pain, pain go away

Hi Mike, my wife has been using Fentanyl Patches for almost 9 months now,she started using 12.5mg,which has now been increased up to 25mg. I think the patch works slightly differently to an injection,by slowly releasing the Fentanyl through the skin over a 3 day (72 hr) period.Thats why the Patch must be changed every 3rd day.my wife rotates the site,upper body only, 1st site left upper arm. 3 days later her right upper arm, after that her right abdomen then on the 3rd day on her left abdomen,then repeat all over again. The Patch doesn't take the the pain fully away,but makes it more bearable with her. It might work differently with you. Hope this has answered any of your queries ?  Good Luck Mike.  kind regards. John.

Something went very wrong with that injection. It must have gone through the joint capsule and damaged the Sciatic Nerve that lies behind the joint.  You need to ask for a neurology/ neurosurgical opinion as this is a very serious complication.

Part two:  Your pain is a second issue.  Fentanyl works well, but you will need to be monitored as to what dose you need. Each person needs different amounts. 12.5mcgm patch is a small dose for an adult but you have to start there. It depends on how your body metabolises the drug.  Eventually you adapt to it and may need more.

Good luck!

Thank you all for your replies, well i am now on 50mg of fent, and feel like a zombie, but if i don't have the patch on i am in so much pain, i did go back down to 25mg but that was not working so at the moment have to stay on 50mg, plus my tarmadole, and my gapapentine, feel really bad, i have had more MRI on my hip and knee and even been to dif hospitals and the consultants just says to me that he can't see anything, i said well its not in my head and there is no machine in the world that can see pain. i also told him and many others that i can have as many MRI scans as you wish to gibe me, but it will not pick up and kneedle pricks in any nerve, they said yes your right it won't, so  after having my hip injection done on the 14th of Nov 2014 and spending 6 days in hospital because of it i am no better but worse, i now have a stair lift put in, i now have a electric mobility scooter, i have a simmer fraim, i have a bath lift, i have a walker, i have a toilet aid, and all this becasue i went to my gp about paind in my left knee and he sending me for a xray on my knee, then the hospital consultant telling me that he thinks the pain is from my hip and not my knee even thou i told him the pain is in my knee i should know its my body, but no he insisted that i have a hip injection and have cortasone injected into my hip, so they injected under xray guidance, that was the worse day of my life, as i walked into that hospital but had to be rushed off to a major hospital and stayed there for 6 days and no almost unable to walk and need to be cared fro by my wife, i am on al sorts of pain killers and none seem to be working and i also ge told that there is nothing wrong with me, i told my gp and the hospital consultants that all this is not in my head and after doing my research and having copies of my hospital and gp notes i feel that the femarial nerve and maybe some ther small nerves have been damaged by the needle, they all said no that could not happen, i am so upset and fighting this so much, i have even said to my GP i want my leg taken off, and many times i just don't want to be here living with this pain, and seeing my wife looking after me like this, i am 51 years old and now my life and the quality of my life as been taken away by some blunder that the hospital as caused, and they are deniying that they have done anything wrong, yes i have been toa solictors, and she tooks weeks to get things started, she then sent me all my gp and hospital notes back to me and said sorry she can't represent me for a neg claim as i signed a consent for to have the hip injection done, however if i paid her £2500 she would start to take thing forword and start to make a claim, i am here typing this in tears and upset by it all, what would be your advice on what i should be saying, doing and asking? ps, sorry about the spelling

Hi I use fentanyl patches for various reasons and I'm on 125.mcg patches I also take 600 mcgs of sublingual fentanyl and also 100mcgs of fentanyl nasal spray for breakthrough pain I have to say the patches worked for a while I also started on 12th mcgs but my body has become opiate tolerant now so my advise is just keep an eye on things and try not to end up like me

I have read a few of your posts and the discussions around them.

Your problem is almost certainly due to the needle severing your sciatic nerve or the other possibly is that the cortisone was injected into it an being the cause of the injury. Cortisone injections when used around nerves should NOT be injected into the nerve but next to it!!  That would be as is done to reduce swelling around a nerve. Your description of what happened fits in with this. You have written elsewhere.

You need to experiment with your fentanyl patch. I must say I leave my patches on for 6 days to suck out the very last bit of fentanyl. This has been a help to me. You could also use a lower dose every two days as some people metabolise it differently.  It is an opioid drug. In fact all these pain killers work in much the same or very similar ways even though they have different names.  I use my patch every 3 days and that lasts only really for one day and for the next two days I use either cocodamol 8/500 2 tabs 4x/d or tramadol 50mgm 2 caps 4x/d. I swop them around. I am also on amytriptline 25mgm and clonazepam 2mgm both at night. This only just keeps me going. You should possibly be on these.

These last two drugs are essential as they improve your tolerance to pain. The clonazepam affects sodium transfer across the nerve cells. Some people need more of the amitryptiline, I cannot as my bladder neck function. Gabapentin and the other drugs like it are really only helpful in some people with other types of neuropathies, but may be the cause of a lot of side effects such as those you have. Probably useless in your case where there was almost certainly nerve injury caused by the needle or the cortisone being injected INTO the sciatic nerve, as in your case.  There are other add-on drugs like gabapentin that can be used, but they are for people with other types of neuropathies.

You should try and find a lawyer who will work on a no win no fee basis and they are around. You seem to have spent a lot on all the other things you have had done, or were they paid for by the NHS? What happened to you was not right, even if you signed consent. It is a known complication, but you do not sign away your rights when you sign consent. When a mistake is made that can be malpractice as not enough care was taken. They were doing under a X-ray control and the needle should not have gone through the joint capsule into your sciatic nerve. That must have happened and is the cause of your horrific complications. In fact your description fits in with that. You are actually young and the injury should not have happened. When the X-rays are done at the time some dye is sometimes put into the joint to identify the position, and does not always show if the damage was done BEFORE the actual injection of the other drugs took place and the needle went too far and into your sciatic nerve. I am pretty sure this is what happened to you. The pain you had at the time of the injection points to that.

Someone else not involved with the case needs to review the X-rays. More scans and X-rays are not going to show anything and are not going to help. It is possible that some very specialised nerve studies will show the injury.

Also you need to be asked to be referred to your nearest Specialised Pain Clinic. They are around in the bigger hospitals.

So there are many things that can be done for you. Do not lose hope and get a lawyer.