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Re: death » Elizabeth

Posted by cmcdougall on April 27, 2002, at 13:13:47

In reply to death » cmcdougall, posted by Elizabeth on April 26, 2002, at 19:20:11

> > I graduated from college in 1977. What a wonderful time to grow up!
>
> I dunno, some of the styles of dress left much to be desired.... :-}

Hey, I still dress like that! ;-)

> There are a lot of people out there who are like that (addicts who have good jobs, education, money, etc.). You never hear about them because they have the resources to get their drugs without having to resort to dealing, stealing, etc.; and they only interact with the "drug scene" as buyers. They don't have to spend all their time or money getting drugs. Their lives lack the chaos often seen in the life of addicts who don't have the advantages they have. They provide a picture of what addicts' lives would be like if drugs were affordable and easy to get; and they cast doubt over the assumption that the chaotic lifestyle of many addicts is caused by the drugs themselves.
>

I agree 100%

> > Near the end of her life, she was receiving about 4ccs [of morphine] every 15 minutes.
>
> Umm...what was the concentration (how many mg in a cc)? Was it a continuous drip, or did she get discrete injections once every 15 minutes? (People can take surprisingly large amounts of medication on an IV drip. I'm told that at one point when I was in the hospital last February, they had me on 120 mg/day of Ativan.)
>
I don't have a clue what the concentration of morphine was... The hospital pharmacy delivered it to the house - at first they brought 1cc glass ampules. When we started using so much, they brought little bottles containing 10cc each. She had a porta-cath (tiny little catheter inserted into a vein and going all the way into her heart - originally used to deliver her chemo) in her arm and I slowly injected the morphine directly into it.

> > Eventually, the morphine quit working and we augmented w/ Valium.
>
> My god. They didn't even try giving her fentanyl or anything? Every opioid has a limited effect size -- eventually, after you've become tolerant to very high doses, it will plateau and it won't do anything more no matter how much you increase the dose. (Buprenorphine, a "partial" agonist, plateaus at a much lower effect size.) At that point you need to find a stronger drug.
>

Nothing else was ever offered - at the time, I didn't know very much about meds. I felt the docs were doing everything they could. They were soooo generous w/ the morhpine.

> > After 6 days, Pop slowly went into respiratory failure (from the cancer that had invaded his nervous system) and died peacefully.
>
> How long was your sister on the morphine?

She started it on a Thursday afternoon and died the next Wednesday morning. So, 5 1/2 days.

>If your father-in-law didn't become even a little bit tolerant to the diamorphine, that suggests that he was in relatively less pain than she was, and I'm also guessing that he wasn't on it very long. Still, I have little doubt that if it had been available, diamorphine would have been of help to your sister.
>

Thank you for your response and kind words. I always enjoy reading your posts and learn a lot from them.

Love and luck,
Carly


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