Is there natural pain relief for end-stage congestive heart failure?

Groaker, this is an old post, but you raise some interesting points.

I haven't done any studies or research on why people refuse pain relieving drugs. So I don't know whether it's because of fear, or like me, impurities and lack of quality control in manufacture of ingredients for the end results of pills. Or, just not being reliant on drugs at all.

After reading about the filthy conditions in certain emerging market countries, and seeing photos in a congressional hearing of specific manufacturing plants in one of those countries, I was even more determined to screen whatever medications we take and buy only from pharmas in industrialized countries.

I eventually found a good pharmacy which buys quality medications.

However, I still would prefer to use natural substances that are proven, such as those used by Native Americans.

It's not a fear of becoming addicted though. I'd rather use meds sparingly, period.

I have congestive heart failure, and have been (and am on, home hospice .) I was a biochemist in Public Health for thirty five years. I am literally shocked by the fear of pain relieving drugs. Many believe that the single use of morphine and other analgesics will turn the patient into a ravening addict, a criminal, or a mental vegetable.

I take the meds as needed, and have done so for nearly a year. They very much allow me to function as I did before the disease became pronounced.

I have a strong interest in the application of computer science to medication and their impact on disease and patients. I spend most of my day working on these problems (for free) with colleagues from the past. I am not a paid consultant, but receive my remuneration by knowing that I can still be of help to the sick and dying. To be able to help others. I can only do this through the relief from pain that is afforded me through meds.

I become angry that some caregivers refuse utile medications for their charges, when they could be relieved from a great deal of pain and suffering in their months last on earth. In today's political climate, patients are far more likely to suffer from under medication rather than over medication. Not only does proper dosing reduce the suffering, and improves the patients quality of life, but improves many of the ancillary symptoms as well as the lucidity and clarity of thought.

One of the most interesting observations that demonstrates the truth of the above assertions is that patients who have control of their own pain meds, use less, and report less pain, than patients whose pain meds are controlled by a third party.

Have you considered CBD (cannabis) oil for pain relief? Oils and edibles are blended for different uses, with different levels of compounds for different needs. With the work that has been done to understand the benefits of the compounds of this plant, people no longer have to fear "being stoned" and many older people are successfully using cannabis products for pain relief.

Elizabeth: See my first post.

Nope. Nothing that works as well as far as I'm concerned.

Thank you for all these answers since my last post. Assandache, I don't know what you mean by "desperate hope". I'm fully aware she's dying and I'm not desperate for anything except information about other pain medications beside morphine. Nobody is trying to save her - she doesn't want to be saved. She wants to be in Heaven with the rest of our family. Who wouldn't, right? So we're jus trying to make sure that her path is as free as possible from stones - making her comfortable is our only goal.

Imo it's all desperate hope at this stage of the game...

I wasn't going to respond after Elizabeth wrote the first time that she wouldn't be following or posting on the thread.

But the answer is that there are herbs which lessen or mitigate some pain. Salmon oil has helped me with knee pain. I have a great muscle salve with a variety of non prescription substances that is the most effective thing I've used for pain. But it's for muscles aches.

However #1, these are minor pains compared to more serious medical conditions.

However #2, and this is the clincher, since I'm not a certified herbalist, a naturopathic or homeopathic practitioner, I wouldn't consider suggesting anything.

Any qualified practitioner would obviously need to meet with a potential patient and take a detailed history so that if anything was prescribed, it wouldn't interact or counteract with any other meds.

And some of the herbs in question might be sourced from countries that don't have a reputation for purity of products. That might be worse than no pain relief at all.

We often tend to think of medicine as a first choice, but there are hundreds of years of history during which Native peoples and herbalists and perhaps even some medical practitioners didn't have access to the volume and sophistication of meds these days. And some meds are in fact from natural sources.

It is the nature of threads to take on a life of their own, and since they are never closed they can draw responses far beyond any usefulness to the original poster. Once you have taken what you want from the answers you can choose to Stop Following a thread.
And yes, some people obviously post without reading anything beyond the first question or checking the date, that is why we get so many seemingly irrelevant answers and posts resurrected from years ago.

As far as I'm aware there isn't a better equivalent. And I would be extremely sceptical about anything claiming to be. Well, when I say sceptical - I mean I wouldn't touch it with a stick.

But I fully agree with your aunt and you that she shouldn't take morphine unless she herself feels she needs it (she shouldn't be afraid to take it, though, either - perhaps check that she hasn't been scared off it through misinformation?).

Back her up if anyone gets pushy with her, and guard against the kind of nurses - we've all met 'em - who forget their training and breeze up to administer the drugs without so much as a by-your-leave.

Elizabeth, I'm so glad that you're still with us!

Thank you, Churchmouse. The facts: My Aunt, who is experiencing mild, everyday type of pain, is lucid and aware that she has morphine available to her if needed. She is adamantly against its use unless absolutely needed and I am in full compliance and agreement with her. My original question - Does anyone know of any natural alternative to morphine? - was lost in a sea of accusation and the politics of Hospice and morphine. Not surprising, since I've gotten the same response in the real world and reacted with the same frustration at having been completely misunderstood. Again, I'll thank the thoughtful and kind posters who responded to my question, too many to respond to individually. It's time for me to move on to another topic in another thread this one has run its course.

