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butran vs fentenyl

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tamera View Drop Down
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    Posted: Feb/21/2011 at 8:49am
because of a stupid insurance thing, my doctor is trying to switch meds for me, but continue to keep me in control of pain. She has switched me to Butrans, middle dose, and expects to want to put me up.  I hate this so far. I know it takes three days to get in your system, but man the pain is horrid.  I have now been on a week and no noticable better symptoms, the pain is horrid. I stilll take loritab for breakthru. I am also having horrid exhaustion, and feeling depressed and that is new for me.  I am having stomach issues like feeling like I am going to throw up.  MY kids tease me that "Mom is gonna blow again" LOL.
Any suggestions. I have to call today or tomorrow, the doc.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Stevie Quote  Post ReplyReply Direct Link To This Post Posted: Feb/21/2011 at 9:31am
Hi Tamera and welcome,

First of all, what type of chronic pain are you being treated for as the choice of medication may be different for different problems.

You have been taken off Fentanyl and switched to Butran?  After 7 days, you should have noticed pain relief.  Here is my thinking---Fentanyl is used for severe pain.  Butrans for moderate, persistent pain.  The side effects that you mention such as  nausea and drowsiness may dissipate in time, but I would surely not take anything that is making me feel depressed.

So, honestly----no pain relief after 7 days and very bad side effects would be enough for me to tell her that this isn't working.  A higher dose , while possibly helping with pain control would seem to only increase the side effects.

I would definitely call and talk to her about your reactions to this.  Let me look into this further today, and in the meantime I am sure others will be here.  Take good care, Stevie

Please donate to help Chronicpainsite.com continue to help others.


The information and articles provided on our website are designed to support, not replace the relationship between patients and physicians.

Spinal Fusions L5-S1 and L4-L5. Recent changes now with diagnosis of Lumbar Stenosis with neurogenic claudication. To have multi-levl posterior fusion with laminectomy and decompression of L2-3 L3-4 and fusion and revision of L4-5 L5-1 with instrumentation. Cervical DDD, stenosis, spondylosis, spondylolisthesis and facet arthropathy throughout cervical spine from C3-C7. Thoracic Spine: dextroconvex curvature of the thoracic spine, centered at approximately T8.(Scoliosis with 20 degree curve). At T7-8, a disc bulge. Degenerative disc disease T7-T9. Disc dessication from T3-T11.


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Post Options Post Options   Thanks (0) Thanks(0)   Quote tamera Quote  Post ReplyReply Direct Link To This Post Posted: Feb/21/2011 at 9:59am
Spinal fusion, severe pain, leg pain, etc.  Etc...
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MVA spinal fusion surgeries, etc.. Severe nerve pain, and am on neurontin to help with that.  It is horrid.  this is not cutting it. I feel horrid.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Stevie Quote  Post ReplyReply Direct Link To This Post Posted: Feb/21/2011 at 11:16am
Tamera--

I needed to dig back through some other members posts, and also check on a few things before I responded further to you about the Butran patches.

We have several members here on Butran.  From the UK where it has been used for awhile for chronic pain.  Here in the States it is a fairly "newly" approved drug for the use of chronic pain.

We had one member have a severe reaction to it, and she can never take it again.  We have another member on it who is getting pain relief, but has had to have her dosage cut down and is battling severe drowsiness.  Another member is doing well on it.

Butran patches are Buprenorphine.  This narcotic (from what I am understanding) blocks the effects of other opioids through it's agonist/partial antagonist relationship with opioid receptors. It in essence kicks other opioids away.  IF I am interpreting this correctly, I would then question if your Lortabs are working.  If I were you, I would call my pharmacist and have a talk with him/her about Butran patches and if what I have said is possible.  I would also appreciate you letting us know anything that you find out.

As always, we are only here to provide general information, not medical advice, and so your Dr and Pharmacist are the ones to lead you in the right direction where this or any medication are concerned.

I am hoping that anyone else reading this who has any further information on Butran patches will also post.  But, in all honesty, after a week and being in so much pain with such lousy side effects,  I would be questioning the rationale for staying on this.  Best wishes, Stevie

Please donate to help Chronicpainsite.com continue to help others.


The information and articles provided on our website are designed to support, not replace the relationship between patients and physicians.

Spinal Fusions L5-S1 and L4-L5. Recent changes now with diagnosis of Lumbar Stenosis with neurogenic claudication. To have multi-levl posterior fusion with laminectomy and decompression of L2-3 L3-4 and fusion and revision of L4-5 L5-1 with instrumentation. Cervical DDD, stenosis, spondylosis, spondylolisthesis and facet arthropathy throughout cervical spine from C3-C7. Thoracic Spine: dextroconvex curvature of the thoracic spine, centered at approximately T8.(Scoliosis with 20 degree curve). At T7-8, a disc bulge. Degenerative disc disease T7-T9. Disc dessication from T3-T11.


NATIONAL SUICIDE HELPLINE 1-800-273-TALK (8255)
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Post Options Post Options   Thanks (0) Thanks(0)   Quote tamera Quote  Post ReplyReply Direct Link To This Post Posted: Feb/21/2011 at 11:21am
makes sense!
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Post Options Post Options   Thanks (0) Thanks(0)   Quote medic008 Quote  Post ReplyReply Direct Link To This Post Posted: Feb/21/2011 at 11:43am
Stevie and tamera,

You were right on the agonist/partial antagonist issue. In the hospital, when we have patients come in that are taking Suboxone/Subutex/BuTrans(all have buprenorphine in them). We need to give LARGE doses of fentanyl in order to override the buprenorphine. I'm talking 300-500mcg just to touch the pain. Just so some of you understand, that type of dose is what would be given to someone just out of MAJOR surgery, or someone that is VERY opiate tolerant.

As far as the side effects here is a list of common reactions:
  • Nausea
  • Headache
  • Dizziness
  • Constipation
  • Drowsiness
  • Vomiting
  • Dry mouth
  • Skin irritation at the patch site
Here is a list of serious reactions:
  • Potentially life-threatening breathing problems
  • Serious skin reactions and allergic reactions
  • Severely low blood pressure
  • Liver problems
  • Increased risk of seizures
  • Physical dependence
  • Addiction
So it seems that everything but the depression is know about. But that would be something that I would talk to your Dr about, as depression just leads to more pain.

Tyler


Left shoulder hemiplasty, needing a complete replacement.
Lower back problems still being sorted out.

