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Opioids I got a Feeding tube for meds.....

s10onn2o

s10onn2o

Greenlighter
Joined
Nov 5, 2010
Messages
8
Location
South East Texas
Hey guys i have been coming here the past few months, i have chronic pancreatitis and been put in the hospital over 25 times in the past year for it almost dieing twice. Well i have been on dilaudid IV and pills 8mgs the whole time. The docs have put a feeding tube in to see if i can ease the pain by putting it though to the intestint it works great the one promblam is now im out of dilaudid and the docs want me to goto a pain manament doc and thats a pain in the ass to find one im having some f-up with draws i have some tramadol 50mg hcl will that help i just dont know how much to take cause when i inject meds in the tube its like haning a IV and I dont want to overdo it i just want some relief till i'll get into the doc cause these with draws are killing me please help.
 
I don't know much about this, does taking the dilaudid this way bypass first pass metabolism? If so, estimating your doses will be difficult (and you have yet to tell us how much you're using exactly).

Tramadol is unique so its more difficult to precisely convert doses than with typical opioids. Its generally agreed that 100mg tramadol is equianalgesic (provides equal pain relief) to about 25mg of oral morphine which is equivalent to 6.25mg of ORAL dilaudid but if your method of ingestion bypasses first pass metabolism, 100mg of tramadol will be equivalent to more like 1-2mg of dilaudid.

The dosing guidelines by the FDA only allow 400mg of tramadol to be consumed daily because it lowers the seizure threshold.
 
Yea i really have no idea if it does bypass metabolism, if this helps the tube is also for feeding that also goes into the intestint to bypass my pancress when i do have a atack. On a normal day with low pain i take about 4 to 6 dilaudid on a bad day alot of pain i take 6- 8. Also i have 100 mg mylan fentanl patches and about 8 vicdon 10-325 im not looking to get high just pain relief and somthing to take the withdraw down a notch to get though the weekend thks for the reply and help.
 
Here are some basics on first pass metabolism. I would estimate the bioavailability of the way you're taking it to be similar to the plugging route (intrarectal), which is about 150% as strong as orally... so my best ESTIMATE is about 4mg of dilaudid the way you are taking it would equal 100mg of oral tramadol... the oral and plugged doses of tramadol are nearly the same.

Here is a link to a narcotic converter so you can figure all this out on your own for the different drugs you have, note that vicodin is a brand name for hydrocodone (and the preparation you have is norco or a generic equivalent anyway).

Here is a link to another converter that is solely for fentanyl patch conversion.

You should probably consult your physician about how much stronger the dilaudid is via the route you're taking to be sure. I would guess that its about 1.5x as strong so if you are using the other medications via a different route (such as transdermal fent) you may want to adjust your dilaudid dose up in the converter above so its about 1.5x higher.

With your tolerance, I'm not too worried about you overdoing it, also since you aren't trying to get high. You can even do this without all the precise conversions... just start small and work your way up until you find what you need.
 
K thank you for the help i just took two of the tramadol about 5 min ago well see if it helps out, yea my tolerance is pretty high thanks to all the pain meds they have been feeding me in the past year im surprise my liver is still alive, so im like you not to worried about overdoseing just wanting to get these withdraws down i have never been though this before my god is it ruff but...... thks agian for the help.
 
^no problem, that's why this site is here!

The opioids you've been taking aren't damaging to the liver, if you were taking tons of the norco/vicodin then the acetaminophen would be damaging but drugs like dilaudid, fentanyl, etc. are not hepatotoxic.

There are lots of pain patients on doses higher than your for literally decades and their livers are fine.
 
Good advice cane... Positive energy off this post... Good Luck with your situation Mr. Texas :) Hope all works out for you in the future.... Suboxone does work really well for pain relief and for a very long time imo... and.. also lowers your tolerance quite rapidly after a few days on it..... 8)
 
^thanks man, I appreciate that.

If pain management is something that the OP is going to require for a long time, suboxone is something to consider but as long as he isn't abusing his medications (idk if he does or not) he could alright with full agonists.

I think a lot of people on BL overestimate how many PM patients abuse their medication because its so common around here. I'm hooked into the US chronic pain community and its pretty rare... you see more people feigning or malingering to score drugs than actual patients who need medicine who are addicts.

Very few people without drug abuse/addiction history prior to their treatment become addicts when treated for pain but those stories always stick out so the image of the poor housewife who broke her leg and turned into a junkie stand out.
 
^Great thoughts there, Ksa. It can be really, really easy getting caught up in the PM process, trust me. It never ends up being a fun, rewarding plight unfortunately.

Seeing a specialist and improving your overall health will probably reduce your need for PM long-term; I agree fully with this. OP - good luck man. 25 hospitalizations in one year is remarkable. Stay with us, and best wishes for your recovery.

~ vaya
 
Wow ill really like the support here i am addicted to a point i would say for the reason of me running out of my main pain med. and really on the point of flipping out. cause im not going to lye this is really ruff, I'm on a real strict diet as far as low to no fat to help with the pain but theres some days the pancress just wants to say hey i want to hurt you today.......it really does sux for me trying to get into a pain doc. every doc or (clinic) i goto they dont take inscurence people call them scrip docs i think i have no idea but i was looking into all the meds i was taking to see how bad or good they were and found this site and i must say yall really make things alot easyer. I'll also post different stuff i come across incase someone in the future ends up like me with a tube and has no idea what to do...........
 
s10onn2o said:
K thank you for the help i just took two of the tramadol about 5 min ago well see if it helps out, yea my tolerance is pretty high thanks to all the pain meds they have been feeding me in the past year im surprise my liver is still alive, so im like you not to worried about overdoseing just wanting to get these withdraws down i have never been though this before my god is it ruff but...... thks agian for the help.
Click to expand...

tylenol (acetaminophen) is bad for your liver, not opiates (dilaudid, etc). your liver shouldn't have much, if any, damage. also, don't shoot tramadol -.-'
 
I forget where, but i've seen a report that stated sugar causes more damage to the body then heroin, opiates don't really cause direct "damage".

If you are using a tube into your intestine, wouldn't that be the same as plugging? I would assume that it has the same bioavilablility as plugging, and both would bypass first pass metabolism
 
Hey guys whats up im back I got on some good dilaudid 8mgs 4 times a day and 100 mcg/h fentanyl patches with the gel. witch is real nice not just for pain but wow lol ;) so i havn't had a patch on in about 4 or 5 days and I only have about 5 pills left tell thursday till my next refill. Me and my wife are going out to a party at a friends house and well i cant drink cause of my damn pancress and i would like to get a nice feel good i have a old patch from 4 or 5 days ago with a little gel in it i have done a little searching on this and guys ill a little nervous about putting a little gell on my gums what yall think just use a pill or two, i would put a patch on but it take a while and i dont wont to put one one and put gel in my mouth and well od. any input would help thks.
 
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