Aa
How bad is going off of Fentanyl 100mcg cold turkey going to be?
10 years ago I had the Roux-en Y Gastric Bypass surgery, which gave me malabsorption syndrome. That means that food, vitamins, minerals, meds, ect...do NOT digest in my "pouch", they digest in the lower intestine or go through my liver. So all meds had to be adjusted. I have had the same doctor for 3 years, she put me on Fentanyl 25 every 72 hours and 4 norco 5/325 for break through pain. A month later, she upped the Fentanyl to 50 mcgs every 72 hours due to pain coming through even with the norcos. A month later, she upped it to the Fentanyl 75 mcg every 72 hours. A month later she upped it to Fentanyl 100 mcgs every 72 hours. That is where she stopped. I have been on that same dosage now for 2 years. With my gastric bypass, she was supposed to monitor my med levels by blood as with urine it doesn't show up as well due to the malabsorption syndrome. She ran a urine test on me last month, I told her she needed to do a blood screen, not a urine, she didn't listen. I was to go to her on the 15th of this month for my refills, and called to confirm my appointment, and the receptionist told me she was dropping me as a patient because my norco, and xanax levels weren't where they were supposed to be. I explained to her that I have to have blood levels checked so that they can see how much medicine I have taken for the whole month, due to my malabsorption syndrome. She refused to see me period. Now I have no doctor, and have been told I have to go cold turkey off of my Fentanyl 100's, my .05 Xanax 3 times a day, and my Norco 5/325 4 times a day. All of my other meds have refills on them, like my blood pressure meds, my depresssion meds, my allergy meds,ect...
I tried to go cold turkey, but after day two, the pain was intolerable. I have a spine condition called sacroilliac joint disfunction. I have been trying to find a new doctor in my area that will take my insurance, as I am on SSI Disability due to my conditions, but when they find out I was dismissed from my doctor and why (I tell them up front because I have nothing to hide, and if I would lie, they would dismiss me also), they refuse to become my doctor. I am in such pain that I have been going through my old patches and trying to wear them for a day. HELP...I don't know what to do. I can handle the diarreah, upset stomach, hot/cold sweats, and the trembling, but the pain is so bad all I want to do is find something to knock me out. I can hardly sit or lay. Even with the patches I hadn't slept in my bed in over a year due to my back pain, I had to sleep in the recliner, and that was only for 3-4 hours a night. I just don't know what to do. Any suggestions? I have been told that my doctor is inhumane for the way she treated me. Thanks in advance for any suggestions/help?
I tried to go cold turkey, but after day two, the pain was intolerable. I have a spine condition called sacroilliac joint disfunction. I have been trying to find a new doctor in my area that will take my insurance, as I am on SSI Disability due to my conditions, but when they find out I was dismissed from my doctor and why (I tell them up front because I have nothing to hide, and if I would lie, they would dismiss me also), they refuse to become my doctor. I am in such pain that I have been going through my old patches and trying to wear them for a day. HELP...I don't know what to do. I can handle the diarreah, upset stomach, hot/cold sweats, and the trembling, but the pain is so bad all I want to do is find something to knock me out. I can hardly sit or lay. Even with the patches I hadn't slept in my bed in over a year due to my back pain, I had to sleep in the recliner, and that was only for 3-4 hours a night. I just don't know what to do. Any suggestions? I have been told that my doctor is inhumane for the way she treated me. Thanks in advance for any suggestions/help?
You're correct Phil. I hope her PCP will read the Report - Sadly I'll bet she won't be able to convince the PCP won't even read it or change her decision. I truly hope I'm wrong.
However she should carry it to other PMPs - they may read it (or be aware of it) and treat her. She should begin her call with the information. It's a war out there - PMP or PCP often just don't want to listen. If you've been in one location with one good PMP you cannot imagine what it's like trying to locate and keep a good PMP.
My Best,
~Tuck
However she should carry it to other PMPs - they may read it (or be aware of it) and treat her. She should begin her call with the information. It's a war out there - PMP or PCP often just don't want to listen. If you've been in one location with one good PMP you cannot imagine what it's like trying to locate and keep a good PMP.
My Best,
~Tuck
Oops -- I hit the Send button too soon.
