Controlling breakthrough pain?

scoutmm56

Just doing palliative care for now after being dx with recurrence in bones and liver.  Is anyone else doing just palliative care after a recent dx of mets and how are you controlling the pain?  I can get by for now on about 4 ibuprofen throughout the day.  Occasionally I have the breakthrough pain and I basically run to the bathtub and soak in hot water and throw down a couple more ibuprofen.   I do have some hydrocodone 5 mg but it doesn't seem to touch the pain during the breakthrough.  Thankfully these episodes are not too frequent. I am seeing the Dr's assistant this week to come up with a better pain game plan.  I don't need or want to be convinced to try other tx at this time, I have been down the chemo, hormonal road and those side effects are worse than what I have now.  It is just my choice, I know I am in the minority.  But trust me I don't need convincing-I have a support group here of valiant women doing traditional tx who give me the inside scoop if I decide to go the traditional route.

kayfh

There are palliative care teams comprised of physicians, nurses, social workers, pharmacists who will work with you. Just because you are doing palliative care doesn't mean the end to treatment ya know.

Chemo for stage IV for example, is considered palliative, it is intended to reduce or alleviate symptoms caused by the cancer. But I know what you mean. Accepting the inevitable is hard for all of us. And sometimes more anything, more chemo, more hormonals, more appointments where you are exhorted to try one more thing, is way more than you want to do. I respect that.

Brendatrue

If you are trying to avoid narcotics, some people find naproxen to be more helpful than ibuprofen for bone pain. A friend of mine used ketoprofen, which is also available topically (gel or cream). If you are having more frequent breakthrough pain, your MD may want to up the dose on your hydrocodone or have you take the hydrocodone 5mg on a scheduled basis and add an NSAID for breakthrough. Some people find a low dose pain patch helps (like 25mg fentanyl). I am very sensitive to pain meds and very allergic to many, so I have limited options. When pain is tough on me, I add lorazepam (ativan) to boost my pain med response, and it helps. Hope you get some input and a good plan after your medical visit this week!

apple

why avoid narcotics at this point..?

Really, i will be appreciative of all the help I can get.  I have discussed palliative care with my onc.. who is also a palliative care doctor.   i am going to be a total druggy..ativan and antidepressant totally knock me out, so I am not too worried at this point.  I am already on hydrocodone which at the present works PERFECTLY.  .. a pretty low dose.

no pain for me.

CoolBreeze

I have discussed  my treatment with a palliative care nurse and I am hopefully not near the end.  I take oxycontin twice a day.  It's slow release and lasts in your system so it is one you take regularly.  It doesn't make me sleepy or anything but if you aren't used to it, it might do that to you for a few days.  

For breakthrough pain, I'm prescribed dalaudid, which I can never spell.  

I do find hot baths are very helpful.  

I think they like slow acting drugs like oxycontin for us because there are no "ups and downs" with them.  Like with hydrocodone, you take it and feel better but it wears off after four hours and you have to take another.  The oxy stays steady in your system.  I have liver mets too.

Good luck to you, I hope you find some relief!   

Chickadee

I was going to say OxyContin worked for me whereas hydrocodone didn't. Dilaudid makes me puke. I had fentanyl patches fairl constant with the oxy when my vertebrates were collapsing left and right. Don't know which was better.