Re: Excessive Daytime Sleepiness / 's sister

December 30, 2002

In a message dated 12/31/2002 4:48:42 AM US Eastern Standard Time,

ryndle@... writes:

> >>>...my sister still suffers from Pancreatitis, but has been able to return

> to work part time. ..her new primary care doctor believes that ... an

> autoimmune disorder that is causing her Pancreatitis. .. a friend of mine

> who has serious health problems .. on 200 MCG of Fentanyl Duragesic Patches

> and takes ACTIQ .. My friend is also on several other medications which

> have a drowsiness side effect. ... falls asleep cooking, sitting down in

> the bathroom, smoking, etc. I really am uncomfortable with this, and I have

> tried talking to her about it. ... do any of you have the problem of

> falling asleep standing up from pain meds no matter what... my friend is

> afraid of telling her dr about this because they will take her pain meds

> away.<<<

Excessive daytime sleepiness is a diagnosis often given to persons with

Chronic Pain who require narcotics and other meds that cause drowsiness to

manage their pain. There are two schools of thought on this. She needs to

decide where she stands, then find a doctor who supports that philosophy.

One belief is that you have to do what you have to do to take care of the

pain, then deal with the consequences, which could not be worse than the

pain. One being excessive daytime sleepiness. Many doctors prescribe

Provigel, a cognitive enhancer and / or a low dose of some form of

amphetamine to keep the patient functioning. This philosophy says that if

they back off on the narcotics the patient will not be able to function

anyway because they are in too much pain.

Another philosophy is that if a patient is falling asleep while they are

cooking and performing ADL's then the patient is over medicated. The doctor

is not going to give them narcotics and then give them amphetamines to keep

them awake. The doctor will back off on the narcotics until the patient is

able to remain awake to participate in her ADLs. This philosophy says that it

is maybe necessary to hurt to stay awake.

It is an individual decision. Whatever the decision it should be understood

that drug dependence is not the same as drug addiction or drug abuse.

Good to hear from you,

Happy Holidays,

Karyn

Karyn E. , RN

Founder / Executive Director

Pancreatitis Association International

Corp. Office: Indps, IN, USA 1-

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