Morphine

Daisylin

For the past few day Lee’s pain in his lower right abdomen was getting worse, to the point where he’d be up during the night, and be groaning in pain all day. We paid a visit to the oncologist on Wednesday and he suggested another CT scan to see what was going on in there. He also prescribed a slow release dose of morphine, along with liquid morphine as a PRN to bump up pain management, as needed.

By early Friday morning he was in agony again and after a few hours decided to go to the ER. We spent the day there, and after blood tests and a CT, the doctor informed us that the pain is likely caused by the fact that the tumors in his liver have grown. He compared it to blowing up a balloon, the growth is pushing on other body parts and causing pain.

So, of course…… here we are, Saturday and can’t do anything about it for the weekend. We are going to call the cancer centre on Monday, and have them review these recent scans and most likely leave our lovely little chemo holiday. The thought of dealing with all the pain, plus morphine, plus all the nasty chemo side effects is daunting, to say the least. Lee is feeling just plain sick and tired of feeling sick and tired. I’m feeling overwhelmed and so, so sad.

I don’t really have any questions in particular, but am curious to know if any of you are using morphine, and how that is working out for you. That drug seems to come with a lot of negative feelings for both of us. We want his pain alleviated, but also don’t want him to become a zombie. The doctor in the ER yesterday told us to double his prescribed dosage for the slow release, (since the prescribed dosage was not even touching the pain) and continue to use the liquid as a PRN. I’ve heard mention of a pain patch, wondering if that would be less harmful than morphine? Already the morphine is causing constipation, tiredness and the ‘itchy scratchies’.

Well, better get to making a big vat of lemonade with all these lemons that life has been throwing at us.

Hope all of you have a great weekend,
Chantal

sandy1943

Hi, I don't want to be
Hi, I don't want to be negative this morning, But after reading about this new hurdle, my heart breaks for both of you. You are both so young. This cancer can hit any age. I pray for everyone to become more aware. I know I was ignorant of what the esophagus was. To me it was part of the throat and went into the stomach. Having a little indigestion--take a pill! even doctors treat the symptoms so lightly. I talk to people all the time, but often feel like I'm talking on deaf ears. People just don't realize how very serious it is.

I didn't have the experience with morphine, but I know others out here have. I just wanted to say I'm praying for you and Lee.

I hope the lemonade is sweetened with God's comfort this weekend,

Sandra

Ericalynn

Morphine
Chantal,

John is allergic to many pain meds. The Radiation kicked his butt the last couple of weeks of treatment (still is) so the Radiation Oncologist prescribed Morphine. He started him on the regular release (to make sure he was not allergic) he did not have a problem so he prescribed the slow release. He was prescribed 15mg and John said it was not helping his pain. I goggled Morphine dosages for Cancer patients and read that “break through” pain is common and also what the average dose is for both types. Morphine gets a “bad wrap” it is a good drug for pain management; disease dose does have to be adjusted. John is taking the slow release (every 12 hours) and the shorter acting in between (when needed) he is at least sleeping better. We were told that the itchy feeling is a common side effect and in hospitals that they give Benadryl all long with pain meds to relieve itching. You could try Benadryl over the weekend so the itchy feeling does not also agitate him. John is having constipation ( he never had the problem in is life) the doctor recommended Peri-Colace and it does seem to help. Hang in there this is all so hard and we (care givers) feel helpless but you are doing a great job! I will e-mail you my phone number if you just want to talk! Take care of yourself too.
Erica

mruble

the patch
Chantal -

Last year my husband spent two weeks in the hospital with abdomenal pain. The pain was so severe it caused nausea which inevitably led to vomitting if he didn't get pain meds quickly enough. Lots of tests were done but they never really figured out the cause. Anyway, he hated morphine! The Fentanyl patch was much better for him and didn't cause him to feel the way morphine had. He still had oxycodone to use in the early days while the patch was kicking in but from there on the patch worked very well. As he weaned off the patch he did have some withdrawal symptoms but they were managable. At the same time he was put on Reglan to help with emptying his stomach. I've heard all the bad things about Reglan but Chad has done well with it. I'm guessing it may also have helped.

Good luck! I'm sure it's very hard to see him in pain -- or uncomfortable from the morphine.

