Pain management

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My husband has been in mostly uncontrolled pain for about a month now.  He's talked to the Onc about it and he is saying that with the amount of morphine he takes a day, nothing else would work with it or instead of it.  He takes 180 mg (120 mg extented release & 60 immediate release) in the morning and supposed to take the immediate 15mg every 4 hrs for break through pain and then at night the same dose as morning.  The odd thing about it is, as soon as he lays down the pain will subside.  As soon as he sits up or stands/walks he doubles over in pain.

Last Thursday he saw his surgeon that did his illeostomy as his fistula is draining after being dried up for months and smells like infection and it has a new hole next to it.  The surgeon suggested it "could" be the cancer eating its way out and then admitted he really wasn't sure what was going on but gave him an antibiotic.  He said looking at his last ct scan done on July 17, there was nothing unusual in that area that should be causing the terrible pain.

He sees Onc tomorrow so if anyone has any suggestions or questions we should ask please advise.  With all of the pain meds out there, isn't  there anything out there that can help him? This is heartbreaking and my anxiety is out of the roof.  Thank you in advance.

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  • LivinginNH
    LivinginNH Member Posts: 1,456 Member
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    Pain meds

    Hi,

    You might want to ask his doctor about him possibly having an obstruction.  You also might want to ask the doctor about other pain meds such as Fentanyl, Dilaudid or Oxymorphone.  Morphine didn't work at all for my Rick.  You also might want to ask the doctor about seeing a pain management specialist.

    Take care,

    Cynthia

  • JanJan63
    JanJan63 Member Posts: 2,478 Member
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    Pain meds

    Hi,

    You might want to ask his doctor about him possibly having an obstruction.  You also might want to ask the doctor about other pain meds such as Fentanyl, Dilaudid or Oxymorphone.  Morphine didn't work at all for my Rick.  You also might want to ask the doctor about seeing a pain management specialist.

    Take care,

    Cynthia

    I read a book about a

    I read a book about a veterinarian with cancer last year and she mentioned that oxymorphine was much better and more effective than morphine. I have no suggestions for pain killers. If I'm in rough shape I take a percocet (oxycodone) but it's only occasionally or if I'm going to have a bad day.

     

  • Lovekitties
    Lovekitties Member Posts: 3,364 Member
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    so sorry to hear

    Have there been any indications of constipation or blockage due to the morphine?  Any opioid can cause constipation.

    For my sister, I took her to emergency room and insisted that they admit her until they got her pain under control. 

    Her onc had to try any number of combinations before they got it to where she was no longer in pain.  I think she had the patches and morphine drops.

    Everyone is different and it may be that there is another combo that will help your hubby better. 

    Wishing best results for him.

    Marie who loves kitties

  • skeets1961
    skeets1961 Member Posts: 56
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    Onc said that with amount of

    Onc said that with amount of morphine he's on that the others wouldn't work.  i just find it hard to believe that there isn't some combination  out there that wouldn't work.  I looked up other Oncologists last night that my insurance will cover.  His scans from 07/17 show no blockage or obstruction.  If we don't get any answers today he's going to see someone else out of this network of drs.  this is crazy.

  • skeets1961
    skeets1961 Member Posts: 56
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    Oh and also, he's been taking

    Oh and also, he's been taking morphine for pain ever since surgery last October.  Maybe his body is resistant to it now?  i will mention that today at the appointment.  In addition to the pain, he's got the rash from the new chemo (panatububamen?) and he's miserable.  My heart is so sad for him.

  • annalexandria
    annalexandria Member Posts: 2,571 Member
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    Onc said that with amount of

    Onc said that with amount of morphine he's on that the others wouldn't work.  i just find it hard to believe that there isn't some combination  out there that wouldn't work.  I looked up other Oncologists last night that my insurance will cover.  His scans from 07/17 show no blockage or obstruction.  If we don't get any answers today he's going to see someone else out of this network of drs.  this is crazy.

    Can he see a pain management doc?

    As Cynthia mentioned above, they might be able to help.  He shouldn't have to be suffering this much!

  • skeets1961
    skeets1961 Member Posts: 56
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    Oh and also, he's been taking

    Oh and also, he's been taking morphine for pain ever since surgery last October.  Maybe his body is resistant to it now?  i will mention that today at the appointment.  In addition to the pain, he's got the rash from the new chemo (panatububamen?) and he's miserable.  My heart is so sad for him.

    At the appointment with the

    At the appointment with the Onc today he decided to add Methadone and a nerve block medicine Gabapentin (in case something is resting on his nerves in his abdomen when he stands and sits.)  These are along with the high dose of morphine he's already on but they want to wean him off of the morphine if everything goes well.  If the pain doesn't get under control, he will need to go into the hospital to try different meds to see what works.  His first PET scan is scheduled for this thursday.  I just don't know if this is the end of the journey or what to think.  I've never been through this before and its so frustrating. 

  • LindaK.
    LindaK. Member Posts: 506 Member
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    At the appointment with the

    At the appointment with the Onc today he decided to add Methadone and a nerve block medicine Gabapentin (in case something is resting on his nerves in his abdomen when he stands and sits.)  These are along with the high dose of morphine he's already on but they want to wean him off of the morphine if everything goes well.  If the pain doesn't get under control, he will need to go into the hospital to try different meds to see what works.  His first PET scan is scheduled for this thursday.  I just don't know if this is the end of the journey or what to think.  I've never been through this before and its so frustrating. 

    So sorry for his suffering

    I am so sorry to read of your husband's suffering.  Pain is so hard to watch in our loved ones.  Maybe going into the hospital is the best way to get it under control.  They may be able to give him a pain pump he can go home with.  They may not like to offer that, but it can be done.  My daughter who is a nurse, pushed for the pump for my husband when he was being released last September.  He decided at the last minute he wanted to control his pain with pills and patches.  He did pretty good on that at home for about 3-4 weeks (with our close eye on him and waking him up to take pills during the night) until he needed better pain management.  He used Gabapentin, fentanyl patches, and dilauded  for pain and Hyoscyamine to control spasms in his intestines.  Dilauded is hydromorphone and always worked well for my husband. 

    Has he had any relief since adding the new meds?  I hope so.  Don't be afraid to yell and scream for help for him.  Sometimes that is what it takes for them to really listen, unfortunately.

    My husband also had pain sitting because of the tumors in his abdomen and where they were pressing.  He always sat in a recliner and was comfortable in that position.

    Good luck,  Linda

  • janderson1964
    janderson1964 Member Posts: 2,215 Member
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    I have had morphine after all

    I have had morphine after all of my surgeries. It helped but the last two times I was in the hospital with lung infections and ablations they would inject me every 3 hours with dilaudid and boy does that do the trick. I understand a lot of doctors are reluctanat to prescribe it. it is supposed to be way more powerful than morphine. I can understand why. i only did it for 6 days but each injection left me longing for the next shot.

  • ron50
    ron50 Member Posts: 1,723 Member
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    Hi Skeets

    I have bad lower back pain . Most of it is due to 75mg daily of prednisone for over 18 mos. I have had bone density scans recently . I am borderline osteo perosis but officially osteo pina. I take 40/20 Targin 40 mg oxycodone and 20 mg of naloxone morning and night. It just keeps the pain under control tho I suffer badly from opiate induced constipation. The naloxone is supposed to stop oic but it does not for me. With every targin dose I take 2 dulcolax to retstart motility and two coloxyl as stool softeners. I have been on the targin for over twelve months. I have one verterbrae 14 mm offset and pars fractures and some fusions. I have been told that long term opiate use can actually cause pain. Ron.