- Oct 2, 2008
My wife has had ALS for approximately 2 years, and now only has partial use of her left arm. Fortunately not much of a problem with swallowing and using oxygen about 3/4 of the day. She hasn't been eating hardly anything since a bout with pneumonia about 6 weeks ago, so she is getting extremely thin. She has been dealing with nerve damage pain for 7 years and has been on a lot of pain medication during that time, so her tolerance to pain medication is pretty high. We have had in home hospice care since coming home from the hospital following the pneumonia. But a couple of weeks ago, she complained of the pain being too intense, and she went into a hospice facility for 5 days. during which they hooked her up to a morphine pump. This has helped a great deal, but it is pretty new to us. She also takes morphine sulfate orally and oxycodone, which she has been taking for years. She still gets spikes of pain and the doctors have been reluctant in giving an idea about what should be considered maximum dosages. I am hoping that someone could share their experience with dosages, just so I would have something to go by. Right now, her pump is set on 11 mg/hr, with 3 mg bollus, and the morphine sulfate is 20mg/ 1 ml, and the oxycodone is 30 mg. She had also been using the duragesic patch, before they hooked up the pump, but they said to discontinue the patch. The other day she was crying in pain, and with 2 extra doses through the pump, she got 17 mg of morphine plus 60 mg. of morphine sulfate, and also 90 mg. of oxycodone, all in the first hour, and all that did was bring the pain level down to a tolerable level. I have nothing to base realistic dosage levels on other than what other patients may have encountered. Right now, with the latter stage that she is in, the only plan is to maintain as much comfort as possible. Any insight into this would a great help.