Topic: Pain Control

I don't see many of the current regulars have posted about pain issues.  I've had pain on and off (mostly on) since my diagnosis in August/September of 2009.  Recently it has become worse, probably due to the fact that I had a recent ERCP and they dilated the duct and the metalic stent really caused a lot of pain for awhile after that procedure.  The pain could also be from the tumor growth, I'm not really sure.  I wish that there was a formula or logic to point to the reason for my pain, but there is not - so we just treat it.

I have been using a Fentynal patch since my diagnosis and gradually increased the dose on that.  The most recent dose is now up to 125 mic per hour - although I find I'm usually only putting on 75-100.  For breakthrough pain I was originally put on oxycodone immediate release (up to 10mg per 4 hours), but after the recent pain issues have moved up to morphine immediate release up to 45mg per 4 hours.  This seems like a lot of opiod pain meds, but I really don't even notice that I'm taking it as I have built up such a tolerance to it.  I do get concerned that if my pain continues to get worse whether or not it will be effectively controlled because I am building up such a tolerance to it now.

On another note, I'm wondering how to properly dispose of the pain meds I am no longer using.  I have a fair amount of this around as I have moved on to different types or doses of medicines.  Some of it I can see maybe using at some point down the road such as the smaller doses of fentynal, but some of them probably not.

I'm also wondering if anyone else out there is needing to take this much pain relieving medications and how far advanced your cancer is?  Is thee a correlation to location, size, etc. of the cancer and associated pain?

Rick

Ulcerative Colitis 1990, Stage 0 colon cancer and subsequent colectomy with J-pouch in 7/2005, PSC 7/2005, Klatsin CCA 8/2009

Re: Pain Control

Rick.....I don't know anything about pain control however, our JeffG appeared to be an expert at it.  His pain had been caused by bone metastases something, I don't believe you are talking about.  But I believe, it might be helpful to peruse some of his postings.  Also, I had returned the unused medication to our oncologist.  I left it up to him to do with whatever although, I was hoping for some other patient to benefit from it.
Good luck, Rick.
Best
Marion

THIS INFORMATION IS NOT INTENDED NOR IMPLIED TO BE A SUBSTITUTE FOR PROFESSIONAL MEDICAL ADVICE. YOU SHOULD ALWAYS SEEK THE ADVICE OF YOUR PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROVIDER

Re: Pain Control

I cant add much to the pain discussion since so far I can manage mine with Ibruprofin. In Sweden, you return unused medicine to the pharmacy so it doesnt end up in landfills and affect the water supply.

Kris

Cancer is a word, not a sentence.

36 year old patient with buckets of hope

Re: Pain Control

Hi Rick,

When my dad came home from the hospital after his PDT, he was on paracetamol 2 tablets 4 times a day. Then that was changed to solpadols 2 tablets 3 times a day then upped later to 2 tablets 4 times a day. He was told to take these every day even if he didn't have pain and that seemed to work for him. Here in Scotland, unused medicines are returned back to the dispensing chemists.

Best wishes,

Gavin

Any advice or comments I give are based on personal experiences and knowledge and are my opinions only, they are not to be substituted for professional medical advice. Please seek professional advice from a qualified doctor or medical professional.

5 (edited by Linda Z Wed, 07 Jul 2010 12:15:26)

Re: Pain Control

Hi Rick,

Even before my resection, when I had a very large tumor in the left lobe, I still didn't have constant pain.  It was more of an "ulcer-type" pain after I ate fatty foods.  That was my only symptom of the cancer. 

After surgery, the pains went away and recently came back when I went for my 2nd set of CT scans.  I was told the pains went away when the cancer was removed, and that since it came back, that was the reason for the pain.  Again, the pain came and went and wasn't consistent. 

I still have tumors, in fact they are larger than before, but the pain has gone away for the most part.  Only occasionally do I get twinges, but no measureable, untreatable pain.  If you think the pain is from the cancer, maybe it depends on where the tumor(s) might be.

Also, returning the meds to the Onc. or the pharmacist for disposal sounds the best to me too.

I forgot too.....I don't have a drain.  Could that be the issue?  Sorry I couldn't be of more help.

Best wishes,

Linda Z.

"Life is not about waiting for the storms to pass...
it's about learning how to dance in the rain."

Re: Pain Control

Hi Rick,
I think I mentioned to you on a recent email that my husband has sold pain meds for years ( fentanyl and oxy). He told me that your dose can be pushed up until side effects limit the dose ( ie: too much sedation), but basically you should not be concerned with becoming too tolerant. He says you can put on up to 4 of the 100 mcg patches at one time ( if your doctor allows (of course) in increments of 25 mcg) but then at these higher levels someone would normally be advised to switch over to oral meds like oxycodone for ease (instead of sticking several patches on your body). (A 25 mcg patch is equivalent to 30 milligrams of oxycodone in a 24 hour period). Another option is pill form Fentora to use for breakthrough pain with the fentanyl. It is supposed to get into the system faster than morphine or oral meds because it is absorbed through the cheek as opposed to your GI track.

Email me if you have more specific questions - we will try to help as  I 'translate' what my husband tells me!! I wish you the best on your trip next week. Very happy to read on your caringbridge page today that you will be flying with a non-profit company. :-) 

Keep us posted.
Ashley

Re: Pain Control

Ashley,
This post promises to be very helpful to my mother some time in the future as she has hundreds of bone mets. Fortunately the gem-cis has for the moment stopped them from growing or multiplying, bit there will come a time when it stops being effective...
Thank you for sharing!!!

Re: Pain Control

Gosh, my husband is taking all the pain meds and patches out of control. Total addiction and if he slacks off he goes into withdrawls and freaks out.   Doc said as long as he needs pain meds, ok to take what you need and stay addicted and they will work with him to wean him off. Personally after 6 months I don't understand why he is still in so much pain!  Stomach hurts, he had part of stomach removed to do the whipple and hook up new tubes and half pancreas removed. Gallbladder removed and liver area was good. Yesterday was though the first day he said he only took 2 pain meds which means the patches he was on were working better. He switched to patches cause he hated how many pain pills he was taking.  Who knows why there is still so much pain, only know that sometimes it can take up to a year to recovery from all the surgery and get things working right. All we care about now is gaining some weight!