I am a RN/EMT-P, any and all advice given is my opinion and not to be taken as medical advice. ALWAYS seek the guidance and expertise of your DR!
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Stevie Quote  Post ReplyReply Direct Link To This Post Posted: Feb/21/2011 at 11:57am
Tyler,

Thank you for supporting what I was able to come up with--and add to it so well.   As this drug was not being used here in the States when I was practicing, I am learning as more of our members are placed on it.  I really appreciate this information, Tyler.  Stevie



Please donate to help Chronicpainsite.com continue to help others.


The information and articles provided on our website are designed to support, not replace the relationship between patients and physicians.

Spinal Fusions L5-S1 and L4-L5. Recent changes now with diagnosis of Lumbar Stenosis with neurogenic claudication. To have multi-levl posterior fusion with laminectomy and decompression of L2-3 L3-4 and fusion and revision of L4-5 L5-1 with instrumentation. Cervical DDD, stenosis, spondylosis, spondylolisthesis and facet arthropathy throughout cervical spine from C3-C7. Thoracic Spine: dextroconvex curvature of the thoracic spine, centered at approximately T8.(Scoliosis with 20 degree curve). At T7-8, a disc bulge. Degenerative disc disease T7-T9. Disc dessication from T3-T11.


NATIONAL SUICIDE HELPLINE 1-800-273-TALK (8255)
http://www.crisisclinic.org/
IN THE UK 0845790 90 90
http://www.samaritans.org/
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Post Options Post Options   Thanks (0) Thanks(0)   Quote tamera Quote  Post ReplyReply Direct Link To This Post Posted: Feb/21/2011 at 1:14pm
Thanks so much. I stopped at the phamacy also and they said the doc really screwed up with me, and can take a week to get out of system. I stopped the butran TODAY.  My nausea is not as bad.  Still no appetite. Waiting on line now with the doc. 
I think this will go away, but
 
 
ok dc butran go back on fentenyl.
YEA, sort of wishing I could go off everything, but no a possiblity. Docs office says to go to DR> OZ and see if he can help> LOL>  Pain management again, I guess, once insurance is straight!
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Stevie Quote  Post ReplyReply Direct Link To This Post Posted: Feb/21/2011 at 1:34pm
Tamera,

Good job.  Hopefully each day will get better for you as the med gets out of your system.

I hope that you will hang around and we can get to know you better, and hopefully help you with ways to deal with your pain. All of us here try lots of alternative methods, and learn from one and support one another.  So, again welcome and when you feel up to it check out the other forums and Articles Section, etc.  Stevie

Please donate to help Chronicpainsite.com continue to help others.


The information and articles provided on our website are designed to support, not replace the relationship between patients and physicians.

Spinal Fusions L5-S1 and L4-L5. Recent changes now with diagnosis of Lumbar Stenosis with neurogenic claudication. To have multi-levl posterior fusion with laminectomy and decompression of L2-3 L3-4 and fusion and revision of L4-5 L5-1 with instrumentation. Cervical DDD, stenosis, spondylosis, spondylolisthesis and facet arthropathy throughout cervical spine from C3-C7. Thoracic Spine: dextroconvex curvature of the thoracic spine, centered at approximately T8.(Scoliosis with 20 degree curve). At T7-8, a disc bulge. Degenerative disc disease T7-T9. Disc dessication from T3-T11.


NATIONAL SUICIDE HELPLINE 1-800-273-TALK (8255)
http://www.crisisclinic.org/
IN THE UK 0845790 90 90
http://www.samaritans.org/
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Post Options Post Options   Thanks (0) Thanks(0)   Quote tamera Quote  Post ReplyReply Direct Link To This Post Posted: Feb/21/2011 at 1:43pm
Thanks, so much. What a stupid waste for me and the kids.  I homeschool. So the kids suffer when I have days/weeks such as this.
As far as the depression. I was not bad. I think more discouraged, as you feel helplesss.
Wierd that the docs office would recommend doctor Oz. to me though!
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Post Options Post Options   Thanks (0) Thanks(0)   Quote tamera Quote  Post ReplyReply Direct Link To This Post Posted: Feb/21/2011 at 1:46pm
I thot all this wierd as I go off the fentenyl once and a while, due to messing up the patches, etc. I do not go thru what I did this weekend EVER.  I just do not ever want to sound to the doc like a druggy! Wierd, but you have to think that and they have to be suspicious.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote paingame Quote  Post ReplyReply Direct Link To This Post Posted: Feb/22/2011 at 4:38pm
hi tamara,  i hear what you are saying. my gp has me on the 10mg butrans patches and i think that they are useless, they dont even take the edge of the pain at all for me.  so im just going to go back to him and let him know - my doc is really lovley and does really want to help me, so i hope your doc has the same attitude. if you decide to go back to your doc, let me know how you have gotten on.
good luck and sincere wishesSmileLOLOuch
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Post Options Post Options   Thanks (0) Thanks(0)   Quote tamera Quote  Post ReplyReply Direct Link To This Post Posted: Feb/22/2011 at 5:53pm
Thanks. I am going back on the old meds.  We only switched due to insurance issues.  My doc apologized profusely, as did the pharmacist for not catching, that the two would cause problems.  YIKES>  They blame it on pharm reps and being a brand new med in the states.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Quaver Quote  Post ReplyReply Direct Link To This Post Posted: Feb/23/2011 at 3:44am
Dear All,

I have been on Butrans patches for about 18 months (I am in the UK) I am now on 30 micrograms. They usually work well for me. I have oxynorm 10 mg for breakthrough. I take one almost every day and rarely two. I have yet to try fentanyl. The only reaction I have apart from the constipation which I get from all pain meds, is a local skin irritation. To combat this I take an antihistamine every day. I was more than usually off with the fairies in the early days of treatment but that has settled. I still feel that I am in a bit of a daze but I have Hashimoto's and fibromyalgia too so who knows what to blame that on!

Hope this helps and good luck!

