i have chronic pain and COPD - help!!! pain meds make breathing worse

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Pain Lady
Regular Member


Date Joined Mar 2011
Total Posts : 21
   Posted 3/28/2011 5:52 PM (GMT -7)   
in May 2006, i had spine surgery which left me with pain in my spine,
nerve damage in my legs and feet, and fibromyalgia.  Pain is horrible.
I am currently on duragesic patch and oxycodone, lunesta for sleeping,
zanaflex for muscle relaxant when needed, and cymbalta for fibromyalgia.
Three weeks ago Pulmonary Doctor put me in ICU for 5 days because breathing and wheezing was so bad.  I haven't smoked in more than 20 years and i believe the Pain meds i am on have been making my breathing worse and worse over the last almost 5 years.  I need to get off the pain meds if i want to breath but I need a solution for the pain which is horrible.  Any suggestions would be appreciated.  thanks.

mrsm123
Veteran Member


Date Joined Dec 2007
Total Posts : 1124
   Posted 3/28/2011 6:06 PM (GMT -7)   
All of the opiate pain medications can cause respiratory depression, but some seem to cause less than others. It may be that you are going to need to try different medications to see which ones allow you to breathe better than the fentanyl. While fentanyl is a great pain medication, I also have COPD and have noticed when I was using the patches, my breathing seemed more shallow and I was more prone to respiratory problems.
Talk to your pain management doctor who can best direct you to other medications and help you find one that will work best for you.
Sandi

Jim1969
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Date Joined Jul 2009
Total Posts : 2042
   Posted 3/28/2011 6:07 PM (GMT -7)   
I would suggest researching every medication you are on and see which ones tend to cause breathing problems. I know many narcotic medications have this potential side effect but I do not know about the others you are on. Once you have your list of medications that can cause breathing issues I would take that to your doctor and have a long talk with him about finding substitutes for what you are on for at least some of those meds, as I suspect you can probably handle a few of them but are taking enough of them to cause problems.

If you have not tried it, one thing you can talk to your doctor about is TENS therapy. It does work for some and might be worth trying. There is also the SCS units which are implanted and work by blocking pain signals. Some have good luck with those and others no. If this is something that you try they do a trial run before permanently implanting the leads. There are several discussions about the SCS and a few of our members have one.
2 confirmed herniated lumbar discs. Spinal Arthritis. Spinal Stenosis, diabetic peripheral nueropathy.

Tirzah
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Date Joined Jul 2008
Total Posts : 2203
   Posted 3/28/2011 6:07 PM (GMT -7)   
Very tricky. The only one that didn't give me probs was methadone, but due to some kind of heart issue, you can't take methadone within a few hours of a rescue inhaler. I didn't happen to need my inhaler while I was on it, but it always made me nervous -- what if I just took my dose of methadone 15 minutes ago & start having an asthma attack? Obviously, I'm gonna use my inhaler, but it would suck to end up with a heart attack (or whatever the issue was).
Wish I had better news. Maybe someone else has an idea.

mrsm123
Veteran Member


Date Joined Dec 2007
Total Posts : 1124
   Posted 3/28/2011 6:19 PM (GMT -7)   
And Cymbalta, lunesta and even zanaflex can all cause respiratory depression, so the combination of the medications can all be cumulative , there may be other medications that will provide better relief , and melatonin is a natural supplement that does wonders to help someone sleep. It occurs naturally in the body, and is an essential part of the sleep cycle of the body.
Try using melatonin or L-Tryptophan or a combination of the two to see if they will allow you to get restful sleep without the next morning hang over that sometimes comes with using sleep aids. Neither one of those over the counter supplements causes any respiratory depression.
Sandi

Pain Lady
Regular Member


Date Joined Mar 2011
Total Posts : 21
   Posted 3/28/2011 9:39 PM (GMT -7)   
Hi, Jim and Sandi,
thank you for your responses.  Would you be able to tell me what pain meds you are on currently?
also, do you by chance know which is worse in terms of COPD, the oxycodone or the duragesic patch
(i am between 50 and 37 mcg's.  Depending on how bad the weather is.  thanks, marsha

CRPSpatient
Forum Moderator


Date Joined Mar 2011
Total Posts : 1193
   Posted 3/28/2011 10:10 PM (GMT -7)   
Hi Marsha, and welcome. I'm afraid I don't have too many suggestions, but I do have a spinal cord stimulator so if there's anything you want to know about them, please do ask !

