Hi guys,

Just visited a friend in the hospital who has leukemia, has an infection, is severely swollen, and is having severe pain. Doctors have no idea what is wrong. While I realize this is not H&C cancer, I figure pain is PAIN. They had him on Oxycontin (2 40mg in am I think) but it made him loopy. Morphine pump was having no effect on pain yesterday. Could you please post what drugs you were able to take in what dosages so I can give him some ideas. I know there are patches, but someone just posted that the Fentynal patch made her husband very sick. This guy is at a local hospital and can't get moved to Fox Chase until Feb 8. He was so disappointed that I had no info for him because he assumed that I had had simliar pain. Tell me what worked that didn't make you loopy.

Thanks,
Eileen

Hi Eileen,
the downside of sudden, aggressive pain management is nausea and loopiness. I don't think it is possible to avoid that. Much of that should go away after the tolerance thresholds are hit. Simply put, opioids literally substitute some of the brain chemistry, so there is always an adjustment period while things rebalance themselves (this is why there is always a withdrawal from narcotics while the process is reversed). Patches (Fentanyl) are great, especially if swallowing is an issue but they take 24 hours to come up to speed.

Some people's body chemistry simply won't work with some drugs so they may have to fiddle with it a bit.

There are 2 basic classes of pain meds:

Long term, such as Fentanyl, Oxycontin. Methadone, etc. which are used to medicate the "normal" expected daily pain.

Short term, fast acting, such as Morphine, is used for breakthrough pain where relief is needed in 15 minutes (orally) or faster by injection or pump.

There are specific guidelines for cancer pain management on the NCCN site. Print the doctors a copy. Demand adequate pain management - use the scale in the NCCN guidelines to describe it -The doctors and nurses usually understand that.

Everybody reacts differently. I was on the patch for months and other than constipation (which is a side effect of all pain meds), had no problems with it.

Hey Eileen,
I know it must be hard to see your friend suffer, but what a good friend you are! Dan used Morphine after his initial surgery and he was pretty out of it which was good in that case. During his chemo/rad treatments he had a Duragesic Patch going from 25 mg. to 150 mg., and used Oxycotin. It worked well on the pain, helped him to sleep and did not make him crazy. He had about two days of "crawling" skin and inability to sleep after going off the drugs, but he really did it cold turkey and should have went down more gradually.
God bless sweetie!
Debbie