#48495 07-08-2007 03:45 AM | Joined: Apr 2005 Posts: 60 Supporting Member (50+ posts) | OP Supporting Member (50+ posts) Joined: Apr 2005 Posts: 60 | Thank you for the replies Nelie, Liz.
I looked up morphine and fentanyl toxicity, and here is what they say about fentanyl.
List of symptoms of Fentanyl toxicity:The list of signs and symptoms mentioned in various sources for Fentanyl toxicity includes the 14 symptoms listed below: Respiratory depression Hypotension Circulatory failure Coma Convulsions Rhabdomyolysis Renal failure Pinpoint pupils Agitation Vivid dreams Nightmares Hallucination Confusion Myoclonic jerks
The last 7 of these descrie him to a "T" I did ring and speak to the nurse about the possibility, but they blew me off, I am going to the hospital and will INSIST they look into it.That and morphine Toxicity too. I looked at his records last night and found that a quack who filled in for his regular doc, who had never seen him before had prescribed morphine when he should have been off all narcotics, I had to fight to see the chart as I was told DH could not consent......luckily I could provide a recent pre-authorization signed by my DH. However they would not give me copies of the chart. Fear is turning into anger now, but I promise I will keep calm for hubbies sake. Will update when I can. SAmmie
C/G to Husband Richard SCC Op 4/1/2005 T2N0M0,Neck disection, 35% of tongue removed. Reoccurance 3/2007,Lymph Node same side Positive SCC, Swelled to 2.5 inches. IMRT X35 Cis X3 Completed 33 IMRT Cis x2 carbo X1 MET to lungs post treatment 10/04/2007 Passed peacefully 31st July 2008.
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#48496 07-08-2007 05:59 AM | Joined: Apr 2005 Posts: 2,676 Patient Advocate (old timer, 2000 posts) | Patient Advocate (old timer, 2000 posts) Joined: Apr 2005 Posts: 2,676 | MUst be diferent in the UK- once I was signed into the Medical Privacy record as the person who was entitled to all of John's medical info, I had no trouble asking for charts, etc. While JOhn was in the hospital, I reviewed his overnight chart as soon as I got there in the am and if there was someting I didn't understand, I ask the Nurses to explain what was done and for what reason. This info was very useful when the Docs made rounds and I could ask them questions. When we came home, I learned the charting system the visiting nurses were using and entered everything the way they did when I was alone with him. That kept us all on the same page. Sammie, I know you are searching for answers, but my guess is the answers are in the charts and in the meds. Stay strong. Amy in the Ozarks
CGtoJohn:SCC Flr of Mouth.Dx 3\05. Surg.4\05.T3NOMO.IMRTx30. Recur Dx 1\06.Surg 2\06. Chemo: 4 Cycles of Carbo\Taxol:on Erbitux for 7 mo. Lost our battle 2-23-07- But not the will to fight this disease
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#48497 07-08-2007 04:28 PM | Joined: Feb 2005 Posts: 2,019 Patient Advocate (old timer, 2000 posts) | Patient Advocate (old timer, 2000 posts) Joined: Feb 2005 Posts: 2,019 | Sammie, So when he had that reaction to the sedative before the MRI he was actually already on morphine only no one knew (because of the "quack" doc?)? I'm guessing he just is having a toxic reaction to both morphine and fentanyl.
A recent study in the U.S. showed there is an average of one-two medical errors per patient per day oin US hospitals and I'm assuming this might be true in the UK too so get in there and be his advocate as much as possible!
Again, I am so sorry you are ahving to deal with this when the regular treatment is tough enough without this but hang in thee.
Nelie
SCC(T2N0M0) part.glossectomy & neck dissect 2/9/05 & 2/25/05.33 IMRT(66 Gy),2 Cisplatin ended 06/03/05.Stage I breast cancer treated 2/05-11/05.Surgery to remove esophageal stricture 07/06, still having dilatations to keep esophagus open.Dysphagia. "When you're going through hell, keep going"
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#48498 07-10-2007 05:05 PM | Joined: Apr 2005 Posts: 60 Supporting Member (50+ posts) | OP Supporting Member (50+ posts) Joined: Apr 2005 Posts: 60 | Hi All, Hubby is still in CCU, still hooked up to vent, and has been since Sat night. They will try and remove his breathing tube tomorrow, but as of today he is still too swollen in the throat area. They are giving him steroids to reduce it. there was alot of soft tissue damage when they tried to tube him as he was fighting in his mind for his life as he couldnt breath. The good news is they think he is out of danger, stable to be exact. The Docs have come to the conclusion that the delerium he experienced was to to sensitivity to medications (he NEVER takes anything stronger than Advil apart from when undergoing treatment) So you guys were spot on! No one will admit there could have been an error, but his reg chemo and radiation docs were extremely upset as they had put in the notes for him NOT to medicated with anything stronger than Ty #3 or codine, But Nurologist wanted MRI and was worried he would move about so they sedated him, the "quack" I have not seen since, but when this is over I WILL FIND HIM. Me on the other hand I have drawn strength that I didnt know I had, but I was told by DH's Rad doc that if I didnt go get sleep he would ban me from CCU for 24 hrs! Will update again when I have more news. Sammie P.s Tnx again for all the posts, they REALLY did help.
