any additional relief from extreme pain of sciatic nerve damage due radiotherapy?

[spacechase]

Are there currently any relief methods of extreme pain of the sciatic nerve due to radiotherapy in addition or in lieu of the current treatment being carried out?    Brief details below.

Current meds for my wife in hospital for two weeks now suffering with extreme pain in the pelvis and legs.  Currently one crack in pelvis.  Mobile with walking frame most of the time.  When pain extreme, unable to stand.
Meds:
5 to 8mls 10/1 morphine as breakthrough pain every 2 hours if required.  Needed 2 to 4 times dailey.
100mg slow released dry morphine daytime.
200mg slow released dry morphine nighttime.
25mg northiptilene at night.
8 panadol daily.
1800mg gabapentin per day
3 drops Rivotril 2.5 mg/ml

Currently suffering with hallucinations due to a lot of meds.  Any alternative suggestions to the current medication cocktail would be much appreciated.

Terry

[Tuckamore]

Hello Spacechase,

I am so very sorry to hear about your wife's condition. This must be very difficult for you. I think those that love us suffer as much as we do when we are so very ill and in severe pain. As said above, she is very blessed to have such a caring and concerned husband as you so obviously are. My heart goes out to both of you.

When I was in a very traumatic MVA and not expected to survive I was given extremely high doses of morphine. It too made me hallucinate. I knew I was hallucinating, which made it even worse. I begged the team of physicians to decrease or change the morphine. They told me it that my pain would not be controlled. I informed them that the pain wasn't controlled anyway and I could no longer tolerate the hallucinations. Reluctantly they agreed to change the narcotic. I was given Demerol, Diazapam and  Dilaudid for break through pain. The horrible hallucinations stopped for the most part but occasionlly returned when I had all three narcotics in my system.

So I think it is the very high dosage of morphine that your wife is receiving that is at the root of her hallucinations. You may be correct that the Xanax is adding to the issue. I would ask the attending physician to try a change in her narcotic regime. However be aware that all opiates (narcotics) can cause hallucinations in high doses. You may not be able to alleviate the issue entirely until your wife is experiencing less pain. I am thinking that she may prefer the hallucinations over the severe and unbearable pain that may come with a reduction in her pain medications. But I cannot speak for her. I know it is very difficult for you to see her in that condition but certainly it would be more difficult if she were crying out in pain all the time.

They took blood cultures to rule out or rule in septicemia, a serious and dangerous systemic infection that is present in the blood. That happens when an infection from another site enters the blood stream. It is not clear by your post as to her primary diagnosis. You have mentioned a bone issue, a crack and I'm sure you have been told how very severe bone pain can be. With the elevated temp at 104 they may also be looking for osteomyelitis (infection in a bone) or possibly that is her current diagnosis. Osteomyelitis can also be extremely painful.

I'm hoping for the very best for you and your wife. Please know that we are here to support you in anyway we can. We will look forward to your updates. And please don't forget to take care of yourself.
Peace, Tuck

[Mollyrae]

Hello Terry. i am so sorry to hear that your wife is in such bad shape. It is hers to see a loved one in that much distress. I do believe that the hallucinations are due to the very high pain medication. I experienced this side effect during my hospital stay back in 2007.

I managed to pull the IV's right out of my arm and some how made it to the garage of the hospital after having back surgery...How, I don't know.  I managed to pull the fire alarm thinking someone was after me. I had everyone looking for me. The Fire Department finally found me. Needless to say, they took me off of the Morphine drip. They also brought in my Physician to evaluate me for Psychotic tendencies which I had none.

This story just goes to show you how these meds can effect the mind. I feel that they need to re-adjust the medications. They might try Dilaudid instead. It has a slightly different compound.

I feel that the fevers are due to the high amount of pain that she is having.  On the days when my pain is greatest and I do not have good pain control, I will experience a low grade fever until I get the correct dose of pain meds in me. This is why I feel that your wife's fevers are produced by pain. It sounds far fetched but I really do believe that tremendous pain causes fevers.

To sum this up, I really do think that the combination and the amount of medication your wife is getting is causing the Hallucinations and with a medication change, I feel that this can be controlled. I wish I had better advise for you but I think my story will tell you that a med change might do the trick. Please keep us informed. Take care,
Mollyrae

[spacechase]

Thanks for your comments regarding my wife.  I would also like to update you on the current situation.  For the past two days my wife has been unable to support her weight.  Doctors has increased nighttime dry morphine to 250mg.  Also forgot to mention one additional med.  Three times a day .5mg Alprazolam (Xanax) and at night 1.5mg.  Xanax prescribed due to being anxious and distressed with current condition and being in hospital for extended length of time, now almost three weeks.  The doctors are actually trying to build her strength up so see can have a transverse colon operation to hopefully eliminate bad vaginal leakage, causing constant infections in the pelvic area.  Pelvic bone has deteriorated due to radiotherapy in 2004.  Currently one small crack in pelvic bone.  Also currently on IV antibiotics once a day, about 10 more weeks to go on this.  
Hallucinations very bad today and constant.   At 0300 she awoke with severe pain and liquid morphine given with rivotril drops.  At 0600 she awoke with a 40C/104F temperature.  Pulse 115, BP 117/94.  Blood cultures, ECG and chest x-ray taken.  After about 30 minutes temperature began to drop and normal after about 4 hours.  Have not heard of test results yet as am now at home and will return to hospital in the morning.  
As a personal note, I don't thing that Xanax mixed with the morphine is doing the hallucinations any good.  Any info on the mixture of these two drugs regarding this?
Thanks again for your comments.  Any info is much appreciated

Terry

[sandee1818]

I am not sure you can go any further as far as increasing her dose safely. With this much medication it is very good that she is in the hospital so they can watch her as the respiratory system is slow on these medications. How long has she been on this current dose of medications?
I would definitely ask the doctor about trying different methods for her pain control to alleviate the hallucinations if at all possible.
I am certain she is glad to have such a great husband supporting her! I hope she is doing better very soon, in the mean time take care of yourself too so you can help her:)
Others will also add their opinions.