I'm prescribed Fentanyl – AMA

The worst part is when it flares up, the best I can describe the nerve pain is like cramp but it is absolutely excruciating (the only way to treat it is to run a cold shower over my leg). The Fentanyl patches does help tone down the extreme end (I don't normally take anything for the breakout-pain as it's a slippery slope). I actually find cold compresses to be the best treatment for the swelling and have a constant rotation of icepacks in the freezer at home and fridge in the office). There's often a dull pain, part of which feels like I need to go to the toilet (so I end up going much more often 'just in case').

The annoying thing is that my last operation temporally fixed my knee (they removed some of the fatpad (hoffa's syndrome) in summer 2013). For three months I was able to stop taking pain killers (Tramadol at the time), swim, get back in the gym and cycle (although I never really went for it, I have a carbon-fibre road bike still in storage). It started getting painful after exercising, and gradually over six months later I was back on crutches. :(

I believe there is an underlying issue with my knee which can still be repaired. Unfortunately the Dr's I've spoke to are scared to operate (they find my case interesting until they can't figure it out and then refer me). I want to try another operation to repair it before going for a knee replacement.

Opiates play a vital role if they're respected my both the practitioners and patients. I don't think they are something to mess around with or joke about, Fentanyl is very dangerous if abused as a small mistake with the dosage often leads to death.

However, I do think that medicine is too reliant on big-pharma. It's too easy to hand out pills rather look at other treatments. There's exercise, hot/cold therapy, natural medicine (such as weed). Even mood has a large factor in how pain is perceived.

I was running my own business at the time, and found it very hard to work. I turned down new projects, only trying to support my existing clients. Luckily I was able to work from home, but the injury still meant I lost a lot of income and have had to use a significant amount of my savings.

It has been very important to me to help working and not rely on benefits as a friend of mine from college injured his back, he lost touch with his friends, spent all day playing computer games and he will be 40 soon and is still living in his parents attic. It's not been easy, but I am glad I stock with it. I did become isolated (Facebook & the web became my window to the world), work was actually the main thing that got me through this time. I moved to London a couple of years ago, where because of the fantastic public transport (baring the occasional strike) I'm able to get around and not be isolated. I strongly believe if I didn't move that I wouldn't be here now.

You're meant to taper off the medication as there's a large risk of withdrawals. I stopped taking Tramadol dead two weeks after the operation (day I had my stitches out, and started swimming the next). The only noticeable side effect/ withdrawal was a running nose. So believe I can do it again.

I made the mistake of wearing a patch in the sauna (I thought holding a bag of iced water over it would keep it stable). The high dose made me disorientated and may heart beat did go noticeably shallow for a couple of hours afterwards. Not a mistake I will repeat, I'll remove the patch before taking a bath or sauna again.

That's quite alright, I find it annoying that the only time Fentanyl is discussed (Opiates in general) is death and addiction.

I do strongly believe GP's shouldn't be prescribing pain meds for prolonged periods. They should refer patients to pain specialised after six month or if the patient complains that medication isn't adequate as pain is a very complex subject.

Then I was refereed to pain clinic, I was prescribed Amitripyline (it's not a Opioid), which was used as an anti-depressant (~150mg), but in much lower dosages (~30mg) it works for nerve pain. One side effect (which is actually great for me) is that it does make you drowsy, so taking it in the evening greatly improves sleep.

I've also tried Hydrocodone (which I found very good), occasional Oxycodone for breakout-pain. I've found patches (initially Buprenorphine) to be much more beneficial as they provide stable relief and lesson waking in the middle of the night/ early morning as traditional pills wear off.

The biggest increase to my prescription was just over a year ago when I did some intensive physio to try and beat the CRPS (there's some good medical data to back this up), unfortunately it meant I need to for from 5mg of Buprenorphine to 20mg (the max dose) in the course of about three months. After I stopped the treatment the pain didn't really subside.

I switched to Fentanyl patches a few months ago as the Buprenorphine wasn't working. Initially for trial, but we decided to switch to them as there were very little side effects and these mean not needing anything for the breakout pain. The stronger meds seem to do very little for the day to day pain (pain becomes normal), but seem to be far more effective when the pain is bad.

Fentanyl is the first drug to scare me, the first thing I did when applying the patches was watch some of the material on Youtube (addiction & deaths) to give me a healthy respect for the drugs.

There's no easy solution for opiate addicts if they want to get high. I do think law and society need to view/ treat addiction has a health issue rather than criminal.

The biggest problem I've had with my medicine is from Naproxen (a NSAID), for around a year I suffered from Iron deficiency anaemia (I was prescribed Iron supplements to try and mask the issue), I still lost a lot of weight and more severe bleeding. To the extent that a different doctor was so concerned she wanted to rush me to hospital. I'm now diagnosed as a coeliac which I believe is caused by the long term Naproxen use (the jury is still out on the relation, one doctor swore blindly that there is no correlation between NSAIDs and coeliac disease), I'm the first in my family and it's meant to be hereditary..

Now I only use a topical NSAID gel, which is another reason for needing stronger medication. One good thing about switching to patches is they have less impact on your gastrointestinal tract. Strangely, I seem to have no issue with constipation (a common opiate side-effect).