Dan&cheryl
11-15-2002, 12:27 AM
Well after my Husband took all the pain pills he had, as directed, with a couple extra for bt pain, he is now in the hospital getting a drip where he presses a button for a bit extra. Am I supposed to believe that radiation is going to ease the pain enough to come home? I don't know any thing about pain control so I guess I just need to start asking.
Thanks, David, I know I'll hear from you...
Thanks, David, I know I'll hear from you...
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davidc66
11-15-2002, 02:40 PM
Hi Cherel, I'm sorry your husband is having such a hard time. He does have options though. l000 mgs of morphine sounds like a lot but there is virtually no ceiling on pure opiates as long as Dan is tolerant.
The most powerful opiate available is going to Be Fentanyl, This comes in the patch which lasts 48-72 hours, you can also get Actiq lolipops, Fentanyl lolipops that come in strengths from 200 micro grams up to 1600 micro grams. Fentanyl is roughly 900 times more potent than morphine mg to mg. So a 1600 microgram pop is equivelent to about 1500mgs of morphine in a single dose. Because it's transmucosal delivery it works very fast. He could use the Actiq pops for breakthrough pain along with another long acting med to give him continuos coverage.
You also have options through home Hospice care. He can come home with a PCA pump and just needs a hospice nurse to check on him daily and refill the unit as needed.I personally believe that mixing opiates, like using morphine as a base med, Kadian would be my choice because of the lack of ups and downs and the actiq pops for BT pain. Using multiple classes of opiates covers a wider range of opiate receptors giving him better anelgesia.
I was doing research on methadone a couple years ago before switching to meth and ran across an article about meth used in hospice. They were compounding 600mg meth suppositories for one patient. This is also about the equivelent of 1800mgs of morphine in a single dose. So there really are quite a few choices and absolutely no reason for your husband to suffer other than a docs discomfort with prescribing high doses of opiates.
You actually develop such a high tolerance to opiates that it becomes virtually impossible to OD on opiates, so managing his pain at home is very possible and safe.
If there is anything else I can do please ask, If I think of something else I will post again on this thread. Take care of yourself so your able to take care of Dan. Good luck, David
www.actiq.com (http://www.actiq.com)
[This message has been edited by davidc66 (edited 11-15-2002).]
The most powerful opiate available is going to Be Fentanyl, This comes in the patch which lasts 48-72 hours, you can also get Actiq lolipops, Fentanyl lolipops that come in strengths from 200 micro grams up to 1600 micro grams. Fentanyl is roughly 900 times more potent than morphine mg to mg. So a 1600 microgram pop is equivelent to about 1500mgs of morphine in a single dose. Because it's transmucosal delivery it works very fast. He could use the Actiq pops for breakthrough pain along with another long acting med to give him continuos coverage.
You also have options through home Hospice care. He can come home with a PCA pump and just needs a hospice nurse to check on him daily and refill the unit as needed.I personally believe that mixing opiates, like using morphine as a base med, Kadian would be my choice because of the lack of ups and downs and the actiq pops for BT pain. Using multiple classes of opiates covers a wider range of opiate receptors giving him better anelgesia.
I was doing research on methadone a couple years ago before switching to meth and ran across an article about meth used in hospice. They were compounding 600mg meth suppositories for one patient. This is also about the equivelent of 1800mgs of morphine in a single dose. So there really are quite a few choices and absolutely no reason for your husband to suffer other than a docs discomfort with prescribing high doses of opiates.
You actually develop such a high tolerance to opiates that it becomes virtually impossible to OD on opiates, so managing his pain at home is very possible and safe.
If there is anything else I can do please ask, If I think of something else I will post again on this thread. Take care of yourself so your able to take care of Dan. Good luck, David
www.actiq.com (http://www.actiq.com)
[This message has been edited by davidc66 (edited 11-15-2002).]
crazeeladee
11-15-2002, 04:04 PM
Hi Cheryl!
Having worked for many years with terminal patients, I understand that this doasage sounds enormous, but please believe what David tells you - he needs at least this much due to tolerance. I also agree that a variety of opiates may be the best solution. When a person is in the sort of pain Dan is having, there is no such thing as overkill. Insist that the doctor at least consider it, and do some research to help make him/her understand. Good luck, and I hope things get easier to deal with. As David said, PLEASE take care of yourself. You're in my thoughts and prayers...
Having worked for many years with terminal patients, I understand that this doasage sounds enormous, but please believe what David tells you - he needs at least this much due to tolerance. I also agree that a variety of opiates may be the best solution. When a person is in the sort of pain Dan is having, there is no such thing as overkill. Insist that the doctor at least consider it, and do some research to help make him/her understand. Good luck, and I hope things get easier to deal with. As David said, PLEASE take care of yourself. You're in my thoughts and prayers...