Sunday, July 21, 2013

4 Days of Fentanyl

Day one began after 2 hours of sleep and 4 hours in the car which was a culmination of 2 very emotional doctors appointments. I met my new pain management Dr. Though I have come to hate all things MCV over the years I will say I was not unimpressed with the new doctor. He actually spent 2 hours with me going over every pain issue and reason for it and every pertinent medical fact of the last 5 years. And he tolerated my tears and seemed to understand my frustrations. He also decided that continuing to increase morphine was simply not an option. Yes, I would most likely benefit from increasing the dosage however he knows the insurance refuses to pay anything above 120 mg a day. Plus as my medical records have suggested, I have built a tolerance to it that isn’t going to get any better.


At this point he decided the next option would be to try Methadone or the Fentanyl patches. He did not want to prescribe methadone based on my age and the fact that 95% of my causes of pain are inoperable and will not be going away anytime in the future. More about that appointment and the other 2 appointments in those 2 days later.


So I started the patch that afternoon. Put it on, fought the heat while cooking dinner on the grill. Took about 4 hours before I noticed a decrease in pain. All was well until bedtime. I took my meds and was in my room getting ready for bed when the nausea hit. As soon as I laid down, I was jumping back up to run to the bathroom because my dinner refused to stay down. Finally managed to fall asleep but was extremely dizzy and very nauseous.


Day 2  I awoke with a splitting migraine and an already scheduled follow up with my primary care doctor. I couldn’t say for sure that is was the new medication making me sick because there were a LOT of other factors to consider. There was the lack of sleep, the heat, the emotional roller coaster ride, and yes, I already mentioned the lack of sleep, but the lack of sleep is enough to make anyone sick. Day 2 was yet another insanely hot day and the heat was not helping. The headache went away as did the nausea… until I ate lunch. The nausea came back with a vengeance and I attempted to lay down for a nap. The room began to spin and I had to get back up. The rest of day 2 was spent fighting the nausea. I had a handful of Nauzene tablets and some dry cereal for dinner as it was all I could stomach. One thing I will also point out that I noticed on day 2 was an intolerance to light. I am usually the person who insists on turning on the lights in the living room when it starts getting dark out (My kids prefer to sit in the dark, unless they are leaving a room which which case the light is guaranteed to be on), but I could not stand the light, and even reading a text message on my phone hurt.


Day 3 came with both pain and you guessed it….nausea! But worse than fighting the urge to puke was the pain that had come back. I began to feel a little better that night. I did spend the day complaining that MMJ is still illegal in Virginia as I had a feeling it would work a heck of a lot better than those disgusting cherry flavored tablets.


Day 4 I woke up in as much pain as when I started the patch. Figures since it was time to switch it for a new one. Took more than 1 cup of coffee to talk myself into putting on another patch. This time I did change locations. It’s been 8 hours since the swap out. So far the pain has gone from a 10 to a 7. But the biggest improvement was the ability to eat dinner and not have to take nausea meds before and after.


All that being said, I will say what I believe may have been the issue from the beginning. Neither the doctor nor the pharmacy informed me of one of the most important pieces of information I found in the tiny words on page 3 of the medication info pack: Avoid hot showers, hot tubs, sunbathing, exercise, or anything that would cause an increase in body temperature as it will cause you to absorb the medication too quickly.


I do believe that is why I was so sick and why it stopped working after 2 days. Which makes absolutely no sense to me why the doctor who prescribed this medication on the hottest day of the year thus far did not bother to warn me. So for anyone out there who is about to start Fentanyl… please be advised… stay away from heat.  Also the patches do not stick very well, and I was smart enough to ask my doctor about swimming with the patches on before I left his office. He recommended Tegaderm, which is both 100% waterproof and LATEX FREE! They work great for keeping the patch in place. I have not tested the waterproof factor other than a quick shower, but so far so good.