and from IUHomer:
If you think that doctors don’t have a problem with dispensing adequate pain meds you should check out this thread and the advice from the Association of American Physicians and Surgeons linked to in that thread’s OP.
Scary stuff.
If it’s okay, I’d like to interview you in greater depth about your lack of reaction, via e-mail.
And on your other point, I know that for me, at least, chronic pain is a lot more disruptive than the effects of daily opioid consumption.
Another from the personal experience department…
A few years ago, I was in a car accident where my hand took heavy damage – my wrist was broken and my thumb was almost torn from my hand. I don’t know what I was given at the hospital, but I was prescribed Tylox (oxycodone and acetaminophen) and instructed to take it every four hours.
I don’t really remember the month that followed very well, but the painkiller worked quite well and I spent most of my time either asleep or sort of fuzzily awake. Aside from being injured and useless, I was feeling pretty good. My mother expressed relief when, after a month or so, I told my doctor that I didn’t need the Tylox anymore; she had been afraid that I would develop an addiction, but didn’t want to take me off the drugs herself if I still needed them.
I still had some of it left over, though, and I occasionally get monsterous headaches. About a year later, I took some of the Tylox to treat one, and was shocked by my reaction to it. First, I became alarmingly… I suppose the only fitting word would be ‘stoned.’ Obviously whatever tolerance I had developed after the accident had worn off, but I had never reacted so strongly to the drug to begin with. Second, after I had come down some, I became very nauseated – another reaction I’d never experienced while injured. It was the same dosage I had been nearly constantly for severe pain, but it seemed to be terrible overkill for pain that was more moderate.
I wish reprise was still around, because she was very knowledgeable about pain management, I think from experience with working with the terminally ill.
What she told me was that the latest pain management research shows that there is a “window of opportunity” before the pain becomes unbearable, and if you treat the pain EARLY, you can use much smaller doses of painkiller to much greater effect. She also said this method results in far less dependency/addiction.
Bascially, once the pain gets to its ultimate, it becomes increasingly difficult to relieve it safely or effectively.
This also works for lesser things like headaches or menstrual pain. Try it. Take a painkiller as soon as you feel the symptoms coming on, don’t wait until it gets bad. You may be amazed that it never gets any worse, and in fact goes completely away. It’s an inversion for me of what I’d previously believed and practised - suffer stoically until it’s absolute agony, and then take pills. Taking them early really is more effective.
I have a question regarding morphine, cancer, and pneumonia.
I know a woman whose husband died last month from cancer. This woman is, for lack of a better phrase, dumb as a box of rocks. She’s also a bible-thumping Christian and racist/anti-semite to boot. This is why I describe her as “a woman I know” and not “a friend.”
Anyway, her husband had cancer, and went through several bouts of pnemonia during treatment. They gave him morphine to help with the pain. She’s now convinced that the morphine constricted his lungs and killed him - I’ve spend way too much time listening to her rant on and on about “why would they give morphine when he has pneumonia?!?”
So what’s the truth on this? Given a patient with both cancer and pneumonia, what makes it OK to give morphine even though it’s known for restricting lung functionality?
Athena, all narcotic pain killers decrease the respiratory drive. That’s how people often die of an overdose; they stop breathing.
But when one has malignant pain from an incurable illness, there’s really nothing else that will help besides opiate painkillers. Given a patient with terminal cancer who’s in pain, but has now developed pneumonia, I wouldn’t hesitate to recommend morphine. A comfortable death is far far better than a painful one.
In some situations, there is no ‘good’ solution.
QtM, MD
I agree with Qadgop. I’ve seen too many people (and doctors too) whose “concerns” like that have caused extended suffering.
In any case, to expand on what Qadgop said, morphine and other opioids don’t actually restrict lung functionality, they decrease the autonomic breathing drive. So in a severe case, where somebody has pneumonia or some other respiratory problem, you could load them up with opioids and then intubate them so that breathing was handled automatically. That’s probably overkill for most cases, though.
As Qadgop said, there’s not really any alternative to opioids for severe pain. I’ve never understood people who get upset about their relatives being on morphine – do they think Tylenol works fine for cancer pain?
I agree with I Love Me. In my experience, two surgeons that performed relatively painful procedures (open tib/fib fracture, hemorrhoidectomy) were very stingy when it came to pain management. For example, five days after I had a plate and 8 screws put in my leg I was instructed to take Advil for the pain. At the time I didn’t know any better, I thought that I was supposed to be in constant pain and not get any sleep for a couple of weeks. It wasn’t until I had some discussions with different doctors that I find out what was up. :mad:
[hijack]Chorpler – sorry. My online activities are my precious escape from my “real” domestic and work life and I don’t like to cross the line. If you are looking for chronic pain sufferers, my advice is to find online support groups and to make contacts at a local rehab center.
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