My condition started 2 yrs ago. I started on lortab 10 3x daily, increased to 6x daily. Taken off and put on oxycodone 15mg 4x daily. Didn't react well, made me very groggy and disoriented at work. Went to ms contin 30mg every 8 hrs and lortab 10 3x for BT pain. The ms contin didn't help at all so relied on lortabs and taking up to 10 daily to take the edge off. I'm a server btw, and on my feet and at a brisk walk 40 hrs weekly. I was referred to a pain clinic and he's starting me on the fentanyl patch 25. I just put it on tonight and was wondering what everyone's experience with this was. How long until it starts working? Will it help someone with as high a tolerance as mine? Do I need to use bt medicine? Is this a high enough dosage to help the pain? He didn't really give me time for questions, just wrote me the scrip and pushed me out the door. My rheumo is pushing for surgery but my ortho wants to wait. I'm so depressed being in this constant pain. It has totally changed my life and I'm miserable. Any answers will be appreciated.
I am 34 yo and suffering from a very aggressive and degenerative form of arthritis?
- 4 Aug 2012 by hollycat1977
- 10 Aug 2012
- lortab, rheumatoid arthritis, pain, fentanyl, oxycodone, chronic pain
Added 4 Aug 2012:
Btw, they aren't sure exactly what type of arthritis I have. I tested negative for rheumo so they were treating it as psoriatic. But I've been on methotrexate for 6 months and no change so he just pulled me off. My rheumo's plan is to keep my pain as tolerable as possible until my ortho agrees to surgery. My ortho recently ordered an Arizone brace for me as well, if anyone has any experience with that.
Fentanyl usually takes at least 8 to 12 hours to start alleviating your pain. It is good for pain like yours. As your tolerance builds, if need be, you can go up on the dose. Do you have bt meds? That would certainly help until the fentanyl kick in 100%. I have severe arthritis and was stuck in a back brace, don't remember the name. I didn't like it, but I don't like anything that feels tight on me.
I really hope the docs get your pain under control.
It's been right at 20 hours now and still no relief. I haven't taken the ms contin since yesterday afternoon. He didn't tell me to discontinue them or not but I'm assuming I was supposed to. I took 2 lortabs about 5 hrs ago and 2 more an hour ago but I don't feel much better. My tolerance to the lortabs is so high they really don't help anymore and the ms contin never has. I was praying that when I woke up today my pain would be better but no change at all. I've been at a strong 8 and sometimes a 9 the last 2 weeks. My right ankle has completely collapsed and waiting tables for a living definitely doesn't help lol. I feel bad to burden my friends and family with all this bc they have no idea what I'm going through. And you don't meet many other 34 year olds with arthritis this bad. What should I do? Let the dr know they're not working? I always hate the look they give you.
With long acting meds, you wont feel the same "kick in" that you feel with short acting meds. This is because short acting meds flood the receptors with the opioid. Long acting drugs dont do this and this is why some people feel like they are not working. Go by pain relief, not whether or not you can "feel" the medication kick in. Fentanyl is very strong, much stronger than Morphine. I'm surprised the MSContin didnt work. Were you taking it every 8 hours around the clock or only when you needed it? MSContin is not an "as needed" or PRN medication. It is to be taken round the clock no matter of your pain levels and is usually much more effective than hydrocodone. You wont feel that "rush" that you do with hydrocodone though. If oxycodone 15mg made you too groggy, I'm really surprised that the morphine didnt work but we are all different.
Like I said, you wont feel a "rush" with the Fentanyl either. You should just start feeling less pain but feel normal. Dont take the morphine with the Fentanyl. The Fentanyl will take its place. You may need to go up to a higher level of patch but with Fentanyl you have to start slow and build up a drug level which takes two to three patches before you get the full effects of the drug. This is not to say it wont help your pain before then, it just takes that long to start getting a consistant drug level in the blood. Once you pull one off, you can still be getting drug from the skin up to 20 hours. He actually started you a little high. For 60mg of hydrocodone the equivelent patch should be the 12.5mcg one so he must have been starting you based on 100mg of hydrocodone. Give this drug time and I think it will help you. Is there any possibilty of getting off your feet a bit until you can get your dose straightened out? Once your pain is under control you could then start to get back to normal activity. You may at some point need to look into a change of jobs or even disability. Is there any possibility of a desk job? This is what I had to do. I'm in a profession that most jobs in my field require a great deal of physical endurance but I was able to find one where I could work from home on a computer at my desk. It is still hard some days because even sitting is hard on my back but at least I'm still working and can be productive. I have little choice as there is no way we can make it on disability so I understand the need to work! Give the Fentanyl a good trial. give it at least a week before you go up in dose. Keep using your breakthrough medication if you have to but after 72 hours try cutting back on the breakthrough to see where you stand on the Fentanyl alone. If after a week you still need the breakthrough all the time then you may need to go up to a 50mcg/hr patch.
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