Hi, Susan:

I have had RSD since August 25, 2001 (ten years and one month ago). My RSD is now generalized and internal. I use several painkillers:
-Duragesic (fentanyl) 125 mcg: one 100 mcg patch and one 25 mcg patch every 72 hours
-MSIR (morphine sulfate immediate release) 30 mg: one capsule once or twice daily
-Tambocor (flecaïnide sustained release) 200 mg: one capsule daily
-Inderal (propranolol) 40 mg: one tablet twice daily

1) Did your prescribing doctor tell you that you became tolerant to fentanyl?

2) Do you take any medications, foods, or drinks that are enzymatic inducers? Enzymatic inducers make medications like fentanyl less effective, which might explain you need such a high dose.

3) Did your RSD aggravate or spread, which might explain you need such a high dose?

4) Did you develop a new health condition that might explain you need such a high dose of fentanyl?

Quote: "I will say I'm in mild pain now with occasional flares." To me, it seems like your medication is working if your pain is mild and you have only occasional fare-ups of breakthrough RSD pain.

Quote: "Maybe should just cont on this path or try to get off it and try something new???" Only you and your prescribing doctor can make such a decision, depending on what is going on with you, according to the four questions mentioned above.

I hope this helps.