gatsby
03-10-2007, 02:49 PM
My mom, 84 y/o is suffering from sacroiliac joint pain. It been going on for two weeks and has completely debilitated her. She is reluctant to take medication. The medication she has tried has not worked: 1 Tylenol 3, 1 Paramacet, and then 1mg Dilaudid. Yes, I know these are minuscule amounts and that she has not given them enough of a chance. [I myself suffer from migraine headaches and need 100mg Demerol for those times when the other stuff does not work.]
So after I explained the situation to my mom's internist, I suggested Duragesic. He agreed and prescribed Duragesic 25. I put one patch on my mom and then after reading the insert, it scared the hell out of me and after three hours I removed the patch. I then spoke to a pharmacist at the local cancer agency (presuming that they would be knowledgeable about PM matters) and she thought that the dose was low enough as to not cause any complications. So I have put another patch on her this morning and its been four hours and so far so good, but no pain relief yet. Any comments?
Thanks in advance.
So after I explained the situation to my mom's internist, I suggested Duragesic. He agreed and prescribed Duragesic 25. I put one patch on my mom and then after reading the insert, it scared the hell out of me and after three hours I removed the patch. I then spoke to a pharmacist at the local cancer agency (presuming that they would be knowledgeable about PM matters) and she thought that the dose was low enough as to not cause any complications. So I have put another patch on her this morning and its been four hours and so far so good, but no pain relief yet. Any comments?
Thanks in advance.
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txmomof3
03-10-2007, 05:33 PM
Duragesic is a great medication, but it is very strong. One of the big reasons the warning is on the 25 mcg box is because dentists and some doctors were using it post-surgically for acute pain. The problem with that is it takes 17 hours for the patch to deliver enough medication into your body to get 25 mcg/hour into your blood. About 5 years ago, a dentist in my area put a Duragesic patch on a 17 year old boy after he had his wisdom teeth out. Well, he had some pain meds and anesthesia at the clinic and then went home and took hydrocodone every 4 hours because the patch wasn't working yet. Needless to say, when the patch kicked in, he had WAY too much narcotic in his system.
I tell you this story not to scare you, but to let you know why that warning is on the 25 mcg box. For someone with chronic pain, it is a great starting point for long-acting medications. Just make sure she does not take any other narcotic pain meds until you know the full effects of the patch (which is usually about 17 hours after you put it on).
Let me know if you have any other questions!
I tell you this story not to scare you, but to let you know why that warning is on the 25 mcg box. For someone with chronic pain, it is a great starting point for long-acting medications. Just make sure she does not take any other narcotic pain meds until you know the full effects of the patch (which is usually about 17 hours after you put it on).
Let me know if you have any other questions!
gatsby
03-10-2007, 06:39 PM
Thanks. She is on no other pain medications, except for a two-week course of Celebrex. I presume that her internist did not believe that the Celebrex would be a problem. If she put on the patch on at 7:00 am this morning, then by midnight she should be experiencing the analgesic effects. Hopefully, it will do the trick, as she is somewhat depressed at not being able to go out for her walks and to do her usual activities.
txmomof3
03-10-2007, 06:42 PM
The Celebrex is fine...it is an NSAID, not a narcotic. I hope your mom will be back to walking soon!
onyxgates
03-10-2007, 10:53 PM
Your mother won't find relief from the patch until it is time to put on the third one. It takes that long before the serum reaches peak levels. Hang in there and I hope your mother finds relief.
gatsby
03-11-2007, 02:00 PM
Thanks. She's having some nausea/vomiting after 24 hours. Any suggestions on how to deal with that?
TraveltoSL
03-11-2007, 04:58 PM
Hi there,
I just wanted to say that when I was taking care of my great aunt for many years until she passed in 2005 at 96....The strongest pain medicine they would give her, even for her broken hip when she was in her 80's, was Vicoden, the smallest amount....And this, along with the Celebrex, helped her immensley, along with PT...The reason they gave was that in the elderly...their body's, especially since my great aunt was only about 110 pounds....can't absorb the medicine like we do....Her diet at that age was certainly diminished as her appetite was much smaller....and she was on many other medicines for her heart and tamoxifen for breast cancer from her 80's....
So, I am TRULY not judging at all, but "feel" that the Durgaesic patch may be wayyyy to strong for her at that age.....especially if you said it's only for joint pain???? Did she have a fall or accident?
There are lots of other pain medicines in between the few mg. of the Tylenol and the Duragesic patch...I see that you are from Canada and it looks like they do things differently their with the meds since you said you get 100mg shot of Demerol for migraine???? I may be totally mistaken and Shoreline will have to answer but isn't that a huge dose here in the US? Isn't that more than we would get in a 24 hr period in the hospital in a PCA unit after surgery???
PLEASE know that I am totally curious and not judging you....please, please.....I am not saying you don't need pain medicine for your migraine or a strong one at that...I don't suffer from them but my best friend does and takes that migraine medicine, Immetrex, along with this medicine that's a mixture of this barbituit, tylenol, caffien, etc....(can't think of the name) So I know they can be excruciating....I am just trying to help with your post based on the info that you are providing and seeing that it's maybe just in Canada they does much higher medicines then here for things...How much does she weigh? I'm sure the Dr. took this into account but I am a little taken aback from seeing an elderly person take such a strong medicine without anything broken....even though many people here take it...i'm specifically talking about "little elderly women" like my great aunt...