Quaver
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Severe back pain since 1997. Lumbar Spinal Stenosis, Scoliosis, DDD. Hashimoto's syndrome, Depression, High Blood pressure, Fibromyalgia, Raynaud's Syndrome. Severe chronic pain in lower back, hips and knees. Osteoarthritis in spine, wrists and hands. Golfer's Elbow. Facet and Sacroiliac injections Dec. 2007, aggravated entire spinal column. L4-L5 L5-S1 spinal fusion plus cage support and titanium spacers April 2008. Facet and Sacroiliac Injections May 2009 allergic to injection medium. Radio frequency June 2009 aggravated entire spinal column. Undetected fracture in L2, Nov 2010, caused L bend in spine more pain. Bilateral trochanteric bursitis. Mobility diminishing now wheelchair user.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Stevie Quote  Post ReplyReply Direct Link To This Post Posted: Feb/23/2011 at 7:25am
Thanks Quaver,

We are learning a lot about Butran recently as it is fairly new here in the States.  It is really good to be informed about all medications and especially the new ones--------and in the case of Butran for people to understand how it works in relationship to other opioids.  Your input is appreciated as with any medication we all react differently, and this does seem to be working well for you.  Hugs, Stevie

Please donate to help Chronicpainsite.com continue to help others.


The information and articles provided on our website are designed to support, not replace the relationship between patients and physicians.

Spinal Fusions L5-S1 and L4-L5. Recent changes now with diagnosis of Lumbar Stenosis with neurogenic claudication. To have multi-levl posterior fusion with laminectomy and decompression of L2-3 L3-4 and fusion and revision of L4-5 L5-1 with instrumentation. Cervical DDD, stenosis, spondylosis, spondylolisthesis and facet arthropathy throughout cervical spine from C3-C7. Thoracic Spine: dextroconvex curvature of the thoracic spine, centered at approximately T8.(Scoliosis with 20 degree curve). At T7-8, a disc bulge. Degenerative disc disease T7-T9. Disc dessication from T3-T11.


NATIONAL SUICIDE HELPLINE 1-800-273-TALK (8255)
http://www.crisisclinic.org/
IN THE UK 0845790 90 90
http://www.samaritans.org/
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Stacey Quote  Post ReplyReply Direct Link To This Post Posted: Mar/02/2011 at 8:43pm
I read somewhere, and can't for the life of me find the source again, that just stopping the fentanyl and going straight to the butrans is just like detoxing. It's not one just replacing the other. So that would cause all of the symptoms that you had, including the depression. I am so happy that your doctor got you back to what helped you. 
"Pick battles big enough to matter, small enough to win."    -    Jonathan Kozol



DDD, 2 herniated discs one cervical, one thoracic. Periphial neuropathy. Fibromyalgia as of 12/12
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Post Options Post Options   Thanks (0) Thanks(0)   Quote sara1 Quote  Post ReplyReply Direct Link To This Post Posted: Mar/03/2011 at 5:15pm
Tamera-That Butrans patch has me concerned my Dr. wanted me to try it also but I see way too many problems with this med and hear it was used to take people off narcotics entirely but maybe it may be useful to some. I'm glad you're back to normal with the Fentanyl and so nice you're Dr. apologized. Now that's a caring Dr.. and rare to see. Sara
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HI,
I am so glad I found this website. I have been suffering from Burning Mouth Syndrome for almost 4 years now and tried many types of medication to overcome the pain. I was put on Butrans patch 5mg about 6 days ago. The side effects are horrid, I have a lot of dizziness and pain, I do have oxycodone 10mg for breakthrough pain and realised that the Oxy wasn't helping at all with the pain, which is not normal. After reading some of the posts on here, I realised the the Butrans is blocking the Oxy from working, I don't understand why the doctor wouldn't tell me this. I am really upset, he gave me the patch and didn't refill my Oxy and he told me that I would be fine when it comes to withdrawals, well let me tell you, I was in W/D for almost 48 hours and after I broke down crying, I got myself to the clinic and got a prescription for Oxy IR10mg and let me tell you that I feel much better now. I just don't get why he would do this, I usually take OxyIR 10mg twice every 4 hours. You can't just take someone off of Pain medication and replace it with another just like that, it doesn't work, I have never felt so bad in my life.
 
I hate the Butrans, it's not doing anything other than making me feel really drowsy. I was coming down the stairs with my baby in my arms and all the sudden I got dizzy and I missed a step and fell down 6 steps with my baby in my arms, can you imagine if something were to happen to her? It's all from the side effects of the patch. Plus on top of it, I don't feel the relief from the OXY. I am so upset.
 
If I remove the patch, how long does it take for the Butrans to get out of my system? I don't intend on going through with the patch and I have an appointment with my pain doctor in 2 hours and I will certainly let him know what happened and how I feel.
 
Again, I wanted to say Hi! to everyone! and thanks for letting me vent!! :o)
Mama to a beautiful baby girl.
I have been suffering from Burning Mouth Syndrome for 4 years, trying everyday to find a cure.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Stevie Quote  Post ReplyReply Direct Link To This Post Posted: Apr/20/2011 at 3:55pm
Hi Alexa's Mom and welcome here:))

Unfortunately, I hate it that you are here under these circumstances, and also that you are having such horrible side effects from the Butran patches.  We do have some members who have been able to tolerate them, but many who cannot.

I don't know why more Dr's do not explain that Butran will block the effects of other narcotics.  Maybe they don't understand it themselves.  Butrans has a long half life and I would ask your pharmacist how long it will take to be completely eliminated.  Also, you will need help in switching back onto the Oxy IR.

Please let us know how you make out at the PM Dr today.  You may also wish to start a new thread about yourself and what burning mouth syndrome is for members who are not familiar with that (it sounds horribly painful).  Maybe in the Other Chronic Pain Issues Forum:http://chronicpainsite.com/mb/forum_topics.asp?FID=28&title=other-chronic-pain-issues

Again, welcome and Alexa is just beautiful.  I am so glad that the two of you survived that fall down the stairs, and really hope that you will be feeling better soon.  Best wishes, Stevie

Please donate to help Chronicpainsite.com continue to help others.


The information and articles provided on our website are designed to support, not replace the relationship between patients and physicians.

Spinal Fusions L5-S1 and L4-L5. Recent changes now with diagnosis of Lumbar Stenosis with neurogenic claudication. To have multi-levl posterior fusion with laminectomy and decompression of L2-3 L3-4 and fusion and revision of L4-5 L5-1 with instrumentation. Cervical DDD, stenosis, spondylosis, spondylolisthesis and facet arthropathy throughout cervical spine from C3-C7. Thoracic Spine: dextroconvex curvature of the thoracic spine, centered at approximately T8.(Scoliosis with 20 degree curve). At T7-8, a disc bulge. Degenerative disc disease T7-T9. Disc dessication from T3-T11.


NATIONAL SUICIDE HELPLINE 1-800-273-TALK (8255)
http://www.crisisclinic.org/
IN THE UK 0845790 90 90
http://www.samaritans.org/
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Hi Stevie,
Thanks for your beautiful message!
 
