(Thread from Diabetes) #: 720060 S16/Ask the Doc (CIS:DIABETES) 23-Apr-97 22:14:01 Sb: Neuropathy-Morphine Use Fm: Diane E. Hill/Mi 104667,2365 To: [F] All Replies: 4 TID: 102079 Par: 0 Chd: 720103 Sib: 0 My husband is a Type II diabetic. He suffers from Neuropathy with severe pain traveling down from the buttocks, both legs and feet. His feet are cold and numb. He is, by his own choice, a non-controlling diabetic. He does not follow a good diet, excerise, he stills smokes 1 1/2 to 2 packs a day, and to top it off he does not take his Glucaphage. He does religiously take his Vicodin DS for the pain. Last night on 20/20, he saw a program segment on pain control through the use of morphine. Now he wants to ask his dr. to prescribe this for him. I need some input on this type of procedure. Is it effective?? Will morphine create further problems down the road?? Will it cause additional heart problems? I have checked the library on this and only found one article. I appreciate any and all responses. Thank you, Diabetic Forum, for being there to aid and educate me. Thank you for your support. God Bless, Diane #: 720103 S16/Ask the Doc (CIS:DIABETES) 24-Apr-97 03:07:04 Sb: Neuropathy-Morphine Use Fm: ARTHUR I. DAW 102110,263 To: Diane E. Hill/Mi 104667,2365 (X) Replies: 1 TID: 102079 Par: 720060 Chd: 720712 Sib: 720106 Dear Diane, You just discribed me, five years ago. It sounds as if your hubby is trying to dodge the issue and hold out for a miracle cure. The cure for my smoking (5 packs a day) was on the table with the baloon running through different parts of my heart. The next day I reached for the pack I had with me and instead of looking for a place to light up, I threw them and the lighter away. (I didn't want to be in the position of offering someone else a light.) While I was In the hospital, I met an individual who had stitches and staples runnin up one leg, across his crotch and down the other leg, the result of some nifty bypass surgery. He was not in the mood to quit smoking or continuing with his treatment program. I reminded him that grand-children are more fun when you can run around with them instead of having them run away from you. I did not see him light up again while I was there. Your husband has to face some facts of life. He is not just living for himself. He has a wife (and family?). His smoking is probably having as bad an affect on those around him as it is having on himself. I think the single best treatment for the Type I,I is Exercise. He does noit need to run a marathon everyday. Start slow and work up to 30 minutes of steady walking each day. It wouldn't hurt for the whole family to join in. You may have to push him for the first steps and then continue pushing until it becomes a habit. But you must realise, Diabetes is a family disease. Everyone has to fight it. Take care and let me know how it goes. Art Daw #: 720712 S16/Ask the Doc (CIS:DIABETES) 27-Apr-97 08:39:16 Sb: Neuropathy-Morphine Use Fm: Diane E. Hill/Mi 104667,2365 To: ARTHUR I. DAW 102110,263 (X) Replies: 0 TID: 102079 Par: 720103 Chd: 0 Sib: 0 Arthur: Thank you for your thoughts. I'm glad you pulled through the by-pass and kicked the habit. Yes, I know exercise would help him. I've tried to get him to walk with me, to no success. Don't even bring up the stop smoking subject. Have you ever heard the expression "Things have to be his way or there'll be hell to pay"? Well, that about sums up my husband. Something very serious is going to happen to him one day, and I must be strong to deal with it. And the words "I told you so" must never leave my lips. I will keep you posted and let you know if he changes his ways. Thanks again and take care, Diane #: 720106 S16/Ask the Doc (CIS:DIABETES) 24-Apr-97 03:36:15 Sb: Neuropathy-Morphine Use Fm: Paula D.-SYSOP 73021,567 To: Diane E. Hill/Mi 104667,2365 (X) Replies: 1 TID: 102079 Par: 720060 Chd: 720715 Sib: 720495 Dear Diane, It seems awfully unlikely that a doctor would be very willing to prescribe morphine to your husband for so many reasons. Long before they would be willing to do that, I'd think they'd want him to go through a lot of evaluation perhaps at a pain clinic and likely some counseling, too. It's an awfully big decision to make, I think. There are some people who have been given Methadone therapy for management of their neuropathy pain, but they aren't all that many. Are you totally confident that his doctors have really looked at every possible thing that could be done and have the right diagnosis? Even being on Vicodin for a long time is not a great concept and, to me, a sign of questionable doctoring to be explored. But I am not a doctor, only a person who has lived with bad pain and excruciating pain for 15 years --and I don't take Vicodin. Do you think his doctors are spending enough time to really evaluate what his problems are, figure out ways to help him and thoroughly explain things to him? It's kind of worrisome that they might not be, considering how he doesn't seem to really understand/believe in the importance of dealing with his diabetes by using