C/G to Husband Richard SCC Op 4/1/2005 T2N0M0,Neck disection, 35% of tongue removed. Reoccurance 3/2007,Lymph Node same side Positive SCC, Swelled to 2.5 inches. IMRT X35 Cis X3 Completed 33 IMRT Cis x2 carbo X1 MET to lungs post treatment 10/04/2007 Passed peacefully 31st July 2008.
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#48499 07-10-2007 06:31 PM | Joined: Feb 2005 Posts: 2,019 Patient Advocate (old timer, 2000 posts) | Patient Advocate (old timer, 2000 posts) Joined: Feb 2005 Posts: 2,019 | Listen to that doctor and get some sleep Sammie!
SCC(T2N0M0) part.glossectomy & neck dissect 2/9/05 & 2/25/05.33 IMRT(66 Gy),2 Cisplatin ended 06/03/05.Stage I breast cancer treated 2/05-11/05.Surgery to remove esophageal stricture 07/06, still having dilatations to keep esophagus open.Dysphagia. "When you're going through hell, keep going"
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#48500 07-10-2007 07:51 PM | Joined: Nov 2002 Posts: 3,552 Patient Advocate (old timer, 2000 posts) | Patient Advocate (old timer, 2000 posts) Joined: Nov 2002 Posts: 3,552 | It's pretty common practice to get anti-anxiety meds for MRI's as people can get very paranoid being in such a confined space. You must also be absolutely still for the images to come out clearly. It is also very noisy and creepy in the tube and for H&N scans you are placed right in the middle of it. This is not the same as sedation - it's nothing more than a muscle relaxant. Until the MRI is actually done the doctors are guessing at this point.
Bear in mind also that the adverse reactions in the PDR are required to be listed (by the FDA) if even 1 in a million have that response (and it may not even be attributable to the drug). Many of us have been on Fentanyl and had no problems, only a relative few have had adverse reactions. The way adverse reactions are written up in the literature is a joke and almost useless. The best advice you can get about a drug is from a pharmacist. Most of those adverse reactions in your list are more indicative of an overdose.
Morphine is frequently prescribed with Fentanyl for breakthrough pain and they typically work well together.
I would be more suspicious of a reaction from a contrast agent that is frequently ordered for H&N MRI's and allergic reactions to that are not uncommon.
Gary Allsebrook *********************************** Dx 11/22/02, SCC, 6 x 3 cm Polypoid tumor, rt tonsil, Stage III/IVA, T3N0M0 G1/2 Tx 1/28/03 - 3/19/03, Cisplatin ct x2, IMRT, bilateral, with boost, x35(69.96Gy) ________________________________________________________ "You are a mist that appears for a little while and then vanishes" (James 4:14 NIV)
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#48501 08-29-2007 05:38 PM | Joined: May 2006 Posts: 57 Supporting Member (50+ posts) | Supporting Member (50+ posts) Joined: May 2006 Posts: 57 | Bless your heart.
Dennis also had this reaction, but it was to the morphine, coupled with lord knows what else. He also hallucinated, told the nurse that she would not tell him what to do in HIS house (ICU at the time), and used to "visit" with our animals. He was convinced that our cat was climbing the curtains of his room, and that our dog was giving him "kisses"
This sounds like a classic case of pain-killer reaction.
I hope they can wean him off the ones causing problems, and get him comfortable.
Love, Mandi
Stage III tonsil, Dx 8/14/2002,chemo and rad...reoccurance 8/3/07,Base of Tongue,vocal cords,stage IVA,total larynectomy and glossectomy 9/4/07 with pec flap...reoccurance Nov. '08 and Feb. '09 (positive margins remained after each operation) Second pec flap May 7, 2009. Still positive margins.
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