I did speak to my PM doctor today and told him how the OxyIR was reacting with the BUtrans, he gave me the look like really??? I know he's smart and he knows what I am talking about. I just think it's funny that doctors sometimes think we just take any medication without researching what is being given to us.
 
Melanie
Mama to a beautiful baby girl.
I have been suffering from Burning Mouth Syndrome for 4 years, trying everyday to find a cure.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Edie Quote  Post ReplyReply Direct Link To This Post Posted: Apr/20/2011 at 9:24pm
Hi MamatoAlexa,
Welcome to CPS!
 
You have a beautiful baby and Alexa is a beautiful name.
 
I am sorry you had to go trough so much pain and W/D because your doctor decided to stop the Oxy and put you on Butrans just like that. I don't know how he expected you not to get any withdrawals after you've been on the medication for some time. May be he believed that since you would be getting some pain medication, on a lighter dose, from the patch would be the same as weaning out of the Oxy a little at a time.
 
If you are not happy with this medication, you have all the right to have it changed to something else that works better. I would be a good idea to call your doctor and tell him what's going on, and at the same time ask him if you can remove that patch, and all the other question you have about it. You may want to write a list of the things you want to ask.
 
Hope things went well with the pm doctor. Is he the same one that put you on the Patch?
 
I hope you keep us posted, and let us know how you are doing...Edie
 
Chronic pain throughout the spine caused by osteoarthritis (DDD). Started at neck, spread to thoracic, and lately to lumbar area. Most of my spine is affected by bulges, disc height loss and dehydration, bone spurs, annular tears, foraminal stenosis, probable nerve impingement, and degeneration at end plates and facets.

The disease extends from Cervical C2-3 to C7-T1. Thoracic T4 to T10.
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That is unbelievable what your Dr did. Buprenorphine(active ingriedent in BuTrans) is a partial agonist, as well as an antagonist. Basically it has a higher affinity to the mu receptors in your brain, the bupe binds to those receptors much better than oxycodone. When that happens, as in your case without stopping the oxy and going into semi withdrawal, you went into what is called precipitated withdrawal, the bupe kicked all of the oxy off and your body reacted to that displeasure in a horrible way.

B ofecause the long half life of buprenorphine, it will take anywhere from 18-72 hours to completely leave your system. But the good part here, is that you can take the oxy with the bupe in your system. It may take a bit more of the oxy to work for that time frame, but rest assured, it will leave.

I youf have any other questions, feel free to ask!

Tyler
Left shoulder hemiplasty, needing a complete replacement.
Lower back problems still being sorted out.

I am a RN/EMT-P, any and all advice given is my opinion and not to be taken as medical advice. ALWAYS seek the guidance and expertise of your DR!
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Thanks a lot Tyler for the explanation, it is very clear now.
I think my doctor knew exactly what he was doing, he is very smart, when I met him yesterday, I pretended like I didn't know anything and let him do the talk. Nowadays, doctors have to be careful of what they do, because of the Internet patients educate themselves a lot. Oh my, the withdrawals were awful, I tell ya. I had never experienced something like that and to top it off, I had to care for Alexa, I swear I felt like the worst mother of all.
 
See he still wants me to wear the patch, I won't, but because we have a new relationship, I don't want to go against what he is saying. I am really afraid that of I wear the patch and my body really gets used to it, than how hard is it gonna be to get off of it? Harder than the oxy? I hated what I felt with being off the oxy and I am afraid of what's gonna happened once he decides that I don't need the patch anymore. If it's anything like Effexor withdrawals, than I am screwed.. Know what I mean? This stuff is no joke, it gets into your body, brain and it's really hard to stop it. At least with the Oxy IR I have control, I decide if I need more or less and can taper myself off of it slowly, because of it's short acting life I think it is easier then a extended release medication, I am no doctor, but please correct me if I am wrong.
 
Edie, thanks for your kind words. Alexa means the world to me, my pregnancy was so hard with the pain, medication and so on, I am nervous the whole time. She turned out to be a little miracle and everyday he smiling to me makes me forget about the negative in my life. As for your question, yes he is the same doctor.
 
 I just started seeing him, I was on a waiting list for 18 months and I finally got into PM. I am so afraid to screw it up so the last thing I want to do is argue with him. I am at a stage where it's still very fragile and I have to really be careful of what I say to him. I went through a lot of posts on this site and from what I see, I guess I have to be careful of what I say or else I can get kicked out pretty easily. I am so new in PM, I don't really know how to act and at the same time I don't want him to know that I am also knowledgeable about medication, doctors don't like that.
What do you think Edie?
 
Thanks for all of your kind responses!
Melanie
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I have been suffering from Burning Mouth Syndrome for 4 years, trying everyday to find a cure.
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Melanie,

Let me see if I understand----your PM Dr. wants you to stay on the patch, but you don't want to. Have you taken it off, or are you still wearing it?

In the US, Butrans was just recently approved by the FDA for use for chronic pain, and honestly, I don't think that every prescribing Dr. understands the problems associated with Butran and it's effects with other narcotics.  I am sure that you have read what Tyler has written about the incredibly high doses of opioids that they have to give people who come into the ER to override the effects of Buphenorphrine. 

If you stop the Butrans, as Tyler explained, you will be able to take the Oxy IR (although you may need more of it until the Butrans is completely eliminated from your system).

I would not hesitate to tell your PM Dr. that you are not doing well on this.  That you fell down the stairs carrying your baby, and that you must be able to take a pain medication that allows you to function.  I too take Oxycodone (IR), and feel the way you do---take the meds only when needed.  I don't think that you will get into trouble with your Dr. as long as you don't make unwarranted demands for a medication.  You have the right to have your pain controlled and to take a medication that works for you and that is safe and effective.  I understand your concerns as you are forming a relationship with him, but it must work both ways.

I do hope that you can come to an understanding with him, and get back on your Oxy IR.  I am unsure who was prescribing for you prior to going to the PM Dr, but if this doesn't work with him, can you go back to the other Dr?  Hugs, Stevie

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Spinal Fusions L5-S1 and L4-L5. Recent changes now with diagnosis of Lumbar Stenosis with neurogenic claudication. To have multi-levl posterior fusion with laminectomy and decompression of L2-3 L3-4 and fusion and revision of L4-5 L5-1 with instrumentation. Cervical DDD, stenosis, spondylosis, spondylolisthesis and facet arthropathy throughout cervical spine from C3-C7. Thoracic Spine: dextroconvex curvature of the thoracic spine, centered at approximately T8.(Scoliosis with 20 degree curve). At T7-8, a disc bulge. Degenerative disc disease T7-T9. Disc dessication from T3-T11.


