Geri,
the reason you have 2 meds is this.

1. The Morphine sulphate is a fast acting opioid for break through pain. Fast acting means it reachs full effectiveness in about 30 minutes - even faster if you have liquid form and faster than any other narcotic. Vicodin takes a full hour and is classified as a medium strength painkiller.

2. Fentanyl is for long term pain relief (pain expected to last a month or more). Use the morphine when the pain threshold exceeds that which is maintained by the Fentanyl. Fentanyl is the strongest synthetic narcotic there is - 100X more potent than Heroin. Follow the directions for use exactly and NEVER apply a damaged or torn patch. If all of the contents were to be released all at once it could be fatal. It is safe when used as directed.

Believe me you'll be glad you have it as treatment progresses. They always start with 1 25mcg patch and if that isn't enough then they will add another patch. I didn't need more than 75 mcg but some cancer patients have had prescriptions up to 500 mcg (like pancreatic cancer). We rarely see persons here using more than 150 mcg. DO NOT add more patches without specific clearance from your doctor.

When you start using more morphine, they'll up the Fentanyl dosage using a titration formula. Keep a log of all meds, food, water, temperature, etc. When you visit the doctor tell him what the pain is on a scale of 1 to 10 with 10 being unbearable and also the consumption rate for the morphine. Properly managed, pain should be 3 or less.

I would ask for a "swish & spit", "pink magic" compound solution as well. Typically lidocaine, morphine and benadryl. Even if he has a PEG he should try to swallow at least water to keep those muscles from atrophy. This will numb the mouth and allow him to swallow. Don't swallow it as you don't want to numb the gag reflex and aspirate liquid into the lungs.

Like Kathy I had Vicodin in the beginning when the pain was moderate but it is a liver killer if you have hep C, which I do.