My husband was a PD patient for 2 years and was having many problems so he switched to in clinic HD. He has been on HD now for several months. He had terrible bone pain while on PD and it has become much better but it is still a problem. The doctors say it will take several more months for the pain to subside. None of the pain medication seems to work. He is only 58 but sometimes looks like he is 90 getting out of the chair or walking around. It is taking a toll on him mentally. He has tried dilaudid and percocet without much success. Can popele share with us what gave them the best pain relief. Thanks for your help.
It was terribly high, in the mid 400 range on PD, but it is now about 120. It has come down dramatically and the pain has subsided by about 60% but he is still in quite a lot of pain, particularly later in the day. He cannot excercise in the slightest. Even getting in and out of the chair is still difficult.
Some days he has hardly any pain at all. No one seems to be able to explain this and I have read that this is not uncommon. However, those days are few and far between.
I’m so sorry to hear that your husband is having problems with bone pain. Since I’m out of town at a meeting, I haven’t had a chance to do the kind of literature search that would be really helpful, but in the meantime:
– Has your husband gotten a referral to a pain clinic? They tend to be up on the latest options for pain management, not all of which necessarily involve drugs. Sometimes things like hot baths, heating pads, ice (or alternating heat & ice), massage, TENS units, etc. can be helpful. (Please ask a doctor before trying any of this at home).
– In some cases, antidepressants (possibly also with pain meds) can help relieve pain. No-one is quite sure why this works, but it can help.
– It might be worth asking about physical therapy–it’s possible that some of the pain is related not just to his bones, but also to muscles and/or joints that he’s using less because of the pain. In that case, there are other pain management options (like iontopheresis, which delivers pain meds through the skin using electrical current), and exercises may help relieve his pain. Since his pain comes and goes, this seems like it might be a possibility.
Is 400 the highest his pth has been? What is the lowest it has been? Going too far in either direction can cause problems. 400 isn’t necessarily high- it depends on what his ratio is. Does your nephro doc use Scantibodies labs? If not, go to their website to learn about a ratio that is used to more accurately measure pth. Without using this ratio, one may have an inaccurate value for pth and have bone turnover problems ( high or low-adynamic bone disease). Dosing with vitamin D analog ( i.e. Zemplar, Hectorol) may therefor be incorrect if the pth value is incorrect. It is a fine balance and must be monitored/measured carefully.
My husband was a PD patient for 2 years and was having many problems so he switched to in clinic HD. He has been on HD now for several months. He had terrible bone pain while on PD and it has become much better but it is still a problem. The doctors say it will take several more months for the pain to subside. None of the pain medication seems to work. He is only 58 but sometimes looks like he is 90 getting out of the chair or walking around. It is taking a toll on him mentally. He has tried dilaudid and percocet without much success. Can popele share with us what gave them the best pain relief. Thanks for your help.[/quote]
[B]No doubt about it, but the most common problem due to bone pain on dialysis is the Parathytoid glands not working right. That was a problem for me, bad bone pain. Sometimes medications really does not do its justice so we turn to surgery. For me surgery did help. Try consulting with your Dr. and talk about the options you have with him/her.