Fentanyl Help (urgent)

Re: Fentanyl Help (urgent)

Emma Dillon — Sun, 31 Jan 2010 14:49:15 GMT

Hi Caro,

My Dad was on patches for a while before he passed away. It takes 24hrs for the patch to become fully effective so he had to take pills until then, You definitely can't cut them and tehnically they shouldn't be disposed of in normal waste as they can be abused although can't imagine it myself.

My Dad would take a shower and just shove a primapore type dressing over the top. He had little or no side effects from them after the first 2 or 3. He didn't have a build up dose period though, the docs just worked out the appropriate dose for him and that was it.

He also took extra pain releif on top at time but he had multiple myeloma so this prob wouldn't apply to your Dad but you can take extra if at anytime you're in extra pain if you know what I mean.

Hope you get it sorted with the docs. Tramadol tabs seem to have various effects on people, my partner felt so ill he only ever took one dose. I had them and was fine, but a little out of it if you like. I could function but it was like I wasn't quite in the room at times. Odd stuff.

Good luck with the doc in my experience talking to people like that is like talking to a brick wall. Same level of intelligence.

Re: Fentanyl Help (urgent)

albatross — Sun, 31 Jan 2010 13:39:22 GMT

can't help with fentanyl but mu is on tramadol 50mg 1 tid. The docs have agreed to up it as combined with paracetamol it wasn't working for her pain (neck of femur fracture and replaced with metal shaft but hip socket not lined so shaft head drilling into pelvis.....9 years ago....)

she is now on dihydrocodeine plus tramadol but of course the dhc is giving constipation.
either mum misunderstood or someone told her wrongly, to replace all painkillers with dhc so she stopped the tramadol.... major depresion and pain followed until I spoke to the doctor and got the correct plan for pain management.

She did try buprenorphine patches for a week, but said they made no difference to the pain level, and the doctor/district nurses said that to help the pain they would have to increase to a level that wasn't safe for dizziness or virtual sedation effect....so she stopped them.

Good luck with your Dad, go and kick some butt...

Re: Fentanyl Help (urgent)

Caro Laithwaite VN — Sat, 30 Jan 2010 21:35:34 GMT

he wears lots of layers as has no body temp so wonder if that counts. Is a struggle to get his temp to above "lo" reading and yes Vicky l agree l need to get it sorted asap.

Re: Fentanyl Help (urgent)

Vicky RVN — Sat, 30 Jan 2010 21:20:01 GMT

Let's hope they'll prescribe them to him if it seemed to help before,

Re: Fentanyl Help (urgent)

Caro Laithwaite VN — Sat, 30 Jan 2010 21:18:22 GMT

Thanks Vicky never thought about that with heat pads he does have a heated underblanket so need to keep patches high so not touch that or put it on his front of shoulders or legs as he can only sleep on his back due to his spine problems.

Re: Fentanyl Help (urgent)

Caro Laithwaite VN — Sat, 30 Jan 2010 21:16:46 GMT

Forgot to add at home he has 2 "baths" a week, at the home as many as he likes so is taking advantage of them.

Re: Fentanyl Help (urgent)

Maisy — Sat, 30 Jan 2010 21:15:22 GMT

[quote user="Vicky SVN"]

Yeah i was thinking about that. Should be ok though shouldn't it, if not in the bath too long? I remember being told at college not to put the area where the patch is on a heat pad because of it.

[/quote]

Apparently steam from hot baths (which hopefully hospitalised patients aren't generally receiving!) can increase the medication dose, as can wearing heavy layers of clothing. The latter again wouldn't really apply to hospital patients, more those who are on patches whilst being treated at home I'd guess.

Re: Fentanyl Help (urgent)

Vicky RVN — Sat, 30 Jan 2010 21:12:06 GMT

[quote user="Maisy"]be careful with the heat from bath water as this can speed up the administration.[/quote]

Yeah i was thinking about that. Should be ok though shouldn't it, if not in the bath too long? I remember being told at college not to put the area where the patch is on a heat pad because of it.

Re: Fentanyl Help (urgent)

Caro Laithwaite VN — Sat, 30 Jan 2010 21:11:53 GMT

It is only at the home he has full baths as they have a bath lift chair he is in. And l doubt the water is hot. At home he has a slat across the bath, he sits on that not in the water and the carer helps him "bath" like that.

Possibly the patch is removable for that or like Vicky says coverable?

I need to get the idiot dr to understand he is started on the LOWEST dose and slowly built up. This seems a foreign concept to said idiot. At the hopspital he had a patch on according to the discharge letter. Trouble is it did not say for how long but l know the a & e Dr put one on so it was from then till..? and he seemed lucid and pain free so am hoping it is going to work.

Re: Fentanyl Help (urgent)

Maisy — Sat, 30 Jan 2010 21:06:03 GMT

Definitely not to be cut, and also be careful with the heat from bath water as this can speed up the administration.

Hope things get sorted for your dad soon Caro.

Re: Fentanyl Help (urgent)

Vicky RVN — Sat, 30 Jan 2010 19:14:54 GMT

That is awful Caro! I too have heard Fentanyl can't be cut in half. With the not being able to get it wet, could it be at the top of his arm to allow him to still have a bath? And maybe a dressing could be put over the top while he's in the bath to stop it getting splashed?

Re: Fentanyl Help (urgent)

Gillian Mostyn — Sat, 30 Jan 2010 19:03:15 GMT

I know what you mean about dosages. During my Dads illnesses I'm sure he was given many overdoses. He was 5'4" and approx 65kg so wasn't 'average man', like they seem to dose for....

Re: Fentanyl Help (urgent)

Caro Laithwaite VN — Sat, 30 Jan 2010 09:27:34 GMT

Thanks Fi and Steph yes anything and everything l can learn will help. Unfortunately there is no cure for old age just making people comfy. I got the impression it was a lot more than 24hrs to stabilise so that is useful. I want to try and get him on, stable, sorted before he leaves the residential home on the 17th feb. to go back home.

I am hoping if it works out he will be able to go on them pretty much full time as that is the impression the a & e Dr gave for use. Provided that is it helps, if it doesnt then ibuprophen will do. It has it's drawbacks but some things you live with.

Re: Fentanyl Help (urgent)

Steph Phillips — Sat, 30 Jan 2010 09:13:23 GMT

omg.. your poor dad :( will try my best to help..

[quote user="Caro Laithwaite"]

How long to stabilise on them (l realise there will be some confusion till dose is sorted)

[/quote]

* Takes up to 24hrs to fully kick in - they can only stay on for 72hrs though, then another one applied in a different area of skin.

[quote user="Caro Laithwaite"]Can you cut them in half or not (l am guessing not)?[/quote]

*No, they shouldn't be cut.

[quote user="Caro Laithwaite"]How was the persons mental state [/quote]

*My mum was on them for about 8 days.. she felt 'ok' but it did make her a tad queezy.

[quote user="Caro Laithwaite"]Can you get them wet. (bath)[/quote]

*Dont think so. mum was told to avoid it anyways!

Hope that helps you caro... I really hope your father makes a full recovery and you manage to get things sorteed. xxx

Re: Fentanyl Help (urgent)

Fiona Leathers — Sat, 30 Jan 2010 09:05:48 GMT

Sorry Caro no help at all but just to let you know I'm thinking about you & wishing your dad well.

As for the fentanyl, I don't think they can be cut in half, is it not a gel inside?????