There is increasing awareness of the importance of pain management - but not all doctors will understand the variety of possible treatments, or accept that something should always be done to help relieve pain. Some doctors are overly concerned about addiction to pain medications. However, most pain experts seem to agree that if people who are truly in terrible pain use pain drugs, then those individuals are very unlikely to wind up addicted.
The bottom line is that pain is NEVER acceptable. Advocate for your spouse to get his/her pain under control. If the oncologist does not take you seriously, try talking with the nurse practitioner or another doctor youçve dealt with. Get a referral to a pain specialist - sooner rather than later.
Pain specialists
If your spouse is consistently feeling pain of a 4 or 5 and higher (on a
scale of 0-10), see a specialist. If he or she cannot sleep (and usually,
consequently, youçre not sleeping either), that is a major warning sign.
And as mentioned, if your doctor is not taking your spouseçs pain or your
repeated requests for better pain management seriously, go to a specialist.
It is your right to demand better pain management!
Types of pain medications
There are several classes of pain medications available to treat cancer
pain. To properly treat the pain caused by cancer and its treatments, it
is important to know the cause of the pain. When you are discussing pain
treatment options with your doctor, be open and honest about the type of
pain, where it is, how bad it is, and what it feels like so the proper medications
can be prescribed. This information is provided as informational only and
is not intended to substitute for proper medical advice. Discuss your options
with a qualified pain specialist.
If your spouse is in serious pain, get help. For more information, please read the extensive information here.
Delivery of pain medications
Depending on the severity of the pain and the pain medication, your doctor
may prescribe an alternative delivery route for the pain medication.
A combination of different drugs and delivery methods may be used as warranted and prescribed by your physician. For more information, please read the extensive information at: http://www.cancer-pain.org/index.html
Personal experience
Matt, a YCS board member, submitted the following experience about his wife
Kara:
Kara began suffering from severe neuropathy, and we waited to seek treatment for the pain. If we had been aware that there were options, we would have asked earlier. Doctors started her on a low dose of Neurontin, and the drugs made her èloopyî a couple of hours after taking the first pill. It was the first time in a long time she was not in pain. We lowered the dosage and slowly worked up to an effective dose. It took several days to find an effective dose.
Karen, a YCS board member, submitted the following experience about her husband Mark:
Mark had serious headaches from the lumbar punctures. Oxycodone and acetaminophen would help but not eliminate the headaches. Later, as the cancer and nerve damage to his left arm progressed, he began to experience moderate to severe pain. Mark was very brave about pain so I learned to read the signs of pain on his face, his tone of voice, and way of walking and sitting.
When he was very close to the upper limit of the oxycodone and acetaminophen, we asked for more pain management. They gave him the fentanyl patch on a lower dose, then a medium dose. He was still in pain. His arm became paralyzed after weakening over several days Œ and he was still in terrible pain (up to an 8-9 when he would apply the 0-10 pain scale) despite no longer feeling his arm. After that, we went through about two weeks after that when neither of us slept Œ I couldnçt sleep because I was hypersensitive to any sign that he was awake, and he was awake because of the pain.
We got an appointment for a pain specialist, who gave Mark nortriptyline and Neurontin for nerve pain. A few days later, before these drugs had really started to kick in, we checked him into the hospital for pain management out of desperation. They gave him a pain pump set to dispense on request up to a certain dose per minute and per hour, which helped. They also started him on Oxycontin. While there, Mark decided to do another round of chemo. Even though it couldnçt have been known ahead of time, the chemo helped to reduce his pain. Equipped with the steroids, fentanyl patch, Oxycontin, and nerve-pain drugs, he went home far more comfortable than he had been 10 days before. , We could both sleep. It was a huge relief to us, and I had a bit of my Mark back for a while since he was no longer in such constant pain.