Mary

jojoshort

Morphine for us, too
Hi Chantal,
This week Steve was having lots of trouble breathing-(mets to lungs)--just getting out of his recliner to go to the bathroom a few feet away was a challenge. His VNA nurse recommended morphine, and we called into the oncologist and got our first bottle of liquid morphine.
It has really improved his lifestyle.
He can now walk about the house again without having the terrible feeling of suffocating. He also has some pain in his abdomen from time to time, and he find relief, whether from the dilaudid, the oxy or the morphine, he can't tell, but I do know that he feels much better and moves much better on the liquid morphine. He takes it as he feels he needs, he has lots of latitude with dose and frequency. I can see no difference in his mental capabilities; in fact, he's much more engaging and easier to talk to probably because he's at ease.
With us, he's "done" with chemo and we are just living day-to-day, hour-to-hour, finding those gems of joy where we can. The morphine has been a blessing in that we can enjoy some moments together.
He only has had one itchy foot this morning but blames it on not having it in a good position last night.
Chantal, please don't hesitate to email me here. I check in daily and we can help one another with coping with our husbands' illnesses.
Jo-Ann

cher76

Fentynal patch
Chantal,
I am so sorry to hear of these new troubles your husband is having. I know how you are feeling. It is so very difficult to see them in so much pain. In Jan. Rickie started on a clinical trial that was a double blind study that involved a placebo. We did not know whether he was receiving the drug or not, but as the weeks went on his condition deteriorated and he was in lots of pain. My husband is a very strong person both physically and mentally, but the pain he was experiencing was tremendous. The doctor had prescribed hydrocodone liquid for the pain and then started him on a fentynal patch as well. The patch was 25 mg and we changed it every 48 hours. This wasn't helping at all. We began to think he had received the placebo. When we went for his checkup mid February, he was taken off the clinical trial, and the scans showed that the mets to the bones had increases, thus causing the pain he was experiencing. We saw a pain management doctor who upped the dosage of the patch to 50mg. We came home and the pain persisted. He was wearing the patch and taking the hydrocodone almost around the clock. For several days I was quite concerned because he seemed so doped up and out of it. He started weening himself off the hydrocodone and as he started on a new chemo the pain started to ease up. In the last 5 months the doctor has upped the dosage to 75 and just lately to 100mg every 72hours for the pain that he has in his back. He explained that as your body becomes accustomed to it you have to increase the dosage. He no longer takes the hydrocodone. Since the dose was upped last week, he says he is experiencing very little pain. For the first couple of days on the higher dosage he looked a little glassy eyed, but seems fine now. He is able to carry on as normal with this medication and not have any side effects. Hope this helps.
Cheryl

oriontj

Ericalynn said:

Morphine
Chantal,

John is allergic to many pain meds. The Radiation kicked his butt the last couple of weeks of treatment (still is) so the Radiation Oncologist prescribed Morphine. He started him on the regular release (to make sure he was not allergic) he did not have a problem so he prescribed the slow release. He was prescribed 15mg and John said it was not helping his pain. I goggled Morphine dosages for Cancer patients and read that “break through” pain is common and also what the average dose is for both types. Morphine gets a “bad wrap” it is a good drug for pain management; disease dose does have to be adjusted. John is taking the slow release (every 12 hours) and the shorter acting in between (when needed) he is at least sleeping better. We were told that the itchy feeling is a common side effect and in hospitals that they give Benadryl all long with pain meds to relieve itching. You could try Benadryl over the weekend so the itchy feeling does not also agitate him. John is having constipation ( he never had the problem in is life) the doctor recommended Peri-Colace and it does seem to help. Hang in there this is all so hard and we (care givers) feel helpless but you are doing a great job! I will e-mail you my phone number if you just want to talk! Take care of yourself too.
Erica

Itching and morphine
My dh who has the ec has not had morphine yet.

But I had it with my first knee replacement that was done locally. It was the drug from hell. It was in a pump, each time I would hit the button, within minutes the worse itching ever would start. I wanted to scratch my skin off and then would come nausea. I only did it twice and the nurses then checked..they did an iv injection and I had a horrible reaction. The doctor took me off norphine and put me on Diludid and I was fine. With my next knee replacement, I listed morphine as allergic to it.

It was awful. I never want to have it again.

jan

Daisylin

cher76 said:

