DURAGESIC woes

[Pain_Man]

I have had a terrible toxicity reaction to the Fentanyl in the patch.

My feet, especially my left (I'm right dominant so I don't why the left) swelled to three times their normal size. My ankle bone disappeared! I couldn't see it due to the swelling. Also my joints, ankles, knees, hips hurt.

I also experience serious, intense depressive episodes, as well as intense anxiety. Coupled with this were inexplicable rages over things beneath trivial.

I also had a constant feeling of dread and misery.

Furthermore, I was suffering from almost constant insomnia. I rarely slept for more than two hours a night, often in my computer chair (which does great things for one's sciatica!). So not only was I sleep deprived I also had an almost existential feeling of fatigue--mental, physical, moral. My family was getting more and more worried about me. My "quality of life" was sinking fast and so was I.

But this all built up over the Nov 2003 to June 22, 2004 period that I took the drug.

Both my wife and I attributed it to my condition and my total disability. I can't work and can't do many of the things a normal husband would so my wife has to, in addition to working 50-60 hrs weeks, do a lot of things a healthy spouse would also do.

So we thought it was just my attitude: that my anxiety, depression, resentment, rages were attitudinal and if I could change my attitude, our thinking went, things would be alright.

Then, three weeks ago, my feet swelled up like the Hindenburg. Irrefutable evidence of toxicity.

It was so bad I saw my Pain Doc several days early on a walk-in and he switched me back to Oxycontin WHICH IS FINALLY GENERIC!!!! HOORAY!!! (The irony is that the generic Oxys are more expensive than the brand Duragesic patches!)

I'm still suffering some effects from the Duragesic, it's very slowly metabolized and most narcotics and their metabolites (no narcotic completely metabolized, there's always a mix of the drug and metabolites in your plasma). Fortunately, narcotics are water soluble--unlike THC--so they are easily eliminated from the body by the liver/kidney complex.

But things are better. My attitude was better within 18 hours of taking the patch off. The swelling in my feet has gone down to almost normal (now I know how my wife felt during the last trimester of her pregnancy). My depression is better. My irrational rage is also going down (as a Conservative I have enough rational stuff to get angry about so I don't need chemical assistance with my Irish temper).

Plus, the fentanyl was causing increasing urine retention (something that can happen with any narcotic, BTW) and the pain control wasn't what it had been.

The Oxys are working quite well. It's not as convienent as the three-day patch, but having a life and not contemplating suicide, not raging like a maniac, not staying up everynight up able to sleep, repairing the damaged relationships with my wife and daughter are all worth it.

So if you're having any of the issues I've mentioned AND you're using the patch, you might want to look at changing it to another med.

I also now don't have to deal with the skin irritation problems or the patches popping off (which one actually did, costing me one of my spares!).

So, like ultram and prozac, they work for some people, perhaps even as a lifesaver, but not for me.

If you're having issues like this, you're not alone. Discuss it with your doctor.

Regards,

Pain_Man

As usual: I am not a physician, physician's assistant, pharmacist or RN. Nothing in any statement of mine is medical advice or intended to be as such. I ONLY relate my own experience to try to help others who may have similar issues. AS ALWAYS, consult your healthcare professional before you change anything about your treatment. PM

[ICNDonna]

I have had some reactions to medications so I do understand.

Anyone who has a reaction to a medication should get in touch with their physician, and if the physician can't be reached, the pharmacist, immediately. The pharmacist cn tell you if the reaction is a possible side effect of the medication and even advise about whether to take any more before reaching the doctor for direction.

I hope you're continuing to improve.

Donna

[SaraJ]

My reaction wasn't as bad as yours, but I recognised it as a drug reaction right away ( I have alot of experience with drug reactions). I started to feel really dizzy and light headed. After that I actually passed out twice. I took the first patch off after wearing it for two days and never put one back on. I can't imagine what could have happened if I would have kept using them. I also know several people who use them all the time with no problems - I guess it just depends on the individual. I am glad you are finding relief with your new meds....I also totally sympathize with the money issue...UGH!

