Friday 5 March 2010

Off and back on the pain patch

Managing the pain regulator

At my last meeting with the oncologist we decided I could begin to wean myself off pain regulation managed by the Fentanyl patch that trans-dermally seeped 25 micrograms of active agent through my skin every hour.

The week before, my treatment superintendent had suggested the best way to half the dosage was cut the patch in half before removing the seal, I had gotten used to having the patch work well beyond the 72 hour dosage time.

Or rather, I did not have any perceptible pain beyond the 72 hour patch wearing recommendation and probably that meant there were no indications of pain as I planned to discontinue the usage of the patch.

Coming off the patch

On Wednesday evening, I peeled off the patch and decided the pain management was over, some 36 hours after, I have had to reconsider that decision.

In addition to pain management, it would appear the patch with the attendant side effects was managing a few other things that gave me a lot of comfort that I think I have lost making me seriously uncomfortable.

It started with a chronic sickly salivation, I was producing so much saliva that I was spitting out quantities bordering on arrested nausea not manifesting as emesis.

The patch generally has a side effect of constipation whilst my general medication has dysentery to boot, at one time I had to take something to handle the constipation but my physiology had adjusted for normal bowel movement.

Without the patch, I suddenly had the runs accompanied with severe abdominal ache which last about 10 minutes allowing for bowel evacuation which seemed to dislodge the discomfort.

Back on the patch

In any case, I was very uncomfortable and sad to discover that the pain management probably masked other issues that would show up on discontinuance.

It would appear I have to be more gradual in withdrawing the pain medication to the point of the current half-dosage that I have for beyond the 72 hour range and then down to a quarter and hopefully with the adequate adjustment I can go off it completely.

I am not in any particular pain per se, but at the same time, I am willing to tolerate any pain like what I suffered for months even when dosed up on morphine and its derivatives, I also need to manage the discomfort because it helps to keep a fresh and comfortable state of mind.

So, the patch is back on the fatty but lean parts of my stomach wall and pain management is just a case of managing oneself off the need for medication much more gradually than a macho act of mind acting over matter and hoping for the best.

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