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Stevie,
 
I have been on Oxy IR for 4 years, prior to that my family doctor was prescribing the medication for me, but since I got into PM about 3 weeks ago, I sign the rights over to my PM doctor for any narcotic prescription, which I am very OK with. I understand they don't want people doing double doctrine, which I didn't intent to do anyways. I never had problems to get my meds since I am backed up with a bunch of medical tests results, papers and so on. My PM doctor did still prescribed me my Oxy IR on top of the patch. I told him about the incident with the baby, but he said it could have been related to the withdrawals also, but in my heart I know it's the side effects from the patch.
 
He had no problems prescribing me the Oxy and the patch, what I don't understand, when I told him the I felt like the Oxy IR wasn't working anymore since I had been taken the patch, he looked at me like what I was saying was all the sudden Alien Talk. Know what I mean? It's almost like I didn't make sense to him. After talking to you guys and researching, I realise that the Bu trans has a huge effect on other Opiates. So what's the point of taking a pain medication for break through pain when it doesn't work? I have removed the patch a little more then 24 hours ago and I can now feel the effect of the Oxy IR again. I knew it had something to do with the Bu trans, I am not stupid, I know my body and plus I have been taking the Oxy IR for so long, if all the sudden it doesn't work anymore, I will know.
 
I used the Bu trans only for 5 days, I didn't see any change in my pain, it was actually worst then it had ever been in a while. Plus the side effects were horrid. I will probably give it a try again, but I am so scared of the outcome, what if I want to stop again, how hard will it be?
 
Stevie, don't worry, I will definitely approach my PM doctor and let him know how it makes me feel and all that. I will keep you guys updated. Smile
 
 
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I am running out the door right now, but I can answer your questions in a little bit when I get back.
Tyler
Left shoulder hemiplasty, needing a complete replacement.
Lower back problems still being sorted out.

I am a RN/EMT-P, any and all advice given is my opinion and not to be taken as medical advice. ALWAYS seek the guidance and expertise of your DR!
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Edie Quote  Post ReplyReply Direct Link To This Post Posted: Apr/21/2011 at 7:50pm
MamatoAlexa,
 
Extended release Opioids are the type of medications indicated for the management of chronic pain. Doctors usually want to start their chronic pain pts on them. Though these medications work fine for some people, they don't always work for everybody. At the beginning, my doctor started me on them, but after trying just about everything he had of that kind, we found out that they all made me sick. Reluctantly, he put me on Morphine Sulfate IR which was the only thing I tried that didn't make me too sick. I've been on it for around 3 years now.
 
I can understand that you don't want to loose your relationship with your new pm doctor, but be aware, that sometimes you have to try many different things before you can find the medication, or a combination of medications that will work for you. This may take some time, and your doctor really should be willing to work these things out with you. Do I understand that he put you back on the Oxy IR? If so, then that sounds like a good start.
 
Take care...Edie
Chronic pain throughout the spine caused by osteoarthritis (DDD). Started at neck, spread to thoracic, and lately to lumbar area. Most of my spine is affected by bulges, disc height loss and dehydration, bone spurs, annular tears, foraminal stenosis, probable nerve impingement, and degeneration at end plates and facets.

The disease extends from Cervical C2-3 to C7-T1. Thoracic T4 to T10.
Lumbar T12-L1 to L5-S1.
It is all non operable.

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Edie,
 
Yes we decided to keep the Oxy IR because I was withdrawing so bad even with the Bu trans, there was no way I could just go cold turkey on them.
 
Melanie
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I have been suffering from Burning Mouth Syndrome for 4 years, trying everyday to find a cure.
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Hey mama,

Just to try and answer a few questions for you and to provide a bit more insight into the BuTrans patches. Buprenorphine is approximately 50-100 times stronger than morphine when delivered in mcg(micro grams) like the patch you were prescribed. So that may be why you were feeling so out of it when you first started. I see you were rx'd the smallest patch they make. I can assure you that if you give your body a chance to adjust to the BuTrans, the oxy IR will work in conjunction with the patch. The buprenorphine will attach tightly to most of your mu-receptors, but not all of them. The open receptors will still accept the oxy. You may not get that "feeling"that you are used to, but the pain reduction should still be present. If that doesn't happen, you may need an increase in the oxyIR. The nice thing about BuTrans is it would provide 24 hour pain control, once you are adjusted to it. If you decide to try the patch again, this is what I would suggest,(remember, I am not a dr so please check with your dr before you take any advice from anyone over the internet). I would stop taking the oxyIR for 24 hours. You will start to feel the beginnings of withdrawal symptoms. I would then apply the patch, wait another 8-12 hours then start the oxyIR again. The BuTrans will take about 3 days to reach steady state plasma levels. When your body is getting the full effects of the patch. This way you won't go into full blown withdrawls like your first experience.

, Now on to getting off of the BuTrans. From what I understand, and from my experience taking Suboxone (same active medication) The withdrawl from buprenorphine is VERY minimal compared to any opiate. Because if the way buprenorphine acts on the receptors in the brain, it actually stimulates 3 different receptors. One of them being the kappa receptor, that receptor helps control your mood and feelings. Therefore, when stopping the BuTrans, the body experiences very minimal withdrawl symptoms. But as with all medications, everyone reacts differently. Just something else to ask you dr.

Good luck, and again if you have any more questions feel free to ask away!

Tyler
Left shoulder hemiplasty, needing a complete replacement.
Lower back problems still being sorted out.

I am a RN/EMT-P, any and all advice given is my opinion and not to be taken as medical advice. ALWAYS seek the guidance and expertise of your DR!
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Stevie Quote  Post ReplyReply Direct Link To This Post Posted: Apr/22/2011 at 9:52am
Tyler--

As always.  Thank you for your detailed and very informative post.  You are the bestClap  Stevie

Please donate to help Chronicpainsite.com continue to help others.


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Spinal Fusions L5-S1 and L4-L5. Recent changes now with diagnosis of Lumbar Stenosis with neurogenic claudication. To have multi-levl posterior fusion with laminectomy and decompression of L2-3 L3-4 and fusion and revision of L4-5 L5-1 with instrumentation. Cervical DDD, stenosis, spondylosis, spondylolisthesis and facet arthropathy throughout cervical spine from C3-C7. Thoracic Spine: dextroconvex curvature of the thoracic spine, centered at approximately T8.(Scoliosis with 20 degree curve). At T7-8, a disc bulge. Degenerative disc disease T7-T9. Disc dessication from T3-T11.


