Health - Urgent advice requested - mother is very sick (cancer)

[nicekato42]

Hello,

I know this isn't a medical forum, but I need your help. First, a little background.

My mother has stage 4 cancer - we believe it started in the lungs, but it is possible that it started in the bones. There are multiple tumors in the lungs, 1 in the liver, and it has spread through most of her bones except for some of her limbs. She has symptoms of spinal compression (due to bone metastasis) and hypercalcimia (spelling? basically too much calcium in the blood). She cannot walk on her own, can barely turn over on her own. We are currently in China, so availability of different painkillers is very limited.

My mother has very bad reactions to at least natural opioids. She tried codeine when she was younger and I believe she went to the hospital. She also went to the hospital when she was in her 20's from marijuana (first and only time). Recently, when her pain was so severe (2 weeks ago), we asked the doctors here for a painkiller and ended up with 30 mg of sustained released morphine. She ended up in the hospital from this small dose as well - her pulse became extremely faint, she passed out and collapsed on the way to the restroom. She had nausea and dizziness for at least 3 days afterwards.

The doctor(s) then prescribed .1g Tramal, which is 100 mg extended release tramadol. However, we are afraid to use it. For a while, she was sort of okay on 2 tylenol 8 hr + 800 mg of ibuprofen + xanax. However, this combo is no longer working.

Should we try 100 mg Tramadol given her earlier reactions to opioids? I know tramadol is fully synthetic and is thus supposed to have less of a chance of nausea/dizziness, but I am still afraid to use it. Any advice would be greatly appreciated. I am only looking for advice, I will not do anything based purely on a single person's input. I am just trying to find out if based on her past experiences with opioids, you all believe tramadol would be worth a try.

Thanks in advance for your help.

Reputation Comments on this post:

Good question, interesting case.

[siverly2006]

I also had a mother who had cancer, she was in the worst kind of pain a human can imagine, so I feel for you and for her because I understand the impact that can have on a person. In my opinion anything is worth a try, I would have done anything in my power to ease my mothers pain, I would give it a try but keep a close eye on her. It's a tough situation with her prior issues with certain drugs, but i can honestly say I would give it a shot.

God Speed my friend, my thoughts and prayers are with you both.

[nicekato42]

Thank you very much for the advice. You see cancer in movies and read about it, but nothing prepares you for the reality. It is an ugly way to go...

[Jasim]

First, swim wants to make clear that 'natural' versus 'synthetic' really doesn't mean much when it comes to biochemistry. Tramadol is a rather different drug than traditional opiates. Tramadol is a prodrug, and must undergo metabolism before becoming active. Additionally the chemical structure is quite different from traditional opiates. Both of these may contribute to a different physiological reaction for her, but not necessarily.

Is her doctor aware of her previous reactions to opiates?

If swiy decides to try the Tramadol, keep a close eye on her for at least 6 hours after taking it. And be prepared.

[nicekato42]

thank you swim. the local doctor at the ER prescribed only 3 of them to try after she went there due to the morphine. I have trouble trusting some of the local doctors. However, he had the same recommendation - have her try it, but keep a close eye on her.

The main problem is my mother's anxiety about taking anything that is similar to morphine or codeine. Due to her anxiety, she may have an adverse reaction (psychosematic or something?). It's only now that the pain has increased to the level of her almost being willing to try it...

Do you guys know if tramadol generally has more of less of a dizziness/nausea effect than morphine?

[dawnies07]

Originally Posted by nicekato42

The main problem is my mother's anxiety about taking anything that is similar to morphine or codeine. Due to her anxiety, she may have an adverse reaction (psychosematic or something?). It's only now that the pain has increased to the level of her almost being willing to try it...

Do you guys know if tramadol generally has more of less of a dizziness/nausea effect than morphine?

Firstly....my prayers are with you, this must be such an awful time for you all....
Your mother has been tolerating the tylenol which contain codeine so she may be ok with the tramadol....My friend takes tramadol and it is great for easing her back pain but taken in higher amounts like 150mg or 200mgs, it can at times cause some slight nausea.....saying that, once her body became more used to them (over a day or two)the nausea disappeared.

Thats only one example though and as advised to you before...please just keep a close eye on her...my friend has never taken morphine tablets so cant compare the two I'm afraid.
But there are lots of other types of pain relief for cancer sufferers out there that I hope they can try with your mother....my aunt has cancer and is currently being prescribed ketamine as well as morphine and diazepam. She finds the ketamine very effective for the pain.
Again my heart goes out to you and you are in my prayers x

[nicekato42]

thank you dawnies07 - unfortunately the tylenol I have is from the US - no codeine. I do wish that it was tylenol with codeine and that it worked for her...it would make things easier.

It is good to hear that your friend adapts well to the nausea. I am hoping that my mother adapts as well. We will be trying the tramadol in about 20 minutes...keeping my fingers crossed...

nicekato42 added 1 Minutes and 4 Seconds later...

i will ask about ketamine and diazepam...it is possible that we may be able to find that in China.

nicekato42 added 1 Minutes and 23 Seconds later...

i will ask about ketamine and diazepam...it is possible that we may be able to find that in China.

[dawnies07]

hey there....was just checkin in with you to see how your mother responded to the tramadol......hoping it has helped her a little and nausea was weak or not there at all!!
I wasnt aware that Tylenol didnt contain codeine....I live in UK...just assumed it did as I have heard many talk about using this tablet for recreational purposes.....sorry for mis informing you though....
please if you get a chance let me know how it all went today......been sending positive thoughts all the way to China from Ireland all day xx

[Herbal Healer 019]

You said your mother had a bad reaction to codeine so keep in mind: tramadol is a synthetic analogue of codeine, & though its effects are not identical to codeine, they are very simular.

