I'm going to preface this by saying that I am in the UK therefore am receiving my treatment on the NHS, so our guidelines for prescribing opiods is different to other countries, especially the US. I also don't have to pay for my medications as I suffer from epilepsy so receive free prescribed medicines for life.

As title - I've been taken off the high dose codeine and tramadol I've been taking for ~3 years as it is no longer effective. Treatment is for chronic severe pain I've been experiencing since I suffered a prolapsed disc in 2017 leading to erosion and eventually shattering of 2 vertebrae. I then had several further back injuries following falls (I have epilepsy, finally got the medication right to control it last September!) and an MRI scan in September last year showed that I'd suffered a further disc prolapse lower down. So L4/L5 and S1 are irreversibly damaged - the damage was probably accelerated by malnutrition I suffered from beginning in my teens. Initially I discussed the possibility of a multi level spinal fusion with my spinal surgeon, however this is now not an option due to my poor health (I was incredibly ill in 2018 when I suffered the brain injury, I was in a coma for 2 weeks and still have nerve damage and partial paralysis) and because I have too much scar tissue in my abdomen from multiple surgeries. I am also only 36 and due to the high failure rate of such surgeries, especially in patients with serious health issues like me, my surgeon would not consider operating until I am much older, certainly not until I'm past childbearing age.

So I began treatment with Matrifen patches on Monday - the 12mcg/hr 72hr patch. Unfortunately after 30hrs of waiting for the first patch to take effect it was clearly insufficient, I was in tears from the pain yesterday evening! I called my doctor who told me to apply another patch whilst she sent a new prescription to my pharmacy for 25mcg/hr 72hr patches which I received today.

I am wondering if I have made the patch less effective because of where I placed it. I applied the patch to my upper arm, however I have both loose skin there from weightloss and fat, as I struggle to use my arms (particularly the left) because of the paralysis and nerve damage. I understand that the patch works best on the upper body and am wondering if applying it to my chest or back is better. I'd appreciate any advice from others who are receiving this treatment!