Hello, Doctor,
I am a 61 year old Caucasian female. My heart and lungs are good.
I have SLE, Scleroderma, high blood pressure, RA and Osteoarthritis. I also have Osteoporosis, (from the many years of steroid use), particularly in my hands, feet and spine. I am almost completely bedridden from these ailments. When I am mobile, I use a wheelchair.
Nearly 10 years ago my PCP prescribed me the 100mg. Phentanyl patch for severe nerve pain. It worked very well. The only other pain medication I used at that time was an occasional Tylenol 3.
Seven, (7), years ago I had the 360 spinal fusion surgery. My surgeon prescribed very high doses of pain medications due to severe pain.
I went into pain management following the 360. At that time my pain management MD called my PCP and insisted that she agree to take me off the 100mg Fentanyl patch. She, (my PCP), refused, but agreed to reduce the patch to 50mg, which my PM MD now writes, and which I apply every 3 days. My PM MD also currently prescribes 20mg OxyContin 2x daily and 5mg Oxycodone 6x daily.
Despite wearing the 50mg Fentanyl patch, and taking these levels of Oxycodone and OxyContin, I am in nearly constant pain. I have told myself that I must live with it.
This past week my husband made a mistake. He applied my Phentanyl patch 1 1/2 days early. We usually apply the new patch at night but also leave the old patch on overnight to lessen the likelihood of withdrawal symptoms during the night. So, with the mistake, I had been wearing what we thought were one old and one new patch.... but were in actuality two good patches.
The next morning, following the mistake with the patch, I told my husband that I felt great, with no pain. We were surprised by my sudden relief! I even refused to take my Oxycodone or OxyContin until late in the day because I wasn't in pain. And frankly, when I finally did take it I didn't feel that I needed it so much for pain, but because I was sweating and beginning to have signs of withdrawal. We didn't discover the pain patch mistake until after all this, when we began to wonder why I hadn't needed to take my pain medication all day. Of course, I had been getting higher levels of Fentanyl following the mistake, but didn't realize it.
This is my question : Why does my PM MD have a problem with the Fentanyl patch, when it obviously does me so much good?
I can't even bring up the subject for fear that he will remember how much he hates them, and try to get me off them again.
Also, my daughter is an RN who has experience working in the pain management healthcare field. She has emphatically advised me not to tell my PM MD of our mistake, saying that he will fire me immediately if we admit the mistake. She states that my PM MD will not take into consideration that my husband and I had an unusually complicated week which led to our mistake. Rather, he will take the mistake as indicatory of additional future mistakes.
Doctor, I cannot begin to tell you of the frustration and agony that comes with being in nearly constant pain, every day, day in and day out. It defies description, and no one, NOT EVEN MY MD, wants to hear about it.
I might add that I made it through the 1960's without taking illegal drugs. My doctor is aware of this, and also that I have never smoked and do not drink. I also have never suffered from depression, (which, in his own words, is, "Simply Amazing.").
Part "B" to my question, upon thinking about it, is, "what should I do now...now that I KNOW that I can be pain free?".
There is no option to change my PM MD.
I hope I have not omitted information which is pertinent to your answer.
Thank you very sincerely for your time.