Need Advice for pain
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We suffered from major constpation from pain killer when we sarted this battle. The resolution of choiceas reccommended by our oncologist is Miralax. May take a ay or 2 to work
Hi,mn,
Some time ago you did mention to get a second opinion from Dr. Lenz. is that what he said that nothing can be done for your mom?
Do you know what is the name of the pink and white pills you mentioned on the other message?Norco 5 or Norco 10 1-2 tablet every 4 hours as needed are the normal dose that prescribed for moderate cancer pain. it is part of the opiate family which constipation is one of the side effect of that group of drugs.
If the Norco can control the pain,I will not ask for morphine for your mom until later when she really needs it.
For constipation:
1.Stool softners
Senna(Senokot) works on colon and can be bought OTC.;they may take up to 6-12 hr to work.Colace,Surfak(Docusate sodium) works on the small and large intestine(colon) and can take up to 24-72hrs to work.2.Stimulant laxatives
ducolax(Bisacodyl) 5mg tablet , 10mg suppository and Fleet enema which are a bit stronger than that of the stool softners.(OTC);they work in the colon too.;they may take 15min to an hour to work.;Castor oil works on the small intestine and it may take up to 2-6hr to start working.3.Saline Laxatives
Magnesium citrate or Milk of magnesium are saline laxatives works on small and large intestine;Sodium phosphates(Fleet Enema) is also a saline laxative but works on colon.(30min to one hour)
4.Lubricant
Mineral oil works on the colon as lubricant;it may take 6-8hr to work.5.Misc.laxatives included glycerin suppository(15-30min-colon), Lactulose(24-48hr-colon), Lubiprostone(24-48hr-acts on GI epithelium),Miralax(48hr-acts on small and large intestine) and sorbitol70%(24-48hr-acts on colon)
As you can see ,there are a lot of choices,but I think the best way to handle your mom’s problem is to ask a GI physician about which one or two ( or combinations) that can work the best for your mom base on the location of BM problem and duration or action of the laxatives he/she choose.
To control pain more precisely ,I will consult a pain specialist.
In hope the info. helps.
God bless.mn–my heart goes out to you and your family. I was just in a similar situation with my momma and I know how it feels as a daughter to want the fix-all for momma with no more tears and enjoying as much as possible. It’s hard to do when they are in so much pain and you feel helpless. My mother had upper and lower abdominal pain, especially after her liver resection in April 2011. She was on a fentanyl patch and dilaudid for pain. I believe they would give her morphine as needed for breakthrough pain. She was on a routine schedule for lactulose for both her ammonia levels and to help her have a bm. It helped a little with the ammonial levels but not much with the bm. They would do scans of her abdomen and found nothing, do more scans and find nothing. Couldn’t figure out why she kept complaining of horrible pain. In July 2011, she starting vomiting for 4 days straight and couldn’t keep anything down. She had a small bowel obstruction and it had COMPLETELY closed shut. She had to have emergency surgery before it ruptured. Have they done anymore scans or xrays of her bowels to be sure?
I am sure that you are doing your best and that’s all that we can do. Stay strong and keep us posted.
God bless,
AshMN, for Mom’s stomach over the counter may not be enough. There are RX for the same type of pills that are a bit stronger. If Morphine was not good for her there are still other pain relievers that can be tried. You are doing such a good job and its doubly hard and heartbreaking when Mom will only do it her way as she is making it harder on herself. Keep on posting, I found it really helped to let things out on this board!
mn, thanks for your update. It has to be difficult to deal with all the things that you are but I certainly commend you for the strength you are showing and the love you have for your Mom. As others have stated, in this day and age there is no reason for people to be in misery. Just keep on those doctors. We love and care for you and your mom.
Thanks for your ideas and I am off this morning to get her some pear juice, even though she doesn’t like pears. Norco is just another typeof vicodin. I will ask her palliative team about morphine. My mom did not want to go into hospice because of the connotation. However, palliative is just the same except you are able to do treatments, such as chemo, while on it.
My moms current pill regimen include a little pink and white over the counter pill for her stomach, Norco every 4 hours, 4 colace, 2 senna, and gas tablets as needed. I will ask her team about morphine. My only hesitation with morphine is that she will think it is near the end if she is on it. Also, she was a bear to deal with in the hospital when she was on morphine…she was not fun.
