Severe pain - can anyone advise?

Background My wife’s breast cancer (stage 4 grade 2) RH breast lymph nodes in the R & L H side of her neck and also mets in both lungs. Diagnosed January 2011 chemo feb to July 2011 then radiotherapy with mixed results. Started Avastin and Taxel 10th Feb after cancer spread. The avastin has been suspended because of high BP which is being treated.

For most of the time since May 2011 my wife has had moderate pain in her RH breast, underarm and top RH back this did subside a bit during and after radio but started again in November when cancer had spread. Over this last 3 weeks she has steadily deteriorated feeling v unwell (but bloods still ok) her shape has changed on her R H side it is as though underarm and chest muscle is disappearing coinciding with this the pain has become very severe especially early mornings when she cries etc which is not my wife she isn’t a complainer.

Her pain relief was 400mg Ibuprofen, Co-codamol and tramadol 4 x daily the tramadol hasn’t suited her so now off it and after 4 visits to hospital in the last week seeing 3 different doctors (with different opinions) as her Oncologist is away she has finally been given Morphine Syrup %ml every 4 hours which thankfully has helped but not ideal she is due chemo on Friday and will also see a registrar to discuss pain.

Could any of you wonderful ladies offer any advice and experience of good pain relief - it is destroying her way of life and it breaks my heart to see her in this way. I have been pro-active and almost lost my temper with them which resulted in the Morphine.

Hi Wellmeant

I’m so sorry to read that your wife is having a bad time with pain and other difficulties arising from cancer and treatments at the moment; you really need a more coordinated approach to pain relief for her.

I wonder if you have had any contact with your local hospice as yet? It’s one of the first support services I accessed when I was diagnosed with liver & bone secondaries in 2003, and I received great care from the doctors, nurses and complementary therapists at my local one.

Hospices are all different in the types of services they might provide, but most have a very good reputation for resolving issues around pain management for people in our position. Perhaps you could contact your local hospice to discuss how they might be able to help your wife. I know not everyone feels comfortable about making contact with a hospice, but please remember that they’re there to start supporting us well before we’re at the end of our lives, and you might find a solution to your wife’s pain difficulties there.

Regards, Marilyn

Hi wellmeant,
I had and still suffer from severe pain due to pleural pain. I got refered to the pain clinic which is the best thing I’ve done to control my pain. The consultant is brillant and will also liaise with onologist GP etc.
I at first would take morphine based drugs due to adverse effects from.anti sick.rads drugs and a unsympathetic GP. I’ve got anti sickness tabs sorted out I take slow releasing oxycotin 20mg which works plus 5mg of oxynorm as a break through pain releif which I take 1/2 .per day.
I really hope you get on th phone and talk to your Gp who can also precribe these drugs and referee you to pain relief clinic at th hospice. As Mariltn has said complementary therapies help relax and give us me take plus feeling lovely when we come out.
Take care of yourself and I hope this helps. Sending good wishes to your lovely wife.
Love
Chris xx

Thank you both so much for your advice.

I was very pro active this morning with the registrar we saw before my wife had treatment. For a start she has now been put on 30mg of Morphine Sulphate controlled release tablets 1 every 12 hours and to take the Syrup as and when for breakthrough pain, she will see her oncologist on Wednesday (earlier if we continue have problems) she will hopefully then be referred to the pain clinic. I have also been in touch with our Macmillan nurse who has suggested our local nurse would visit and try and help sort things out (if all else fails), I have also suggested we have a scan eelier to see what is happening.

Throughout the past 14 months we have been getting terrific support from our Specialist Behavioural Oncology Nurse at our oncology health centre where various therapies are available, these too have been invaluable to us.

I will also have a word with our GP. Unfortunately my wife’s Avastin is still suspended as her blood pressure is very high 159/120 today. So Hopefully within the next two weeks this will be sorted too.

I do appreciate registrars have a difficult job and do an excellent job on the whole - but sometimes you really have to be really pushy and proactive to get things done.

Can I just say from someone who has been on Morphine, make sure your wife takes something for constipation, as Morphine causes awful problems in this department.
As others have said, can you contact your local hospice or Macmillan service and see what they can offer. I have both a Macmillan nurse and a community hospice nurse who I use as much or as little as I need. These people, especially the Hospice nurse are specially trained in pain control.
I hope your wife feels better soon, there is no pain worse than cancer pain.
Jane x