Pain management for Renal Cell Carcinoma bone mets - bad side-effects with 72hr Fentanyl patch? (USA)

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I am dealing with RCC on bones and lungs.  I am very fortunate that I live in the USA where I have access to the best treatment in the world (next to Israel maybe).  I would suggest people ask about palliative care early.  The Fentanyl patch has been a game changer.  But on the third day of the 72 hr patch it gets a bit rough for me.  Has anyone else experienced this.  I have percocet for rise up pain and gabapintin.  I also take Ritalin for fatigue.  It is very good at getting up and out the door to work.  I would not be able to work without it...  My question revolves around the patch.  What are some other people's experiences with the patches?  I have been fighting this now for 32 months.  I am 60.  Odds are I do not have a lot of time left according to survival rates for my stage.

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