Good morning everyone

I'm happy to report that the BuTrans Patch 5mcg/hr is working nicely on my resting pain and I've been able to reduce my hydro on my good days. It doesn't do anything for the pain when I do anything physical. Cleaning, cooking for trying to go to the store still puts me in the bed taking full hydro's 10-325.

I do want to tell you what happened with my 2nd patch and see if anyone has heard of this happening before. Went for my 2nd visit to the pain mgmt. dr yesterday and he said he's never heard of it affecting anyone like that before but was very interested in my details which are:

2nd patch was placed on my upper right arm which I call my SFN arm. I thought the patch would help that arm. Boy was I WRONG about that ! Immediately upon placing the patch my arm felt 'strange'. From the strange it went to pain of 9 and stayed from 7 to 9 for 5 days until my daughter begged me to let her change the patch. Which I did. As soon as the patch was removed I felt immediate relief. It still took me 3 days in the bed, taking my full dose of hydro, after it was removed to get over all the affects it caused.

So that's my question. Has anyone heard of this before ? Of the patch being placed on an offending extremity and causing more pain to that extremity ?

On to my visit of yesterday. He increased my BuTrans to 7.5 mcg/hr which is a brand new dose they have come out with. We again discussed a sympathetic nerve block for my left leg/foot and I have agreed to have it done on Nov 20th under sedation. I'm a chicken and would not have it done if I was awake. Just sayin'

I would also like to mention that reducing my hydro doesn't seem to have affected me in any way. No withdrawal symptoms. Would that be because I'm on the patch ?

Thanks for taking to time to read my current story.

Debi from Georgia

Buprenorphine will displace other opiate drugs from the pain receptors in the brain. Taking an opiod for breakthru therefore may not work well for some patients, as the pain receptors may be blocked by Buprenorphine.

This is pretty complicated and patients do respond differently.
Buprenorphine may in some cases precipitate withdrawal in patients taking high dose opiates for pain. Buprenorphine has less euphoric side effects as well.

Technically buprenorphine is also less effective in lower doses for pain.

I think you should search this drug with a keyword "buprenorphine mu receptors" and take what you find to your doctor. Many doctors do not understand how this drug really works.

I am not finding much on "more pain" with this patch.
But here is a copy of the patient info you should read:
http://www.rxlist.com/butrans-drug/medication-guide.htm

"Inadequate analgesia" is listed at
http://www.drugcite.com/?q=butrans

Don't hesitate to contact your doctor. Also I guess it is possible but not likely that you received a package that was pirated.
Black market forgeries do exist for many drugs...if a drug you use acts strange, this should be reported. I am not seeing any reports today of fraudulent product, but that doesn't mean it can't happen.

You are not seeing a withdrawal from hydrocodone, because Buprenorphine is used to withdraw people from narcotics. Most normal doses of opioid would be replaced on the receptors by the buprenorphine. If you didn't take really high doses like some oxy people do you most likely would not notice withdrawal. In the same token, additional opioids may not work well for breakthru while using buprenorphine.

It is possible you placed the patch over a nerve path..so use another application site and see if the same thing happens.
There may be a local irritant effect that doesn't show up yet on the reports of side effects, as this patch is still quite new.
If you didn't get ANY pain relief elsewhere, I'd worry about a fraudulent product.

From mrsD:

I am not finding much on "more pain" with this patch.

It is possible you placed the patch over a nerve path..so use another application site and see if the same thing happens.
There may be a local irritant effect that doesn't show up yet on the reports of side effects, as this patch is still quite new.
If you didn't get ANY pain relief elsewhere, I'd worry about a fraudulent product


I am on my 4th patch.....3 placed on the left side of my body that did fine. I'm guessing you may be right and the patch was placed over a nerve path being in my right upper arm. The upper right arm is what I call my SFN arm.

I too had researched 'more pain' with this patch and could not find any info on it affecting someone the way it did me on my right arm.

Guess I'm just very curious as to why that happened.

Going forward I will only be using the patches on the left side of my body.

Thanks for your input mrsD

Debi from Georgia

Do you feel this patch is giving you enough added pain relief (aside from the arm incident)? Before your post, I had not previously heard of this patch.

It appears the hydro was not potent enough for your pain. Other than the patch and nerve block; has the doctor given you any other med options?