Ask your doc to read the story in the National Pain Report by Kurt W.G. Matthies:
http://nationalpainreport.com/pain-treatment-technology-update-an-app-for-improving-interpretation-of-urine-drug-testing-8825829.html
or visit the the Remitigate site.
You have been wrongly dismissed.
Ask your doc to read the story in the National Pain Report by Kurt W.G. Matthies:
http://nationalpainreport.com/pain-treatment-technology-update-an-app-for-improving-interpretation-of-urine-drug-testing-8825829.html
or visit the the Remitigate site.
You have been wrongly dismissed.
I just talked with a friend, a doctor of pharmacy well known in the pain management community, Dr. Jeffry Fudin, Pharm.D., FCCP, FASHP Diplomate, American Academy of Pain Management.
He has a small company called Remitigate that offers an app for smart phones that helps PCPs with the interpretation of UDT -- the app is called UrinTel (http://www.remitigate.com/urintel/)
Here's a direct quote from Jeff's email:
"If you run fentanyl tru Urintel, you'll see that a negative is expected. Jeff"
Get this information to your doctor. Most MDs are not qualified to interpret the tests they give to monitor opioid compliance. This is why Jeff and his colleagues developed UrinTel.
He has a small company called Remitigate that offers an app for smart phones that helps PCPs with the interpretation of UDT -- the app is called UrinTel (http://www.remitigate.com/urintel/)
Here's a direct quote from Jeff's email:
"If you run fentanyl tru Urintel, you'll see that a negative is expected. Jeff"
Get this information to your doctor. Most MDs are not qualified to interpret the tests they give to monitor opioid compliance. This is why Jeff and his colleagues developed UrinTel.
I'm so sorry! One should not have to lose a PCP due to a drug screen. I guess I understand her reason for not RX your opiates - but not treating you medically. A shame! Keep searching!
I'll look forward to hearing from you often. I hope you'll become an active member of our community.
Peace n Hugs,
~Tuck
I'll look forward to hearing from you often. I hope you'll become an active member of our community.
Peace n Hugs,
~Tuck
yes, she refuses to treat me period now. So I need to find a new PCP immediately...have been trying since the 15th and no luck yet, they all deny me because of the failed urine I guess. Even with the knowledge of my malabsorption syndrome. I will keep trying though. I am hanging in there...I put an old patch on each morning and leave it there for 24 hours. so the withdrawls have slowed down a bit...and the pain is at least tolerable for now. Hope I find a doctor soon...will keep you all updated, thanks for the welcomed advise from each of you!
Hugs,
Chelle
Hugs,
Chelle
Your story makes my heart ache! It's unbelievable to me that long time PCP or PMP just push ppl out the door - with total disregard for their well-being.
Are you saying this PCP will no longer treat you in general or just PM? There should be some help some where. You might try Phil's suggestions. He's knowledgeable. Don't be afraid to go to ER. I am fearful you will become dehydrated given your medical condition.
MDs and DOs take an oath that in part says, "Do no harm." In my opinion what they have done to you - and so many others is against that oath. Sadly they are all terrified of the government "Watch Dogs". Most are afraid to believe in and stand up for their patients when they fail drug testing for fear of losing their licenses and being red flagged.
It's a very sad situation.
Good Luck,
~Tuck
Are you saying this PCP will no longer treat you in general or just PM? There should be some help some where. You might try Phil's suggestions. He's knowledgeable. Don't be afraid to go to ER. I am fearful you will become dehydrated given your medical condition.
MDs and DOs take an oath that in part says, "Do no harm." In my opinion what they have done to you - and so many others is against that oath. Sadly they are all terrified of the government "Watch Dogs". Most are afraid to believe in and stand up for their patients when they fail drug testing for fear of losing their licenses and being red flagged.
It's a very sad situation.
Good Luck,
~Tuck
Thanks everyone...I'm female by the way...lol. The doctor WAS my PCP, as she never referred me elsewhere, I have WV Medicaid, and need referrals for pain management. Now I have no one to refer me. I did also post in the addiction forum as I thought they may have more info for me. She also talked to my youngest daughter about me and this stuff when she went in for her appointment that day, which is also illegal for her to do. She told my daughter that my levels weren't high enough and that another substance showed up, and I DO NOT TAKE ANYTHING that is not prescribed to me. I'm 47, too old for the partying stuff...have never did anything in my life stronger than marijuana, and haven't done that in YEARS. Only did that for pain relief before I found a doctor to help me. It's just crazy...she knows about my malabsorption syndrome, she knew everything about me.
