| Joined: Nov 2009 Posts: 644 Likes: 1 "OCF Down Under, Kiwi" "Above & Beyond" Member (500+ posts) | OP "OCF Down Under, Kiwi" "Above & Beyond" Member (500+ posts) Joined: Nov 2009 Posts: 644 Likes: 1 | Hi. I'm set to have pretty big surgery on 18 February. I suffered a morphine overdose from the self-administered pump last time (2009). Same thing happened in 1995. It's a ghastly experience and I'm worried about my few remaining brain cells if they go ahead with morphine again. They seem to be reluctant to give me an alternative but I've got three weeks to research this and appeal to the anaesthetist and surgeon for something else. I don't feel that I can refuse morphine outright because I'm scared that other drugs might cause me to hallucinate too. I'd be very grateful if people could share their expertise on this subject.
1996, ovarian cancer surgery + cisplatin and taxol. September, 2007, SCC of left lateral tongue. Excision. October, 2009 recurrence in scar tissue, T1NOMO. Free flap surgery from left wrist - neck dissection. 63 year old New Zealander. No chemo, no RT. February, 2014. New primary in left buccal mucosa. Marginal mandibulectomy, neck dissection, right arm free forearm flap. T1N0M0 but third occurrence and some areas of concern: RT started 8 April and finished 19 May.
| | | | Joined: Mar 2011 Posts: 1,024 "OCF Kiwi Down Under" Patient Advocate (1000+ posts) | "OCF Kiwi Down Under" Patient Advocate (1000+ posts) Joined: Mar 2011 Posts: 1,024 | My experience as a nurse in NZ hospitals, is that if you clearly state that you do not react well to Morphine, they will not use it. Fentanyl via PCA pump is often used as an alternative. It doesn't tend to cause the same problems as morphine, i.e the hallucinations, nausea, vomiting. This is definitely something you need to discuss with the Anaesthetist , they will prescribe the post op analgesia. Just be very clear that you do not want morphine. Kris has the same awful hallucinations and would never have it again. Maybe you could Google Fentanyl and read up about it so that you can have a robust discussion pre op with the anaesthetist. Actually, tell everyone you come into contact with at the hospital when you are admitted or at pre admission clinic. I can guarantee they won't use Morphine. Tammy
Caregiver/advocate to Husband Kris age 59@ diagnosis DX Dec '10 SCC BOT T4aN2bM0 HPV+ve.Cisplatin x3 35 IMRT. PET 6/11 clear. R) level 2-4 neck dissection 8/1/11 to remove residual node - necrotic with NED Feb '12 Ca back.. 3/8/12 total glossectomy/laryngectomy/bilat neck dissection/partial pharyngectomy etc. clear margins. All nodes negative for disease. PEG in. March 2017 - 5 years disease free. Woohoo!
| | | | Joined: Nov 2009 Posts: 644 Likes: 1 "OCF Down Under, Kiwi" "Above & Beyond" Member (500+ posts) | OP "OCF Down Under, Kiwi" "Above & Beyond" Member (500+ posts) Joined: Nov 2009 Posts: 644 Likes: 1 | Thanks, Tammy. That adds to what you said before. I'll definitely do my research and dig deep into my assertiveness resources when I see them.
1996, ovarian cancer surgery + cisplatin and taxol. September, 2007, SCC of left lateral tongue. Excision. October, 2009 recurrence in scar tissue, T1NOMO. Free flap surgery from left wrist - neck dissection. 63 year old New Zealander. No chemo, no RT. February, 2014. New primary in left buccal mucosa. Marginal mandibulectomy, neck dissection, right arm free forearm flap. T1N0M0 but third occurrence and some areas of concern: RT started 8 April and finished 19 May.
