Morphine. Introduction

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2 Morphine Introduction Doctor..has ordered morphine, for the relief of the pain that you have that other pain relief does not seem to help with easing that pain for you. In this booklet we have answered the questions that people like you will ask when they first go on Morphine and other pain relief tablets. The reason that we use Morphine as a pain relief is not as a last resort, but to keep you the patient as pain free, so that you can live as comfortable as you like in your own home and to continue living the life that you are used to. We feel that it is very important that when you have cancer that you should not have to suffer with any sort of pain. Oral Morphine is recognised around the world as one of the best ways to relieving cancer patients of any pain that they will get.

3 What is Morphine? It is medicine to help ease the pain, when panadol and panadeine can t ease the pain for you anymore. Where does Morphine come from? Morphine comes from a natural plant called the poppy plant. Does this mean I will die soon? No! We use Morphine to help stop the pain that you feel when other pain relief does not work. It helps you so that you can move more easily than what you were able to do before. Sometimes Doctor will use other medicines with the Morphine to help with any other pain or illness, (as if you were to vomit). Will I be sleepy and tired when I take Morphine? For the first few days you will be because you may need to catch up on sleep that you didn t have while you were in pain. If on the correct amount of Morphine you shouldn t be tired after the first few days, but if you are still tired and sleepy let Doctor or one of the team members know straight away. By letting Doctor know if you are still sleepy and tired after the first few days she/he can put you on the correct amount that you need to be on. Will I become dependent on Morphine? You can not become dependant on Morphine as we use it to control the pain that your cancer has caused you. The only way to become dependant on Morphine is if you have used drugs before to get high. Can I still drive while taking Morphine? When you take Morphine it slows down your reflexes, so it is best that you don t drive or handle machinery. Often you will be a little tired too or not as fast with your thinking as you were before to be able to drive. Can I take other tablets when I take Morphine? Some tablets and alcohol can cause or increase your chances to feel very sleepy. Let Doctor..know all the tablets that you are on. Doctor will tell you which tablets to keep on taking. Will Morphine affect my bowels? Doctor will give you laxatives as a daily tablet to stop you from getting constipated. If you do get constipated let Doctor.. know straight away. Will it make me vomit or crook in the stomach? If you start to feel sick in the stomach or like you are going to vomit, Doctor can give you tablets to help stop you feeling this way.

4 Will I get forgetful or misplace things when I take Morphine? If you start to forget where you put your things or can t remember what you were going to do this means that Doctor. needs to see you so that she/he can put you on a lower dose of Morphine. Will I be having too much Morphine? Each person is different and will need to take different amounts of Morphine. This is where Doctor has seen the amount of pain that you have had and seen what pain relief you have taken. Doctor then works out the amount of Morphine that you need. What happens when my pain returns? If your pain returns you need to see Doctor straight away so that she/he can increase your Morphine. Do not take any extra tablets without seeing and talking to Doctor first. If I whinge too much about pain am I a pest? Doctor is happy for you to tell her/him if you have got extra pain anywhere else from where you had the first pain. This helps Doctor to know where you are getting pain and how she/he can treat that pain that you are getting. Nobody else knows that pain best than what you do.

5 MS Contin Introduction MS Contin is medication ordered for you by Doctor MS Contin is another type of Morphine that when it is used it slowly releases into the body. MS Contin only needs to be taken once every 12 hours letting you have better pain control and being able to sleep through the night without having to be disturbed. MS Contin comes in both tablet and liquid forms. MS Contin tablets How come they are different? Q Why are they so small? A They are smaller so that they are easier for you to swallow. Q If they are too strong or not strong enough can they be changed? A If Doctor needs to change the amount of MS Contin that you need to take they come in different doses that easily lets Doctor do that. Q Why do they come in different colours? A They come in 6 different colours as this shows that they each have their own dose from the other.

6 Having extra pain before your next due to have your MS Contin? Let Doctor know straight away when you re on MS Contin tablets or suspension so they can increase your doses to stop you from getting that extra pain. Often Doctor will give you an immediate release Morphine preparation: to stop that pain until you are on the right dose. MS Contin Suspension When given MS Contin Suspension you place the packet into 10mls or 2 teaspoons of water and take it straight away. Ms Contin Suspension also comes in two different doses 20mg and 30mg. Ms Contin Suspension is to be kept away in a cool but dry place where there is now moisture.

7 Important issues to remember when taking MS Contin Do not chew, crush or break your tablets as this will break the long acting medicine in the tablet that keeps the pain at ease for 12 hours. Always swallow the tablets whole. Keep MS Contin tablets and packets in a safe place and out of reach of children and visitors. Nobody else but yourself is allowed to take MS Contin. If Doctor has changed your dose of tablets remember to write this down so that you know the correct amount that you should be taking. If you are taking it all the time, it probably means you need more MS Contin and you will need to see Doctor Sometimes Doctor has ordered an extra dose called short-acting Morphine: This is also called breakthrough dose: This can only be taken when Doctor has ordered this for when you have been getting extra pain when doing little chores. If you are taking it all the time, it probably means you need more MS Contin and you will need to see Doctor When are the times that I should take MS Contin? MS Contin should be taken when Doctor has ordered them for you to take. As MS Contin needs to be taken every 12 hours. It would be easier for you to take them when you wake up at between 7 or 8 in the morning and then at 7 or 8 at night. Can t I just take it when I feel that I need to? No! For the best results of MS Contin it is best to take them when Doctor has ordered you to take them. To take them at the times that you are supposed to, it will ease the pain otherwise it will get worse. If you don t take MS Contin at the regular times you will find that you will not get any pain relief at all.

8 Thanks to my uncle and cousin Harry and Shannon Gertz for the artwork that they have done in this booklet. Without their artwork the booklet would have been plain and dull. Hope this booklet will bring better understanding for our indigenous population. Helen Burns, Aboriginal Palliative Care Liaison Officer, Mount Isa District Palliative Care Team

9 Compiled by Mount Isa District Palliative Care Service C/- Mount Isa Base Hospital Mount Isa Qld 4825 Telephone Gregory Terrace, Fortitude Valley Qld 4006 Telephone Facsimile Cancer Helpline toll free CSSQ /08