Your PCP should be the one to help in this case, until you can find a new pain doc.
If this is impossible, I don't often recommend this, but an addictionologist may provide an appropriate consult at this point and be easier to see.
If you are a Medicaid patient, you may be eligible for a three day, in hospital detox.
I realize three days aint going to do it, but if you find a good center, a busy social worker may find a place for you within that time.
Within those three days, they can treat your withdrawal symptoms (without listing you as an addict).
The problem with pain docs is there are so few of them (not that addictionologists are falling from the trees like ripe fruit).
But let me also warn -- once you are branded as an "abuser" or have an "addiction syndrome" -- it can be difficult to get pain treatment.
However, you have a diagnosed condition. Any doctor can see the need to treat your pain.
These ******* opioid contracts and urine tests (UDT) have become a trapdoor through which many a legitimate pain patient falls into the void. These are another "well intentioned" idea that have turned against pain management due to the problems of "unintended consequences."
I work regularly to get the various pain societies to see the truth behind these two mechanisms to "prevent abuse."
It is bad enough as a physician to take an opioid dependent patient and cut them off from the medication on which you have made them dependent.
Where are the ethics in administering and charging for a test (UDT) where the physician cannot properly interpret the results?
Where are the ethics of taking this misinterpretation and using it to dismiss a patient.
May God in his Mercy show these people the folly (and cruelty) of their actions.
If this is impossible, I don't often recommend this, but an addictionologist may provide an appropriate consult at this point and be easier to see.
If you are a Medicaid patient, you may be eligible for a three day, in hospital detox.
I realize three days aint going to do it, but if you find a good center, a busy social worker may find a place for you within that time.
Within those three days, they can treat your withdrawal symptoms (without listing you as an addict).
The problem with pain docs is there are so few of them (not that addictionologists are falling from the trees like ripe fruit).
But let me also warn -- once you are branded as an "abuser" or have an "addiction syndrome" -- it can be difficult to get pain treatment.
However, you have a diagnosed condition. Any doctor can see the need to treat your pain.
These ******* opioid contracts and urine tests (UDT) have become a trapdoor through which many a legitimate pain patient falls into the void. These are another "well intentioned" idea that have turned against pain management due to the problems of "unintended consequences."
I work regularly to get the various pain societies to see the truth behind these two mechanisms to "prevent abuse."
It is bad enough as a physician to take an opioid dependent patient and cut them off from the medication on which you have made them dependent.
Where are the ethics in administering and charging for a test (UDT) where the physician cannot properly interpret the results?
Where are the ethics of taking this misinterpretation and using it to dismiss a patient.
May God in his Mercy show these people the folly (and cruelty) of their actions.
Sadly Molly, I don't think he has a choice - at least not at this point. Did I misread the post?
He is in for a heck of a ride!! So unfair!
~Tuck
He is in for a heck of a ride!! So unfair!
~Tuck
My input...
DON'T do that. You'll experience some of the worst withdrawls anyone could have. It's like the worst flu you've ever had on steroids. Fentanyl W/D's also last for at least 4 weeks if not more.
My best,
Molly
DON'T do that. You'll experience some of the worst withdrawls anyone could have. It's like the worst flu you've ever had on steroids. Fentanyl W/D's also last for at least 4 weeks if not more.
My best,
Molly
Hello IceyBlue,
Welcome to our Pain Management Community. I'm so sorry to hear about your situation. It's one I am always afraid I'll find myself faced with - I too have Malabsorption Syndrome. Mine is from a MVA that almost took my life. I lost over 99cm of small intestine.
I've not been able tolerate the Fentanyl Patch - long story. I take only oral medications. Thus far my drug screens show a bit less than one would expect for someone that did not have Malabsorption Syndrome. I experience all the symptoms you describe.