How did she end up in the hospital from marijuana? Im assuming it was a panic attack?

Personally I think you should give a high potency marijuana tincture (marijuana extracted into alchohol) a try because marijuana has many anti-cancer properties. I have created a thread on Rick Simpson, http://www.drugs-forum.com/forum/showthread.php?t=71110, who claims marijuana oil "hemp oil" has cured his skin cancer & cured several of his friend's cancer with whom had terminal cancer & only months to live. I highly recomend you check out the thread or the "run from the cure" video on youtube (Rick simpsons story).

I know you're probably skeptical with the idea that marijuana can cure cancer, but it wouldn't hurt to try considering it's life or death here. Also keep in mind if it was a panic attack caused by smoking marijuana that sent your mother to the hospital, that cannabis taken orally has significantly different effects (no anxiety, less intense/overwhelming than when smoked) and is highly effective for pain releif without the nasty addiction and withdrawels, which is why many cancer patients prefer cannabis for pain releif than any opiate/opioid. Marijuana has been used as medicine for thousands and thousands of years.

I wish you and your mother the best of luck & I do hope you approach my suggestions with an open mind seeing as cannabis has been proven to have anti-cancer, nueroprotectant, anti-inflammatory/oxidant, etc.. properties, & more specifically inhibit & attack tumor cells. This knowledge could drastically improve your mothers condition if taken seriously, although I'm not sure what China's medical marijuana availability and laws are.

Good luck

[nicekato42]

Here's a quick update.

My mother opted to not take the tramadol pill - her anxiety set in and I was afraid to give her a pill if she would just panic. Unfortunately, that means her pain continues.

However, my father just came back from Guangzhou with 5 fentanyl patches. I have heard good things about these in the past - my sister's friend manages an old folk's home and says that the patches are the least nausea/dizziness inducing opiates available (can anybody confirm this?). We will be trying the patch later today (it is 3:30 pm here now).

I would love to have my mother try the medical marijuana, but unfortunately china has a pretty strict no-marijuana policy here. I believe it's quite a hefty punishment to even own a bit of it. I was a student at UC Berkeley, not too much against marijuana.

thanks again for all of your kind advice and well wishes.

nicekato42 added 21 Minutes and 56 Seconds later...

I just reviewed the dosage that my father got from the doctor in guangzhou, and it is 50 mcg/h. From what I can tell, this is too much...especially for somebody who isn't currently on an opioid. According to rxlist.com, patients can use 50 mcg/h if they are currently taking 135-224 mg/day of morphine. As you may have read, my mother had a very bad reaction to just one 30 mg does of morphine. If he had gotten that 12 mcg/h, I would be more comfortable...now I'm doubting whether or not we should try the patch...

[RoboCodeine7610]

Just have her take it under the supervision of a doctor,like inside a hospital.Also, try non-narcotic painkillers like Meloxicam (Mobic) or celecoxib (Celebrex).

[nicekato42]

update - we gave my mother the 100 mg tramadol as recommended by the chinese doctors. Strange thing is that they said the only side effect was usually itchiness and rash...something that I did not read anywhere else. Has anybody had this side effect with tramadol? Or are the chinese doctors just a little crazy?

In any case, the tramadol is working pretty well. She's still in pain, but less so. She is not experiencing nausea, dizziness, or any of the usual side effects. To be honest, I am very surprised by this. (We are about 3 hours into this dose now, so the side effects should have manifested by now I believe).

I'm hoping the tramadol will have a greater pain relieving effect once it gets into her system in the next couple of days. My father is also going back to guangzhou to see if he can get a lower dosage fentanyl patch.

[Jasim]

That's great to hear. Keep us updated.

[dawnies07]

Delighted to hear the tramadol appear to be working for your mother and yes they make some people itch like crazy!!
Some people take an antihistamine along with it and that seems to ease the itching if your mother develops that side effect. So glad she didnt get the nausea!

[Jasim]

Itching is a very common side effect of opiates.

[chinaman]

hi there,

i just wanted to give you and your mother my whole-hearted love and sympathy and let you know that i spent the better part of 2 years with my mum as she was battling with metastases cancer (colon, hip-bone, lung and liver). they gave her a lot of synthetic morphine (lollies etc) but it never seemed to really take care of her pains anyway. i dont what painkillers she (your mum) ought to try but i can at least offer the small reassurance that with cancer, even morphine doesnt always work, so dont be totally disheartened. lots of love and i wish you strength. and remember that the soul has a long journey in many different manifestations - this life ISNT all there is....

[frankz81]

remember about 7% of the white population will be allergic to morphine and not be able to metabolise it. that includes codeine as it turns into morphine,well some of it anyways. swim is allergic and felt just like ur mother from morphine and codeine, mostly ER visits and sick for a few days after...
semi synthetics are mainly designed for ppl allergic to these, as swim has read on multiple occasions.
swim is ok with all the semi and full synthetics like oxy, fentanyl and methadone.

100mg of tramadol is such a small amount for a cancer patient. if you are experimenting with opites on her, why not use oxycontin which will be more effective if it works,of even duragesic would be a good option, but a low dose obviously

Reputation Comments on this post:

Some good info

[pilipuntos]

Hello, I lost my mother because of cancer a year ago and just want to tell that my heart are with you both. I can understand your feelings. The love from her family is what she needs most now.

My mother used to be fine with morphine. In the last stage of the cancer it was the only thing that worked.

Wish you all the best.