diet, exercise and the Glucophage. Especially if his circulation is poor, cutting back on his smoking seems an awfully important thing too. Is it possible that his doctors just haven't explained things well enough to him for him to treat his diabetes seriously? is he just so worn out from the pain he is in that he just doesn't have the oomph to care about his diabetes? is there a chance that he is clinically depressed? I am not sure there is ever a good way to say this, but it's almost impossible to go through a lot of pain and not have it affect our personalities and spirits. Whatever the cause of the pain, it eventually wears hard on us and, in truth, pain meds can have some less than wonderful effects, too. Pain doesn't have to change us for the worst, but it often does, especially if we don't make a big effort to prevent it. Of course, few of us ever see that, when we are the ones who are going through the changes, and we can be awfully resistant to hearing that message. Sometimes we are so fed up and exasperated that we hear most everything as a criticism, rather than as a loving suggestion to get more help. It sounds so much like your husband is having a tough time coping with all the things that that can be tough for anyone to cope with, let alone all at once. This has to be tough for you, too. I guess that is why I am wondering so much if his doctors are really 100% on top of his situation and helping him enough. I hope so much that there is something more that can be done, Paula #: 720715 S16/Ask the Doc (CIS:DIABETES) 27-Apr-97 08:50:16 Sb: Neuropathy-Morphine Use Fm: Diane E. Hill/Mi 104667,2365 To: Paula D.-SYSOP 73021,567 (X) Replies: 1 TID: 102079 Par: 720106 Chd: 720807 Sib: 0 Paula: Thanks for the reply. Personally, I think his doctor is a pill pushing quack. That's why I thought he would end up getting a prescription for morphine. You have a very good point on a complete evaluation at a pain clinic. My husband will not put himself into a situation where he may end up being told what to do (case in point, look at the treatment his own physician applies). For my own knowledge and peace of mind, I ask the questions and try to educate myself for two reasons: one-prepare myself for the worst possible scenario. Two - Continual reinforcement of I am not responsible for his decisions!!! Thank you again. Diane #: 720807 S16/Ask the Doc (CIS:DIABETES) 27-Apr-97 22:08:20 Sb: Neuropathy-Morphine Use Fm: Paula D.-SYSOP 73021,567 To: Diane E. Hill/Mi 104667,2365 Replies: 0 TID: 102079 Par: 720715 Chd: 0 Sib: 0 Dear Diane, I'm so glad you write here. There are quite a few of us who have diabetic family members who are not yet facing into their diabetes well and who understand a lot about how you must sometimes feel. I have diabetes myself and a lot of diabetic family members, too, some of whom are very resistant to treating their diabetes and one who hasn't seen a doctor in several years now. I have tried hard to understand what is behind it all and to think of how to help, but I think it has something to do with their feeling that going to the doctor somehow means giving up some kind of control to the doctor -- and they just won't see it otherwise. It's not just refusing to see the doctor or take care of their diabetes, though -- it seems like *no one* can tell them anything about anything and if anyone tries, they are being "unsupportive" or "critical" or "don't know what they're talking about" and can go to blazes! Sometimes, trying to talk to them feels like we have gone there, indeed! (g) Of course, running around with unchecked diabetes and high blood sugar levels makes a lot of folks exhausted and extremely irritable, which doesn't make it any easier to talk about these things with them. The pain your husband is in doesn't likely help things much, either, but then again, there's rarely a particularly convenient time to take on big changes in our approach to life and problems. I wondered too, as Dr. Chapin mentioned, about whether the buttock pain wasn't more related to sciatic nerve problems or whether a physical therapist skilled with sacroiliac and lumbar problems couldn't make some difference for him with muscle energy, work on the hip flexors, etc. and other techniques. (In other words, not just watching him do a bunch of situps, but actually working with him to mobilize his pelvic joints and strengthen some muscles that might not be much used at this point.) I know some people swear by them but I don't think much, personally, of chiropractors, but I do think the world of physical medicine specialists. If your husband could find a doctor specializing in Physical Medicine and rehabilitation, he'd be seeing a doctor well-trained in nerve, bone, circulation, muscle and movement problems -- and most likely to be able to diagnose the problem and find some ways to help. The pain alone must be wearying and, being stressful, make his diabetes management a bit harder and the inability to walk well and long takes a bad toll on the circulation in our legs, particularly if we smoke. It seems like if he could get