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Thanks Stevie! As you know, I enjoy helping people understand the medications they are taking. Isn't that part of being a nurse? :-) I really enjoy pharmacotherapy, so much so that I really am thinking of applying to the nurse anesthetist program when I am eligible. I am torn between that program and the NP program. I have a feeling that they will both be in HIGH demand in the next 5-10 years. That way it would cut down on my heavy lifting on the floor, and possibly prolong my career!

Tyler
Left shoulder hemiplasty, needing a complete replacement.
Lower back problems still being sorted out.

I am a RN/EMT-P, any and all advice given is my opinion and not to be taken as medical advice. ALWAYS seek the guidance and expertise of your DR!
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Stevie Quote  Post ReplyReply Direct Link To This Post Posted: Apr/22/2011 at 10:17am
Tyler--

Either NP or NA would be perfect.  I basically did the same thing after my first fusion when I couldn't work as an RN any longer--but went the PA route.  Nice thing about NP/NA is that you work under your own license rather than a supervising physician (which is what a PA must do).  Anyhow, I am completely off track now in this thread, but want to encourage you to go for it----I was 39 when I went back to school, and have never regretted the decision.  Stevie

Please donate to help Chronicpainsite.com continue to help others.


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Spinal Fusions L5-S1 and L4-L5. Recent changes now with diagnosis of Lumbar Stenosis with neurogenic claudication. To have multi-levl posterior fusion with laminectomy and decompression of L2-3 L3-4 and fusion and revision of L4-5 L5-1 with instrumentation. Cervical DDD, stenosis, spondylosis, spondylolisthesis and facet arthropathy throughout cervical spine from C3-C7. Thoracic Spine: dextroconvex curvature of the thoracic spine, centered at approximately T8.(Scoliosis with 20 degree curve). At T7-8, a disc bulge. Degenerative disc disease T7-T9. Disc dessication from T3-T11.


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Tyler,
 
Thank you so much for all the info. I will definitely try what you said about applying the patch. If it doesn't work and I am in full blown withdrawals, than I can just take my Oxy IR again. The way you explained it makes it so much more easier to understand. I will keep you guys updated on my situation. I am suppose to get more patch on Tuesday, I plan on putting it again as soon as I get them. My concern was really the effectiveness of the Oxy Ir, I am used to the way it's working and the first week I put on the patch, the Oxy wasn't doing it's job. I will try your way and see what happens. Thanks a lot. :o)
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I have been suffering from Burning Mouth Syndrome for 4 years, trying everyday to find a cure.
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Thanks for the kind words. But please make sure that the way I described is O.K. With your Dr. I am just a nurse(and a relatively new one at that), and really, you never want to take advice over the internet. I wouldn't want someone to get hurt because I made a mistake.

Thanks,

Tyler
Left shoulder hemiplasty, needing a complete replacement.
Lower back problems still being sorted out.

I am a RN/EMT-P, any and all advice given is my opinion and not to be taken as medical advice. ALWAYS seek the guidance and expertise of your DR!
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Tyler, no worries!
Smile
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I have been suffering from Burning Mouth Syndrome for 4 years, trying everyday to find a cure.
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I am not a big fan of BuTrans for pain, but know some get great relief from it.  I don't feel like the US docs have a strong enough grasp on it, which scares me - my pain doc may understand it well, but the pain specialists at the hospital system where I just had surgery are not using it and don't get it.  And that's a recipe for disaster!

For example, I went into the hospital on a Butrans patch, and had many medication complications due to it while in there - they had to put me on a Dilaudid pump while I waited for surgery plus extended release Morphine and Percocet.  After surgery, they added IV Fentanyl and Actiq (Fentanyl lollies - gross).  It was a mess and they almost killed me 2x by making me try to swallow Kadian, which instead dissolved in my throat...

I just had my first post-op appointment with my regular pain doc, who wasn't involved in my surgery and didn't know about it for some weird reason, and he felt so bad that my pain management had gone so poorly.  He put me on a Fentanyl patch with Morphine IR for BT pain - all I can say is thank the heavens for small favors.  Never been on a Fentanyl patch, and hope I don't need to stay on it forever - but I am pleased so far!

No more Butrans for me, unless part of a weaning process.  I see the value of it for detox and rehab - and understand it's helping a lot of people for chronic pain.  Just not this girl!
You can't judge pain by a person's appearance, but if you pay closer attention - it's all there to see!

NEW as of May 2011 - Anterior Revision C5-6 AND Posterior Corpectomy of C4-7 with plastic cage (8-9 hr surgery)

2 ACDF surgeries with Titanium Plate/Screws: 2005 C6-7 (fused); 2008 C5-6 (non-union, broken screws & loose plate)

Herniations: L4-5 (congenital stenosis), T12

Post-Herpetic Neuralgia for 12 years...

Kidney Stones (approx every 5 years), Biliary disease (gallbladder removed)

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Post Options Post Options   Thanks (0) Thanks(0)   Quote Stevie Quote  Post ReplyReply Direct Link To This Post Posted: Jun/18/2011 at 3:26pm
Prettypain,

Your story is unfortunately not uncommon.  Butrans has only recently been approved for use of chronic pain in the States, and you are correct----too many physicians do not understand the ramifications of treating someone following surgery or an accident who is on the patch.

Our member, Medic knows a lot about it having worked ER, and can tell you that people on Butrans he has treated and need further opioids for pain control are given very large doses.

I hope that the Fentanyl will work well for you.   Do let us know.  Best wishes, Stevie

Please donate to help Chronicpainsite.com continue to help others.


The information and articles provided on our website are designed to support, not replace the relationship between patients and physicians.

Spinal Fusions L5-S1 and L4-L5. Recent changes now with diagnosis of Lumbar Stenosis with neurogenic claudication. To have multi-levl posterior fusion with laminectomy and decompression of L2-3 L3-4 and fusion and revision of L4-5 L5-1 with instrumentation. Cervical DDD, stenosis, spondylosis, spondylolisthesis and facet arthropathy throughout cervical spine from C3-C7. Thoracic Spine: dextroconvex curvature of the thoracic spine, centered at approximately T8.(Scoliosis with 20 degree curve). At T7-8, a disc bulge. Degenerative disc disease T7-T9. Disc dessication from T3-T11.