Fentynal patch
Chantal,
I am so sorry to hear of these new troubles your husband is having. I know how you are feeling. It is so very difficult to see them in so much pain. In Jan. Rickie started on a clinical trial that was a double blind study that involved a placebo. We did not know whether he was receiving the drug or not, but as the weeks went on his condition deteriorated and he was in lots of pain. My husband is a very strong person both physically and mentally, but the pain he was experiencing was tremendous. The doctor had prescribed hydrocodone liquid for the pain and then started him on a fentynal patch as well. The patch was 25 mg and we changed it every 48 hours. This wasn't helping at all. We began to think he had received the placebo. When we went for his checkup mid February, he was taken off the clinical trial, and the scans showed that the mets to the bones had increases, thus causing the pain he was experiencing. We saw a pain management doctor who upped the dosage of the patch to 50mg. We came home and the pain persisted. He was wearing the patch and taking the hydrocodone almost around the clock. For several days I was quite concerned because he seemed so doped up and out of it. He started weening himself off the hydrocodone and as he started on a new chemo the pain started to ease up. In the last 5 months the doctor has upped the dosage to 75 and just lately to 100mg every 72hours for the pain that he has in his back. He explained that as your body becomes accustomed to it you have to increase the dosage. He no longer takes the hydrocodone. Since the dose was upped last week, he says he is experiencing very little pain. For the first couple of days on the higher dosage he looked a little glassy eyed, but seems fine now. He is able to carry on as normal with this medication and not have any side effects. Hope this helps.
Cheryl

morphine
Hi and thank you all very much for your thoughts on morphine. I think that while in the ER, they gave Lee a whole heck of a lot of morphine, and he was dizzy and mostly incoherent. Since we've been home and he's on the slow release and the bumper, he seems much better, not stoned or zombie like at all. (whew!) And best of all, he's had little pain since, and his appetite is restored to normal levels.

It seems so weird to think that a mere 6 months ago, I had to use spell check to write the word esophagus..... ah, what I would give to go back to those blissfully ignorant days!

Ericalynn

Daisylin said:

morphine
Hi and thank you all very much for your thoughts on morphine. I think that while in the ER, they gave Lee a whole heck of a lot of morphine, and he was dizzy and mostly incoherent. Since we've been home and he's on the slow release and the bumper, he seems much better, not stoned or zombie like at all. (whew!) And best of all, he's had little pain since, and his appetite is restored to normal levels.

It seems so weird to think that a mere 6 months ago, I had to use spell check to write the word esophagus..... ah, what I would give to go back to those blissfully ignorant days!

Pain Managed
So glad to hear that Lee's pain is managed today. I hear you about six months ago.
One Day at a time, try to stay in the moment ( easier said then done) I am telling myself the same thing as I write the words to you
Thninking of you!
Erica

fredswilma

Hi Chantal
Sorry Lee is
Hi Chantal
Sorry Lee is having so much pain, hopefully the doctors will get the pain relief mix right for him, just with regards to ending the lovely Chemo holiday wanted to let you know that we ended Mark's chemo holiday because his tumor was once again trying to be in control and his lungs were just a mass of small tumors so we opted to start on Taxol, he has handled it really well so far not as harsh as the first mix of Chemo, I know the decision to do another round of chemo is one not to take lightly as sometimes the side effects can be worse than the cancer itself, and no two people will react the same, just wanted you to know that for Mark this seems to have been the right decision.
At times this is really overwhelming and the sadness is unbearable, but then there are times that are just so beautiful, I try holding onto those times.
Will be thinking of you both and just by the way Lemons are great with a gin too.
Ann

unclaw2002

Chantal,You are right
Chantal,

You are right morphine can be a blessing and a curse. It is necessary at times to give our loved ones relief from pain but it is a balancing act. There are times when as a caregiver you want them to be more with you in the present, but the morphine gives them relief. I know my dad would on days take more or less depending on what he could tolerate because he didn’t want to be all doped up and sleeping. My dad took the slow release and the liquid as needed. The body does build up a tolerance so more and more is needed to provide comfort.

However, Morphine as with everything has some side effects you should be aware of . . . .

1. Urine output --- morphine effects the ability of the kidneys and bladder to function and may result in an inability to urinate and fluid retention. If you see this immediately contact your doctor. They can do ultrasounds of the bladder and if necessary drain the bladder.

2. Stomach emptying --- morphine can also effect the digestive tract and slow down the ability of the stomach to digest food. This can lead to many things which include a loss of appetite and wanting to drink. The stomach can become swollen and uncomfortable and the patient doesn’t eat enough or drink enough.

3. Constipation – add on to the two above the inability to go to the bathroom and you have a pretty serious trifecta going on.

4. Even if you don’t have the above symptoms the patient can lose all interest in eating and drinking and run the risk of dehydration. Also additional effects include nausea and vomiting.

5. Respiratory depression – be aware if it appears that they have a slow respiratory rate and a very sleepy patient with pin point pupils. You may need to have oxygen available which should be given by face mask.

It is so important to have pain management – but when you are the caregiver at home it is critical to keep an eye on the above potential side effects so you can intervene as soon as possible.

I wish you the best and hope that you find the balance to achieve good pain management. Watching our loved ones suffer is difficult. Enjoy the lemonaide and the moments you have - time is so precious.

Hugs and prayers,
Cindy