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Normally my pain level is about 9-9.5 since the patches (except for the past days) it's about 8-8.5. I now have to watch how it goes and then I have to call or e-mail dr. Tisscher on Monday, probably I will then get a stronger durogesic patch. After all we are still looking for the right amount of fentanyl for me. You got 4 strengths; I now have the lightest one which delivers 25 µg fentanyl/hour, then you have 50 µg, then 75 and strongest are 100 µg fentanyl per hour.

By the way my gp barely could believe that I have no side-affects of the morphine, he had never heard of this before... well then I am the first, I said. Fairly spoken I do hope that he now wished he had give me morphine years earlier... maybe I wouldn't have been bedridden all those years.

02/08/2004: I actually had to put a new patch on Friday morning the 30st, but I just couldn't hold it anymore. I was in so severe pain, probably due to all that noise from the past 2 days at the neighbours, that the pain level had risen to 9.5-10. So Thursday night, about 10 hours too soon, I put a new patch on. I really couldn't hold it anymore from the nerve pain while that same day, Thursday i also had got a new B12-shot. About an hour after I put the new patch on the pain started to decrease a bit again, so apparently the lightest patch is still too light for me.
So the next patch had to be put on on Sunday night, but again the pain began to decrease about 18 hours before and so I again had to replace a new patch too soon. And also this time the pain started to decrease about an hour after replacing the patch.
On Monday I called dr. Tisscher about it, I had to report him about the past week and so he decided to prescribe me a stronger fentanyl patch, the one of 50 µg-hour.
Tuesday night I put this one on (of course again too early) and now the pain decreased even a bit more, but we'll have to wait how long I benefit from this patch.

With this stronger fentanyl patch my pain level is now dropped to 6.5-7 which of course if better tolerable. Now I also have to change the patch every the 72 hours, so that's normal. Although I do notice some hours in front (about 10 hours) that the patch is working less, but I don't need to change the patch earlier. Those last 10 hours the pain level rises to about 7.5-8 and sometimes peaks of a 9. But well, those peaks of 9 can also still be due to the relapse of last week (those 2 days of noise at the neighbours) and the fact that I got my period isn't of course also a reason for less pain.

Luckily I still have zero trouble with side-affects. Well, I do notice that my constipation has got a bit worse, so I think I will try the lactulose I got from my gp.
At about the middle of the week I'll e-mail a report to dr. Tisscher and then we'll see what he says of it.

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