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[KaraShannon]

Hi all

What would you do with your patches in this situation?

I'm on Evorel Sequi, and on the final combined patch, to be changed on Thursday.  However it has come half off.  Tried to get an emergency one today but to no avail as apparently my prescriptions have been changed from 'repeat' to 'acute.'  I've been on this for 5 years so only god (and my surgery) know why.

I'm feeling more and more confused and forgetful tonight which is usually a sign I've forgotten to change a patch.  I haven't I just don't have the combined one.

I do have the neat Estradiol ones though.

Should I just start my Estradiol a few days early?  I imagine my symptoms are low estrogen but this is annoying because when on cyclical hrt it does feel like my body knows where it is in the cycle so I don't really want to mess with that.  Plus it's only because of such minimal prescribing of patches that I don't have an extra one in an emergency.  Not asking for loads more, just the odd extra in case of this sort of thing.  Palpitations tonight also.

I'm not liking this world much anymore, but I'll leave it at that as that's a whole other box of tricks to open up    (and probably partly hormonal too)

[KaraShannon]

I do have a sealed 2023 combined patch in a drawer, wonder if that would work..

[KaraShannon]

Can't sleep.  Facial flushing.

I don't think I'll risk the old patches, I think I'll change to estradiol only.

Nightmare.

[Taz2]

It's only a couple of days early and as it is causing you so much stress I'd start the oestrogen only one. I guess I'm lucky as I don't notice any difference if I've had to go a few days without a patch.

Taz x

[KaraShannon]

It's only a couple of days early and as it is causing you so much stress I'd start the oestrogen only one. I guess I'm lucky as I don't notice any difference if I've had to go a few days without a patch.

Taz x

Thanks Taz

I didn't change it over last night in the end, and feel really weak today. 

I've sent in an urgent request to the doctor's and just holding out till 3pm to see if it goes to the pharmacy today.  If not, I'm changing over to estradiol. 

I could have done a work trip today but haven't.  These things really mess some of us up, but if it doesn't affect everyone then maybe that's why the doctor's don't realise what a big deal it is to some of us.  Maybe it's worse because of my thyroid issues compounding it.

My mood is through the floor as well, thankfully I'm long enough in the tooth to know it's just a hormonal thing.

[sheila99]

IMO any patch is better than nothing. Perhaps you could order a couple of boxes from an online pharmacy so you're not in this situation again.

[bombsh3ll]

I would use whatever you can get your hands on for now, because an interrupted supply of estradiol is detrimental to both your quality of life and associated with negative health outcomes vs continuous treatment.

However I would schedule a routine appointment with your prescriber, which could take place over the phone, and make them aware that the manufacturers' directions to change twice weekly do not reflect the real world longevity of a plaster on someone active who showers daily.

You could use the analogy of a car manufacturer quoting miles per gallon, which was achieved under pitch perfect test conditions with no doors on, no passengers, no luggage, no spare wheel and only the drivers seat in place. It doesn't reflect real life.

You could also ask if they have ever cut themselves and worn a plaster, and whether after living their normal life, it was still there 3 or 4 days later.

Unless they are either particularly sedentary or have questionable hygiene, they will surely understand your perspective and be happy to increase the quantity prescribed to reflect real world use.

[KaraShannon]

IMO any patch is better than nothing. Perhaps you could order a couple of boxes from an online pharmacy so you're not in this situation again.

Thanks for that, I'll remember that rule in future, after 24 hours on the estradiol none of this seems to matter anymore 

[KaraShannon]

I would use whatever you can get your hands on for now, because an interrupted supply of estradiol is detrimental to both your quality of life and associated with negative health outcomes vs continuous treatment.

However I would schedule a routine appointment with your prescriber, which could take place over the phone, and make them aware that the manufacturers' directions to change twice weekly do not reflect the real world longevity of a plaster on someone active who showers daily.

You could use the analogy of a car manufacturer quoting miles per gallon, which was achieved under pitch perfect test conditions with no doors on, no passengers, no luggage, no spare wheel and only the drivers seat in place. It doesn't reflect real life.

You could also ask if they have ever cut themselves and worn a plaster, and whether after living their normal life, it was still there 3 or 4 days later.

Unless they are either particularly sedentary or have questionable hygiene, they will surely understand your perspective and be happy to increase the quantity prescribed to reflect real world use.

Thanks Bombsh3ll

Great analogy.  I usually find they stick well even with my daily showering, but I know that's not true for everyone.

It's just that the prescribing at the moment doesn't allow for a patch that might come off but I have a review soon and I will ask if we can time it so I have just a couple of spare patches.  I know we have to be careful not to waste them of course. 

[KaraShannon]

2 weeks later I've put on a combined patch, just a mental note. 

I thought I'd try and stick to the old schedule and put it on on thursday but tonight flushing, as if my body knows it's two weeks since the last change over.  Hope this is right.

Unless all this extra flushing means more estradiol is needed and a review.