Hi All,
They started Mike on morphine 15 mg in the morning and 15mg at night. This has made his back pain stop completely. However, he sleeps all the time now. Only waking up for trips to the bathroom and and meals. And when he’s awake he seems like he’s still half asleep, acting loopy and forgetful. Should I just accept this is the trade he has for treating his pain?
Thanks,
Blair
Hi Blair,
Sorry to hear about Mike's pain. It would be good to see if adding CBD to his protocol helps then he could back down on the Morphine dose level. Also, if he could try to get in some mild excercise and walking in every morning it could help with his energy level. How is it going at UCSF?
He will acclimate to some of the morphine side effects over time.
He will get used to it. Avoid alcohol and Benzos like Xanax, Valium.
Hi Blair ... you could try finding a place between where you are now , med amount wise , and where the pain will start to be intolerable , speak with your prescribing doctor about that if you want.
Still , a case of the “ nods “ is a common side effect of initial morphine use and will slowly disappear over the next few days to couple weeks or so , maybe a bit longer ....this as his physiological resistance builds to the opiate and it has less effect on him. This is the “ sweet spot “ with morphine when it works best. Eventually it will become less and less effective as his natural tolerance builds. What you hope for is an eventual long period where relief continues with just modest discomfort from the pain at his current level of dosage. Eventually his body will be able to resist the 15mg of morphine and it will have little to no benefit for him. Hopefully this comes way down the road as far as possible. At this point is where some people resort to “ crowding “ their doses ... where you take them more often than you should, for relief ... or even worse ...doubling up on them to keep them doing the job. Both these are extremely poor choices.
Morphine like any opiate will build up “ dependency “ ( not to be confused with addiction, which could also happen ) ... crowding doses and double dosing just raises the level of receptors in your body making coming off the drug ( withdrawal) more difficult and intense. For most people, withdrawal is a seriously ugly event to experience and may even need a few days of inpatient treatment to accomplish without the horrible effects happening. The more you take , higher level of mg a day , the more difficult the withdrawal. Your doctor will be happy to assist coming off higher amounts of morphine dosage and Mike should be able to handle 15mg individual total dosage fairly easily. Different people react differently, this description is a generalization. Keep your eye on him and let him have his blissful , pain free, rest. Like always, your doctor should have a prescribed treatment of Narcan available if you check your prescriptions online. Order a Narcan kit, learn how to use it properly... and keep it where you can get to it quickly. You’ll probably never need it, but just in case.
Peace Blair ✌️✌️✌️✌️🌸🌼🦋🌻
I also have been on a regiment of morphine along with intermittent oxycodone to manage severe bone pain. The biggest difficulty I got into was with a fecal impaction due to extreme constipation! It was so severe that I nearly needed to be hospitalized. The only thing that has worked for me is milk of magnesia. It’s very important that He takes a double dose or some other alternative!
Yes, he’s been dealing with constipation also ☹️
The standard fix for anyone on heavy opiates is two or three Senna laxative pills every day to keep things softened up gently and moving along. The one I use is “ docusate sodium 50mg as a stool softener and sennosides 8.6mg stimulant laxative “. It’s a standard OTC product.
I’m a plus sized guy and this works well for me , recommenced by my GP.
✌️✌️✌️
No wonder the graffiti written about you in ladies rooms always mentions "that you're Priceless"........ ✌️✌️✌️✌️🌸🌼🦋🌻
Good Luck, Good Health and Good Humor.
j-o-h-n Sunday 04/05/2020 2:15 PM DST
You've been lurking around ladies rooms? Painting over graffiti? Priceless.
He keeps writing his number in there, but men keep calling him ... go figure.
😂😂😂😂
SIGH 1
Good Luck, Good Health and Good Humor.
j-o-h-n Sunday 04/05/2020 10:48 PM DST
We have lactolose and an otc product a friend recommended called cleanse and a probiotic.
The Costco version of Miralax softens everything up, tasteless powder, along with Kaliber's Senna.
Has he tried high doses of Vitamin C?
Hi Blair, I’ve been here on hu for just about as long as you have.. 3 yrs now. I don’t see how you have much choice ?, only acceptance.. Thank God for morphine when needed.. I would probably be just like him if I was on it . I went thru a period of great fatigue after rt. However ,it wasn’t drug induced . That’s tuff to deal with . Be strong . I’m sure that he really needs you now more than ever. Thank God for you and all wife’s partners and caregivers . Scott🌵
My dad was like this and it was very hard. He decided to try doing the morphine only at night and used Percocet during the day. He takes other pain meds for his shingle pain.
After awhile his back pain improved and he stopped the morphine. It is a hard balancing act.
Hello Blair-
What I can tell you is that they first started my husband on the 15 mg dose.