| | | | Joined: Jan 2009 Posts: 1,844 Patient Advocate (1000+ posts) | Patient Advocate (1000+ posts) Joined: Jan 2009 Posts: 1,844 | Usually the strong analgesics are going to give you the loopy side effects, particularly if you don't have a tolerance built up. Even though most of us have been on opiates long term, when we are off for long periods of time the body can actually become "more" sensitive to the drug upon reintroduction. Lot's of OD's happen that way actually. Hydromorphone would be another alternative, I really enjoyed those trips...on a short term basis though as the long term side effects of those drugs at the doses we usually need them in become horrible. Personally anymore I'm a big fan of the cannabis concentrate oils, where not at the analgesic levels of the heavy opiates, they work rather well for everything but the highest on the pain scale. I've found them to be rather effective at lessening the amount of pain medications that I took, and eventually helped me ween off and eventually step down to the flower or "bud" (vaporized, or ingested, never smoked!). Where some of your new age hippies will be familiar with "dabbing" or vaporizing pens, the dosage can be tricky at first�but there's never a fear of OD'ing. I have had a few interesting experiences with it though�like laying in the backyard holding onto the lawn so I wouldn't slide off the earth type of fun. I eventually landed and really wanted a sandwich Good luck, and keep your head up! E
Young Frack, SCC T4N2M0, Cisplatin,35+ rads,ND, RT Mandiblectomy w fibular free flap, facial paralysis, "He who has a "why" to live can bear with almost any "how"." -Nietzche "WARNING" PG-13 due to Sarcasm & WAY too much attitude, interact at your own risk.
| | | | Joined: Jun 2007 Posts: 10,507 Likes: 6 Administrator, Director of Patient Support Services Patient Advocate (old timer, 2000 posts) | Administrator, Director of Patient Support Services Patient Advocate (old timer, 2000 posts) Joined: Jun 2007 Posts: 10,507 Likes: 6 | I would have to agree with Tammy....if you tell everyone you meet with about your morphine issues they wont give it to you. Im sure the hospitals there are as sensitive to opening themselves up to a lawsuit as they are here in the US. @ Eric if you are using copy/paste the new upgraded forum does not support it. You need to always type out all of your replies in the white box to have them appear. Posting issues thread ChristineSCC 6/15/07 L chk & by L molar both Stag I, age44 2x cispltn-35 IMRT end 9/27/07 -65 lbs in 2 mo, no caregvr Clear PET 1/08 4/4/08 recur L chk Stag I surg 4/16/08 clr marg 215 HBO dives 3/09 teeth out, trismus 7/2/09 recur, Stg IV 8/24/09 trach, ND, mandiblctmy 3wks medicly inducd coma 2 mo xtended hospital stay, ICU & burn unit PICC line IV antibx 8 mo 10/4/10, 2/14/11 reconst surg OC 3x in 3 years very happy to be alive | | | | Joined: Mar 2011 Posts: 1,024 "OCF Kiwi Down Under" Patient Advocate (1000+ posts) | "OCF Kiwi Down Under" Patient Advocate (1000+ posts) Joined: Mar 2011 Posts: 1,024 | Just want to say that we have non liturgation laws here in NZ. You may not sue anyone. Works fantastically well. We have something called the Accident Compensation Corporation. It is Govt. run, we all contribute through taxes. It pays out when someone is said to have suffered an injury through an "accident". though there are hoops to jump through. Works fantastically well compared to the old sue everybody policy. Been law here for about 40 years. Tammy
Caregiver/advocate to Husband Kris age 59@ diagnosis DX Dec '10 SCC BOT T4aN2bM0 HPV+ve.Cisplatin x3 35 IMRT. PET 6/11 clear. R) level 2-4 neck dissection 8/1/11 to remove residual node - necrotic with NED Feb '12 Ca back.. 3/8/12 total glossectomy/laryngectomy/bilat neck dissection/partial pharyngectomy etc. clear margins. All nodes negative for disease. PEG in. March 2017 - 5 years disease free. Woohoo!
| | | | Joined: Nov 2009 Posts: 644 Likes: 1 "OCF Down Under, Kiwi" "Above & Beyond" Member (500+ posts) | OP "OCF Down Under, Kiwi" "Above & Beyond" Member (500+ posts) Joined: Nov 2009 Posts: 644 Likes: 1 | Yeah, suing isn't an issue in NZ but I remember the surgeon sounding embarrassed and regretful when I overdosed on morphine last time. It seemed to take a hell of a lot of staff to get me back on track with the antidote. (Some of my memories might be fantasies though.)
