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HELP! Severe pain - diagnosis unknown!

Hi

Really hoping somebody could help here as I am struggling to get the right help from our national health service here in the UK.

My dear old dad - 75 - has been suffering with severe pain in his body for around six weeks. He was diagnosed with stage 4 prostate cancer around 9 years ago and underwent hormone treatment and radiotherapy which contained the tumour and ever since then the cancer has not impacted his life much at all.

He does, however, suffer with several other ailments and takes medication for these every day, including tablets for blood pressure, type 2 diabetes, cholesterol and stroke; he suffered a pretty serious stroke about 3 years ago but has no obvious physical impairment as a result, although he has been impacted cognitively in terms of memory and such like.

As mentioned, he began experiencing severe pain around six weeks ago which originated in his lower back and pelvic area and has since spread around his body to include his chest, arms and legs; he has difficulty describing the pain but has said it is like a box and at each point of the box it feels like pressure. The pain at times has been unbearable, but he tends to be able to bare it if he is motionless; it tends to flare in whichever area of his body he moves.

Our initial concern was that his prostate cancer had become active again and possibly started to spread to his bone. Consequently, we had a bone scan and MRI scan arranged. In the meantime, his GP prescribed morphine patches and advised him to apply these (10mg) and take any additional painkillers if required. Initially he suffered awful side effects to the morphine - shaking, inability to walk, slurred, incoherent speech and vomiting - which have since subsided somewhat; we have, however, been unable to eradicate his pain.

We rushed him to A&E last week as he was in a very bad way when he awoke - he had not moved from the position he had been in since going to bed, and was unable to speak or focus on anything, and had a very wheezy chest. He was treated for a water infection in the hospital and discharged a couple of days later, saying his pain had subsided somewhat. He was able to speak clearly again and walk, wash and dress himself with little assistance - something he's been largely unable to do for several weeks.

We then got the results of his bone scan & MRI scan back from his oncologist - the cancer has become active again in his prostate but it does not appear to have spread to his bones. Whilst this was something of a relief, the oncologist was at a loss to explain his pain, insisting he does not believe it is related to his prostate cancer, and has suggested we ask his GP to refer him to a urologist.

We are hopeful of organising this tomorrow, but in the meantime we are still struggling to bring his pain under control. We managed to bring it right down yesterday to what my dad described as '2/10' in terms of severity - '10' being unbearable - from an earlier high in the day of '7' - by administering prescribed liquid morphine (2.5mg) plus paracetemol - on top of his usual meds. But today he has been in severe pain again, despite taking the liquid morphine and paracetemol as he did yesterday.

The pain is of huge concern to us not only because we are struggling to bring it under control, but also because we do not know what is causing it; in addition to the pain, he is extremely fatigued - he just wants to sleep all the time (and has advised that when he drifts off to sleep he is conscious that he is not in a deep sleep) - and he has an extremely diminished appetite - eating and drinking very little. When the pain is at its most severe, he seems to struggle to focus and communicate, but when it is not so severe, he communicates freely and can be mobile and we feel this often helps. Unfortunately, at the moment, he cannot find the energy to do anything.

I wonder if anybody else recognises these symptoms and can offer any guidance or support?

Yours hopefully

Rob
3 Responses
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547368 tn?1440541785
This is an older thread. I haven't seen Rob in our community recently.

You may want to try to send him a personal note or message on his Profile Page. Sometimes non-active members will respond to a personal contact on their Profile Page. This can depend on if and how they set up their notifications.

Best of Luck,
~Tuck
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Avatar universal
Have you ever found the cause?
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7721494 tn?1431627964
Perhaps the dose is too high.

Have you tried other pain medications?

Hydromorphone is easier to metabolize than morphine.

Methadone is also an excellent pain reliever that works slightly differently than morphine.

Both come in oral formulations -- perhaps your doctor can try the lowest dose -- 2mg of hydromorphone or 2,5mg of methadone?
Helpful - 0
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