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I haven't had time to read through all the posts here (I'm new here, and have just had time to register), but I wanted to mention that suddenly (within the last couple of weeks) my oxygen level had gone from 85% to 96 or 97% on room air. The only change in my lifestyle has been the change from Fentanyl (I cannot remember the dosage, but I have it on file somewhere) to BuTrans (10mcg), and am no longer needing any breakthrough pain medication (I had been taking Hydromorphone or Extra Strength Tylenol).
Even more related to this post, I got used to the new patch overnight. I changed to the new med, then four hours later, started developing withdrawal symptoms, took 2 extra strength Tylenol, and then 4 hours later it was bedtime. Expecting that I may need more breakthrough during the night, I took 2 more extra strength Tylenol and after that gradually decreased the amount of Hydrmorphone I had to take for breakthrough.
The only thing I dislike about the BuTrans is that the adhesive leaves that sticky stuff behind and I have to remove it by adhesive remover pads once a week.
So BuTrans is not bad for everyone!
~~
It's Auntie Dee
had Osteogenesis Imperfecta since birth, 5 years ago had surgery to correct Basilar Invagination and have had chronic pain and oxygen issues ever since
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Stevie Quote  Post ReplyReply Direct Link To This Post Posted: Jul/13/2011 at 4:57pm
Welcome Auntie D

Thank you so much for sharing your experience with Butrans. I was especially impressed with how it affects your blood oxygen levels as we know that narcotics are respiratory depressants. It is interesting to know that Butrans hasn't had that effect on you.

We do have members here who do well on it. As it is newly approved in the States, we can learn more from our Canadian and UK members.   It really is not well understood by enough of the medical community---especially when surgery and/or ER treatment may be needed.

As we all know we all react differently to medications and are very glad to hear positive results.

Again welcome to our site and we look forward to getting to know you better. Stevie

Please donate to help Chronicpainsite.com continue to help others.


The information and articles provided on our website are designed to support, not replace the relationship between patients and physicians.

Spinal Fusions L5-S1 and L4-L5. Recent changes now with diagnosis of Lumbar Stenosis with neurogenic claudication. To have multi-levl posterior fusion with laminectomy and decompression of L2-3 L3-4 and fusion and revision of L4-5 L5-1 with instrumentation. Cervical DDD, stenosis, spondylosis, spondylolisthesis and facet arthropathy throughout cervical spine from C3-C7. Thoracic Spine: dextroconvex curvature of the thoracic spine, centered at approximately T8.(Scoliosis with 20 degree curve). At T7-8, a disc bulge. Degenerative disc disease T7-T9. Disc dessication from T3-T11.


NATIONAL SUICIDE HELPLINE 1-800-273-TALK (8255)
http://www.crisisclinic.org/
IN THE UK 0845790 90 90
http://www.samaritans.org/
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Thanks so much for the welcome, Steve.

My GP had told me that BuTrans was relatively new to Canada as well. He is a pain specialist, but also a GP, and I believe I am one of his few patients on pain management and certainly the only one he has prescribed BuTrans.

~~
It's Auntie Dee
had Osteogenesis Imperfecta since birth, 5 years ago had surgery to correct Basilar Invagination and have had chronic pain and oxygen issues ever since
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Post Options Post Options   Thanks (0) Thanks(0)   Quote MamatoAlexa Quote  Post ReplyReply Direct Link To This Post Posted: Jul/13/2011 at 9:15pm
A little update on my Bu Trans situation.
 
So I am totally off the Butrans, it gave little to no relief and it made me feel like crap. I suspect that my doctor is a big fan of Butrans because he gets a cut from the rep. After talking to the pharmacist, he told me that all of his patients were on Butrans. So, I guess my suspicions were right.
 
So after being off the Bu Trans, he puts me on Nucynta, another new controlled release pain medication that is new to Canada. Again, no relief and all it does is built up in my system and I have to take more IR pain meds to get the relief, so I am not in a better place. I decided to just stop all the controlled release medications and just stick with my OxyIR. So far, I am trying to get my system clean up from the other medications I have taken, since I have taken those my system has built up such a huge tolerance to IR medication, it's unbelievable. I almost have to take double what I take in Oxy IR compared to what I  used to take to feel any relief.
 
I just want to warn people about that. I explained it to a doctor that I see and he confirmed to me that this is what happens. The controlled release medication I was taking, well what it does in your body is that it builds up and when you want to take just your regular (for example) OxyIR, well because you already have the other opioid in your system, you have to take more of the IR medication to feel something. It's just a matter of science, how it works in your system. It's hard to explain, but I hope I make sense to anyone.
 
I am seeing my doc soon, I will keep you guys updated on the new plan.
Melanie
Mama to a beautiful baby girl.
I have been suffering from Burning Mouth Syndrome for 4 years, trying everyday to find a cure.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Edie Quote  Post ReplyReply Direct Link To This Post Posted: Jul/13/2011 at 10:43pm
Hi AuntieD,
 
Thanks for sharing your experience with the Butran Patch. Finding the right combination of drugs to manage chronic pain is usually so difficult. It is great that you have found what works for you and hope that you continue to feel better.
 
Hope you come back and let us know how things are going...Edie
 
 
Chronic pain throughout the spine caused by osteoarthritis (DDD). Started at neck, spread to thoracic, and lately to lumbar area. Most of my spine is affected by bulges, disc height loss and dehydration, bone spurs, annular tears, foraminal stenosis, probable nerve impingement, and degeneration at end plates and facets.

The disease extends from Cervical C2-3 to C7-T1. Thoracic T4 to T10.
Lumbar T12-L1 to L5-S1.
It is all non operable.