Laura
CRPS since 1999, diagnosed in 2005 and since spread to full body, spasms, dystonia & contractures, gastroparesis, orthostatic hypotension.

On Oxycontin/Endone, Topamax, Mobic, Magnesium, Florinef, Somac, Cipramil. Have a spinal cord stimulator, intrathecal pump with baclofen & bupivacaine and doing physio.

straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 11656
   Posted 3/29/2011 12:04 PM (GMT -7)   
Hi Marsha and welcome to Healing Well's chronic pain forum. I too have COPD and I have been on oxygen 24/7 for the past 3 years I believe, maybe 4, I have lost count. Is there a reason the pulmonary dr did not institute oxygen therapy for you? When you were in the hospital what pulmonary tests were done and did your breathing improve when placed on oxygen along with your numbers improving? I was to the point of passing out from lack of oxygen and it took the drs a long time to figure it out. I too had some problems when I was on the Fentanyl patch. I now have a pain pump and have a combination of meds in it. Dilaudid is the medication used for pain in the pump.

It was difficult getting use to being on oxygen, in the house I am hooked up to my liquid tank and it does sometimes make me feel like a dog on a leash. I just remind myself how much better I feel when I am hooked up to i. It can work on your head a little when you first start.

Anyway, I wanted to pop on and tell you welcome aboard. Take care.
Moderator Chronic Pain Forum

Pain Lady
Regular Member


Date Joined Mar 2011
Total Posts : 21
   Posted 4/18/2011 8:47 PM (GMT -7)   
hi laura (crps patient) - i don't even know if i am doing this right.  But i have another question.  if you have the scs, why do you still have to take all those meds?  thanks, marsha
L3-L4 with hardware and cage, may 2006. Failed spine surgery. Now have fibromyalgia, nerve damage in legs and feet, in chronic constant pain. narcotic meds have left me with COPD. Not Fun.

Pain Lady
Regular Member


Date Joined Mar 2011
Total Posts : 21
   Posted 4/18/2011 8:49 PM (GMT -7)   
thank you all for your responses. They are really, really helpful
L3-L4 with hardware and cage, may 2006. Failed spine surgery. Now have fibromyalgia, nerve damage in legs and feet, in chronic constant pain. narcotic meds have left me with COPD. Not Fun.

straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 11656
   Posted 4/19/2011 10:07 AM (GMT -7)   
Pain Lady the purpose of the SCS unit is to decrease your pain at best 50% and most people with these units still require medication. Not everyone gets a 50% reduction in their pain. The unit will not make your pain go away, instead it creates another sensation that is suppose to over ride the pain signal. If the drs are telling you that you will be pain free with an SCS and not need pain medication, then you are not being told the truth. Every person that has come to this forum with an SCS unit has had to stay on medication, some have had their meds reduced a little but not stopped.

I do hope that you will do more research about the SCS unit before agreeing to one. Have you done the trial for one yet? If so, did it help you? Good luck.
Moderator Chronic Pain Forum

ak angel
Veteran Member


Date Joined Apr 2011
Total Posts : 3127
   Posted 4/19/2011 8:31 PM (GMT -7)   
pain lady- I am new for the first time. I suffer from severe pain to. I was reading your story and I have tried about all the medications on the market for pain. After being on narcotics for so many years my body began to become immune to them. They stop working, unless I had huge doses and even that it was short lived.I would wake up in the morning with my body needing my narcotics because I came so dependent on them. I started to have severe depression with suicidal thoughts. I didn't want to live with all the pain anymore. I finall got some help. I wanted off the narcotics, but they knew I would need something. They thought I was crazy at first. I went to treatment to get off the narcotics and to learn how to live with chronic pain better. I had the best dr. that supported me with my chronic pain. I was started on subutex (other half of suboxen) I had no problems coming off the narcotics and it work wonderful for my pain. It causes no depression, no feeling drug up. I love it. I know it's not for everybody, but look on line and you will see the people comments on how much they love the drug.
people comment how they got their life back, me too. I look forward to getting up now. It's very powerful, more then morphine. Less addiction rate also.