[Krowe5656]

Hello :

What dose were you using? If it was between 02/04 and 05/30 and the patch was either 50 or 75 your reaction could have been because of a default in the patch. My mom uses the 50's and when she went to get them in March she could not have them filled because the 50's and 75's had been recalled. Our pharmacist told us that the co. which makes them had a huge problem with "leakage" and that people were getting far too much of the medication at one time. They also had a problem with pain not being controlled by them because by the time the patient got the patches the medication had leaked out! Just thought you may want to know. Our pharm. said that it was a national recall. I may be off about the timeline a bit but I know it was this year because my mom had trouble.
I hope and pray your pain is under control! God bless and take care. :pray: << for {{{{you********

[Pain_Man]

to Donna for the kind words.

Thanks to Krowe for the info.

I was taking the 100s. Or, rather, using the 100s. I did have occasional problems with their adhering to my arms (I tired my chest but just didnt' work). I actually had one pop off when I move wrong. It ended up having to be wasted. Fortunately I had a two day "reserve" I'd managed to build up, so there was no issue of withdrawal.

All I can say is what I said about Prozac: I glad it's helped millions of people. I hope it continues to help millions of people. But for me, for my family (which it nearly destroyed by unleasing or creating demons in me I didn't realize I had), it was a seven month nightmare.

I really don't think it was a functional problem with the patch. I think it was just a.) the strength, it's thousands of times stronger than heroin, b.) the length of toxic build up and c.) the combination with Valium I take for pelvic floor syndrome and Dilaudid for breakthru pain.

I had a similar reaction to Xanax. By itself it had never bothered me, but with narcotics it turned me into a drinkless drunk, slurring, stumbling, obnoxious beyond toleration--almost.

I just wanted to know if others have had any reactions as extreme as mine. It doesn't appear so and I hope not. It nearly ended my marriage and might have ended my life.

But for those it helps, God bless you. The pain relief is tremendous.

[Krowe5656]

Pain_Man:

I'm uncertain rather you were referring to prozac or the patch with regards to your marriage.
Either way you're so not alone. I've known people who have had similar problems with the patch and the other medications you mentioned.
As far as prozac goes, have you ever read the book: "Listening to Prozac" I forget the author but will find the book... been in my new home for 2yrs and still haven't been able to finish unpacking..and let you know. It's a wonderful book and it tells about experiences like yours. When prozac hit the market it was praised as being the "cleanest" antidep. ever. But of course they hushed up about all the people it effected in an adverse way. I recall one story about a woman who drove her car off a bridge and before that she couldn't control her rage or any of her emotions. There was a good amount of people who became suicidal while on prozac. The book explains everything about how antid's were created and how they got from point "a" to prozac. An other good book is: "Beyond Prozac". Both are about all antid's not just prozac.
I hope you're doing better these days! Take care and I'll get back to you about the authors, if you're interested.
Take Care,
Kara

[Zookeeper]

Hi there, I was on DURAGESIC for awhile. My reaction was much different. I had a kind of a 3rd degree burn & I did notice some swelling from them, but I have problems with most meds allergy wise.
I'm sorry you had to go through all that.I do hope the new script works much better for you.
Have you thought about starting up with an anti depressent again? Not prozac LOL, but some thing a little milder like Celexa or amitriptyline (which also help you sleep) or some thing like that.
I hope all works out great for you.Please take care.
Love Zookeeper Kim
:grouphug:

[Pain_Man]

Sorry I was unclear. I'm somewhat dyslexic and I miss words and letters sometimes when I write. Sorry about that.

I haven't taken prozac since I was 18. Everyday I took it I had to find a reason NOT to kill myself. Eventually, I threw it down the toilet. If helps others, great. But it nearly killed me. And it's also been responsible for murders and suicides.

Some of it wasn't the maker (Lilly)'s problem. It was GPs handing it out like they did Valium in the 60's. "Not feeling good? here, take this!"

