Topic: Pain killers & nausea -- any suggestions?

Hi,

To control my back pains, my doctor moved me from percocet onto oxycontin pain killers.  The idea is to use a time released version of the oxycontin (2 20 mg tablets every 12 hours) and then supplement with 5mg tablets for any breakthrough pain.

I've noticed that when I take the main dose every 12 hours, I get very drowsy and feel somewhat nauseous (sp?).  I think it might be better if I try balancing the dosage out (maybe 1x20mg every 6 hours so it is level loaded) or something.  Wondering if anyone else has any ideas about how they have timed their pain killers to deal with similar issues?

Thanks!

-hans

Re: Pain killers & nausea -- any suggestions?

Ok, the final word from my oncologist..........re: nausea.

Before each chemo treatment, I am given a small IV bag of Decadron, and a push of Aloxi into the chemo line.  So far I haven't vomited from chemo, and its been over a year.  Just wanted to share with everyone whats worked for me.

Re: Pain killers & nausea -- any suggestions?

My husband uses Fentanyl patch (50 MCG/HR) for pain which is replaced every 72 hrs.  For breakthrough pain, he takes Dilaudid ( sorry,can't remember the dosage, he has the bottle with him. He's on his way back home from San Diego for the weekend).

Re: Pain killers & nausea -- any suggestions?

My dad always takes Kytril.

Re: Pain killers & nausea -- any suggestions?

my dad is always nauseous from the oxycontin too. he lost so much weight because he cant keep his food down

6 (edited by JeffG Sat, 23 Jun 2007 16:49:08)

Re: Pain killers & nausea -- any suggestions?

Hi Deeko... Iv'e been in hospital for the last few days specifically concerning this issue.  Pain management I found is so importtant.  1.  Change your medication to  another type of pain killer Myself was morphine so4 60mg 3 times daily and with the understanding that I can cut back if I few it is to droggy for me.  Along with this I have  Diluad ( generic name is HYDROMORPHONE) 4mg to Take every 4 hours  as needed for breakthru pain.  Again, don't use unless you have to. 2.  Egg carton crate mattress is grreat for pain relief.  Can get at Wal mart for $40.00.  Supports your body and applies pressure on body points to allow proper blood flow. 3.  What ever you have or are doing that keeps your body/spine out of alignment will not help no matter how much pain medication you take.  4.  Adema/ water retention can case pain.  DEXAMETHASONE will help relieve adema/water retention and help with nausea. METOCLOPRIMIDE HCL 10 mg every 6 hours Is primarily for nausea. So, if no edemia is involve you would take this instead and personally take every 6 hours more continously than not even though it is says PRN.  You can cut back slowly after nausea is under control.  Deeko in 3 days I put 6 pounds on just from sorting out out my pain.  Pain if not controlled will hamper your battle right from the begining.  If all this fails then you should be requesting CT or Preferabaly MRI of thorasic  to insure cc  has not mets to wear it is blocking or putting pressure some where it shouldn't.  In my case after MRI it was found an additional tumor was developing and and was putting pressure on my spinal roots.  Found just in time before it got into spinal canal itself.  Had 2 radiaton treatments already and is working well. I do have a neuro surgeon consult set up just to cover all bases. I don't think it got in to the spinal cord yet but want to watch closely and make sure the radiation does the trick.  5.  When nuasea under control and appetite returns, eat slowly and make six small meals  a day  instead of three. Don't want to eat heavy that to could be putting weight on your intestines  and cause pressure thats not needed.  Also right now start drinking nutrirional drink like ensure or gerneric form from Walmart to get srength and desire back to conume food more.  Pain and control  can make or break  your good progression with battling cancer in a heart beat and if you can get it turned around you'll do great and feel much better.  Remember PRN doesn't always mean wait until feel nausea then take, but take it before so it will do you some good and keep taking effect for a while until under control and the cut back slowly if no longer needed.  Prevacid I tablet each mornig at lest 30 minutes before breafast to reduce your stomach acid for the day works wonders.  I know things were getting out of control for me quickly ,then discovered the hidden culprit ,got back on track and been feeling great for the last 2 days gained weight and sleeping like a baby. Deek0 have your dad give it a whirl and get the prescriptions from your doctor.  Generic form works just fine and in my opinion get him off the crappy oxycontin, never did like that drug.  Also, does your dad have this favorite recliner he likes to hibernate to?  Big problem with proper ergo posture of spine and muscle, and blood flow.   Hope this is of some help to your dad  and others who read this post.  I was home about one hour and got rid of the chair I was using at this computer as with in 15 minutes I was in terrible pain.  Went and got me a chair the contours and fits my back and supports my arms and walla no more pain!  And it took a while to post this to you so I know it worked instantly for me.  Best of luck Deeko for you and your Dad. Lets us all know how things go for you. God Bless.
Jeff G.  P.S 
Had to edit this post. It was obviously written under the influence of prescribed medications .  Cut the dose back a little today.