spinal soldier
Veteran Member


Date Joined Dec 2009
Total Posts : 629
   Posted 4/20/2011 3:51 PM (GMT -7)   
ak angel read my mind. before i had read about you using Duragesic patches i thought about Suboxone at a pain control dose, (up to 32mg/24hrs.), or Subutex would be the same without the addition of naloxone that prevents IV abuse. the generic name is Buprenorphine which is a potent opioid, about 1omg of morphine sulfate IV equals 0.3mg Buprenex, it has a ceiling effect at 32mg/day but that would be equal to quite a lot of morphine. the great thing is it's effects on the breathing center of your brain are less depressant like and it has a ceiling of respritory depression unlike pure opioid-agonists. Buprenorphine is a opioid agonist/antagonists, it has a agonist effect on the mu-receptor and a antagonist effect at the kappa-opioid receptor and all kinds of weird unique effects at the other opioid receptors maybe giving it a advantage for certain types of pain like fibro.. it has very high binding affinity to all receptors so it will prevent or reverse other agonist opioids. i was on the max dose for pain; 2 tablets in the morning 1 afternoon and bedtime (8mg/2mg sublingual tabs.) and it did work well but it was so expensive it could not keep up. for your COPD Dx you may get better deals. Lunesta has respiratory depressant effects especially with an interaction with another depressant. i don't know your oxycodone dose or if it is conventional release but i would think the fentanyl patch is more of a risk, it never stops delivery of drug into your blood, even when your sleeping. Zanaflex may cause dizziness upon rising or drowsiness but it is not a central acting depressant that would potentate another. the drawback with Suboxone/Subutex or the newer patch(maybe not in US YET) is switching from the fentanyl patch that leaves drug concentrations in the fat that are not active until hours after the patch is removed. the period of hours/days may be longer until the first dose of buprenorphine is taken. the one other drawback is no breakthrough med would work other than more buprenorphine, with the new patch the sublingual tablets are used for breakthrough in Europe. also one study showed benzodiazepines like Valium or Klonopin had a deadly respiritory depressant effect interaction, both at perscribed amounts but it seems they have learned otherwise since then(2000-03) because they combine them now. it may be the best thing you ever did or the worst but it is worth a try and i would say to find a different sleep med because Lunesta is a dangerous med relatively. Seroquel at a low dose is gaining popularity for insomnia. it works for almost all but it cal effect lipids and glucose and strain the liver, but in a low dose most likely not. Melatonin is a great idea even if it does not work it is one of the most powerful anti-oxidants known. GABA, L-theanine, lemon balm, valerian, hops, kava, 5-HTP, and calcium/magnesium citrate or gluconate are some thing that can start to improve sleep. Tart cherry extact capsules contain high concentration of Melatonin and are more commonly used as a anti-inflammatory and joint health. GOD bless and best of luck to you.

Pain Lady
Regular Member


Date Joined Mar 2011
Total Posts : 21
   Posted 4/21/2011 3:47 AM (GMT -7)   
okay, i just found the reply button.  Thank you, both of you for the information.  I will now go and do my research.  My appointment with my new pain doctor who practices with my lung doctor is the second week in may, i think.  I am so glad i found this sight.
i am now wondering how i get to where you guys post your questions/complaints/observations etc.
Can someone let me know where to look? i would appreciate it.  Navigation is not my forte.
best, marsha
L3-L4 with hardware and cage, may 2006. Failed spine surgery. Now have fibromyalgia, nerve damage in legs and feet, in chronic constant pain. narcotic meds have left me with COPD. Not Fun.
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