some help with this problem, it might go a long way to making his daily living a lot more pleasant and help combat the toll that diabetes can take on us. In any event, I hope you'll keep writing and know that lots of us know how frustrating and frightening it is to see someone we care about struggle and evade taking care of themselves very well. Our love keeps us trying to help, but, as you say, we can't be responsible for what those we love choose to do. Wishing you strength, Paula #: 720495 S16/Ask the Doc (CIS:DIABETES) 26-Apr-97 05:08:23 Sb: Neuropathy-Morphine Use Fm: Barrett Chapin, MD 104156,2006 To: Diane E. Hill/Mi 104667,2365 (X) Replies: 1 TID: 102079 Par: 720060 Chd: 720717 Sib: 720902 >> My husband is a Type II diabetic. He suffers from Neuropathy with severe pain traveling down from the buttocks, both legs and feet. His feet are cold and numb. << Pardon me if I but in. First of all, I realy liked what Paula D. said about using narcotics for this type of problem, and I second that. And I thought it was great read Arthur Daw's experience of someone who's been there. I would have remained silent except that part about "severe pain traveling down from his buttocks, both legs, and feet" doesn't sound like neuropathy pain to me. It sounds like your husbands problem MAY be Sciatica, which usually comes from compression of a nerve in your back. I would recommend he see a neurologist before going to see a pain specialist. -Barry #: 720717 S16/Ask the Doc (CIS:DIABETES) 27-Apr-97 09:19:16 Sb: Neuropathy-Morphine Use Fm: Diane E. Hill/Mi 104667,2365 To: Barrett Chapin, MD 104156,2006 Replies: 0 TID: 102079 Par: 720495 Chd: 0 Sib: 0 Barry: Thanks for the reply and a new possible solution to the problem. My husband had a motorcycle accident close to forty year ago. Dirt bike race, he fell, two other cyclists rode over the lower part of his back. He's always had back pain. Sees a chiropractor about 3-4 times a year (says he can not afford to go more - in truth does not want to go). About 10 years ago, through a check-up, his blood sugar was close to 300 and his trigylcerides were over 1200. Nothing much was done. He took a few pills for a short period of time. I went with him to a nutritionist to learn how to prepare food more healthfully, he responded with "I make a good living and no one is going to tell me how to eat!!" and walked out. That was the beginning of my change in attitude. I am NOT responsible for his decisions but I will educate myself for the future ( the day he strokes out or dies). About six years ago, the impotence set in. You'll like this, it was my fault - I'm not attractive anymore, to heavy (I gained 40 pounds), etc. At this time, I also found out he did not have life insurance - doesn't believe in it- yet he told me he had it. (just so you know he's 59 now and I'm 43) Anyway, I tried to get a policy on him and through the physical he was diagnosed as a diabetic. Goodbye potential policy!! Looking back over our history together, I feel he's been a diabetic for close to 15-16 years. Leg pains - 6 years ago - same time as impotency. Nothing was done for three years. He went to a urologist who sent him to a neurologist. Several tests were done, no dyes were injected, (my husband refuses all tests that require that), something with electrodes was done. Everything came back normal and clear. The urologist recommended several treatments - you already know this answer - my husband rejected them. I know this is extemely lenghty and I apologize for unloading on you. I do appreciate everyones time and concern from this forum. You all provide such a great service to so many that want and need the help. I feel guilty for troubling you and Paula over matters about a diabetic who refuses to ACCEPT his disease and the treatments available for him . Thank you again, Diane #: 720902 S16/Ask the Doc (CIS:DIABETES) 28-Apr-97 03:34:23 Sb: Neuropathy-Morphine Use Fm: Kay Allen 104110,1716 To: Diane E. Hill/Mi 104667,2365 Replies: 0 TID: 102079 Par: 720060 Chd: 0 Sib: 0 Hello Diane, If you live in the U.S. your husband probably won't get Morphine from a regular Dr. The drug is highly regulated by the government. He would have to go to a pain center. And they will offer many solutions. My Mother was on Morphine for Neuropathy some years ago. It came on acute and sudden. But it didn't travel, that sounds more like a back- nerve problem. But I don't know I'm not a Doctor. But I do know a pain center will treat back problems too. She did extremely well on Morphine. She was so much her old self after going on the Morphine. I was never big on pain medicine before but the change was so dramatic I became a believer. It change her from someone with no quality to her life, to someone who wanted something from her life. She had heart problems and they warned her about the medicine slowing her heart. She never had a problem. But it's something you should discuss with the doctor. I hope this helps, if you want to ask me any more questions feel free. I hope everything goes well for you and your husband. Take good care, Kay