I have also tried the Duragesic patch and with the 25mcg..passed out on my bathroom floor after a long, hot shower since it got too much of the medicine in my system at one time....I was also throwing up constantly for the next 2 days after taking it off (advised by the DR.)...
So, I will close with saying that I truly believe that the medicine may be too much for your mum to be taking at her age and maybe talking with the Dr. about a less potent and stomach upsetting medicine would be better for her????
I would certainly call the Dr. immediately about her getting sick to make sure everything is ok and see what he thinks....I feel it's best to call and be safe and get their advice...
Just things to ponder and please, again, not "telling" you what to do, just my opinion from my experience...
If for some reason I come across the wrong way, if you could let me know and I will correct any statements I made since my intentions are only to help....(Picture me smiling right now:):)
Blessings,
Ingrid
I just wanted to say that when I was taking care of my great aunt for many years until she passed in 2005 at 96....The strongest pain medicine they would give her, even for her broken hip when she was in her 80's, was Vicoden, the smallest amount....And this, along with the Celebrex, helped her immensley, along with PT...The reason they gave was that in the elderly...their body's, especially since my great aunt was only about 110 pounds....can't absorb the medicine like we do....Her diet at that age was certainly diminished as her appetite was much smaller....and she was on many other medicines for her heart and tamoxifen for breast cancer from her 80's....
So, I am TRULY not judging at all, but "feel" that the Durgaesic patch may be wayyyy to strong for her at that age.....especially if you said it's only for joint pain???? Did she have a fall or accident?
There are lots of other pain medicines in between the few mg. of the Tylenol and the Duragesic patch...I see that you are from Canada and it looks like they do things differently their with the meds since you said you get 100mg shot of Demerol for migraine???? I may be totally mistaken and Shoreline will have to answer but isn't that a huge dose here in the US? Isn't that more than we would get in a 24 hr period in the hospital in a PCA unit after surgery???
PLEASE know that I am totally curious and not judging you....please, please.....I am not saying you don't need pain medicine for your migraine or a strong one at that...I don't suffer from them but my best friend does and takes that migraine medicine, Immetrex, along with this medicine that's a mixture of this barbituit, tylenol, caffien, etc....(can't think of the name) So I know they can be excruciating....I am just trying to help with your post based on the info that you are providing and seeing that it's maybe just in Canada they does much higher medicines then here for things...How much does she weigh? I'm sure the Dr. took this into account but I am a little taken aback from seeing an elderly person take such a strong medicine without anything broken....even though many people here take it...i'm specifically talking about "little elderly women" like my great aunt...
I have also tried the Duragesic patch and with the 25mcg..passed out on my bathroom floor after a long, hot shower since it got too much of the medicine in my system at one time....I was also throwing up constantly for the next 2 days after taking it off (advised by the DR.)...
So, I will close with saying that I truly believe that the medicine may be too much for your mum to be taking at her age and maybe talking with the Dr. about a less potent and stomach upsetting medicine would be better for her????
I would certainly call the Dr. immediately about her getting sick to make sure everything is ok and see what he thinks....I feel it's best to call and be safe and get their advice...
Just things to ponder and please, again, not "telling" you what to do, just my opinion from my experience...
If for some reason I come across the wrong way, if you could let me know and I will correct any statements I made since my intentions are only to help....(Picture me smiling right now:):)
Blessings,
Ingrid
gatsby
03-11-2007, 08:09 PM
Thanks. No problem.
My mom's weight is 174lbs. In some ways she sounds much like your aunt, as she is now taking Letrozole after taking Tamoxefin for 5 years, and takes BP and Diabetic medication. My mom hates taking pills -she complains at the amount that she has to take for her conditions besides pain. She tried Tylenol 3, Tramacet and Dilaudid, but those did not relieve her pain. (Mind you she did not give them a chance or try increased dosages.) Consequently, the patch appeared as the only option.
Interestingly enough, Duragesic 25 after 36 hours haS only diminished her pain by about half.
As for me, I have Toradol, Tylenol 3 and Imitrex for my migraine pain. When that does not work, I take 100 mg or ORAL Demerol with Gravol for nausea.
My mom's weight is 174lbs. In some ways she sounds much like your aunt, as she is now taking Letrozole after taking Tamoxefin for 5 years, and takes BP and Diabetic medication. My mom hates taking pills -she complains at the amount that she has to take for her conditions besides pain. She tried Tylenol 3, Tramacet and Dilaudid, but those did not relieve her pain. (Mind you she did not give them a chance or try increased dosages.) Consequently, the patch appeared as the only option.
Interestingly enough, Duragesic 25 after 36 hours haS only diminished her pain by about half.
As for me, I have Toradol, Tylenol 3 and Imitrex for my migraine pain. When that does not work, I take 100 mg or ORAL Demerol with Gravol for nausea.
