my sugestion is go back on the morphine, and add to it this, 2 stool softners in the morning (colace), and at night add 2 Senna S. If that doesn't work then add miralax. Thoes are all OTC and can be found at your nearist pharmacy.

its not just the constipation, they also make me itch something fierce. my pharmisist recommended something but again i have to wait on the damn dr.

I am also really sorry your going through all that. Living in pain just plain sucks, I have had a down day my self, just tired of not sleeping, can't work, lost my job on account of my health. So yeah I can agree with you when your body is going south it's really hard I will keep you in my prayers

thank you.

Hi ~ You don't have to wait for your doctor for the itching. Get some Benedryl. The pharmacist should have told you that!!! You can get the right over the counter. It's an antihistamine, and it will work just fine!! That's what they give people for bee stings when they're slightly allergic, and that's what you are ~ slightly allergic to the oxy.

So take the Morphine with a stool softener, such as Colace or Senna (I take Senna ~ about 3-4 of them) and then take the Benedry for the itching. You can't overdose on the Benedryl ~ it will just make you sleepy. lol

PLEASE take your meds as prescribed so you can have some level of comfort. You'll feel so much better and I'll feel better FOR you. God bless you dearheart, and God bless. hugs, Lee

i do take benedryl but i was worried about o.d.ing! plus they do make me sleepy, which may not be a bad thing right now!! i usually take only 2 benydryl can you really take more?

you can get non drowsy benadryl, however I like 24 hour zertyc it lasts all day and it doesn't make me sleepy

Loralp- Who have you tried seeing in the Seattle area? Have you tried Swedish Pain clinic? They gave me pills on my first visit. They didn't make me wait until my second visit because of the amount of pain I was in. If you don't mind driving a few more miles you can see Dr. David Goodman in Kirkland. He owns his own practice and is very nice. I ended up not staying with him because I found an RA to take on my pain management. Also there is Dr Jutla in Edmonds at the mind your body clinic. At my very first appt they made sure I had a good med combo to try. Saw me back after 2 weeks and then refilled my meds because they are working. Dr. Jutla is a gem, she is such a sweetheart. Then there is Laurie Marti, MD. She works out of a small office in Bellevue. She is cash only unfortunately and her fees are $400 for the first visit. Then $200 for the other visits. She gives you a bill so you can submit a claim to your insurance company. Only if you have out of network benefits tho. She doesn't participate with any insurances. She is very thorough orders a ton of blood test that other drs would never think to run. She got down to the bottom of a few things for me then gave me a treatment plan that made sense. Anyways just thought I would share a few names of drs you may want to go see. I would definately look into finding another dr. It doesn't sound like you are on a good medication treatment plan. Good luck and I hope you can find someone good soon.. ((hugs))

Thanks for posting this kmiller...
I was just about to post this...
I have also heard Dr. Neiman (Kirkland) is good- alot of people like him.
Dr.Paul Brown- Seattle- I HAVE seen him and he is very good as well. Very soft spoken - Diagnosed my Fibro- helped with pain. Does NOT take Insurance which is a bummer.

I've been where you are... Notice I said I've "BEEN" there, which means I'm not anymore and there is hope for you too! It took me 5 years of seeing doctors, trying this med and that med, one after the other not working, and if it did work, it was only for a month. Then I'd be back where I started, leaving the office crying each month, crying because I was so desprate for help I wasn't getting. I'd have days or weeks that I didn't have hope but then I'd try something else, whether a medication or other treatment. It took me five years of leaving offices crying because another month had passed without getting any help, gaining and losing hope, but I DON'T DEAL WITH THIS ANYMORE!

If I'd have given up hope any of the many times I'd have liked to, I wouldn't be where I am today. After 9 years of pain, 5 years of evil doctors that made me cry instead of help me, more tears cried and hours spent on this site than I'd care to admit, I finally found a doctor that not only listened to me, but HE HELPED ME AND TREATED ME AS AN INDIVIDUAL. I'm not pain-free but I attained my personal goal of having 60% of my pain managed. For the first 6 months with this doctor, it was a lot of trial and error, but I again had renewed hope! It's now been a year with Dr. Wonderful, haha, and not only have I stayed on the same meds and doses for two months in a row (never happened before voluntarily) but I haven't needed or wanted to change anything in 6 months!!! I reached a dose that has kept working for my body, and gives me enough relief to make it through my average day. No, I'm not tap dancing in high heels till dawn, nor will I ever be able to do many of the things I once did or dream about doing, BUT I can work full-time at a sit-down job for the first time in 5 years!!!!! I can now stand for 10 minutes, when before this doctor helped me, I couldn't even stand for 5.

