My dad is awaiting surgery in 2 weeks and he is in unbearable pain. Hes currently taking oxycodone liquid every 4 hours with some tylenol every 6 hours. I asked the dr what options he had to assist with pain and I was told this was the best medicine for him. He said unfortunately the cancer pain is outweighing the strength of the medicine. My dads working full time and he previously didnt want to go beyond the oxycodone so he could function and drive. It looks like its gotten to the point where he cant take it. Its hurting me to see him in constant pain day after day. What suggestions do you have for pain management? Should I be asking for something else? What has worked for you?

Im so sorry your father is in so much pain. Call and ask the doc about the fentayl patch. It has worked very well for many here, including myself. This medication is a step up and step down one where it would gradually be increased or decreased. Read the directions thoroughly. The fentanyl patch is the strongest pain killer available. Never fold, bend tear, cut, rip or damage the patch. Always put it in a different place, changing it every 72 hours. I used to change mine about every 68 hours to make sure it didnt wear off. It can take up to 24 hours before it starts to work. If he could get the patch on today, about 12-16 hours later he would begin to have some relief. When wearing the patch do no long hot showers or baths as very hot water could trigger too much medication being released causing an over-dose. It also can make the patient tired and constipated. I would guess your father would start at at least 50mg, maybe even 75mg. He can also use other pain meds in case he is having breakthru pain. Liquid lortab, oxycodone or neurontin (aka gabapentin for nerve pain) all are great for breakthru pain.

Hope your father gets some relief very soon! Being in pain is never good for any patient, it just makes everything so much harder on them. The doctor should have offered fentayl, its much stronger than oxycodone. Please dont hesitate, call right away and get this prescription for your father.

Best wishes!

There are pain meds that can stop the pain. Christine mentioned fentanyl. There is morphine as well which helped me. If that did not work the patches were the next step which always seem to work once given in the correct dose.

Sometimes some doctors are not very helpful in the pain department. If one doctor is not being helpful, tap another to get what is needed to stop the pain.

Good luck

Maybe see a Pain Management/Palliative Care doctor associated with your CCC. Mine was helpful. But I didn't need their service before treatment, only during, after for neuropathy, then teeth pain, brachial plexopathy. They were really helpful, kind of heavy handed in the dosage frequency for my taste, but are committed to treating your pain, and have had no problem with them writing scrips in these days of controlled substance abuse, doctor scaredness, and required tracking of these meds, even pharmacies are afraid to carry, issue them too.

Good luck.

Paul,

Good point about the heavy restrictions and controls now placed on those involved with prescribing and dispensing these very strong pain medications.

Even for clearly essential medical need, the procedures are a real burden. Triplicate hard copy scripts on special imprinted paper, pharmacies always doing double triple checks and then checking their very limited inventory.

I'm certain there is some system that monitors how many scripts each doctors prescribes of the schedule II drugs too and fearful about getting a call from the DEA.

On a personal note of the three main specialists: MO, RO, ENT, I found the RO was most free with writing the heavy hitting pain meds. I got the sense prescribing these are far more part of their daily pattern than other doctors.

In New York State, which may go nationwide, there is I-Stop, which is an Internet controlled substance registry since 2013. The doctor has to check the registry to see your history, for level II, III and IV controlled substances before issuing a written script to you. The pharmacist has to do the same, enter the information, and doctors who prescribe often are flagged, so some don't bother getting involved in this. My PCP refused to give out anything stronger than Ibuprofen 800, a joke and waste of time, when I was in real pain. I had just finished seeing all my specialists for follow-up, and of course is when issues usually arise right after that, at night, and weekends too, so I went to pain management who I knew would issue a script. Just to get Percocet, I had to go to/call 10 pharmacies to get it filled, and they look at you like it's a robbery. It's going to get worse, so find a doctor/pharmacist that will work with you, if needed now or in the future. Like you Don, my RO was helpful. My Oncologist even more so. I don't ever remember my ENT prescribing pain meds, or me asking, except after surgery upon discharge, but otherwise I usually turn down meds too often. The system doesn't apply for hospital discharges, after surgery and such.

On the other hand, oxy meds are out of control here with doctors, pharmacists and others, even ice cream trucks lol, involved in theft/fraud.

https://www.health.ny.gov/professionals/narcotic/prescription_monitoring/

That's why I have used the same pharmacy since 1999. One of the pharmacists is still there. The other one I use is the same the cancer center/hospital system uses and they deliver 24 x 7 if I ever needed anything.

Going to the same pharmacists certainly makes the survivor more comfortable not getting the evil eye and magnifying glass on the ID card but it does not reduce the burden related to managing and tracking the controlled substance.

While I was getting bottles of the stuff filled, I heard ridiculous prices each pill was worth on the street. No wonder there is so much abuse. I'm keeping all my leftover for the revolution; they ought to keep food in the pantry for awhile longer. :-|

After a few calls to the dr, I was finally able to get dilaudid prescribed for my dad. The on call dr this morning was nice enough to try something different. I was starting to get concerned because my dad is refusing to eat due to all the pain. Hopefully this helps. My dad works at night so hoping this isnt going to cause crazy side effects. Any feedback on side effects for this medication?

Sorry, no experience with this one. Of course, side effects are impacted by dosage which is a balancing act between pain relief and increased side effects.

If there is still much pain keep pressing for adjustments. Paul; mentioned earlier the pain management unit that specializes in managing pain. Ask around if you have access to this group as they are most capable of dealing with pain issues.

Just be careful that he has a doctor who is knowledgeable on how to ween him off of dilauded.

I tried to be a hero and went too fast. I ended up in the fetal position for a weekend sever flu like symptoms sweating/chills and vomiting. There were several things going on at once and I didn't tie it in my head that I was going thru withdrawal until it was over.

We're in a difficult area of pain management beyond most of our experiences. We can't advise anything about medications, especially the very strong stuff. We can only pass on our experiences with what we had.

There is a fundamental principle in pain management about "keeping the bath hot". If you're sitting in a bath and trickling in hot water regularly it stays hot. If you let it go cold you need to put a heap of hot water in and its very uncomfortable while the temperature stabilises. Thats how pain management was described to me. You have to keep on top of the pain by having the right dose taken at the right time (eg 4hrly) and not wait for the pain to take hold.

He should not be trying to be a hero, be worried about addiction, or any of that crap. That is a problem, if it becomes a problem at all, for another day.

Pain is worsened by distress. So as well as the pain itself, you have the fear and worry about the pain. Do your best to remain calm and positive around him. Make sure he feels heard by the doctors, but don't fall into arguments with them, its extremely distressing when you lose faith in your medical team.

Lastly make sure he is eating, drinking and toileting properly. Pain and the meds play havoc with all three, at a time when you need all three to be working properly.

OZ, I was in no way trying to say don't take the pain meds, and hope I didn't come off that way. I needed them, and sometimes probably something stronger.

You're right, he shouldn't worry about addiction until much later, but withdrawal can be avoided and that's all I was trying to point out.

Not at all Brian, the hero reference was not in response to you, it was a more generic comment. I think we've all tried to tough it out, I think its a natural part of the fight.

And then again, we ARE heroes! Patients and carers alike.

I hope you've been able to get your Dad's pain under control. I'm having some issues with pain and came across this thread. We're having a hard time getting a prescription filled because they are out.

One tip; Always count your pills in front of the pharmacist at the counter before you leave, we had some taken once.

It's a shame that people abuse these drugs. It shouldn't be so difficult for those who really need them can get them with out so much trouble.

I am finding some easy movement and light lymph massage is helping too.