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02/29/2004: Since Tuesday 24 February I put on the 2nd day a new fentanyl patch and on the 3rd day I remove the old one. This on advise from dr. Tisscher, because the pain on the 3rd day still kept decreasing.
Did you know that fentanyl is not the same as morphine and that fentanyl actually 40 times stronger is then morphine. This just as information.
The past few weeks I once in a while wake up really sick (nauseous, stomach ache, very feverish etc.) and as the day passes it gets worse and worse. Against the evening I have to poo and then it's a bit better, but still not completely over yet. The next day it was completely over again. The first time as this happened was on the day that I had to put on a new the patch. The second time that it happened it also was on the day I had to put on a new patch. So I was wondering if it was some kind of adjustment/addiction? Or that the patches of 50 mcg still would be too heavy for me? Or that maybe it is from the constipation (IBS)? I wake up sick more often, actually it's normal for me, but now with the patches you start wondering if it has something to do with it. However as I had it the third time it was NOT on the day of a new patch, so yes that rules out the patches. The night before I already feel I have to poo soon, so it will be constipation.
By the way I got some lactulose from my gp for the suspected constipation due to morphine-use, but I don't react really well to that lactulose. It was to expect considering the fact it contains lactose... I have a lactose-intolerance. I actually have to use 15 ml a day, but I only use not more then 2.5 ml once a while and still I get complaints like more headache, more pain, diarrhoea etc.
I have emailed all this to dr. Tisscher and now for my constipation I have to eat a bit of something to which I react with diarrhoea, in my case among others potato. At least since the last half year or so I can't tolerate them anymore, this will be due to all that potato-salad from last summer.
Since I use that lactulose I can't tell anything about my constipation; then it is every 3 days, then every 12 days etc. Now I don't mind constipation that much, but I hate it when it has become 1 big hump of cakes poo... that hurts. So also yesterday, on advice of dr. Tisscher I eat a few French fries from Henk and yes a bit later I can go to the toilet. By the way I had forgotten to check my agenda to see that it already had been 8 days again since the last time. I have to register this in my agenda otherwise I don't know when the last time on the toilet was.
So I went to the toilet... pain oh boy what a pain! I almost didn't get it out and as it finally was out it was real clear to me why it did hurt so much... the hump was at least 5 cm in diameter... AUTSCH! So it is again going the way it was as I were very ill, as they had to empty my rectum with a spoon because the hump was too big and so hard that it was impossible to get it out by yourself.
You probably do understand that I now hurt a lot on my ash... I can't even fart without having pain *hihi*.

But well coming back to the morphine: since I put a new patch on every second day and remove the old patch on every third day my pain is more steady and not worse anymore on the third day and with peaks, so that's nice. My gp by the way still isn't cooperating with prescribing sequel-recipe's for morphine patches.

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