Hey Al fan,
Hope the pain is treating you right today. The chart my P.D. has shows a conversion of 50mg/h equal to 80mg of
oxycodone.
That said, last fall I became concerned about the titration required to maintain pain control with oxy. I had worked on a new product through the summer and was putting the pieces in place to begin manufacturing and rollout, interference from a drug was the last thing I needed for the company. Two years after a complicated neck fusion I was at 230mg/d with roughly 60% relief. I wanted to be pain free, but had begun to question my motives, was I an addict or just tolerant to the med? My GP and family made sure I knew about the latest OD or which star was going to rehab to get off of the stuff before their habit got the best of them. At my December appointment with the PD I requested a med change.
We set a plan to begin gradual change from oxy to
fentanyl with a goal to have the pain back under control by February. Stayed on 160mg/d of oxy 'til I got used to wearing 125mg/h of fentanyl. The combination, or addition, clouded my thought process (fuzzy doesn't quite cover it) and taking a nap to fight the new felt fatigue was a necessity. PD assured me that everyone adjusts to the patch and encouraged patience washed down with a little caffeine. By January I'd convinced myself that the unrelenting somnolence could have been the result of the combined effect of the two drugs and (without my PD's knowledge) I CTed the oxy one week before my February appointment. Still hurting, but knew that the Doc was planning to change the fentanyl script.
The oxy withdrawal process washed over me without discomfort because at this point I couldn't stay awake for any longer than it took to eat dinner with my family. I assumed that as the oxy cleared my system, my world would return. I was absolutely elated to have dismissed the drug with so little fanfare.
The February plan was for 150mg/h. I remember kidding the Doc that I'd lost so much weight since December that body fat to put the patches on had become a rare commodity. I was down almost 23% since December and we laughed at the thought of wearing the patches instead of underwear. Picked up a fresh supply of 100's, 25's, and 50's on the way home. I felt hopeful the fentanyl war on pain was making headway, except the pain seemed to grind on my thoughts a bit more than with the oxy. My assumption was that negative observations of fentanyl's effects were created by an addicts' desire to find the past, and that once I had attained the proper fentanyl level balance would return to my life.
I put on 125mg/h and waited for the pain to fade but went to sleep instead. Thirty four hours later my wife was shaking me awake, chattering about Friday night and entertainment plans. I took a pass and went back to sleep 'til it was time to change the patch again. Told the PD about sleep issues and received a sample pack of
Provigil to help me stay off of the couch. He threw in a script for
Klonopin to knock down the anxiety that had grown from "this doesn't feel right" proportions, to an occasional thought that I might not find my way to the entrance of the rabbit hole I'd fallen into...but I put on that last patch.
At 150mg/h my world was gray. Weeks had past since I'd glanced at e-mail. My obligations, my plans, my future eluded me. I couldn't remember being happy. An afternoon nightmare previewed the end of my story and was the first action of my unconscious self to drag the fentalyl damaged pieces back into the sunshine. I stopped waiting for the fentanyl to work, didn't call the Doc, didn't need validation of MY plan, and ripped 50mg/h of poison from where there used to be undies (still gotta laugh!). Gave the stuff a new name based on what it had done to me---Dementors Kiss---thought it apt from my recollection of a Harry Potter story I'd read to my kids.
I wasn't able to drive myself to the March appointment with my PD, but watching the steam rise from his face as my wife told a story that I had missed complete chapters of, made my day. No doubt one pissed off fella, but to his credit he sat still while I relayed my opinion of the toxic gel inside those patches of sorrow, and then I laid out a Pain Plan that I could live (literally) with that included eliminating fentanyl over a three week period (was still wearing a 75), oxy, a little constipation (keep eatin' the apples), acupuncture (fingers crossed), exercise, and sunshine.
Sorry for the drawn out story, certainly didn't begin with the intention of airing my knotheaded, and after a re-read, weak nature. But I've made so many errors these last few months--stupid decisions in hindsight--poorly reasoned without medical understanding of the myriad pitfalls--all to willing to allow "just a little longer" for a new chemical---guess I'd rather share my blunders than have them repeated.
The medical community is full of wonderful caring folks, but I'm going to my next appointments with a new set of guidelines that are all about ME. I'll never change a successful program for petty reasons. Doc's are practicing their trade every day with the hope of getting really good at it someday. Doc's are busy folks with a never ending stream of customers looking for a little magic to put life right again, the magic comes to them from sales reps with a quota and a family to feed. Side effects don't boost sales. Assume the worst will happen as I read the entire drug information sheet. Oops-starting to sound a little bitter...
I'm nothin but a sack of chemicals and the delicate mix has to be gaurded. I don't care what the drugs' reputation has been...if it feels wrong in my body it doesn't get a second chance, its garbage. My Doc knows that I expect very serious consideration and am intolerant of negative chemical results.
I refuse to be groggy, fuzzy, one step behind, sedated etc., etc., etc.. Pain relief does not come with a side order of stupid.
Feels great to be back (almost), in full color, and sorta cranky if I so choose.
Hope there's a smile on your face and that you've got tomorrow's schedule full of joy.
Just started On Fentanyl (Patch) HELP!!! 
Linear Mode