I am still not "normal" and I still live with a lot of pain, but again, if I got helped, YOU WILL GET HELP TOO! It's just a matter of finding something within yourself to carry you through the hopeless times. I think a lot about where I'd be if I'd given into those horrible feelings and deep depression. Quite honestly, if I hadn't found my own motivation, something within me to keep me going, I probably wouldn't be here talking to you today. My soul would have died a long time ago. You just have to GIVE YOURSELF PERMISSION TO BE HUMAN. Think about that statement and what it means to you. Take that day to have a tiny self-pity party, but after that, start searching for your next option. It's good that you're coming to DS because this is where I found a lot of my strength and my "next steps" when I thought Id exhausted all options. When I felt I was out of hope, I'd post here, and suddenly have new avenues to try, new ideas, or restored hope to try things I'd already tried. Most importantly, I learned that I didnt HAVE to be strong all the time. In fact, we wouldnt be normal if we stayed strong all the time. Living in pain, and all the BS it brings takes its toll on you both physically and emotionally! You can always message me. If I don't respond but it shows I'm online, that's just because I stay signed in and will always respond when I'm back at my computer. You don't have to stay strong here. Here, we stay strong for each other. I can say for sure that I'll help you stay strong in every way I can!

Much love and understanding,

Lisa

I had the same problem with the morphine sulfate and no amount of stool softeners helped.. I got lucky though and after talking to my Dr. he took me off it without blinking and changed me to hydrocodone. You may need to shop for a new Dr. it wont be easy but you might get lucky.. I hope all works out for you

When you go back on the Morphine ES around the clock, take at least one Colace with each Morphine ES. If you don't find that to be sufficient to maintain a semblance of normal bowel regimen (I too have stopped taking my medication (OxyContin) twice a day because of the constipating side effects before), add Senna (or Ex-Lax, which seems to be gentler on the stomach than the senna tablets), starting with 1/2 twice a day and working up from there. I also find that Miralax taken once or twice a day, works miracles. It's a stool softener (mixes with any fluid; is tasteless and has no texture; it's also available by prescription as PEG 3350). It stays in the diggestive tract, so your system doesn't have to digest or metabolize it and it can be taken with Colace and Ex-lax if needed. I find it can make you regular in a matter of days and keep you that way without the need for the senna (and it would be nearly impossible to overdose on Miralax; in super high quantities (the equivalent of two large bottles) it's called go-lytely, the stuff they give you to clear you out before a colonoscopy!).

Right now I find that Colace faithfully taken with my OxyContin, plus an extra Colace whenever I need my breakthrough medication helps to keep things moving along nicely (that extra Colace with my breakthrough meds really helps).

You ALSO need to be drinking plenty of fluids (preferably water) and slowly increasing the fiber in your diet. We should all be eating 25-35 grams of fiber per day, something few if any of us ever get. I find that when I back off on the amount of water or fiber I get in a day, I pay for it a day or two later in the form of additional pain and constipation. Fiber One Honey Clusters has 13 grams of fiber in a single serving, so it's an excellent source of fiber. If your body isn't used to getting anywhere near that amount (which is half of what we should be getting daily) start with half a serving and work your way up. It tastes good even as a dry snack, so you don't have to worry eating it with milk.

About the Benadryl, contrary to LeeAll's thinking on the issue, yes, you can overdose on Benadryl, especially when you're taking it with Morphine ER and oxycodone. All of these medications affect the breathing center of your brain and the combination may cause some central apnea, causing you to slow or stop breathing at times, especially during the night. Try to stick with the minimum dose of Benadryl (diphenhydramine HCL) needed to control the itching from the morphine; if that is one tablet as directed during the day and you need two at night, you should be fine. But don't go overboard; you can overdose on most any medication and definitely on anything that can cause sedation, especially when combined with your pain medications, which also cause sedation.

I do not know if Claritin and the other non-drowsy antihistamines work will have the same anti-itch effectiveness as Benadyl does. Even patients who have anaphylatic reactions to medications or bee stings will end up getting a shot of Benadryl along with epinephrine and steroids, so it's a well known, well used medication for allergies.

As soon as your doctor is back, ask to switch to a medication that you are not allergic to. Itching is a sign of an allergy. The solution is to CHANGE medication, not to give you yet another medication to cover the symptoms of your allergy. It would be one thing if this was the ONLY medication available to treat your disease and your pain, but it's not; there are plenty of other options available. You should not have to treat the symptoms of your allergy with yet a third medication, especially when the medication you're on isn't working in the first place and increasing the dose is simply going to exaccerbate your allergy; that's just poor medical practice. In addition, chances are, if you were to be given a large dose of IV morphine you would have serious adverse reaction, well beyond the aggravating itching you're experiencing now. It's not worth risking your life by being continously exposed to a medication that you're allergic to (and morphine is a common allergy) when there are so many other options available.

On the strength chart, hydrocodone is the weakest and has no sustained release dosing available; all you can do is chase the pain, and you have to do it with acetaminophen as there are no hydrocodone preparations without acetaminophen in them. Morphine comes next, but you're allergic to it. Then there's oxycodone, which you seem to do well on based on your experience with your breakthrough pain medication; the sustained release version of that is OxyContin.