It took about a week and he stopped sleeping so much.
This is where it gets hard because remaining active is so important through therapy.
Try to encourage walks and weight bearing exercise if you can so muscle mass remains .
This got very hard to do with my husband and eventually he got very weak- too weak to receive additional chemo.
With little children around maybe it will be easier for you!
I hope Family is close to you and can help you.
For me, it took a tribe of people during Toms last 6 months.
Eventually he went to 30 mg twice a day and it was great in controlling pain.
So the fatigue and sleeping will probably pass!
Peace be with you.
You might talk to your Oncologist about switching to Methadone. It is a lot more effective for chronic pain. One dose works for an 8 hour period, much longer than Morphine without as much of the "sleepy" effect.
eventually, the sleepiness will stop as he adjusts to the drug. my husband was on morphine for four years. after a few weeks he was able to do just about anything he did before. give it time.
Yes. But his body will adjust a bit and should show less sedation.
RE: Fecal Impaction
I'm also on 15 mg Morphine Sulphate ER every 12 hours, and an occasional Percoset 5/325 every 4 hours, as needed.
I usually take one dried prune before and after evey meal and docusate sodium 50mg as a stool softener after breakfast. Prunes are a tasty snack, too.
For I am on Eligard injections, Zytiga/Pednisone therapy. I quit Xtandi for the intense vertigo/fatigue issue, but I can't say its any better with the Zytiga. I believe the Pednisone may have reawakened my appetite, leading to some undesired weight gain.
In general, I've been moving regularly upon arising. 
I am in the San Francisco east bay. My oncologist here and the one I see at UCSF both have me referred to a Palliative Care doctor. Hopefully if you don't have one ask for a recommendation. I have mets to the lungs, but also severe bone pain. The PC doctor is the one who reviews pain issues with us. I'm on methadone. I know your invested in so many areas now but if you don't have a PC doctor consider it. He will eventually be my hospice doctor.
Let's hope hospice is a long, long time from now. I'm guessing you are using prostate cancer medications and Keytruda.
Palliative care doctors and teams are NOT just for hospice. They are for managing pain and quality of life for anyone with a long term, chronic or life shortening illness. They are excellent at pain management and treat cancer related pain so much more effectively than oncologists.
The problem with some opioid pain relief is the drowsiness that comes with it, and other side effect of constipation for which 2 Senna pills a day might work to get those brownies a movin right along.
I had a stomach blockage last November and had a minor operation to cut adhesions of small intestine to previous RP surgery scar tissue in 2010.
The nurses set up a machine which gave small dose of Fentannyl to relieve the post op pain, but it made so dull minded, I asked for it to be removed after 2 days. There was a little pain, but it was bearable, and I could still sleep. But sub-cutaneous inserts for slow release Fentannyl are also used for bone pain in Pca cases. Is Mike going to be treated with something to stop Pca growth? Like maybe Lu177?
I have preferred morphine for acute pain relief which removed pain and left me alert, but that has only rarely been used while I was in hospital for a short time. Long term use of morphine causes addiction and when they stop giving it to you you can feel generally awful for a day, or more, depending on how long the morphine has been used. But for me it didn't happen often, or for very long, and I got through that time OK and morphine was just great. With cancer pain, it keeps going, there's no healing of the cancer lesion, it gets worse.
Patrick Turner.
Hi Patrick,
We actually tried LU 177 but Mikes cancer has morphed into small cell so they said it wouldn’t work. He has had 1 cycle of the ippi/ nivo combo and is set to have another next week. Nothing seems to be stopping his cancer ☹️
This is for small cell lung cancer but may apply to your case.
I had 4 shots Lu177 last year, 8 weeks apart. before last May. I had a good response.
Bone mets were up to size of a pea.
I don't know what ippi / nivo is. But the docs here said that if my Psa goes up, and PsMa expression goes down, I may have to have my DNA analyzed for Brca-2 gene, and have Pca met DNA analyzed and maybe I have olaparib treatment. My Psa was 3.5 at 2 weeks ago and is going up, and doubt remains on what is causing that, so docs are allowing a little more Psa rise before another PsMa scan gives a better picture. I feel well though.
There may be a time when nothing can halt Pca increase. Since diagnosis in 2009, Gleason 9, inoperable, Psa 6, age 62, I have never been sure I would live another year.
Patrick Turner.
Narcotics are always pain versus brain. Right now, the brain is losing. Talk to your doctor about a different medication of lower dose. Generally look for a 30 to 60% reduction in pain with a clear brain.
Sorry you and husband are going through this at such a young age. Hope the boys are holding up well.
The case of Guy Tenenbaum
After Radiation Issues
SBRT side effect
Barnes Jewish
prostate metastasis 
