Tamara,
There's all kinds of drugs out there for pain management and sometimes it takes a few days for the body chemistry to adjust to them. Morphine is one of the oldest and is a natural, fast acting opiate. Orally, it is in full effect within 30 minutes - faster than any other pain killer. Some persons do have bad reactions to morphine and/or other medications so you may have to experiment with different ones to find the most efficacious.

We should discuss the 2 basic types of pain management tools available to you:

1. Long term: These are for long term pain management, in other words, pain that will be constant for a month or more. They will often use a time release patch like Fentanyl. Morphine also comes in a time release patch. Fentanyl is the most powerful pain killer there is. It is a synthetic opiod and 100X more powerful than Heroin. Typically started in 25 mcg increments, they can go as high as 500 mcg. It is extremely important that you understand and follow all of the warnings, precautions and indications/limitations for use with this drug or ANY narcotic. It can be lethal if not used correctly. Many of us had this during Tx and had no problems with it. I doubt I could have endured the pain without it. I never went past 75mcg. Oxycontin and methadone, I believe are also used for long term pain management.

Short Term: Is pain that lasts for a short period of time or it could also refer to "breathrough pain" where the pain threshold exceeds that moderated by the long term drug. If there are too many daily "breakthrough" events they will adjust the long term pain killer to a higher dose.

So most persons will have both types in their pain management tool kit.

NEVER adjust any pain meds without clearance from your doctor - and that means either way. It can be just as deadly to suddenly quit taking opiate (or synthetic opiate) pain killers.

Always communicate the level of pain, using the pain scale of 0-10, 10 being unbearable. Pain should be managed to "3" or less and is a basic patient right. Demand it if you need it.

Special warning to patients with liver disease: Many synthetics, such as Vicodin or Percoset have high doses of acetomeniphen in them which is very toxic to the liver. You will need "natural pain meds such as morphine or codiene. Fentanyl has no acetomeniphen in it either.

Always talk to your pharmacist when getting pain meds.

In my experience the MO was the most qualified person to manage my medications.

Constipation is a very serious side effect of narcotics and there are countermeasures that you can get from the nutritionist.

It is especially important to stay hydrated.

If you are putting meds down a peg tube, particularly crushed tablets, always clear it first with your doctor or pharmacist. Crushing a time release tablet can have serious consequences.