Take it to the Limit,One More Time! (Eagles)

Re: Pain killers & nausea -- any suggestions?

Jeff,

Great to have you back!  I've been wondering while we haven't had the pleasure of your company in a while.  Thanks for the information about Prevacid and other nitty gritty matters.  I've been trying to get information on when the proper timing is for taking Prevacid.

G

Re: Pain killers & nausea -- any suggestions?

Hi G....  Thanks!  I thought I would just go and give the doc's and nurses a hard time for a few days.   It was like a mini Vacation Ha!  I just couldn't believe the inconsistencies in the knowledge and way they did things from shift to shift.  Just totally amazing.  I quizzed them with the same questions about my meds and what they were for and side effects and of course I just said oh okay thanks. Unbelievable.
How is things going on your end lately?  Some more radiation treatments for me the next 2 weeks or so. Take Care!
Jeff G.

Take it to the Limit,One More Time! (Eagles)

9 (edited by glightfoot Sun, 24 Jun 2007 19:17:07)

Re: Pain killers & nausea -- any suggestions?

Jeff,

I had a bad MRI scan in mid May -- so it's back to being diligent about treatment for me also.  I'm going to have Sir Sphere -- radaition treatment on Tuesday.  I'm a bit nervous about it as I haven't had it before, I only have one lobe of liver.  So this is my only shot at radiation. 

I'm due to restart chemo the following week.  I'll be using a chronotherapy schedule with those.

Good luck with your radation.  You are an inspiration to me -- your courage and how you just keep perservering.

G

Re: Pain killers & nausea -- any suggestions?

G,  It's Tuesday and hope Sir-Sphere radiation went okay for you .  I'm in the same boat with my left lobe missing.  We'll have to be as cautious as we can.  Some years ago I mis-understood when they told me my liver would regenerate back to normal. At the time, I thought that it grew back to normal size. but nope it only regenerates internally the vessels required to function properly.  Wishful thinking didn't even come close on that one.  G, we are all an inspiration to each other.  This website is so sharing and giving of knowledge that it provides strength for us all in some way at some time.   Take care and let us know how your doing when your up to it.  Rest comes first which I seem to keep forgetting.
Jeff G.

Take it to the Limit,One More Time! (Eagles)

Re: Pain killers & nausea -- any suggestions?

hey jeff g,

thank you so much for your reply. that was a lot of useful information. we already started using some of your advice and my dad feels better. my mom thanks you too!

deeko

12 (edited by JeffG Thu, 28 Jun 2007 14:49:44)

Re: Pain killers & nausea -- any suggestions?

Hi Deeko... You and your Mom quite welcomed.  I did want to add one thing.  Dependig on the amount of pain medication being taken, it will cause sluggish bowels and constipation in turn making you nausea and not wanting to eat in turn loosing weight and energy.  It all seems to have a snowball effect.  You can use a colace(stool softener) and a mild(vegtable laxative) senokot or generic brand to help keep you cleaned out. Will make your Dad feel like a new man.  I would certainly run this by the doc as you can use to much as well.  Drink plenty of water and stay hydrated when using.  Bless you Guys!
Jeff G.

Take it to the Limit,One More Time! (Eagles)

Re: Pain killers & nausea -- any suggestions?