We are a pill culture!

I've tried a dozen anti-depressents. One cause priapism--so that's out (and you'll have to look it up if you don't know what it means). Others have cause intestinal issues, extreme drowsiness.

They just don't work for me.

And I don't have much use for shrinks anyway.

As for the fentanyl. What a nightmare. I miss the convenience of the patches, but it was driving me insane.

I actually found myself, some months ago, standing in my downstars bathroom, everyone else asleep, with razor blade pressed to my wrist, desperate to do ANYTHING to get rid of the feeling of utter awfulness--I can't even describe the feeling.

Fortunately, I made the right choice and my wife helped save my life. It took a while longer, but the fentanyl's almost gone from my system (two weeks now) but not totally.

But I actually feel like my old self.

I'm so glad that in my wasted youth I never tried narcotics for fun. I always knew it was stupid and that time I actually listened to myself.

If fentanyl helps you, I'm happy for you.


IF you are taking AND you are suddenly feeling very abnormal take a look at what's changed in your medicine regimen, diet, etc.

Don't just do nothing as I did for seven months.

[Morgan Stone]

Pain Man,

First of all, i am glad you found the problem and got your meds straightened out.. sounds like you went through quiet an ordeal.

I was given the patch when I went to the pain clinic the first time and I was to start mine 3 days after surgery (to remove ovaries and scar tissue and adhesions). I used the first one along with percocet and wasnt feeling a lot of pain and then on the 5th day (2nd patch) i woke up that morning having cold sweats, hot flashes, sick to my stomach, the area under the patch was on fire! I took it off and it took me 2 days before i even felt close to normal. I had fentanyl in the hospital without any complications so my pain doc thinks i was allergic to the material the patch was made of.

I was changed to oxycontin and havent had any problems since but I can say that while i was on the patch and even after a major surgery, they took care of the pain quiet well. And yes, the convience of not worrying about taking a pill for 72 hours would have been great. I have to set the clock to remind me to take my oxy every 8 hours because it works so well and i forget sometimes... by the 9th hour tho, my body reminds me its time for another one and i thank the Gods for the creator of this medication as it has changed my life!

I'm still having a little breakthrough pain in the mornings but my pain doc says that i will just have some days that I have to deal with it. I asked for breakthrough meds and he said he would rather not so i left it at that since I went for so long without any pain control and don't want to lose it now that I am finally getting it.

Thanks for sharing your story with us.. I am so glad to hear it has a happy ending :-) Wishing you continued pain-free days :-)

[ICLori]

Hi, Painman, I figured out why I thought heroin was created to cure opium/morphine addiction - because it was marketed for that among other uses!

I found this on the web...thought it was interesting...my cousin is a heroin addict, I think he's free of it now but he was an addict for some time..

I wonder where percocet rests on the scale of effectiveness/habit forming abilities? I suspect it is fairly high up....

I know that both codeine and morphine did NADA for me for pain relief, just made me throw up and give me hives..


In the 19th century in England opium was a widely available panacea for everything from women's problems to infants' complaints. It came in many forms of patent medicine and the eventual restriction of its supply to licenced pharmacists was more a political move than a moral or health measure.

Morphine„Ÿthe good bit in opium, which when isolated is ten times the strength of the poppy„Ÿwas identified in the early 19th century when it was welcomed for its superior ability to ease pain and marketed as a cure for opium addiction.

Heroin, several times stronger again than morphine, was synthesised in the late 19th century, when it was welcomed for its superior ability to ease pain and marketed as a cure for morphine addiction.

It was named heroin because of its heroic properties. Nothing was stronger than this. Mighty heroin, vanquisher of pain and suffering, bringer of a bliss nothing could disturb.

Few drugs are more potent or more addictive.

