Need advice on pain meds

CherylS · 11-26-2005, 06:52 PM

An earlier thread about bone and joint pain from Herceptin got a discussion going about pain meds. I am finding myself taking 1-2 Vicodin pretty much daily, later in the day when pain starts to take over. It is primarily in my back and I believe mostly from tissue expanders. What concerns me is knowing that pain meds that contain Acetaminephon cause a depletion in glutathione which can weaken the immune system and cause cancer. Percocet knocks me out, and Darvocet does nothing for the pain. Vicodin is the only one that works and my onc says it is safe. I am taking Whey protein and NAC to keep glutathione levels up, but this daily pain med still worries me, yet I can't feel very good without it right now. Anyone to validate or calm my fears? An Atavan now and then helps with muscle spasms too I think. Thanks in advance. There is so much knowledge on this board.

al from Canada · 11-26-2005, 07:14 PM

Hi Cheryl,
I have spent considerable time researching this very issue. When Linda has raging liver mets (80%) the one thing we wouldn't accept was any formulation with tylenol in it. This drug plays havoc on the liver, which was the last thing Linda needed.

We requested a single entity narcotic. Why? Because mg per mg narcotics are the most effective pain medication. We settled on hydromorphone which is approximately 7 - 10 times stronger that morphine and ussually won't turn you into a Zombie. Linda takes 12 mg 3Xday and has the back-up of 4 mg. break-through pills in case the long acting takes too long. This is down from the initial dose of 24 mg 3Xday.

If you are in the US then you have access to a relitively new non-opiate med called Tramadol. This is an exciting analgesic as studies have found that tramadol actually increases NK Cells. There is some research that suggests that opiates may cause the cancer to proliferate. Tramadol is available as a single entity, mixed with tylenol and very recently in a sustained release formulation. Canadians need not apply! This drug as a single entity SR formulation would be my first choice. On the following post are some links for tramodol.

Good Luck,
Al

al from Canada · 11-26-2005, 07:18 PM

http://www.sciencedirect.com/science...ba97af9aa3e8ab

http://www.ncbi.nlm.nih.gov/entrez/q...&dopt=Abstract

http://www.anesthesia-analgesia.org/...ract/90/6/1411

http://freud.tau.ac.il/~shamgar/pdf_files/52.pdf

This is a lot of reading but, winter nights are long; especially in this God forsaken, snowed-in part of the planet we call the great white north.
Al

Ginagce · 11-26-2005, 09:20 PM

Thanks for the information in this thread. I've been taking percoset for pain off and on for over a year now. I did not know about the liver problems or the immune system problem which concerns me the most at this point. I will read your info. Then probably have more questions to ask.
Ginagce

CherylS · 11-27-2005, 05:59 AM

The thought that opiates may cause proliferation scares me to death. Expecially since I have been taking the Vicodin since surgery in September, 1 or 2 per day.
It would be both in the class of Tylenol type medicine and opiate, right?
Anybad news about Lorazepam/Atavan? It seems to relax the back some. Plastic Surgeon tried to give me Valium. No thanks. Sure wish the Vicodin was just OK. It works so well! How do we win!? Al, I'll check the infor you posted on tramadol. Were you concerned with the cell proliferation with the single entity narcotic? If not, why? What is the difference between this and a drug like Vicodin or Percocet?