Hi Jeff,

I am back on the computer again after Sir-sphere.  I have had some complications -- which I have not sorted out yet.  I have had pain which I think may be due to some extra embolization that the interventional radiologist did. Also, nausea and vomiting -- which I am not sure what to attribute it to.  And also for the first time, some jaundice -- again an unknown attribution.  My liver panel does not look as good as usual so I guess the sir spheres must be raising a ruckus. 

Interestingly enough, I got recruited to take part in a study to measure the blood flow to my liver tumor using ultrasound and microbubbles.  I had a baseline study done before the sir-spheres and I will be getting another look tomorrow.  I think this would be useful in terms of finding out what is going on with the tumor before any changes can be detected on the MRI.

But the good thing is that this all pertains to the topic at hand of pain management and nausea.  So, I will be putting all that good advice to use. I am thankful for your encouragement and the support of all of us here.

G

14 (edited by JeffG Mon, 23 Jul 2007 14:13:18)

Re: Pain killers & nausea -- any suggestions?

Hi G,  So how did your micro bubbles study go?  I have never heard of that.  I start new chemo Regimen on 30 July.  Taxotere (Docetaxel) straight up IV.  A member of the taxol family.  Is not normally used for CC but some recent studies showed small percentage of complete and partial responses.  I'm going to see if I can get in to that small percentage of complete response.  If not I will take what I can get.  I was a little hesitant at first.  I keep weighing the option of quality vs quanity but I've come this far might as well keep on trucking.  Radiation appears to have done some good but it was going on for some time and damaged some nerves in the subcutaneous of my right flank toward the belly button area.  Hopefully I can work it out.  Also the nuero surgeon said nurotin (sp) is good for pain also stimulating nerves.  Will discuss with Doc next week.  catch you on the flip side G.
God Bless,
Jeff G.

Take it to the Limit,One More Time! (Eagles)

Re: Pain killers & nausea -- any suggestions?

Good luck Jeff with the new regime. I'm betting on you being one of the 5%. Nothing new here. Tom is getting his stent changed on Thurs. We're enjoying the summer as I hope you are too. This has been one of our best after having our worst last year. Take care. Mary

Re: Pain killers & nausea -- any suggestions?

Hi Jeff,

I hope that your Taxotere will work.  Let me know if it suits you side-effect wise. 

I had several microbubbles sessions so far, one before radiation, 3 days after and 10 days after.  I'm going to have another one on Friday.  So far the results have been ambiguous -- they measure blood flow, blood volume and overall enhancement/blood flow.  Some things decrease then  increase.  I don't know what to make of it. The doctor who's running the study didn't know what to make of it either.

I'm back on chemo -- Gemcitabine and Carboplatin for right now.  I've been doing it according to the chronotherapy schedule -- having Gemcitabine early in the morning and having the Carboplatin late in the afternoon.  I'm not totally sure that it helps because I tried it earlier with my chemo regimen earlier this spring with ambigious results.  But I figure it wouldn't hurt.

Good luck Jeff,

G

Re: Pain killers & nausea -- any suggestions?

G ....Good luck with the chrono schedule of gemcitibine and carboplatium.  Second day of Taxotere and I've gone from pale,tired,minor stomach cramps too red and warmth from neck to head, little numbness in fingers, and those darn hiccups from the pre med steriod.  Will let all know next week after check up how this stuff is doing. Take care!
Jeff G.

Take it to the Limit,One More Time! (Eagles)

Re: Pain killers & nausea -- any suggestions?

Good luck Jeff, hope all is well with you, and Deeko, hope your Dad is feeling much better.

Re: Pain killers & nausea -- any suggestions?

Hi Jeff,

Thanks for your words of encouragement.  Sounds like the Taxotere is do-able for you so far.  What's your scheduling for it? Would you give a couple of months before scanning?

When I first started back with the chemo it seems to take more out of me than before in terms of fatigue and constipation.  I went with an infusion once a week-- two weeks on and one week off.  Now, I'm on every other week and that feels alot better for me.  It gives my WBC a chance to recover without using Neupogen injections.

I've been with a friend who's into Qigong and she's gotten me into doing it every morning this last week.  I don't know if that's why I am still feeling pretty good two days post chemo.  But I am glad to be so.

G