It's becoming common knowledge that Fentanyl Transdermal (Duragesic) patches last up to 48 hours, not the 72 hours promised by the manufacturer. Most physicians are aware of this and if you request changing the patches at 48 hours, they will comply. Some people change the patches daily, if they suffer from contact dermatitis.
A better way to avoid withdrawal symptoms when d/c an opioid is to use an opioid antagonist, like Suboxone or naloxone. The antagonist will offset the pain-relieving value of the opioid; but one is assuming that you no longer require the drug for pain (why else d/c it?).
Many people use Fentanyl Transdermal so long that they become significantly tolerant to it (at the maximum safe dosage). At that point, they rotate to a chemically different pain drug, only to discover that it is not efficacious.
Fentanyl is about 80 times more potent than morphine. It is the most powerful pain medication available. This conundrum is revealed when a chronic pain patient attempts to switch to a different medication. The patient may discover that Fentanyl tends to work better even when the patient is highly tolerant, than less powerful pain medications.View Thread
Methadone can create vision problems as a side effect. It doesn't happen often, but it's possible. There are many newer opioids that have far fewer side effects, especially for vision.
I'm wondering why you're not using a long-acting opioid. Research clearly shows that chronic pain patients do much better with a long-acting opioid (Kadian, Oxycontin, Fentanyl Transdermal, etc.) and then you can keep your oxycodone for BT pain. You might discuss this with your physician.View Thread
1. WebMD does not allow us to recommend specific physicians or practices.
2. I would refuse to move from my current location for that very reason. Without our current medications, many (most?) of us would find life not worth living. I would never take that chance. The only possible exception would be to move to a state with medical marijuana laws, which greatly benefit millions of Americans with chronic pain.
3. I am so very sorry for you and your current circumstance. I'm one of a very small population of people who can truly comprehend your agony. I wish you the very best luck in finding a compassionate physician or PM program.
4. Let this be a lesson for all of us contemplating a move from one location or one state to another one. If you currently have a compassionate physician who is providing ample medication to meet your needs, be forewarned about moving. It could become the worst decision.View Thread
That's the problem with pain management programs. You're more like a widget on a factory line than a person. Contracts, rules, rules and more rules. Sometimes its better to find a GP, family doc or internist willing to prescribe all of your medications, including those for chronic pain.
One will always become tolerant to a medication over time. That means you'll need higher dosages to achieve the same result that you originally achieved with the starting dosage. You climb this ladder until you reach the maximum safe dosage. When tolerant to that, you must rotate to a chemically different pain medication for at least several weeks. After that, you can return to the original medication with improved efficacy.
The solution is honesty. Call your PM doc and explain that the existing dosage is no longer effective. Ask if a higher dosage or a different medication would help. All doctors understand that tolerance is the inevitable result of using the same medication for a long time.
I'm hoping that you won't have to wait out the contract period without a change. Typically, a family doctor that knows and trusts you will give you the higher dosage or different drug without forcing you to wait. But a PM doctor with a contract could be reticent to assist you.
IV Fentanyl will provide near-instant pain relief. Good luck obtaining it. Then you'll need to start an IV on yourself. Careful about respiratory depression.
The above, of course, was in jest. Almost nothing works instantly. However there are some new delivery options that are faster than IM injections, medication that you digest or use transdermally. I'm talking about transbuccal delivery (ex. Fentora). Takes about one or two minutes to start working.
Yes... on each of your questions. Yes, they will know. Yes, they will tell your employer that you failed. Yes, they will tell your employer which drug is in your system. No, you do not automatically "pass" since you have an Rx.
But, many employers will not hold it against you if you can display the Rx and the condition requiring it. As is the case with most of life, honesty is the best policy.View Thread
So... you can risk your life for your country, but your country won't help you with chronic pain when powerful medications are available to manage it? That should be a crime. But how do you put the DOD behind bars?View Thread
If you have a spinal condition that might include a herniated disc, spinal fractures, osteoporosis or spondilothesis, then undergoing chiropractic manipulation is THE MOST DANGEROUS option. Chiropractors are not medical doctors. They do not attend medical school. They do not participate in a residency. They do not participate in a fellowship. Compared to a lawyer, they are a legal secretary.
Fortunately, 80% of all humans have an experience with severe back pain and almost all of them get better on their own. Many such people praise their chiropractor when doing nothing would have the same result.
However, after 43 years of sitting in the waiting rooms of neurologists, neurosurgeons, osteopaths, orthopedic surgeons and other medical doctors, I've seen the terrifying results of chiropractic manipulation. The medical doctors and surgeons have all told me that the most common symptom of new patients is for damage done by chiropractors.
If you have a muscle, tendon or ligament problem, and it has been verified by a medical doctor with a CAT-scan, MRI or X-ray, then have at it with a chiro.
But chiropractors, not being medical doctors, have few or no hospital privileges. Chiropractors cannot order and are not trained to interpret the most definitive diagnostic instruments, including radiological imaging. They only use X-ray. But soft tissue, like tumors and extruded disc material do not visualize on an X-ray. So a chiro is operating in the dark. You could go to a chiro with a spinal tumor for years and never discover it until it has metastasized into a fatal condition.
Nothing is more important than your health. SO why treat it with someone who never went to medical school?View Thread
You must remain perfectly still whenever having any invasive spinal intervention, including the IT Pump, the SCS and injections. I've had more than my share of spinal interventions, including injections, a facet rhyzotomy and surgeries. The amount of time required to remain perfectly still is not that long. It's doable for everyone but the most anxious, or for those with tremors or convulsions
If it's implantation of a surgical device, like the SCS or IT Pump, you will be sedated or under general anesthesia.View Thread