very aged father in a lot of pain, in hospital, asks me to kill pain

[Chip (OP)]

my dad is at his end-of-life and is in much pain (spontaneous internal bleeding in leg).

thet are giving him oral Oxyc/Naltrexone (5/2.5 mg) and I want to bring him some 'done (he ask me to help with the pain).

will the Naltrexone render 10 mg. of 'done useless ?

shall I bring it in and dose him ?

[Dopeless Hopefiend]

While I really don't know enough about naltrexone to say whether or not it would make the 'done useless, I'm wondering if you or another family member might have any luck just speaking to his doctor(s), telling them that he's reporting significant pain still & maybe they would increase his meds? I don't know how it is in Australia, but here if it's an end of life/palliative care patient they are normally MUCH more liberal with the pain meds. When my husband was dying they were giving him pretty much anything he asked for the last 6 months or so.
In any case, I'm really sorry to hear that your dad isn't well.

[traplord69]

Hey I'm sorry to hear about that.  I agree with dopeless.  Controlling pain is extremely important in hospital settings, especially when someone is nearing the end.  They actually consider a patients pain level as one of their vital signs, atleast here in the us.  They should be very receptive to someone, especially in his situation, if he says that his pain in not being adequately relieved.  I'm pretty shocked that thats all they have given him

[DeadCat]

I would think if he is at ed of life and his doctors knew he was still in pain they would order stronger pain meds without thinking twice. Maybe he is too proud to tell them but is confiding in you? I'd tell the doctors first but then...

A friend of mine who had a habit was once hospitalized with a collapsed lung. He would mix up his shots and inject them into one of the ports in his IV line, just like the nurses did to administer him other IV meds.

[Dopeless Hopefiend]

A friend of mine who had a habit was once hospitalized with a collapsed lung. He would mix up his shots and inject them into one of the ports in his IV line, just like the nurses did to administer him other IV meds.

That's a dangerous game. They sent me home with a picc line to do 3 months of iv antibiotics in 2005. That was a really stupid call on the doctor's part, but I was in heaven. Went from having no veins to instant access 24/7. I developed a monstrous speedball habit with that line in. I'm lucky I didn't kill myself, but I felt like I was in serious mourning when they pulled it out.
Sorry, not trying to derail your thread chipper. Dead cat's post just made me all nostalgic for a minute. 

[Chip (OP)]

thanks for your advice - they gave him an additional 2.5 mg. Morph shot just before I left today.

I just don't know if I should and maybe it's best that I put my energy into pushing for more sanctioned pain relief.

he is frail and has dementia too, with swelling on his new pacemaker site.

this is difficult - he wants to end it but I don't want to be seen as part of that end - but surely 5 mg. of 'done can't be that risky.

much to think about.

[Opi-ette]

Chipper I'm sorry to hear about your Dad. I know how hard it is to see them suffering and not really being the Dad that they used to be. Thankfully when my Dad was dying he wasn't in any pain but he also didn't have the mental or physical capacity to speak for himself so we as his family made every decision for him so don't be afraid to speak up for him. Its actually your right to do so. Tell them he needs something stronger.

I don't know about the naltrexone interfering but hopefully you won't have to worry about that and they will make your Dad comfortable. Also you have to think about what other meds hes on, could the Methadone interfere with those too.

[Fleas Bass]

Id push for more medication from the healthcare providers. He deserves it, and we all know how meager a dose becomes in the face of serious pain.

My grandfather just coded yesterday and is on a ventilator, so I really empathize with you right now. I hope the best for yall chipper. Keep us updated

[Esoteric Anhydride]

my dad is at his end-of-life and is in much pain (spontaneous internal bleeding in leg).

thet are giving him oral Oxyc/Naltrexone (5/2.5 mg) and I want to bring him some 'done (he ask me to help with the pain).

At those little doses, I think the purpose of naltrxone is to potentiate, not block, but that's a guess on my part.

Luck with it Chipper..

[Z]

Isn't naltrexone relatively inactive orally?  The reason they add it is to discourage IV use I thought.

I still wouldn't give him any.  Pandora's box, and getting it closed again, and all that.

Edit: I think we are getting naltrexone and naloxone confused here.  Those pills contain naloxone, narcan, and are poorly active orally.  Naltrexone is a different med with a similar effect.  It is active orally, and mixing it in a pill with oxycontin would make no sense.

[Tainted]

Isn't naltrexone relatively inactive orally?  The reason they add it is to discourage IV use I thought.

I still wouldn't give him any.  Pandora's box, and getting it closed again, and all that.

Edit: I think we are getting naltrexone and naloxone confused here.  Those pills contain naloxone, narcan, and are poorly active orally.  Naltrexone is a different med with a similar effect.  It is active orally, and mixing it in a pill with oxycontin would make no sense.

im pretty sure your not getting them confused. they put nalTREXONE in suboxone because its not supposed to be active at all sublingually, only slightly active orally, its mainly there to prevent IV use.

if he has a lot of health problems, i'd be nervous giving him anything extra that depresses respiration that the doctors aren't aware of, but that's just me and is probably a bit overly paranoid since your not talking about any kind of a large dose. if you do decide to do that, i'd just be wary of it after few days (the methadone clinic gave me a chart showing how you can take the same dose every day, but because of the long half life, it can build up and you can OD on the 5th day of taking the same dose cause it built up)

[Chip (OP)]

Thank you, guys - i won't do it ... you have talked me out of it.

[Z]

im pretty sure your not getting them confused. they put nalTREXONE in suboxone because its not supposed to be active at all sublingually, only slightly active orally, its mainly there to prevent IV use.

if he has a lot of health problems, i'd be nervous giving him anything extra that depresses respiration that the doctors aren't aware of, but that's just me and is probably a bit overly paranoid since your not talking about any kind of a large dose. if you do decide to do that, i'd just be wary of it after few days (the methadone clinic gave me a chart showing how you can take the same dose every day, but because of the long half life, it can build up and you can OD on the 5th day of taking the same dose cause it built up)

Nope.  Subs contain nalOXONE.  Google it.

[Tainted]

Nope.  Subs contain nalOXONE.  Google it.

huh your right. has it always been naloxone? for YEARS i've thought it was naltrexone/wasn't the same ingredient as narcan (and ive had a script for suboxone the better part of the last decade)

i guess embedda has morphine/naltrexone, but i could have SWORN subs did as well

[candy]

Chipper,
I went through similar with my own dad at the end of his life and I think
it is best to just continue to advocate on his behalf for pain meds.
Good that they gave him morphine and I would consider asking for it around the clock to keep him comfortable.
They can give it orally or through an IV and it may be a better option than Oxyc/Naltrexone option.
I am not sure how they do end of life care where you are.

The swelling at the site of the new pacemaker is most likely normal and they should be monitoring it quite often.
Swelling at the site of any surgical procedure is normal and as you know and of course the pacemaker is felt just below the skin and is visible.
When was the pacemaker put in? I know you mentioned he is at the end of life, so I was just curious as to when it was put in.

I know you decided not to give your dad anything on your own and I am glad you did. That would be the last thing you need.

I am so very sorry about your dad. It is so very hard to lose a parent and even harder when we feel we have no control over
their care, especially at the end of their lives.
Keep pushing for your dad's needs. No reason he must experience any pain.
Make sure they take a look at the pacemaker site. If you should notice any increase in swelling or redness at the site, it could be an infection.

Keep us posted. My thoughts are with you my friend and please keep yourself healthy through this. We often
forget ourselves and our own needs which is completely understandable.