Gerry

Good morning, so great to find that others are using Butrans patch. I have CRPS, small nerve fiber polyneuropathy and erythromelalgia. Been using it (20 mcg and recently added a 5 mcg) for over 2 years and it has definitely helped with pain control. I also use Nucynta for breakthrough pain. Before switching from OxyContin, which I requested, I had pain flares wrecking havoc on my physical and mental state. With the patch and a steady stream of med in my system, I can function at a baseline 5-6 pain level. Like you mentioned Debi, any physical activity or sometimes just walking down the hall can cause a flare up to 7-8. I don't always take Nucynta for these, as getting my feet elevated ( a must because the bottoms of my feet, especially the soles are involved) meditating, resting, etc....can sometimes bring the pain level back down.

I'm happy to read it's working for you! I've not experienced what you described, increased pain after placing the patch as my initial injury was my right foot. I use my upper arms and my chest for placement and rotate them. The upper chest gets into my system faster, I think, as there is less fat in this area. Good luck going forward and I will look for your updates.

Thanks mrsD for great info about the drug. I wish more folks were able to use it.

The patch is not giving me enough added pain relief but is helping some. More so than just the hydro alone. Hydro is the only thing I've taken for the SFN since last May until this patch. I guess I didn't realize how new this patch is.

I believe I had become tolerant of the hydro. After 18 months and 4 doctors telling me I needed to see a pain mgmt. specialist I finally gave in. This 5 mcg/hr BuTrans patch is the first thing he started with and told me to use my hydro for the breakthrough pain. We did discuss methadone but that would require an EKG every 6 months and right now I don't need another dr to have to go and see. My husband or daughter have to get off work to drive me now. The dr said he felt like the only thing that might give me the relief I'm looking for is the SCS but I told him that would be a last resort if I agreed to it then. He didn't mention it on this 2nd appointment.

I've just started my 5th patch today. The new 7.5 mcg/hr so I'm hoping it will help a little more.

This is all very confusing to me and sometimes I feel like I have no dang idea what I am doing at all.

I slept most of the day yesterday and didn't do much today except take a shower and then rode 2 houses down to my daughter's for my grandson's 10th Birthday Party. We got there at 2 and by 3:30 I was in some serious pain in my feet. Was very upsetting for me since I didn't do anything to cause this.

Thanks Gerry

Debi from Georgia

Nice to find someone who is using this patch and it is helping them.

And on my feet it's mainly the soles that hurt so much too. Do you find yourself hobbling to the couch or bed when the pain hits ? Until a few months ago I was able to walk on my heel if the pad and middle of foot started but the heel is now affected and when it all hits at once I'm a sight to see trying to get somewhere to sit down

The heel feels like there is a stone bruise on the entire heel. Remember those from going barefoot in the summer time ? I honestly don't know if all of my feet issues are the SFN but I just blame it all on that. Guess I really need to have a foot dr taking care of my feet ?

Thanks much for your post

Debi from Georgia

I am going to try and see the podiatrist soon about this ankle and the heel pain. I have serious heel spurs but don't usually feel them because of the numbness but now that I am having trouble walking at a all I think it may be time to see if these pains can be separated and possibly treated. This SFN makes it impossible to know what is going on sometimes! I definitely can relate to the pains you describe.

Hi Debi, I completely understand how you feel! Having the soles of my feet affected by the conditions I have makes walking very difficult as sometimes they all act up at once; hot, cold, red, purple, black. I've given up trying to figure out which condition causes which pain. Pain is pain and since I'm never out of it, I just take it one day, sometimes one hour at a time. My Achilles tendons burn and the top of my are affected by CRPS
My hands have the same issues in fingertips and palms. It feels like I have lost all the padding on the bottoms of feet and am walking on bone. I can still walk on my heels but long term, that will probably do more harm. Actually, everything hurts, legs, arms too. The SFN in action!

One of the best things I've done, although I resisted it for a long time, was to get a mobility scooter so I can go out of the house on occasion. Getting one was admitting I'm sick but I finally got over it. I have a number of providers I see and haven't added a Podiatrist but probably shouldThanks for writing and I hope things improve for you soon! Deb

Deb,

Good idea about the scooter. Not quite there yet; but I will keep it in mind.
Debi just might find a scooter very useful for her as well.
Thanks,


Gerry