My GP gave me a special patch for my back pain ... what is it exactly?
I HAVE really bad back pain and I’m waiting for an operation. My GP gave me some patches but I’m a bit afraid to use them. To me, it doesn’t make sense that they deliver as much pain relief as pills. Do they work?
Nuala, Dublin
THESE pain-killing patches usually contain an opioid — a strong painkiller that is delivered though the skin around the clock.
Unlike pills, which may need to be taken every hour, patches work well i n terms of convenience, compliance and pain control. Depending on the brand, the patches vary in how long they are left on, but one of the most popular is a three-day patch. The medicine passes from the patch through the skin and into the body.
When you put the first patch on it won’t work instantly, as it takes time for it to get into your system. You will need to take pills orally until it kicks in. You may also feel flu-like symptoms as you go from pill to patch, as you experience withdrawal of one drug before you restart another.
When you get established on the patches, if you still need to top up your pain relief with two to three more doses of painkillers per day, then you are probably not on a high enough dose of the patch, so you will need to talk to your GP about that. When you are placing the patch, clean the relevant area of your skin with water only. Apply the patch on to hairless skin on the upper part of your trunk or upper body. Write the date and time of application in permanent marker on the patch, otherwise you are likely to forget which day it went on. When you replace the patch, you must then put the new one on in a different location.
Dispose of the old patch by folding it in two and putting it in the bin. Think of how dangerous it could be if a child or your dog got hold of this, so it’s very important they are disposed of safely.
You should not take hot baths, use saunas, sun beds, electric blankets or heat pads as they may result in overdose due to the patch getting heated up. These drugs may also make you drowsy and should not be used with alcohol.
Constipation is another common problem. Nausea and vomiting may also occur but again they tend to wear off. The patch itself can irritate the skin. Weight gain, lack of sex drive and itching may also occur. The patches should, of course, never be given to anyone else. Opioid drugs come from the opium poppy, as do drugs like heroin and methadone.
They are very effective painkillers but if used inappropriately, they can become highly addictive.
Always take the dose as directed by your doctor, remembering that doubling up doses could prove deadly. Pain cannot only be disabling but very depressing so must be dealt with. Delivering pain relief by means of a patch may help you get a better quality of life.
I SUFFER from asthma but recently, I’ve been getting discomfort in my chest and shortness of breath, as well as pins and needles in my arms and around my mouth. It doesn’t happen when I exercise but seems to come on if I’m stressed. I’ve just started a new job and don’t want to have to call in sick.
Jennifer, Waterford
CLEARLY you have asthma, so this could all be related to deterioration in your condition. This is particularly important if certain factors in your new place of work may be flaring up your asthma, such as dust, mould or pollen in your environment.
Other lung and heart problems need also to be ruled out, so a visit to your GP is a must.
However, I’m going to focus on one condition, which often gets missed — especially in asthmatics — hyperventilation.
This is the excessive ventilation of the lungs, beyond what is necessary for breathing. It actually means you are ‘over-breathing’.
It can occur all the time but is more likely to come on in bouts. It is thought that as many as eight per cent of non-asthmatics, and potentially one-in-four asthmatics, suffer from hyperventilation at some point. When a bout strikes, you tend to feel short of breath and you may experience discomfort in the chest.
Pins and needles occur in the hands but also the toes, and around the mouth.
You may furthermore feel dizzy or light-headed, and feel like you are going to suffocate.
You find it difficult to speak during an attack, feel anxious and vigorously try to suck air into your lungs. Your recent job change may be a provoking factor, while worrying about having an attack creates a vicious cycle.
In short: you need to learn how to deal with your stresses and triggers. Physiotherapy can be very useful for teaching you how to really breathe efficiently and effectively. On a personal level, singing is helpful as it helps you to control your breathing.
Try to speak slowly and avoid t aking l arge gasps between sentences — for the same reasons eating slowly also helps.
Avoid unnecessary t hroat clearing and coughing. Make sure your posture is such that it is comfortable to breathe; if you are crouched you will often feel you can’t get enough air in your lungs.
In an acute attack you should stop what you are doing immediately and sit down.
Slow your breathing to eight to ten breaths per minute.
You can create a mask with your hands covering your mouth and nose, slowly concentrating on your breathing.
Speak slowly and try to relax, remember that although the symptoms may be severe they usually don’t result in any serious long-term problems.
Good luck!