Dilaudid Lethal Dosage? (Page 3)

I am a stage IV cancer patient and member of an invitational research and survey type website.

Members primarily consist of other stage IV cancer patients, but in some cases, may be the caregiver of a stage IV patient.

A little over a month ago, a caregiver launched a blog-like diary of sorts. He states his wife has end-stage, metastasized, breast cancer. His postings started with news his wife had to be hospitalized when she began the dying process and indicating shut-down. However, many of his statements do not sound clinically correct or even possible. For example, after she was admitted to the hospice section of the hospital, he stated she emerged from days of a coma-like state to experience what he called a rally. This rally consisted of engaging in conversation with himself and hospital staff...only to sink into another coma-like state after being administered IV anti-biotics for a major infection due to compromised immune system (an extremely low, chemo-caused low white blood count). During this time, he also stated that both kidneys shut down...then...a week later, miraculously regained normal function. In still another posting, he describes she emerged from yet another coma-like state to devour a huge meal, although she had and was still on a PEG feeding tube!!! (All patients I know had to slowly acclimate over a period of several days to oral feeding with jello, puddings, non-spicy soups, etc.) He now states he has moved his wife back home where she can die in the comfort of familiar surroundings. Now at home, he described another coma-like experience, followed by yet another rally of low-level activity as if she had no health issues at all. Today, (July 23) his posting states she was in great pain the night before and her doctor increased her Dilaudid pain medication to 7mg/hour. If you had read between the lines of every post since this person started about 6-weeks ago, you'd quickly get the idea this person has the capacity to cause a faster than normal passing of his wife. For what reason?...so he can start re-establishing his social life! More than one prior comment had this type “social life” focus, though subtle. Far more troublesome are comments I feel would cause any perceptive person to wonder if he is capable of engaging in deliberate acts to cause his wife to expire sooner than later. In hopes a professional monitors this board, I have a quick question: Under her circumstances, does 7MG/hr of Dilaudid seem appropriate and correct...or...is does it sound more like an accumulative, lethal dose? I apologize for the length of this post, but am somewhat bothered by what may be the abuse (or worse) of a person that cannot defend themselves. Thanking you in advance, Nodawgs

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JACK reply to post 35

Thank you for that post. I'm sorry you have such unrelenting pain.I too suffer from a similar condition and manage with about the same dosage as you. I'm a few years younger so my over riding concern is future pain relief without complete tolerance.Rarely do I hear the adminition to control the use of such potent narcotic containing pain meds so as to have some upward titration available in the days to come. Very well stated. Regards,

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My husband suffered from stage IV colon cancer with mets to liver and lungs. Morphine constipated him so severely that he spent hours everyday screaming in pain and discomfort, and the primary pain wasn't even alleviated. Dilaudid was the ONLY thing that worked. He took reasonable doses over the course of about a year, but by the time he was in the active dying process, he needed 16 mg/hr in order to maintain a MODERATE level of comfort. The doctor was in awe when lower doses didn't do the job, and even tried Morphine again, which just did not work for him. THANK GOD that this doctor was open-minded enough and had the compassion necessary to do WHATEVER it took to make my husband's passing a little less traumatic.

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I take 4mg 4 times a day and am also on a fentyal patch. They labeled my daiudid wrong once when I was on a dose of 3mg 4 times a day as need for pain to rake once every 3 hours. I was told if I had not listened to the doctor and followed what was written that I would have more than likely died the first night as that would have been way to much. So 7mg every hour seems wrong and fatal.

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Hi, I must comment on this discussion about Dilaudid. Unfortunately, I have suffered with chronic pain for over 25 years. During that time I have been on every known pain medication available.
I am presently under the care of a pain doctor and I live in New York. A few years ago a drug attic robbed a pharmacy in my area and killed the pharmacist and all the patients in the store . As a result New York and the insurance companies have begun to punish those patients with true pain syndromes from getting their necessary medication. Once a week I get a A letter from Aetna telling me that a dose of Dilaudid above 30mg a day is not effective and that he will start paying for it .This is completely unfair to patients they truly need it.. As many other readers have said unfortunately you build up a tolerance to all of these medications . I presently take 16 mg of Dialaudid every four or so hours. Up until eight months ago my pain doctor instructed me to make sure I took my pain medication on a regular basis to prevent my pain from becoming intolerable.So I have been doing that and now she has suddenly changed her and told me that I must less medication less often because the insurance company will no longer pay and the state is watching each dose we take. Having chronic pain is one of the worst things to live with . I recently was in the hospital for kidney stones. The pain was unbearable . I explained to the doctor that I was a chronic pain patient and presented him a letter from my pain doctor explaining the medication that I am prescribed.
The ER doctor says you're my wife oh my god this dose would kill an elephant! As you can imagine my wife became so alarmed . The doctor would give me no more than 1 mg of morphine as I was crying in pain. He didn't believe that the letter that I always carry with me and my wallet was legitimate and try calling my doctor at 1 AM. As is always the case my doctor was not on call and the doctor on call said I don't know the patient so I can't comment. So next 15 hours I screamed in pain until the stone moved. As you might expect I always have pain medication with me and the doctor scared my wife to such a point that she refused to give me any additional medicine.

I bring this up simply because as pain patients we go through hell every day. It's bad enough being in pain but for a doctor cannot believe you and for for the insurance companies are now decide if you're in pain or not because of the all mighty dollar is insane. You could be sure that if the CEO of Aetna wife had chronic pain this would never happen. I am so afraid that within the next few months make those is going to be cut and it will be completely out of my doctors hands because the state and the insurance companies are running the show.

Finally as pain patients everything is out of our control except the horrible pain that will rain every day. Are use tens unit, lidocaine patches, physical therapy, heating pad, you name it I've tried it and as a result my life is so miserable that I wish I could just die.

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Re: Brynn (# 13)

You are so spot-on, I've been saying that my whole life as I watched my dad suffer and die of cancer... we have the mercy to put a dog down peacefully but not a human... dr. Kevorkian was the way to go

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