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Pain relief Dosage

User
Posted 25 Jan 2018 at 18:05

Hello all, I posted a while back about my Dads ongoing battle with Advanced Prostate Cancer. 

I have a quick question relating to pain relief dosage. We are getting rather confused with it all at the moment. Dads care is being dealt with between the oncologist (other than HT, all other active treatment has been put on hold as he is so weak at the moment) the GP and the local hospice team, He also saw a neurologist recently for sciatic type pain. They have all been playing around with his medication to try and get the balance between satisfactory pain relief and minimizing his 'dozziness'

To cut a long story short after a recent stay in hospital. as a result of an infection,  some of his medication cocktail was stopped (Diazepam and Amytripiline to name two) and his current daily medication is 80 mg Oxycodone (he also has the liquid form for breakthrough pain but he does rely on this 10 ml four hourly) dexamethasone 5 mg daily (steroid prescribed by the oncologist), Gabapentin 500 mg daily (as recommended by the neurologist for nerve pain), also something to protect the stomach, that I cannot remember the name of and paracetamol in between.

Our confusion is this: We see one person, perhaps the Oncologist who looks at the medication and says, 'Hmm. that's rather a high daily dose, we will have to monitor this' Then we see, for example the hospice nurse, who will increase the dosage to combat an increase in pain and when we query it, as a result of the previous comments made, they say, ' Not high at all, everyone is different when it comes to pain relief'

It doesn't help that it would seem, reading between the lines, that the hospice team do not seem to have a very high opinion of the hospital team and vice versa. 

Obviously we put our faith and trust in 'The Experts' but at the end of the day Dad still has pain and we are totally confused by it all and what to do for the best.

What experience do others have with this? Are these daily doses high or not?

User
Posted 25 Jan 2018 at 20:11

Would the stomach protector have been Omeprazole?

We can't control the winds - but we can adjust our sails
User
Posted 25 Jan 2018 at 20:56

I can't answer your specific question about dose and combinations of tablets. However, my experience (and that of many others on here in the past) is that the experts in cancer are oncologists and the experts in pain relief are the hospice nurses. We have seen so many men on here end their days in pain and distress because the hospital teams couldn't get the balance right.

It is very difficult to get the right mix between pain and sleepiness and you may have to accept that dad is going to sleep more and more as the doses increase.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 26 Jan 2018 at 17:53

Thank you both for your replies.

This forum and the people on it are such an amazing source of information and much needed quiet support. I rarely post but I check in and read it so often (I fear I may well be becoming an addict!!!) I feel very privileged to follow other peoples journeys and share in their lives and stories, it's a bit like I have become part of a secret second family, so thank you to you all. I wish you all well.

 

Lynn I would 100%, absolutely. prefer a sleepy Dad to him suffering and being in pain any day........It is he that has a problem with it, as well as he doesn't like a fuss etc (stubborn old school 'Man' mentality).

Each time his pain elevates (which seems to be increasingly regularly) I have to battle to be 'Allowed' to phone the hospice team and ask their advice, which would usually mean a visit from them and a suggestion of an increase in pain relief BUT he now has it in his head he is on 'High Dose' . As well as that, he also knows an increase in meds means he will be more dozy. As much as he can't bear the immense spikes in pain he gets (And we all hate to see it) I think he is trying to hang on to a clear head and those precious last threads of control he has.

I can relate to all of this and obviously respect what he wants but I think if there is something we can do to ease the pain we should do it.

 

Edited by member 26 Jan 2018 at 17:54  | Reason: Not specified

User
Posted 30 Jan 2018 at 12:04

So some (sort of) good news. Dads pain relief medication has been increased and, at the moment, seems to be making the pain more manageable.

Once again, thank you all for your support.

Loo Loo

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User
Posted 25 Jan 2018 at 20:11

Would the stomach protector have been Omeprazole?

We can't control the winds - but we can adjust our sails
User
Posted 25 Jan 2018 at 20:56

I can't answer your specific question about dose and combinations of tablets. However, my experience (and that of many others on here in the past) is that the experts in cancer are oncologists and the experts in pain relief are the hospice nurses. We have seen so many men on here end their days in pain and distress because the hospital teams couldn't get the balance right.

It is very difficult to get the right mix between pain and sleepiness and you may have to accept that dad is going to sleep more and more as the doses increase.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 25 Jan 2018 at 21:08
Yes, that's the one, Omeprazole
User
Posted 26 Jan 2018 at 17:53

Thank you both for your replies.

This forum and the people on it are such an amazing source of information and much needed quiet support. I rarely post but I check in and read it so often (I fear I may well be becoming an addict!!!) I feel very privileged to follow other peoples journeys and share in their lives and stories, it's a bit like I have become part of a secret second family, so thank you to you all. I wish you all well.

 

Lynn I would 100%, absolutely. prefer a sleepy Dad to him suffering and being in pain any day........It is he that has a problem with it, as well as he doesn't like a fuss etc (stubborn old school 'Man' mentality).

Each time his pain elevates (which seems to be increasingly regularly) I have to battle to be 'Allowed' to phone the hospice team and ask their advice, which would usually mean a visit from them and a suggestion of an increase in pain relief BUT he now has it in his head he is on 'High Dose' . As well as that, he also knows an increase in meds means he will be more dozy. As much as he can't bear the immense spikes in pain he gets (And we all hate to see it) I think he is trying to hang on to a clear head and those precious last threads of control he has.

I can relate to all of this and obviously respect what he wants but I think if there is something we can do to ease the pain we should do it.

 

Edited by member 26 Jan 2018 at 17:54  | Reason: Not specified

User
Posted 26 Jan 2018 at 18:43

Have the hospice nurses got access to acupuncture or other less threatening options perhaps?

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 30 Jan 2018 at 12:04

So some (sort of) good news. Dads pain relief medication has been increased and, at the moment, seems to be making the pain more manageable.

Once again, thank you all for your support.

Loo Loo

User
Posted 31 Jan 2018 at 11:51

Heenan73, thank you very much for taking the time to reply.

He takes the paracetamol four hourly daily. Interestingly enough we did wonder if this was still necessary and if it was actually doing any good as he is also on much stronger medication. I will take your advice on board. thanks again.

Loo Loo

 
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