I had warned them about my previous problems but because I don't have a true allergy to morphine I wasn't listened to. I had also asked for the wrong thing. In 1995 after the epic morphine failure I got total relief from paracetamol and voltaren suppositories. Same thing happened after my first little tongue op/biopsy. I asked for that and was told it wouldn't be enough.
This time I'll ask for Fentanyl or another drug, but I'm going to have to be assertive. Even the specialist nurse at the ward advised me to write a letter (I suggested the letter idea)and give it to the anaesthetic staff as I go into the op. Heavens above! My GP said surgeons are surgeons and that their priorities don't extend to overall patient welfare so I'll have to bypass them somehow. Hmmm.
I had constant hallucinations on morphine but funnily enough my worst nightmare was on Day 8 when I ran out of the ward at night convinced I was a soldier. (After I came round I persuaded them to send me a psychiatrist.) I had pulled my NG tube out and broke down completely when a nurse tried to put it back in. It's an uncomfortable procedure when the patient is tense and upset and I felt they were punishing me for my escapade.
Staff attributed that event to a combination of ondansetron and citalopram but I'm not so sure because it carried on from the morphine dreams.
How nice it would be to have pain meds that got me through the first week in a state of mild euphoria instead of tension and nightmares!
1996, ovarian cancer surgery + cisplatin and taxol. September, 2007, SCC of left lateral tongue. Excision. October, 2009 recurrence in scar tissue, T1NOMO. Free flap surgery from left wrist - neck dissection. 63 year old New Zealander. No chemo, no RT. February, 2014. New primary in left buccal mucosa. Marginal mandibulectomy, neck dissection, right arm free forearm flap. T1N0M0 but third occurrence and some areas of concern: RT started 8 April and finished 19 May.
| | | | Joined: Dec 2010 Posts: 5,260 Likes: 3 "OCF Canuck" Patient Advocate (old timer, 2000 posts) | "OCF Canuck" Patient Advocate (old timer, 2000 posts) Joined: Dec 2010 Posts: 5,260 Likes: 3 | Eric thanks for editing that long and informative post,, (just kidding) I had a similar problem with morphine - wild dreams and NO pain relief. Told them it stop the meds the day after surgery. Be strong and tell them outright hugs
Cheryl : Irritation - 2004 BX: 6/2008 : Inflam. BX: 12/10, DX: 12/10 : SCC - LS tongue well dif. T2N1M0. 2/11 hemigloss + recon. : PND - 40 nodes - 39 clear. 3/11 - 5/11 IMRT 33 + cis x2, PEG 3/28/11 - 5/19/11 3 head, 2 chest scans - clear(fingers crossed) HPV-, No smoke, drink, or drugs, Vegan
| | | | Joined: Jan 2013 Posts: 1,291 Likes: 1 Patient Advocate (1000+ posts) | Patient Advocate (1000+ posts) Joined: Jan 2013 Posts: 1,291 Likes: 1 | Alpaca,
You are so much more aware this time I am sure you can discuss some alternatives to morphine. But as you say there are drug interactions that complicate deciding what best to use. Fentanyl patches are often prescribed once morphine is left behind but that is almost always post surgery. What they use while in surgery is totally within the domain of the anesthesiologist. Good luck.
Don Male, 57 - Great health except C Dec '12 DX: BOT SCC T2N2bMx, Stage 4a, HPV+, multiple nodes 1 tooth out Jan '13 2nd tooth out Tumor Board -induction TPF (3 cycles), seq CRT 4-6/2013 CRT 70gr 2x35, weekly carbo150 ended 5/29,6/4 All the details, join at http://beatdown.cognacom.com | | | | Joined: Jan 2009 Posts: 1,844 Patient Advocate (1000+ posts) | Patient Advocate (1000+ posts) Joined: Jan 2009 Posts: 1,844 | No copying or pasting for me actually. I've not had a lot of success with my posts showing up
Young Frack, SCC T4N2M0, Cisplatin,35+ rads,ND, RT Mandiblectomy w fibular free flap, facial paralysis, "He who has a "why" to live can bear with almost any "how"." -Nietzche "WARNING" PG-13 due to Sarcasm & WAY too much attitude, interact at your own risk.
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