The pain specialists may be thinking of switching to Methadone and steroids as they are aware that your mom isn't taking her breakthrough meds, or they feel she is developing tolerance to the current regimen. However, this sounds like more of a patient education situation, than inadequate pain control. If her pain is tolerable with her current long-acting and short acting oxy, then I would think they might keep her on her current regimen.
Do you think there may be other reasons beyond fear of "addiction" that you mother may have? Is she struggling with nausea, constipation, forgetfulness, or other symptoms? Could she perhaps be avoiding the short acting med as she is afraid or scared, not of addiction, but of something else? Could you or another trusted family member have a heart to heart with her, asking her what is most important to her right now? I remember you saying how she was able to go out to lunch with her friends recently. Is this something that brings her joy? If she is in a lot of pain, it may be difficult for her to do these activities, and perhaps then she will mull it over and decide to try the short acting meds again.
http://www.cancercare.org/publications/ … tting_help
As you know, she will not develop addiction, tolerance yes. From my experience, pain medication may need to be increased as needed as patients develop tolerance to a drug. For individuals with cancer pain, this is acceptable and common. Pain medication will need to be increased or rotated as cancer progresses.
The reason for my asking about the Fentanyl patch, is because this is a method of pain control I see prescribed frequently. Pain must be controlled though prior to switching, but this may be useful in the future if she has difficulty eating/drinking or has nausea. What does the oncologist think? Do the pain providers have a lot of experience with progressive cancer pain, or do they specialize more in chronic pain syndromes?
Providers generally start transdermal Fentanyl at a low dose of 12.5 mcg, then 25, 75, 100, 150 mcg, but it depends as well on the previous dose of oral long acting drug that was given.
I am sorry to hear her pain has increased. I was so happy to hear she was feeling better for awhile, and do so hope she finds relief again soon!
THIS INFORMATION IS NOT INTENDED TO BE A SUBSTITUTE FOR PROFESSIONAL MEDICAL ADVICE. PLEASE CONSULT YOUR PHYSICIAN OR HEALTH CARE PROVIDER IF YOU HAVE ANY QUESTIONS OR CONCERNS
This information is not intended nor implied to be a substitute for professional medical advice. If you have questions or concerns, please consult your physician or health care provider.