morphine

[Mahealani]

what are your thoughts on morphine for pain? does it affect breathing?

-mahealani

 

[Alyoop]

One of morphines common side effects is respiratory depression. I would think that it would need to be monitored extremely carefully, in patients with ALS.

 

[sadiemae]

Most narcotics for pain will suppress breathing. My husband was on 30 mg extended release morphine twice a day, and had no trouble, however it didn't touch his pain. He is now on 4 mg hydromorphone 4 times a day, and again no problems with breathing, and it does help his pain. He got 2mg of hydromorphone in an IV Mon night in the ER, and it did affect his breathing for a short time. Start out slow, like 15 mg of the extended release twice a day. When he was on this,(15 mg twice a day) he also was able to take .25mg of oxycodone for breakthrough pain. What type of pain do you have? He has degenertive disc disease in both his back and neck, and has pain 24/7. If it is nerve pain, try Gabapenten or Lyrica.

 

[Phil's wife]

My husband has cancer and takes 10mg methadone twice a day using 4-8mg hydromorphone every 4 hours as needed for break through pain and it doesn't seem to affect his breathing.

 

[notme]

The thing with morphine--is it seems to loose it's effectiveness rather quickly. My dosage was doubled within the last 3 years--and doesn't seem to do much in the way of pain relief anymore. I take 30ER twice a day and 15IR 3 times a day. Percocet or vicodin--weaker meds--work better for some strange reason.

If the pain isn't severe--you can ask to start on tramadol and move up as needed. The one thing with tramadol--you can't skip doses and still get relief. It can't 'chase' pain.

All narcotics, as they've said--can depress breathing--as the body adjusts-that seems to lessen with most people. Only the doc could say for sure with ALS weakness in respiratory muscles.

Mine is for pain from bad discs in multiple levels--but it does nothing to help with nerve pain, and it certainly doesn't help with the spasms. I use diazapam and baclofen for spasms--and nothing for nerve pain, as I react very badly to Neurontin.

 

[sadiemae]

Notme(Is it Dianne?) For my husbands nerve pain, the Neurontin isn't cutting it, so we are hopefully going to try Lyrica.

 

[Miss]

Since my husband isn't planning on a trach, we were told to hold off on the morphine until his breathing becomes difficult. The morphine will suppress the feeling of suffocating. As it loses it's effectiveness, they will continue to increase the dose.

 

[Jellycat]

Ok. This is a little off thread. Any pals out there using oramorph (oral morphine) for breathlessness? My pals diaphram is doing some daily intermittant large heaving. She feels breathless so hospice recommended oramorph for when the spasms & breathlessness get too much. She's bulbar and this is an oral medicine. I'm wondering how this will go as it's a couple of years since she could tolerate liquid by mouth. Any experience to share with me?

 

[Gma'sMeMe]

Miss: your comment was helpful to me as my Mom has ALS and has made it clear that she will not want any types of tubes (for breathing or feeding) when the time comes. I worry so much about if she will suffer because of this choice, so knowing that morphine is an option that will help her eases my mind. BLESS YOU for being a caregiver.

 

[AXIL]

Yes, most all opiates effect breathing to some extent with morphine, oxycodone but i think fentanyl (transdermal patch) effected my breathing more so than the others. Be careful! Which ever you use, depending on how much als has effected your breathing, it wouldn't take much to shut down breathing all-together. Take as prescribed but be alert as to how you react to it, my friend...........peace

 

[brooksea]

That was good info AXIL.

Welcome to the forum.

 

[kelly]

I had to administer morphine for the first time last night. My hubby was having great difficulty breathing and could not stop coughing. I tried everything to avoid giving the morphine...but ended up administered a tiny dosage of .25ml. It was really emotional....running on 3 hours of sleep today. I ended up calling hospice because he began trembling like crazy. They told me to give him an ativan with the morphine. He finally fell asleep around 1am..but was moaning in his sleep all night. Woke up at 5am and was so thirsty I had to give him allot of water in his feeding tube. His breathing is slightly better today..but we are both running on empty. This is no easy ride! However, on a positive note...even feeling like crap he went to an ALS art fundraiser and had me read a speech he wrote. Came home and went right back to bed. I am so proud of him! Here is his speech!

When you are thinking of amyotrophic lateral sclerosis: it is probable your not equating it to art. A L S isn't pretty. But then again art isn't always about aesthetics. Artisans use many means of expression to convey their personal perspectives. Making life interesting and provocative. I Still hear the echo of laughter as my art history professor was stating the differences between nude and porn is only the staples.
As a person living with A L S and being “locked in.” Creativity is a challenge. My canvas is my mental attitude. An edge-less canvas. Which I try to fill in with images of hope. Hope is a powerful resource and the staff of saint peter's A L S center fosters individually. Thank you for supporting the 140 families they guide through this journey. This art show fund raiser is a great opportunity to get a visual perspective from another persons expressions that has been affected by a l s. Many times the surviving family are emotional and spiritually drained. I am looking forward to see the pieces that keeps the bond alive. I do believe each of us have a symbiotic relationship with others. This Leeds me to my tattoo story. since it is art too!

I have a caregiver who has bonded with us. She was asking my opinion for adding to a new beautiful flower tattoo she had just inked. She felt something was missing. I suggest a humming bird and a BEE. Not realizing I was being stealthy looking to support the long-term couple quest for children. Two weeks later on vacation with her new “birds & bee's” tattoo a call came. They had been selected as adoption parents. Ironically the mother had an inclination to name a daughter Ragan. Thank God it is a boy.

You never really know who or what influence you may have on giving situation. Your continuous support to the center is greatly appreciated. Until the day comes where every 90 seconds some isn't diagnosed globally your help will be needed. Thank you again for contributions towards Saint Peters A L S center. Without you families like mine will journey this alone and have far less HOPE!

 

[linny]

i also was afraid of the morphine however, it was worse to seem him suffer. With the guidance of your health care professional, don't be afraid of the morphine. We used it more and more before my wonderful husband passed in february. He seemed calmer and more comfortable, even though it may be out of your comfort zone. Soon you realize, it is all about making them feel comfortable. There are other drugs we combined with the morphine that our nurse suggested which made the effects longer. I loved my husband and i would do it all the same way. Anything you do is out of total love for another person; never forget that.

 

[lostin]

Makes me constipated. Pop 30 capsules though and you'll have no more ALS worries!

 

[Sequoia]

Linny, what other medications di your doc add to the morphine which made him more comfortable? This might be good info for other cals and pals.
Praying for all of you who give such good care to the pals you love!