Discussions that mention morphine

Pain Management board


Hi Jen Can you tell us about your condition. Why were you in hospital, why so long , what is causing pain, etc? Sleeping comfortably all day isn't the goal of pain management and if 50 mics has you sleeping this much, Duragesic may not be the right med for you. 75mics may leave you completely non functional. There is a difference between sleeping all day because your drugged and being bed wridden because your in too much pain to stand or walk. As far as feeling the meds, not feeling them is the goal of all the long acting med, smooth releases, to reduce peaks and valleys so that you can function. If a big release of meds just knocks you out and you continue to be knocked out by given meds while asleep, what kind of qulaity of life do you have. That sounds more like Hospice care where your trying to make someone comfortable up untill their last days. You havne't said and if that's the case, I doubt your doc will care if you sleep all day, but if the goal is to restore as much function as possible, more meds that keep you in bed is no way to spend the next 20+ years of your life.

Every med does have a slightly different side effect profile, some make you very drowsy, some are actually stimulating and can prevent sleep. However, acute pain like post op pain, or intractable pain from cancer treated by hopice and chronic pain where a condition leaves you in pain are all treated very differently with different goals in mind.

Even with implanted morphine pumps, the goal is 50% pain reduction. 50% is just as relative as the pan scale. What may be a 7 to you may be a 9 to someone else or a 4 to me. 50% reduction may mean the diference between being bed wridden and able to help around the house or it may be the difference between working and not. When explaining your levels of pain it's good to explain it terms your doc can understand. Like when the pain is a 7 all I can do is take meds and lay down and hope it takes the edge off, when it's a 5, I can help with the cooking and cleaning but must rest after X number of hours or minutees. Being able to communicate where you are pain and function wise is very important. Your describing fairly high levels of pain, but very low levels of function. Is this because the meds knock you out or are you simply unable to get out of bed in an attempt to keep the pain under control. When people have good pain control, they can usually sleep without significant problems, so you don't want to report conflicting levels of pain and levels of function. I don't know many people that fall asleep when their pain hits 7+. Any movement wakes you if your able to sleep.

Try to explain your condition in terms the doc can understand. Everyone uses a pain scale of 1-10. Some patient continually report high levels of pain trying to get their point across, but when a doc seees 50 patients a day and everyone reports being at an 8, you don't take the same action on every patient, action or changes in meds are based on level of expected function given your conditioon, prognosis, and type of pain. You do loose a tremendous amount of strength and muscle tone while bed wridden and if sleep is an escape, giving you more meds to allow you to escape more is only considered a good thing imediate post op or in hospice. If your pain is chronic, the goal is to find a med that doesn't knock you out, where you still feel motivated and your pain is controlled well enough you don't have to stay imobile to keep it from increasing. Sleeping all day isn't a tolerable side efffect to most people or most docvs unless yopur dying, thnhen pain management focuses on making your comfortable andless on function.

With some of the LA meds you do feel some of the characteristic releases of certain meds. You may break into a sweat an hour after taking oxyContin or MSContin, This doesn;'t equate to pain relief, but it is a feeling that you know the last pill wasn't a dud for some reason. I don't know why but i'm under the impression your pain is abdomoninal pain of some sort, this is where duragesic has an advantage because it tends to be less constipating. PM is truly tiral and error and the pain relief lasts long after you stop feeling the med kick in even with a new med or stronger dose.

Meds like Lyrica can make you sleepy, opiates can make you sleepy, meds for nausea can also, but if you're say 40 years old, 30 years is a long time to spend in bed for the treatment of chronic pain. Youmay have to play guinea pig and do the trial and error thing with many meds from the opiate clases or anti seizure lases to find what works best for you pain wise and function wise.Initial side effects like sedation or flushing and nausea do deminsish with time and your simply left with pain relief or the absence of pain.Some side effects don't get better with time and get worse with dose increases, Constipation is an inherant problem for al people wyaking pain meds. Sleep is a common problem for people in pain. Jst work on communication or relatig what your desrcibing to something your doc understands.

Good luck, Dave