Dear Angron,
First, is like to express that I am so sorry to hear of all of your troubles and the subsequent surgeries that no doubt have contributed to your difficulties. I suffer from an acute case of disc degeneration, severe scoliosis, spinal stenosis and osteoarthritis --- all a result of an automobile accident in 1995. I had a neurologist/ pain specialist managing my pain who had me on a litany drugs some of which you're taking currently. When I returned to the care of my GP, the VERY FIRST thing he did was recognize that I was becoming tolerant to the drugs that were supposed to be helping me and that in no time my liver would be shot to hell. I also had had a gastric bypass which brought about it's own problems because anti-inflammatories were a "no, no" and because of how my stomach had been redesigned, I was only able to absorb about 50% of the benefit of the drugs I was taking. My doctor put me on a Mylan Fentanyl patch --- and took me OFF of evetything else (save 15 --- NOT 50 --- Loratab per month for breakthrough pain). It has completely managed my pain, improved my quality of life and kept me in check. Now for the part you MIGHT not like --- you knew that was coming, Right?
It sounds as though you need to find a new doctor --- the cocktail of prescriptions that you're on is killing your liver--- the good thing about the patch is that it is absorbed through the skin, stored in your fat cells and bypasses yoyr liver altogether. From what you've written, it sounds like you are not opposed to taking your medication in doses that are contrary to the directions that your doctor has written, which I guess an extra Norco here or there can't hurt if your writhing in pain, but can DEFINITELY kill you when it comes to Fentanyl --- you SHOULD not take a medication that you have NOT BEEN PRESCRIBED --- you have NO IDEA about Fentanyl and the difference between a wave of relief and an overdose is the equivalent of 2 grains of salt --- no lie!!!
You don't know how it will interact with ALL of those other drugs and without the guidance and expertise of a physician, you are dancing with a cobra. It takes Fentanyl approximately 12 to 24 hours to get into your system and you would need a well-devised plan to stop taking your other medications and begin the patch. It IS NOT something you jyst "try" and I'm shocked that your "friend" would just casually give you 2 if their 50mcg. patches!!! I'm sorry to be so adamant about how deadly this stuff can be, but facts are facts.
You MUST get a physician's help to calculate the meds you're on now and transpose that to an equivalent dose of Fentanyl. I ALSO advise that you ask to be prescribed the "matrix" style patches vs. the "resevoir" type. If you have children or pets, the reservoir style patches can kill them in that the medication is in a "pouch" which can be easily pierced and lead to overdose by inadvertent exposure. The matrix style is designed to make abuse much more difficult --- I honestly do not understand why anyone would have a death wish like that, but it is very important (if you want to live) that you have integrity with both your doctor AND your pharmacist. If ALL you truly want is find an effective way to manage your pain, then your honesty with both of those individuals is paramount! I have 1 prescriber and 1 pharmacy --- period. I would rather die than betray my doctor and mess around with a very special relationship. If you are willing to have an honest discussion with your doctor about how you feel physically, demonstrate a willingness to give up ALL other drugs (except maybe a VERY small Rx for breakthrough pain --- the patch isn't necessarily a silver bullet) and work with your pharmacist to help calculate any potential reactions, I think you'll be happy with the relief you'll get.
If your doctor won't entertain any conversation about Fentanyl, please ask him the rationale behind his position? I would be scratching my head as to how being on the "cocktail" you're on and the harm it's doing to your liver coukd be better than giving all of that up and trying something that could be more effective.
You could have an agreement with him/her that the introduction of Fentanyl woukd be for a trial period and agree to the "max dose" of which he'd no longer be comfortable prescribing. Once you have a plan in place, do your homework about the drug --- in fact, it wouldn't be a bad idea to do your research BEFORE your next appointment --- your doctor may be more receptive to switching if he feels you've checked into it and weighed the "pros" and "cons".
My doctor and I agreed that we know it's time for spine surgery when 1 of 2 things occurs: a.) I have to increase my dose ABOVE 200 mcg. per 72 hrs. OR b.) I lose functionality in any of my lungs that make it difficult to walk or conduct my daily life. Once you and yoyr doctor set the boundaries, honor them and be 100% honest!
I hope you will feel that I am coming from a place of not only concern, but experience. I've been wearing a patch since 2003 and it has TRULY helped me, but it is a drug that MUST be treated with ABSOLUTE REVERENCE. Please do your homework and talk to your doctor. If he won't help you, then find someone who will, but PLEASE don't take someone else's medication without the appropriate guidance and support!
Mj