Other conditions
Osteoarthritis R Knee.
Torn ACL, MCL L knee,
Pain on legs and calves
Deep vein thrombosis
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Painful spots all over scalp
COPD
Hypertension
Chronic Hyperventilation. Caused by anxiety or stress
Chronic depression and insomnia
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Rocken Roni Quote  Post ReplyReply Direct Link To This Post Posted: Jul/14/2011 at 5:13am
AuntiD and MamatoAlexa, this just goes to show how everyone
requires something different in the way of pain. What works for
one may not work for another. Keep us updated on how you
both are doing.
.
Roni

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1st injured Feb, 1997. Was told it was "Soft Tissue" and sent back to work - no X-rays
Late 1997 attended 1st Rehab Program to strengthen back. Mid 98 PCP took me off work. Tried going back to work over the next couple years, mostly off work due to pain.
June 2000, met with OS for first time. Did MRI , damage was L5-S1 totally blown out. Surgery done Jan, 2001.
Another Rehab program late 2001, attempted to go back to work early 2002. Slipped on water, fell flat on back screw fusion broke.
Went to 3rd Rehab program summer 2002.
Oct 2003 - 2nd Surgery, due to broken screw, had to operate from the front.
No improvement. Attended 4th Rehab program in 2004, at time It was decided NO work.
March 2006, had 3rd Surgery, this time fusion and instrumentation from Si to L3.
June 2008 Surgeon finally admitted I had Failed Back Surgery.
August 2009 WCB Finally put me on Long Term Disability
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Post Options Post Options   Thanks (0) Thanks(0)   Quote primrose Quote  Post ReplyReply Direct Link To This Post Posted: Jul/14/2011 at 1:39pm
My Butrans has been increased to 15micrograms and I feel that at last  an answer has been found,I  am very happy using it.
It will be better tomorrow.
Motor bike accident at the 16yrs.2broken legs,broken pelvis,punctured bladder.Broken ribs,punctured lung and various back problems.Fingers broken and dislocated on both hands. Three Heart Attacks in the last 12 yrs.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote MamatoAlexa Quote  Post ReplyReply Direct Link To This Post Posted: Jul/16/2011 at 4:28am
Primrose.
I am so happy that it's working for you. Keep us updated. When I took the pacth, at the end I was on 20mc. I was relieved of pain at that point (about60%), but the side effects for me were to horrid to continue. I am glad you are able to tolerate it.
Mama to a beautiful baby girl.
I have been suffering from Burning Mouth Syndrome for 4 years, trying everyday to find a cure.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Quaver Quote  Post ReplyReply Direct Link To This Post Posted: Jul/16/2011 at 6:24am
Dear All,
 
I find all this very interesting. I am now on Transtec patches which are the same as Butrans but in higher strengths. I am on 70mc and at long last it's really helping me. I am only adding this in to prove to anyone looking at this thread that it's worth persevering with patches if the side effects aren't too troublesome. I have to take an antihistamine daily to deal with the skin irritation.
 
Primrose I am glad you persevered and that you now have relief. Auntie D I am glad that you too have found relief.
 
Heart  Quaver
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Severe back pain since 1997. Lumbar Spinal Stenosis, Scoliosis, DDD. Hashimoto's syndrome, Depression, High Blood pressure, Fibromyalgia, Raynaud's Syndrome. Severe chronic pain in lower back, hips and knees. Osteoarthritis in spine, wrists and hands. Golfer's Elbow. Facet and Sacroiliac injections Dec. 2007, aggravated entire spinal column. L4-L5 L5-S1 spinal fusion plus cage support and titanium spacers April 2008. Facet and Sacroiliac Injections May 2009 allergic to injection medium. Radio frequency June 2009 aggravated entire spinal column. Undetected fracture in L2, Nov 2010, caused L bend in spine more pain. Bilateral trochanteric bursitis. Mobility diminishing now wheelchair user.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote ItsAuntieD Quote  Post ReplyReply Direct Link To This Post Posted: Jul/16/2011 at 7:17am
I had skin irritation with the Fentanyl patches. a huge red rectangle where the patch was, and itchy, so, so itchy, while the patch was on, and for a few days afterward. Instead of taking the antihistamine, my dr had me spray it on my skin (twas in puffer form)! Sounds strange, I know, but it worked ... a bit, not enough to keep doing it. That was one reason to change to the BuTrans: no (or almost no) skin irritation. That and the fact that I only have to change it once a week, rather than every three days! The only downside is that the patch leaves all that sticky stuff behind, and I have to use adhesive remover swabs and scrub like crazy to get it all. So that I can see what I'm doing, I don't put the patch on my back!

What does worry me, from reading this site, is what happens if/when I need surgery? Will the pain management be handled correctly? Oh well, why borrow trouble? it may never happen.
~~
It's Auntie Dee
had Osteogenesis Imperfecta since birth, 5 years ago had surgery to correct Basilar Invagination and have had chronic pain and oxygen issues ever since
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Quaver Quote  Post ReplyReply Direct Link To This Post Posted: Jul/16/2011 at 7:48am
Auntie Dee,
 
I am surprised you have so much trouble with the adhesive. I find it comes off easily in the shower. My pain consultant tells me to put the patches on my stomach as he says that that is the least itchy part of the body and that the blood supply means it's easily absorbed. Perhaps it's easier to get the sticky remains off the stomach?
 
Heart  Quaver
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Severe back pain since 1997. Lumbar Spinal Stenosis, Scoliosis, DDD. Hashimoto's syndrome, Depression, High Blood pressure, Fibromyalgia, Raynaud's Syndrome. Severe chronic pain in lower back, hips and knees. Osteoarthritis in spine, wrists and hands. Golfer's Elbow. Facet and Sacroiliac injections Dec. 2007, aggravated entire spinal column. L4-L5 L5-S1 spinal fusion plus cage support and titanium spacers April 2008. Facet and Sacroiliac Injections May 2009 allergic to injection medium. Radio frequency June 2009 aggravated entire spinal column. Undetected fracture in L2, Nov 2010, caused L bend in spine more pain. Bilateral trochanteric bursitis. Mobility diminishing now wheelchair user.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote medic008 Quote  Post ReplyReply Direct Link To This Post Posted: Jul/16/2011 at 8:09am
Auntie D. When it comes to buprenorphine and surgery. Your Dr will have you taper off about a week or 2 in advance, or not depending on the severity of the surgery and how bad/long the pain is expected to last. Because of the way buprenorphine works, it won't allow other opiates to attach to the receptors, unless you are taking a very small dose of it.

When we have patients come into the ER while taking any form of buprenorphine, they usually require VERY large doses of the strongest pain killers a hospital has access to. But as you said, this is something to think about when the time comes.

Although I do suggest this, carry something in your purse, wallet etc... That states you are on BuTrans. If you come into the ER unconscious or unable to communicate, and the staff doesn't know what you are taking, your pain control will be almost nothing! Another good idea is to wear a medical ID bracelet stating you take buprenorphine. Those are my thoughts and suggestions, hope you have a low pain day!

Tyler
Left shoulder hemiplasty, needing a complete replacement.
Lower back problems still being sorted out.

I am a RN/EMT-P, any and all advice given is my opinion and not to be taken as medical advice. ALWAYS seek the guidance and expertise of your DR!
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