Pain Medication
Moms View Message Board: General Discussion: Archive May 2006:
Pain Medication
My 22 year old brother has a long history of having to take pain meds...
He was shot at close range 5 times and survived and now has a form of spinal cancer that cannot be removed.
He's on Vicatin for the pain but he says it wears off.
Is there a time release pain medicatin out there? I heard of one that Rush Limbaugh has to take now.
There are a TON of higher strength pain medications and time release capsules out there. The best thing to do is talk to his doctor because with pain meds you have to take into consideration the side effects and long term effects, especially with his condition. Vicodin isn't *that* strong of a pain med , to me anyways.
Vicodin is hydrocodone with acetaminophen, it comes in several different strengths. It is a short acting drug, and you build up a physical dependency to it. He should be on one of the long-term, time release (long acting) pain meds with something like Vicodin for breakthrough pain. Does he have an oncologist? Normally an oncologist would make sure he has adequate pain control. If not, I suggest find a pain management doctor or clinic. He will need all of his medical documentation, and they will probably run tests or ask for records from his previous doctor for more info.
There are several long term/long acting pain meds available, and they are not *loosely* prescribed because they are highly controlled, strong narcotics. They are:
Duragesic patch - It is fentanyl, you change the patch every 72 hours.
MS-Contin - an oral med for serious chronic pain
Oxycontin is yet another, and works very well for some people, and you are normally prescribed a breakthrough med with this one too.
Methadone is another.
Keep in mind, these meds are not prescribed for acute pain, these are prescribed for chronic pain and legitimate doctors who prescribe them, do so only after all other pain control avenues have been tried and failed. Patients are monitored closely, you must have a new, original prescription for each prescription, there are no refills on these meds. There is a high potential for abuse, and illegal use of them also.
There is no doubt that the Vicodin wears off for your brother's pain, and obviously he should be on something long acting for it, but he needs to see a good pain management doctor or oncologist for this.
There are also other things that your brother can do to help his pain, such as visualization, meditation, deep breathing exercises, and even some physical therapy/massage therapy in some cases. He really needs to see the proper doctor for this.
I can't add anything to what Karen says except to agree with her wholeheartedly. Either the oncologist or a pain management specialist should be working with your brother and your brother should work at being totally honest with these doctors about his pain levels and reactions/side effects from pain meds.
My brother had (and died from) pancreatic cancer, which can be very, very painful. The hospital and doctor caring for him did wonders on pain management. I was with him all day every day the last 2-3 weeks, and the only time he had more than mild discomfort was on what turned out to be his last day, which was when they finally went to IV meds - before that he had been on oral meds only. So I think it can be done, but your brother needs to have those conversations with his doctors.
And, I apologize for thinking about painful things, but your brother and you should be talking about him selecting a surrogate to make medical decisions for him if/when he can no longer make them, or at least someone that his doctors have full permission to talk to. Having been through similar situations several times, I can tell you that the last thing your brother wants is for doctors to be making all the decisions because he did not take the steps to legally designate someone to act on his behalf.
I will also add that the DEA has sometimes gone after pain management doctors for the levels/amounts of drugs they prescribe, and some doctors in this field are "gun shy". If your brother's are not helping him adequately with pain management, maybe he needs to be seeing different doctors. Karen can tell you that she had to change doctors because one of her docs had a view of pain relief that wasn't at all helpful to her. I know she has posted about this before.
I would say, in most cases, his age would work against him, in getting certain drugs prescribed. HOWEVER - in view of his medical history, and due to the fact that you say he has spinal cancer, he should be able to get legitimate pain relief. Nerve and bone pain are tough to manage - anyone who has ever had an injury that affected a nerve (as in disk ruptures or herniations) or neuropathy, or bone cancers, or even some arthritis, can tell you that most meds won't touch the pain.
He should be aware though, that they may want him to try some other options either before, or in conjuction with the *big guns* meds. Used properly, those meds are life savers for many people.
Ok, very helpful you all. I hope he can get something different. I'll talk with him about it! THANKS SO MUCH!!! 
You're welcome, Heidi. And if you want to email me privately about it, feel free!
Ditto everything Karen said and I have nothing else to add. Except
Karen--are you sure you never went to pharmacy school?
LOL Debbie! No..........I've learned all I know about illness and meds through personal experience and curiosity and interest! But often I wish I *had* gone into the medical field in some capacity!
Karen--you just stole my thunder. That's all!!!
You're just too good.
I'm sorry Debbie!! Unfortunately, pain management is a subject I happen to know quite a bit about. LOL
Thanks again, Karen. He REALLY appreciated this!
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