Question for DR Shawn

    • Anonymous
      September 9, 2007 at 6:27 pm

      Your mail box is full so I send you a question via a post.

      Hi Dr. Shawn. I have a question.
      Is there any pain medication for people who have Diabetic Neuropathy pain but who have renal problems?

      My Dad is a diabetic and has had a stroke and heart problems and kidney problems and blood pressure problems and he is in a wheelchair. The nerve pain in his right foot is so bad and and that is the side that is paralyzed. He can move his right leg some for regular exercises but he doesn’t walk yet and he can’t feel his foot touching the floor when trying to walk. But the nerve pain is really bad and he doesn’t complain unless his pain is through the roof. He is allergic to morphine. Also Tylenol 3’s don’t do a thing for him pain wise I assume because it doesn’t help nerve pain.

      Any suggestion?

      Thanks again

      Sue Watters1

    • Anonymous
      September 10, 2007 at 4:54 am

      Sue, I just erased all my messages so my mail is now clear. Sorry-didn’t know I had to erase as I went. We use Neurontin, Lyrica, Elavil, and Cymbalta for diabetic neuropathy. I will have to check today at work to see which are safe with renal insuficiency. Off the top I think they all ok but I want to check 1st. Elavil is contraindicated with heart disease. Cymbalta is not recommended with active liver disease. Narcotics can be used also. There are plenty of choice that are not related to codeine. Also, I found when the patients have tight diabetes control they sometimes see an improvent in neuropathy also. Dr. Shawn

    • Anonymous
      September 10, 2007 at 5:00 am

      Just saw the morphine allergy. Not related- hydrocodone(vicodin), oxycodone, propoxyphene(darvocet), and demoral. There is some reallly excellant long acting narcotics such as oxycodone CR, oxycontin. Darvocet is milder. He can not take tramadol(ultram) since it is a codiene relative. Dr. Shawn(sorry so delayed worked all weekend)

    • Anonymous
      September 10, 2007 at 7:14 am

      Thanks DR Shawn just this summer again his kidney were not functioning very well again we thought he would have to go on dialysis but then he bounce back they are working better. But my mom has to watch everything food she gives him. He is very sensitive to medication. He is 76 years old.

      Thanks again
      Also try not to work to hard

      Sue

    • fairly_odd_mother
      September 10, 2007 at 2:32 pm

      not to change the subject but I have a question…

      if a person is allergic to codiene, is it wise to give them morphine or dilaudid? Just a personal curiosity that has been bugging me. The dr’s said the morphine was okay although I thought it was too closely related. And what about the other?

      Thanks Dr. Shawn.

      Prayers for sue’s dad

    • Anonymous
      September 10, 2007 at 9:07 pm

      Morphine and diladid are in different “families” from codeine so usually if it is a true allergy to codeine and not a general side effect to narcotics (ie sedation, hallucinations, confusion, nausea) then a person allergic to codeine can take narcotics in different “families”. Dr. Shawn

    • Anonymous
      September 10, 2007 at 9:08 pm

      Forgot to look up renal safety today. Will check tomorrow. Dr. Shawn

    • fairly_odd_mother
      September 10, 2007 at 11:12 pm

      okay…my mom was highly allergic to codeine and when she passed away they had given her high doses of morphine for pain and when that didnt work they gave her dilaudid. For some reason we found out later from a medication card she had tucked away that it had written on it NO DILAUDID. I had no idea and of course didnt think twice about asking since I made it quite clear to the nurse about her codeine allergy (she would develop breathing problems etc and almost died from it once before…which is how they found out about her allergy to it). On top of the dilaudid they gave her IV ativan. She died during an MRI. I guess I just wanted closure instead of all the unanswered questions that her doctors tiptoed around or gave general answers to. Thanks again, Dr. Shawn.