Dear MN, first I would like to say what a wonderful daughter you are and your Mom is so fortunate to have by her side through this terrible journey. I totally agree with Marion that Mom needs some intervention as all the things that the doctors want to do at this point are to keep her comfortable. I assume she is in Hospice Care? As the tumors grow they press on organs and other things and that is why it is so important to have good pain meds. I have not heard of Norco and perhaps she needs another type of RX like Morphine. When I called Hospice for my husband they started out with Morphine but in lower doses. Then they added Colace and Ducolux for stools and he was always kept comfortable as the Morphine was increased as we moved down the road. If she is not on a solid program it will be harder to make her more comfortable. I have also never heard of pills to prolong a life, what are they called? A colonoscopy is just for findings and nothing can be done at that time. IF your Mom is on Hospice they will do everything possible to keep her comfortable and at that point she won’t need to go to doctors as the Nurses are the go betweens. Hang in, be strong and wishing you the best in getting Mom comfortable.
mn……You are not a bad daughter in fact, you are trying everything possible to make things better for your Mom. Unfortunately it is a difficult situation which demands some intervention. Please advocate for your Mom and speak with her treating physician. We live in a time where all pain can be controlled with medication and the side effects of the medication also can be controlled.
It will take some work to get everything flowing again therefore, you might want to call the physician and ask about some of the medications which have shown to work for some of our members. These medications included: Lactulose syrup, Colace, Ducolux stool softener. And, a huge fluid intake has been reported to be mandatory. Margaret is a big proponent of pear juice. (Her comments are included in the below link.)
It is all about making your Mom comfortable. Finding this comfort takes some work, but generally it can be achieved.These enclosed links may also be of help to you.
http://www.cholangiocarcinoma.org/punbb/viewtopic.php?id=5160
http://cholangiocarcinoma.org/punbb/viewtopic.php?id=4815
http://www.cholangiocarcinoma.org/punbb/viewtopic.php?pid=27960
http://www.cholangiocarcinoma.org/punbb/viewtopic.php?pid=27960
I am looking for others to share their thoughts with us also.
All my best wishes,
MarionHi Guys, thanks for taking the time to read this and I hope many of you can help. The last month has been pretty rough since my mom has returned home from the hospital. Swelling is finally down and she is able to walk from her bed, to the couch, to the bathroom. It is exhausting for her, but that’s what she can do.
We have been to see her second opinion doctor who told her there is nothing else they can do. However, the did prescribe some pills for my mom that would help prolong her life. She picked up the prescription but has decided not to take the medication. She feels the doctors have only made her worse and nothing they have done has ever been for the better. She just wants to enjoy a few months.
My question is, my mom is having severe lower abdomen pains. She is taking Norco every 4 hours for pain control. It has been a battle trying to deal with the gas pains and then being stopped up. She is also in severe pain when she has bowel (or tries to have bowel) movements. The palliative nurses are doing their best to try to resolve this. Is there anything else you can suggest that I do for her?
Also, because of the pain, she is very weepy and sad about the whole situation. Which she has every right to be. I try to pep her up, but she tells me, “Michelle, when you have the flu, do you feel like doing anything?” She has a point! The chaplain that comes to the house seems to perk her spirits up. She got out of the house this weekend and spent the time at a beach house. Went out a little bit while they were there. When she gets weepy the only thing that helps is if I rub her head or her feet…can anyone offer words of wisdom that I am just not thinking of right now?
Last thing…my mom has canceled two of her doctors appointments. She has another one scheduled for next week which she wants to cancel. She doesn’t see a reason to go there. It’s true, we are usually a basket case after we leave the doctors office because they never, ever have anything good to say. She said they want to do blood work. Is there a reason for her to go? I keep thinking they will give us different news, like they made a mistake or there is another chemo they can try. But the last time I insisted on her going to the hospital to have her ascites drained she ended up being there for a week…and was so swollen for a few weeks after that. She was only suppose to be in there over night…I felt like such an awful daughter.
I am worried that her abdominal pain is due to both the pain pills and the tumor. The doctor said the tumor was beginning to go through the bowels and that is why she is having such difficulty. I don’t understand why they couldn’t do something while they were doing the colonoscopy. She did not hear the doctor saying this…nor do I want to mention it to her. At this point we are trying to hold on to the hope that she will have a few comfortable months to do the things she wants to do.
I was planning things out today, since it is almost my daughters b-day and her b-day…and all I keep thinking is I hope she can make it. She wants to go to Disneyland to see the Christmas lights…I am just hoping they can get the halloween stuff down fast and put up the x-mas stuff even faster. We always thought she would beat this.
I appreciate any advice you have from your experiences. Thank you for your time.
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