Your question, "How bad is going off of Fentanyl....?" Sadly you're in for a rocky road. The diarrhea is going to increase! I know - that may be really extreme. You may require IV fluid. Your legs may experience pain and tremors as well as RLS (restless leg syndrome) symptoms. Your body will ache, you may have headaches. Your pain will increase. You may have difficultly sleeping as well as eating and other sx I haven't mentioned. It's not a fun ride.
It's going to be important that you stay well hydrated, eat healthy, try to keep your mind busy and be as active as you can tolerate. Get out in the fresh air. Use a support community or have a support system. Even with doing all you can do, you may require a trip to ER. My concern for you is the fact that in addition to the normal manifestations that present with withdrawal (w/d) you have Malabsorption Syndrome.
You are always welcome here. Please don't think I believe you have an addiction or substance abuse issue - but I'm going to recommend you also post in our Addiction Substance Abuse Forum. I'm recommending this because they have much more experience in w/d than this forum. They have seen hundreds of ppl like you. Again please don't think I am suggesting you have an abuse problem. Our body doesn't know the difference between opiate addiction or opiate dependent - it will experience the symptoms the same.
Here's a link to that forum: http://www.medhelp.org/forums/Addiction-Substance-Abuse
Dominosarah, gnarly_1 and other very knowledgeable ppl are on that forum. They are intelligent and non-judgmental. However please keep in touch with us. I am not sending you away, just offering you more assistance and information.
Someday we Chronic Pain Patients will have rights too. A failed drug screen, especially in someone with Malabsorption Syndrome should not mean guilty - guilty of everything and not entitled to any quality of life. The medical profession and our government should be ashamed of themselves.
I wish you the best of luck. Don't hesitate to go to ER should your sx become extreme. Please keep in close touch and let us know how you are doing. I'll look forward to hearing from you.
Take Care,
~Tuck
Welcome to our Pain Management Community. I'm so sorry to hear about your situation. It's one I am always afraid I'll find myself faced with - I too have Malabsorption Syndrome. Mine is from a MVA that almost took my life. I lost over 99cm of small intestine.
I've not been able tolerate the Fentanyl Patch - long story. I take only oral medications. Thus far my drug screens show a bit less than one would expect for someone that did not have Malabsorption Syndrome. I experience all the symptoms you describe.
Your question, "How bad is going off of Fentanyl....?" Sadly you're in for a rocky road. The diarrhea is going to increase! I know - that may be really extreme. You may require IV fluid. Your legs may experience pain and tremors as well as RLS (restless leg syndrome) symptoms. Your body will ache, you may have headaches. Your pain will increase. You may have difficultly sleeping as well as eating and other sx I haven't mentioned. It's not a fun ride.
It's going to be important that you stay well hydrated, eat healthy, try to keep your mind busy and be as active as you can tolerate. Get out in the fresh air. Use a support community or have a support system. Even with doing all you can do, you may require a trip to ER. My concern for you is the fact that in addition to the normal manifestations that present with withdrawal (w/d) you have Malabsorption Syndrome.
You are always welcome here. Please don't think I believe you have an addiction or substance abuse issue - but I'm going to recommend you also post in our Addiction Substance Abuse Forum. I'm recommending this because they have much more experience in w/d than this forum. They have seen hundreds of ppl like you. Again please don't think I am suggesting you have an abuse problem. Our body doesn't know the difference between opiate addiction or opiate dependent - it will experience the symptoms the same.
Here's a link to that forum: http://www.medhelp.org/forums/Addiction-Substance-Abuse
Dominosarah, gnarly_1 and other very knowledgeable ppl are on that forum. They are intelligent and non-judgmental. However please keep in touch with us. I am not sending you away, just offering you more assistance and information.
Someday we Chronic Pain Patients will have rights too. A failed drug screen, especially in someone with Malabsorption Syndrome should not mean guilty - guilty of everything and not entitled to any quality of life. The medical profession and our government should be ashamed of themselves.
I wish you the best of luck. Don't hesitate to go to ER should your sx become extreme. Please keep in close touch and let us know how you are doing. I'll look forward to hearing from you.
Take Care,
~Tuck
I forgot to mention, that I had my patch on when I took the urine test and it came back fine, only the meds that I take by mouth are affected by the malabsorption syndrome.
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