.

Hope this helps,

Tom 

 

Hi Mediator,

My opinion when my husband was going through treatment was to give him whatever worked. The most critical thing for us when he was in  treatment was to finish his entire treatment plan without any delay or interuption to kill every last cell of cancer.

My hubbie was prescribed codine and then morphene. He took the codine all the way through and was off of all pain meds about 8 wks (maybe a little longer) after treatment ended.

 

Hi ThreePutt: 

Thank you so much for the history and guidance.

For now, he is managing with the 800 mg ibuprofen and 2 Wygesic at night.  We are filling the duragesic patch today in anticipation of a rough weekend. 

I'll ask about the pain mgmt doc today.  I doubt we have one available to us on our plan, in our area.  I do know that his rad doc plans on incrementally upping the dose as needed. 

It sounds like the withdrawl and constipation are worth the pain relieve from your perspective.  And, this is what I really needed to know.  We have Miralax in the house just in case and I know they have withdrawl programs at his treatment center.

So, I completely agree with you about not suffering.  Why?  I've told my husband there isn't a badge at the end, just more pain.  Right?

Thank you again for the information.  My best to you in continued recovery.

 

 

 

 

Hi again Julie:

Be sure to tell your husband that all he said would happen (taste and pain) has now begun!  He also said it is hard to believe it will "happen to me" but it does.

Thanks for the note on the pain meds.  I'm a huge believer in taking what you need to get thru.  But....getting thru to my husband on this is not going so well.  I know he'll come around though and give in as the pain increases.  I guess we all have our own timeframes.

Seems like your husband would agree with ThreePutt on the need for pain meds.  Plus, withdrawl hasn't sounded all the horrible as I thought.  I'll pass this on to my husband today. 

I received another suggestion about halfing the patches with tape.  Some people, when going thru withdrawl, make the process easier on themselves and go down 12.5 mg at a time vs 25 mg but taping part of the patches.  I thought this was rather clever.  I've made a note for the future.

Hope all is still well with your husband.  Please send my regards.

 

 

 

Need some advise.  I went through this same pattern with the Patch and Hydrocodone.

I am going on 2 years since diagnosed, 11 lymph node disection in the neck with tonsil SCC.

I have moderate, uncomfortable pain in the neck area still and especially the lower jaw where the radiaiton was directed.

All of the doctors, including the dentist don't want to give me any type of pain assistance. 

Should I just deal with it.  I don't want to be uncomfortable for the rest of what life I have, even though I'm so grateful to be here, very uncomfortable.

 Any help or suggestions.  Maybe this is just in my head!

God Bless

Patricia

 

Hi Mediator!

You're welcome - sorry i missed your call but Charles was glad to talk with you.

It's funny b/c in the begining of his treatment he would not take any pain meds - he didn't want to be out of it and I think he felt like he was giving up by taking medication.  Sure enough the pain got bad enough and he caved but it took a while for him to catch up - they say stay ahead of the pain and I wish he had.

 If you husband ever does want to talk, I know Charles would.

Best of luck :)

Wanted to add my 2cents here. I had the fetanyl patch after trying other, oral pain meds that all gave me sick, nauseaous, & vomiting times. Think my max was just 50mg's or however they measure. Worked wonderfully! That, and magic mouthwash was all I used for pain and I never suffered. My only problem with withdrawal, and that was 50 to 25 to none, was insomnia. For about 2+ wks and it was bad enough. Perhaps some depression & anxiety, too. Ativan helped alot. No constipation, tho. Gayle 

I've never heard of the tape trick. Depending on the type of patch, it should work.

But, what ever you do,

DO NOT CUT THE PATCH

That could/will release all the drugs at once and will kill you.

BTW, one manufacturer does make a 12.5 patch. I stepped down 12.5 at a time while weaning. 

Excellent information again.  They did inform us never to cut the patch.  Gotta make sure my husband was listening on that one.  Also didn't know about the lower dosages available.  Yahoo!