[Greekladyiam]

My Dr. tried me on the Duragesic patch last month (50) and I took it for five days and it was enough for me. I was nauseous, moody and just felt nothing like myself. I too liked the idea of not feeling any pain and in desperation was willing to try anything but it just didn't seem to agree with me. I will add that I couldn't tolerate dilaudid in an E.R. either though so maybe I am just too sensitive...??? I am glad for those it helps though because if it would have done well for me, I would have continued it. One more thing...Even though I only used it for five days, I experienced withdrawals that my Dr. had to prescribe anti-anxiety meds. for...I would say Duragesic is a very powerful medication. I did read that you have to be opioid tolerant just to take it so maybe I wasn't tolerant enough...??? I hope the information will help someone. Sorry to all of you that also had bad experiences with this medication. It is scary.

[crystilclear]

Wow pain man it sure sounds like you've been through so much. I'm glad she is there to help you through this. My hubby is wonderful and has helped me through some ruff patches too. I'm glad things are better. I have chemical sensitivities to medications too. Take care - Chris

[Krowe5656]

Greekladyiam:

When I was placed on the patch I was already taking oxycontin and I have been on and off narcotics since I was 11 yrs old. I do have a high tolerance, I believe, because of the amount of time my body has had this sort od medicine in its' system. When I first put the pacth on I threw up and felt icky all over. My doc said to continue using it and see if symptoms would pass. Well, it took a good week or so before the nausea clamed down but after that point my body adjusted. Now I don't have any ill effect. Except that if I forget, for some insane reason, to change them exactly when I should, I get the shivers and shakes. It bites but no one will prescribe oxycontin in my state. So, I put up with it, oh and I get terrible rashes too but I get a cream which clears it up in a couple of days. It does help the pain a whole lot but in no way do they last 3 days. Just like advil which is supposed to last for 8 hrs. even my brother who has never taken a narcotic and doesn't drink or anything says that advil only helps him for about 4 to six hours. He's a CNA and he told me that the pharmac. co.'s decide how long medicine last based not on subjective reports by patients but by blood test which show how the drug is metabolized in a group of peoples blood. Anyway, for me at least meds never last as long as they are said to be able to last.
I'm sorry so many have had trouble with the patch. The two or three day change on the patch isn't that great cuz for me at least when I forget to change when I should ... I sure do pay for it with severe pain and sweats. Has anyone else on this med had this problem?
Take Care All
Lv, Kara

[Pain_Man]

Been over a month since I got off the Duragesic. My wife and parents have all noticed a sea change in my behavior. I'm no longer moody (moodier than normal that is); I no longer rage; the depression has mostly gone; no more suicidal idiation.

And, the feeling of being the walking dead is gone.

Thanks to all of your for the support.

And yes, like you Cristil, I couldn't make it without my wife's support. Now that I'm no longer a raging @*#$*@%, my wife's much happier. Knock on wood, things are looking up again. IC's still there, but at least I don't feel like my head is going to explode.

[Pain_Man]

I too experienced rashes and what felt like "burns" underneath my patches. It was another drawback.

Now that I feel normal, I don't mind the inconvenience of taking pills three times a day!!!

[Krowe5656]

Pain_Man
i'm glad you're off the patch since it gave you such a hard time. i hope you're finding reliefe from whatever you're taking now. question: even though "you" take pain meds, long acting and short, are you still always in some sort of discomfort and/or pain? because for me, even though i have pain meds i am still quite often in moderate to severe pain. some, in my life, can't imagine w/all the meds i take that i am still quite uncomfortable. anyone else feel like i do? Lv. Kara

[SaraJ]

Hey Kara... I know exactly how you feel...pain meds provide temporary relief but after a while I still have break though pain. I play the rate the pain game at the docs office and he says I have a high threshold for pain so I usually rate moderate pain fairly low. Each procedure I have done provides temporary relief - but it isn't long lived.... after surgery my pain is usually a 3.. but within a 6 weeks it gradually goes back up - it was a five last week and already back up to an 8... it's like a roller coaster ride that the attendant won't let you off of!! I just keep pressing on and looking up!! :angel: