Well, so my morphine still isn't working much, if at all. I spent all day yesterday unable to leave my chair, even to use the restroom- my son had to help carry me to the toilet. (Quite embarrassing, I feel as if I've hit a new low!)

I'm taking the 15mg morphine sulfate twice a day, usually like 10 am and 10pm (ish), 50mg Ultram twice a day, usually around 11am and pm, and then 1000mg tylenol and 800mg ibuprofen every 4 hours, alternating by 2hrs between the tylenol and ibuprofen.
I usually sit on heating pads, which has been a help, but I've also tried this weekend to put the heat on my lower back, and then sit on an ice pack for awhile (until it melts) which has been some relief temporarily.

I called the doctor's office today, and they say to give the morphine until Thursday- a full week- and to take up to 1000mg tylenol 4x a day. When I explain that I already am, and the ibuprofen, they say 'We'll ask the doctor again and call you back". I would gladly go in to the office, return all of the meds he gave me and take a blood test or whatever to show that I have been taking everything as instructed so far and so they can see that I don't want to keep the morphine for some other purpose- but it is NOT WORKING!
And then it occurs to me, part of the reason he put me on morphine is because on hydrocodone, I was taking too much tylenol each day, but now they are advising me to take tylenol??? I'm sure this had to be a suggestion of the nurse speaking, rather than being relayed from the doctor himself...

I guess I didn't realize how much worse my pain could be. :(

How long does this garbage really take to begin working????

UPDATE--

The dr's office called me back, and I've officially been up-ed to 2 15mg tabs twice a day, but she told me to take a second pill now (4pm) and then take 2 at midnight (my reg. dosing time). My stomach is pretty upset already from all of the tylenol and ibuprofen, but hopefully (FINGERS CROSSED) this will ease the pain...

Thank you to all for the advice and support!

Hi 72daywmn,

Using these two together usually isn't recommended unless specifically instructed by your doctor. More likely than not, it's the ibuprofen that is causing the stomach upset. In any case, no more than 4000 mg of tylenol should be taken within a 24 hr period, and no more than 1000 mg within any 6 hr period (including any that is part of a combination drug like vicoden or percocet). If taken long-term (longer than 2 weeks) the daily maximum is 2600 mg within a 24 hr period. Be sure to check the strength of tylenol you're taking; regular is 325 mg, but extra-strength is 500 mg.

In any case, if taking that much tylenol on a regular basis, it is recommended that you start taking NAC (N-acetyl cysteine) on a regular basis, 750 mg twice a day for as long as you are taking those doses of tylenol, to prevent liver damage
http://yarchive.net/med/tylenol.html

If you develop any severe stomach cramping or rectal bleeding (sorry) discontinue the ibuprofen IMMEDIATELY (voice of experience) and call your doctor.

Doc

Yes, I was thinking that too, that is a lot of both Tylenol & IB to be taking...
unless your Dr suggested /ok'd it.

Yes, when I phoned the dr office this morning, the nurse called back and said that the doc had said to allow a full week (Until this Thurs) for the morphine to really work well, and to take up to 1000mg Tylenol up to 4x a day, and up to 800mg Ibuprofen up to 3x a day, but to alternate between the two every two hours instead of taking them both at the same time. When I explained that I was already doing that since I wasn't allowed to take anything else but the pain was unbearable, she said she's talk to the dr and get back with me.

Then awhile later she rang back to say the dr has changed my script, and I should now take two 15mg morphine every 12 hrs (so basically 30mg twice a day). I had taken my one dose of 15 mg at noon, and this was at 4pm when she called, so she said take another 15 mg then, and then at midnight when my regular 2nd dose would be scheduled, to go ahead and take two pills.

Within 2 hours after the 2nd morphine pill I felt great- little pain at all, but quite shaky and nauseated. After eating, my stomach is better, and it's now almost midnight, about time for my other dose, and I'm just starting to hurt again- about 6/10, which is still pretty mild for my regular pain.

I'm hoping that my stomach can tolerate the two pills together, because overall this dose seems to work for the pain, and I haven't felt a need for a breakthrough dose. So far, it's been the best I've felt in almost 3 years!

Nausea/upset stomach is a common side effect of morphine (and other opiates) but people have been known to tolerate some better than others. Taking with food should help. If not, and the side effects aren't workaroundable, don't despair - there are other long-acting opioids you doc could switch you to (but let that, and which one, be his decision).

Doc

Nausea from opiates does not come from the stomach. It comes from the nausea receptors in brain being over stimulated when pain receptors are full of drug and excess is floating around and move to the apomorphine sites.

Typically nausea will resolve once the pain receptors get used to the new dosage.

I did not know that - just passing along the conventional boilerplate wisdom:
From: http://www.drugs.com/cdi/morphine-su...e-tablets.html
Doc

Morphine doesn't irritate the stomach. Those things are written for the layman.

Morphine has an isomer called apomorphine. The receptors for that cause nausea/vomiting.

This article describes the area of the brain that the nausea receptors are located in.

http://docs.google.com/viewer?a=v&q=...do8bowR4rNZ1TQ

Re: low dose
 

Hi and I do know just a little about morphine. What you are on is a very very low dose. Hydrocodone would work better as you have discovered. Extreme neck issues, failed surgery and another C3-7. I was on 60's three times aday with hydrocodone for breakthrough. I had to sign the contract too. Now that you have, call him and tell him it is not working at all. He is under contract with you too, to help you. It is not your fault this low dose is not working, you can't be afraid of your dr. or not talk to him. The only way they can help is by telling them the truth, loudly if you have to. I didn't care a bit if my doctor saw me cry or mad. There are other doctors also. Sometimes it is a fight to get the relief you need. I am not intimidated by any doctor, they are just humans too. I wish you all the best, and I hope he will up your medication until you get that relief. MS contin, or morphine does work in the proper dose, and I had no symptoms at all from it. Now getting off it, is another story....it is definately one that is hard to withdraw from/ I now take 30's twice a day 8 months post surgery. I can increase, or decrease, my pain specialist gives both 30's and 15's so I can adjust accordingly. He had given me epidurals, and made sure I got the help I needed. Don't settle for less. Ginnie :hug: