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Old 04-20-2011, 11:29 AM   #1
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Unhappy morphine tolerant and operation pain was unbearable

Hi i am new to this site and was wondering if anyone has any advice for me, I have been on morphine 200mg for around 18 years with 10mg every 2 hours of oral morphine so obviously i have built up a tolerance, any way my worst fears came true a few weeks ago after i had an operation, on coming round from the anaesthetic i was in excrutiating pain so doctor gave me 5mg iv morphine obviously it never touched the pain, by this time i was almost hysterical so he eventually gave me another 5mg still no relief and then gave me 2 paracetamol. I explained how much i was prescribed on a daily basis at home and told him that that small amount he gave me wasnt working but he refused to give me anything else. i was screaming in agony so much so they moved me to a side ward but still no relief i begged him to call my own doctor, i was so bad i could not even go to the toilet. anyway after i begged my husband and the nurses to do something (i was suicidal by now) they sent for pain management who verified everything with my gp and upped morphine to a much higher dose more frequently. My worry is if i am ever in a car accident or something and in loads of pain the 5mg iv wont cut it or if i need another operation, so is there anything else i can ask for instead of morphine which barely keeps my everyday pain at bay. any help would be appreciated

 
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Old 04-20-2011, 07:52 PM   #2
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Re: morphine tolerant and operation pain was unbearable

Wow, so sorry. Before my last surgery I made sure to review with my surgeon before-hand what the pain control plan was after surgery in the recovery room. And when I went into pre-op and the nurse asked me if there was anything I was concerned about, I told her I was concerned I would not get enough to treat my post-op pain. And I am not on as much as you are. I take 120mg per day over 24 hours. MY doc gave me dilaudid IV instead of morphine and it worked great. This is so awful I feel terrible for you. It is one of my worst fears, too. I have spent a lot of time thinking about what would happen if I was in an accident or god forbid a fire and had excruciating injuries and the paramedics came and gave me 2mg of morphine. I don't know what we can do about it. In my pill case in my purse I carry a list of my medications and doses so hopefully they would find it??? My heart goes out to you.

 
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Old 04-21-2011, 01:05 AM   #3
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Re: morphine tolerant and operation pain was unbearable

There are SO many other options... Morphine is not the only game in town. In fact, Morphine is one of the weaker ones on the block. Sounds like IV-Fentanyl would have helped you, or at least IV-Dilaudid for the immediate crisis.

Last time I was in the ER I made sure my GF grabbed my pills to bring along....

 
Old 04-21-2011, 09:50 PM   #4
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Re: morphine tolerant and operation pain was unbearable

Just a thought,

It's always good of course to have a list of your medications. The problem with this is that first responders and ER staff do not look for these things. I would suggest taking that list and taping it to the back of either your driver's license of health insurance card. These are two things that the first responders are going to look for. They have to know who you are and for the hospitals, they want to find out who is going to be PAYING them. Those two documents would give you the highest probability of you list of meds of being found.

Now a word of caution if you decide to utilize the driver license. Before I say this let me say that I DO NOT like impaired drivers or condone it in any way. That being said... If you get pulled over, the stopping officer is going to know that you are on high level narcotics. Now you may be very tolerant and able to safely operate a motor vehicle but there his a VERY NEGATIVE stigma in law enforcement toward opiates. You can almost guarentee a run through the field sobriety tests. I personally would elect to use the health insurance card.

As for the ER's use of meds in an emergency, I suppose that is a risk that we take in the chronic pain world. It's a shame and I hope that my advice may help you or anyone else in the future.

Good luck,
"Joe"
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Old 04-22-2011, 12:53 PM   #5
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Re: morphine tolerant and operation pain was unbearable

Thank you joebob. I think the insurance card sounds like a good option. The only time you would be pulling that out is when you are receiving healthcare.

 
Old 04-28-2011, 03:17 PM   #6
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Re: morphine tolerant and operation pain was unbearable

I found after having surgery that the meds they were giving had no effect on my pain relief either. I currently take 50 mg 3 times daily of Methadone (150 mg daily) and 10 mg Oxy-ir for bt pain. So they upped the Morphine but still no relief, So they went straight to Fentanyl which never did a thing in the little doses they were giving. Anyway they eventually went to dilaudid (hydromorphone) and started with small doses then upped until I obtained relief. But all this took so long and I was in soooo much pain. It wasn't a great experience. But since then with iv dilaudid in these situations I have obtained great relief. Now oral dilaudid or the long acting version here in Canada Hydromorphcontin I never found it to be very effective, but again iv Dilaudid in the right dose very effective!
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Old 04-28-2011, 08:43 PM   #7
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Re: morphine tolerant and operation pain was unbearable

Unfortunately this is one of the "bad" side effects of long term narcotic pain management. I've had 21 surgeries over the last 12 years and pain control aftercare is always tricky. Usually I try to take as little of my pain meds as I can for a month before the surgery. I normally take 120mg of MSContin (morphine) and upto 6 10/325 Percocet a day to keep my pain at a 3 or 4. So I try to get it down to know Percocet and around 40mgs of morphine a day and just deal with the daily pain. My surgeons also are well aware of my conditions, since they've been my docs for the past 12 yrs and they know it will be an issue. Usually IV Fentanyl is about the only thing that will knock down the pain after surgery and I go home on a higher dose of LA meds and usually 2 different BT meds. This is one of those things that you have to think about when you choose to go the Pain Management by meds route, and just communicate with your docs and have a plan in place.

For emergencies I keep a detailed CV of my medical/health history up to current date, listing all my surgeries, conditions, and what meds I'm on and for how long. My emergency contact has the same list and she knows all the issues so she acts as my backup contact with the doctors if I can't explain my medical status. Once again if you choose this route, make sure it is someone you can absolutely trust, who you don't get into spats with and not speak to for periods of time, someone who is around/near all the time. That's really about all you can do is just come up with creative solutions to the problems before they become problems.

Good Luck and take care,

kat

 
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