Pain and Constipation

Friends,

Newton’s 3rd law generally states that for every action there is a reaction. This can be applied to pharmacological medicine. It’s amazing how most pills you take have side effects that cause you to take another pill to counteract those side effects. That was the case for me recently.


About 6 weeks ago, I began having pain in my lower left flank (towards the bottom of my rib cage) and more severe pain in my left shoulder. The pain in my shoulder and flank would come and go, at first, but be pretty severe when it came. It got so bad; I went to see the doctor to determine the cause of the pain and find something that would make me feel more comfortable when the pain flared up.


After looking at my past CT scans, the doctors were pretty sure my pain was being caused by pleuritis. Pleuritis is an inflammation of covering that protects and cushions the lungs. I have a small tumor (about 2.5cm in diameter) at the outer edges of my lower left lung which could have moved just enough to rub against the pleura, causing the inflammation. The pain I was feeling in my shoulder is known as transferal pain, meaning the nerves in my shoulder were receiving the same pain response as the nerves in pleural area.


There are a few ways to address this issue. One is to treat it with narcotics. The other is to use surgery or radiation to kill/remove the tumor, thus eliminating the pain. If we can simply eliminate tumors like this one, why can’t we do that for all of them was my question. The answer is that not all of my tumors are that accessible and even if they were, doctors are apprehensive to use that approach because the cancer has spread outside of its originating area in the body, it’s not seen as a way to prolong life. With the options of radiation and surgery for this tumor always there, I decided to try narcotics and see if I couldn’t shrink the tumor with effective chemotherapy.


They initially prescribed anti-inflammatory medication (similar to Advil). This did the trick in the short term and left me pain free for a while. A couple weeks later, the pain came back with a vengeance. To the point, where it hurt to breath, cough, sneeze, or walk upright….ugh! This time anti-inflammatory medication failed to curb the pain. They then prescribed oxycodone as option #1 and dilaudid as option #2. These are some pretty powerful narcotics and worked to ease the pain but left me loopy. The thing the doctors failed to mention and account for in my regiment of pills is that narcotics can cause serious constipation.


And I can certainly attest to that! I did not go #2 for days and began to feel more and more bloated and sore in my abdomen area. I went to RiteAid and purchased some stool softener to help, but that didn’t unplug things. A few phone calls with the doctor later, I’m in the process of receiving my first enema (not an experience I was dying to check off my list!) and picking up some heavy laxatives and milk of magnesia. A small tirade about milk of magnesia. That stuff is disgusting, tastes like chalk and is just generally no good. I took one dose and promptly vomited it back up in the middle of the night. I was miserable by this point and exhausted from the narcotics and “pushing” bouts on the porcelain throne. The doctors were very sympathetic about not planning for this known side effect. After the enema and the laxatives had time to work their magic, I finally had relief…..and what a relief it was!


I am now on slow release oxycodone that I take every 12 hours and once a day laxatives that keep me regular, and am hoping the new chemo regimen helps in shrinking the bothersome tumor. More on that in the next post……

Rhone