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No one answer to that. Depends why on it, how much, how often, and what else is going on. Also, the morphine itself, depending on dose/frequency/nutrition/breathing ability, can bring the end closer, which can be a good thing. But many people go a long while on it.
Why do you ask? If you can explain the situation, we might be more helpful.
Why do you ask? If you can explain the situation, we might be more helpful.
affected
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I agree with Laurie - it's too broad a question.
Chris was taking a 4mg dose at night for around 6 months. He should have been taking a tiny 1mg every 4 hours or so as needed through the day but refused, even though he was so much better the week or so he did take it.
Please let us know just what you are asking so we can try and answer better.
Chris was taking a 4mg dose at night for around 6 months. He should have been taking a tiny 1mg every 4 hours or so as needed through the day but refused, even though he was so much better the week or so he did take it.
Please let us know just what you are asking so we can try and answer better.
Drewsmom
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Sorry for being so vague. Hospice started last week and the morphine is for shortness of breath as well as pain he feels in his ribs. He can take up to 1 ml every 2 hours but right now is taking .25 4-5 times per day. His breathing is the most affected as he can still talk, walk a few feet, and use his arms/hands although weak all over. A few days ago he didn't take his dose right on time and he was sweaty and clammy all over. It was weird how quick that happened.
Atsugi
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The first time a hospice nurse started to give my PALS morphine, I insisted on calling the doctor so they could explain to me the reason. If I was going to kill my wife, I wanted to know it!
The doctor told me that the low dose of morphine is meant to relax the lung muscles so the lungs can open up wide and ease breathing.
The moment I gave her the morphine, she breathed easily.
The doctor told me that the low dose of morphine is meant to relax the lung muscles so the lungs can open up wide and ease breathing.
The moment I gave her the morphine, she breathed easily.
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Drewsmon thanks, now I can gauge what dose he is actually receiving.
We were using a strength of 5mg per 5ml.
So if you give him 1ml he is receiving 20 mg, but giving .25 he is receiving 5mg. This is a really tiny dose and will not depress his breathing at all.
Chris went up to around 30mg per dose at the end and it wasn't depressing his breathing, which was very shallow at the time and he was also having clonazepam which can depress the breathing.
Over time a resistance does develop and so higher doses are needed, but that doesn't happen over days. In fact, when small doses are given with good effect it often takes quite a while for resistance to develop.
By giving him so much less than the dose he can receive now, you are dosing to effect and if this small dose is working well stick with it, but don't be afraid to raise it if he needs it as you are only a quarter of the allowed small dose.
Chris took the 5mg at night for many months and until the pneumonia and then end stage it worked for him. The increase in his doses wasn't because of any resistance to it, it was because he needed more as his situation changed. Taking small doses of morphine also did not have any effect on hastening progression or taking his breathing down faster.
So now, to answer your original question - I would not see starting a small morphine regime like this as meaning the end is near.
Many people think that morphine is a sign of the end, but it's actually a great palliative drug that can be used for a very long time in many illnesses.
We were using a strength of 5mg per 5ml.
So if you give him 1ml he is receiving 20 mg, but giving .25 he is receiving 5mg. This is a really tiny dose and will not depress his breathing at all.
Chris went up to around 30mg per dose at the end and it wasn't depressing his breathing, which was very shallow at the time and he was also having clonazepam which can depress the breathing.
Over time a resistance does develop and so higher doses are needed, but that doesn't happen over days. In fact, when small doses are given with good effect it often takes quite a while for resistance to develop.
By giving him so much less than the dose he can receive now, you are dosing to effect and if this small dose is working well stick with it, but don't be afraid to raise it if he needs it as you are only a quarter of the allowed small dose.
Chris took the 5mg at night for many months and until the pneumonia and then end stage it worked for him. The increase in his doses wasn't because of any resistance to it, it was because he needed more as his situation changed. Taking small doses of morphine also did not have any effect on hastening progression or taking his breathing down faster.
So now, to answer your original question - I would not see starting a small morphine regime like this as meaning the end is near.
Many people think that morphine is a sign of the end, but it's actually a great palliative drug that can be used for a very long time in many illnesses.
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