You've made a more than valient effort trying the morphine, but you are allergic to it (itching is an allergy and don't let your doctor deny it; keep using the word allergy over and over again). You need something that will better control your pain and does not cause an allergic reaction. As you are not allergic to the oxycodone you get as breakthrough pain medication, OxyContin is a reasonable, well-educated option for sustained pain management, with the oxycodone immediate release tablets as your breakthroug pain medication. And be sure to let your doctor know that the amount of medication you are on now (when you're on the full dose and even with the breakthrough pain medication), is by no means sufficient. Be honest when discussing pain levels, if you're at a 9, say so. And if the only reason you're at a 6 is because you took an oxycodone 30 minutes ago, say that too.

You do not have to "accept" substandard care. There are better medications and if need be, better doctors. You have to speak out. One trick is to put your chair in front of the door as soon as the doctor walks into the room and don't let him out until you come to a reasonable agreement (an honest, reasonable, work WITH you agreement on increasing your pain medication to a level that you can truly LIVE with and a way to let him know if and how it's working without having to wait weeks for the next appointment, but by being able to call him instead). Don't move your chair until you get what you need. You deserve it. You are in charge. You hired him for his medical expertise; now let's see him use it!

Best wishes! :)

PS In addition to the concern about seritonin sydrome with tramadol and Celexa, there's another serious concern about the use of tramadol and opiods: "Concomitant use of tramadol increases the seizure risk in patients taking other opioids. These agents are often individually epileptogenic [can cause seizures] and may have additive effects on seizure threshold during coadministration. CNS- and respiratory-depressant effects may also be additive. In patients who have been previously dependent on or chronically using opioids, tramadol can also reinitiate physical dependence or precipitate withdrawal symptoms."

I found this on the www.drugs.com interactions checker, where you can put in all your medications and it will give you a list of interactions between your medications (from serious to minor) as well as with foods and herbs. I just checked the medications you listed and it came back with the tramadol/morphine and tramadol/oxycodone warnings first followed by the seritonin sydrome warnings. I didn't check if there was anything else; I'm sure there were warnings about multiple medications that can cause sedation, interfere with breathing, etc. The bottom line recommendation I'd take from this is to avoid the tramadol entirely.

Good luck at your next appointment and lots of hugs for those times you're feeling low!

DEFINATELY listen to the Pharmacist re: the Tramadol! The Pharmasist knows much more about the meds than a doctor does, after all that is what he/she went to school for! A doctor symply can not learn all there is to know about the meds... they have too much else to learn. Always do your own research on what meds are recommended by the doctors to see if they interact with anything else you are on, also check with the pharmacist. I have been taking 5-htp to control Fibromyalgia pain, 5-htp is a natural way to raise your serotonin levels which is what celexa, trazadone, elavil and other meds do by synthetic methods. In researching the 5-htp I learned it can be dangerous to take 2 or more meds that raise your serotonin levels because of the risk of serotonin syndrome. I quit the Trazadone and went on an herbal sleep med for this reason. I was therefore dissappointed when after explaining to the jerk Rheumy I went to that I take the 5-htp and how it works that he wanted to put me on Lyrica or Effexor. He obviously did not either know of, or unterstand the risk of serotonin syndrome. Being PCP your doctor probably is not familiar with it either. It might be a good idea to tell him what the Pharmacist said and poss copy our some internet info form a good site on serotonin syndrome so he will understang you not taking the risk of combining the two meds. Keep looking for a pain doc or a good rheumy, don't give up hope!

I'm on the same, MSC, I know others have luck with it but I hate it. Can't seem to raise my dose without severe headaches & out of all the meds this one seems to constipate me the most. Since this is the only med my insurance will cover for now I'm stuck.
I wanted to share what has worked with me on the MSC. Activia seems to help. There are times I have to take the stool softners &/or Mettamucill (sp?) along with it. If I drink plenty of water I'll go on a more regular basis. The days I slack on the water I notice I have problems.

I really don't care for yogurt & was surprised at how good the Activia is. I wish I would have tried it along time ago. I just assumed it would be another thing I'd have to force down.

The pharmacist should be able to help with the itching problem. Ive discovered a good pharmacist is almost as important as a good PM. Took along time but afer my pharmacists got to know me they would actually make suggestions on what they felt may help me. Along with loosing my meds that worked I may be loosing my pharmacist as they don't carry the generic MSC that I can somewhat tolerate. Frustrating but I have to believe things will get better. If I stop believing then what do I have? I know exactly how you feel as I'm struggling with life since going on the MSC. I had great success on the Oxycontin but one month after finding the right dosage for me we switched insurance.

Its hard knowing there is better relief out there & I can't afford it.
It took along time to find the right combination of meds but we did & although I still had pain it was much more controlled. I think I smiled for days.
I feel very much like you do & there are days I just don't want to be bothered but I have to believe there is hope, some how, some way. Its hard not to let yourself fall into that deep hole of depression but I just think it could be worse & try hard to not let the pain take every bit of happiness from me.

I do feel for you & your in my prayers.



I hope with all the suggestions here you find something that works. Sammy