TraveltoSL
03-11-2007, 08:25 PM
I'm sorry that she's not getting lots of relief from the patch...Hopefully you can talk with her Dr. soon and see what he can do to help....Maybe a combo of a long acting med like Oxycontin or MSIR??? and then a breakthrough like Percocet or Vicoden...That way, she has much better control over the medicine and take at different intervals...
For instance, I take Oxy 20mg 3 times daily and the Percocet for B/T when needed...especially in the AM after very stiff and sore and in the evening or after traveling all day....
Thanks for the info about your migraines...again...it "sounded" like a lot of Demerol but I don't take that or know the specific dosages....I just saw the
100mgs and thought...wow...100mg of anything is strong....and I do know that Canada has different regulations than us like the Tylenol 3 being over the counter I think....I hope that your combo gives you relief when you need it...
Well, I'll pray for your mom and hope that maybe you can work out something better with the Dr. to manage her pain...
BTW...I LOVE BC!!! It's so beautiful there...I took a 9 week, camping cross country and Canada trip back in '91....Went to 31 states and 3 Provinces and put 14,000 miles on my Toyota 4-Runner......***Before the days of pain and surgeries....(ahhhhh....let me bask in that memory for a minute.......)....ok....back to reality....LOL.....
I came up through Glacier National Park where I saw the Northern Lights for the first time...and it didn't get dark until like 10:30 at night!!! then traveled through BC to Vancouver.....Had a nice lunch in the park by the water....Just gorgeous!
Keep us updated on your mom please...
Blessings,
Ingrid
For instance, I take Oxy 20mg 3 times daily and the Percocet for B/T when needed...especially in the AM after very stiff and sore and in the evening or after traveling all day....
Thanks for the info about your migraines...again...it "sounded" like a lot of Demerol but I don't take that or know the specific dosages....I just saw the
100mgs and thought...wow...100mg of anything is strong....and I do know that Canada has different regulations than us like the Tylenol 3 being over the counter I think....I hope that your combo gives you relief when you need it...
Well, I'll pray for your mom and hope that maybe you can work out something better with the Dr. to manage her pain...
BTW...I LOVE BC!!! It's so beautiful there...I took a 9 week, camping cross country and Canada trip back in '91....Went to 31 states and 3 Provinces and put 14,000 miles on my Toyota 4-Runner......***Before the days of pain and surgeries....(ahhhhh....let me bask in that memory for a minute.......)....ok....back to reality....LOL.....
I came up through Glacier National Park where I saw the Northern Lights for the first time...and it didn't get dark until like 10:30 at night!!! then traveled through BC to Vancouver.....Had a nice lunch in the park by the water....Just gorgeous!
Keep us updated on your mom please...
Blessings,
Ingrid
gatsby
03-12-2007, 12:33 AM
Virgina is nice too. I was out that way in 2005.
onyxgates
03-15-2007, 04:12 PM
Gatsby,
How is your mom? Is she finally getting some relief from the patch?
I like your name, is that in reference to The Great Gatsby?
How is your mom? Is she finally getting some relief from the patch?
I like your name, is that in reference to The Great Gatsby?
Tripletmom
03-15-2007, 09:38 PM
Gatsby~
Both posters gave you good advice...I am on Durgesic 75, and was even given breakthrough meds to help until it kicked in, as well as when I have moments of bad pain.
I am also the caretaker for my 79 yr old mother, who moved closer to me and my family after we had to move for business. When she came down here 2 yrs ago, she was pretty independent, but that has changed. She is currently on pain meds, as well as tranqs, and I am always fearful that she may forget what she has taken and take too much.
Anyway, I have been on the patches for 4 yrs and found them to be much more helpful then oral meds. If she does well on them, but maynot be getting just enough relief, you can take something in between (over the counter or RX) or...you can ask the Dr to up her patch strength. If she is getting relief most of the time, I would just give her something in between. Of course, always check with her Dr before hand :)
Best of luck~
Both posters gave you good advice...I am on Durgesic 75, and was even given breakthrough meds to help until it kicked in, as well as when I have moments of bad pain.
I am also the caretaker for my 79 yr old mother, who moved closer to me and my family after we had to move for business. When she came down here 2 yrs ago, she was pretty independent, but that has changed. She is currently on pain meds, as well as tranqs, and I am always fearful that she may forget what she has taken and take too much.
Anyway, I have been on the patches for 4 yrs and found them to be much more helpful then oral meds. If she does well on them, but maynot be getting just enough relief, you can take something in between (over the counter or RX) or...you can ask the Dr to up her patch strength. If she is getting relief most of the time, I would just give her something in between. Of course, always check with her Dr before hand :)
Best of luck~
gatsby
03-15-2007, 10:12 PM
Yes, she's on her second patch and is getting relief. No side effects, constipation etc., but she does wake up in the moring with some nauseau. However, if takes 12.5 mg of Gravol (OTC Canadain brand brand anti-nauseau medicine) before bedtime, she is okay.
Yes, my nickname is from the novel.
Yes, my nickname is from the novel.