Um. I haven't read all of the responses in detail. I was just going to say that as long as your aunt is lucid I should check with her whether she wants her next morphine dose or doesn't feel she needs it.

I couldn't resist. Where on God's green earth did I imply that I didn't know she was dying, or that I'm denying her meds?? Do some of you even read thoroughly before you post, or do you just sight, load, and attack? Do we have trolls in our midst here? Methinks we do!

Excuse me, but Tylenol #3 is a narcotic.

Uhmmm.... just what do you think codeine is, Cak???

I don't think anybody here is a fan of meds, especially opoids. Leave that red poppy alone, let it be in the field. Tylenol w/ codeine is 10 times better

I agree, if she can still communicate then allow the med. Even if she got addicted she is leaving you.

Elizabeth49: I know of NO OTC medication that will ease this level of pain. Stick with the narcotic.

It seems that some people have a very difficult time accepting terminal illnesses. Even in those who are very old. I recall that years ago, I thought that hanging on to every minute of life was the ultimate goal. Then...life happened and I saw how enduring pain and agony are not your friends. I changed my perspective. I realized that it's crucial to put your feelings on the topic in writing and hope that the person you trust will properly interpret your actions if the time comes.

We never know what something is like until we experience it. That's why I like to get those personal and candid perspectives from those who have been there with their loved ones.

I'd say try the morphine in low doses without the Ativan, greatly reducing risks for respiratory depression and unwanted sedation. Most people taking oral morphine can be lucid. It is not otherwise really terribly "toxic" - watch for constipation, that would be the most common side effect.

I think the answers on this thread have been very good, thoughtful and informative. We often encounter those on this forum who are totally anti hospice anti morphine/ativan and seem all too willing to dismiss the good along with the bad, so I don't think there is anything wrong in those posters who cautioned against this. As others have stated so well, life and death are never black and white, but an infinite variety of greys.
Elizabeth, I wish you and your Auntie peace.

My mother's doctor said absolutely no Ibuprofen. Not only is it hard on the stomach it is bad for the heart. My mother ended up with the morphine and yes, she did die, but she died peacefully and she would have died with or without the morphine.

Now, my own doctor says, don't ever take Ibuprofen again, because of your heart. It make irregular heartbeats worse.

When my mom went on hospice, morphine and Ativan were the first medications to arrive. They stayed in the refrigerator for months, before we actually needed them. Mom used Oxycodone for pain, and then added Ativan for the anxiety resulting from her shortness of breath. My dad and I were in some disagreement about when to use the morphine- the decision seems so final. About two weeks before Mom died, she asked for morphine. She started at twice a day, and then began to ask for more. During the last week, she would just whisper "morphine", and open her mouth and wait for its delivery. Yes, she was pretty much in Lala land those last two weeks- I would tease her, and call her my "baby bird". She would pat my hand and drift off.....
Anyway, we didn't try "natural" painkillers, other than basic comfort measures.
I think the idea of consulting a Naturopath is a good start, and I also think it will become obvious when it's time for the Morphine. I know that in my own anxiety I was always trying to look ahead to the next "phase", but it wasn't really productive- as the dying process was it's own moment by moment affair.

Ask the doctor to give her a self-administered pump to use the morphine as she wishes. We will be sorry to see you go, but that is your decision.

Correction: THIS will be my last post. So that everyone understands where we are coming from, my aunt is lucid and actively involved in her own care. She objects to the use of morphine because like me, she is aware that a toxic dose is all too easy to administer. She has asked for alternatives and knows that if she changes her mind and requests the morphine it will be given to her. And FYI - morphine is no longer poppy- based, it is synthesized - and the kind that Hospice hands out is the strongest made. The drug fact sheet that accompanies it states clearly that it may cause death. I would rather not accidentally kill my aunt because she had a gas pain and had to fart. In no way does my refusal to be trigger-happy with the morphine bottle imply that I would allow her to suffer. I think my remarks about our particular Hospice have created some bad sentiment but I've never been one to dance around the truth. It is all too easy to administer a drug with a heavy hand; it's not as easy to live with the possible consequences of doing so. Making the decision to use a powerful and potentially deadly drug like morphine requires thought and consideration - and that is not something that our particular Hospice encouraged in the least. As I write this, my aunt is sleeping peacefully in her own bed, not drugged up and not in pain. That's as it should be. Thank you again for those good responses I did receive in this thread. Over and out.

"This poor lady needs to die in peace." And " You can't stop chf." Where in my posts did I imply that any of that was applicable? Some of you should really watch the way you say things here. This isn't an interrogation. Most of us who have given up two years of our lives to care for a loved one instead of shuttling them off to a nursing home love them enough to not allow them to suffer. Nowhere did I state that she is in pain or that I would allow her to suffer. I simply asked about natural alternatives to morphine. People come here for comfort and advice, not a barrage of accusations and abuse. As much help as I've received here - and I sincerely thank all who responded thoughtfully and kindly - this will be my last post.

If she is saying her pain is "mild", then the morphine is working. What makes you think someone dying is going to be helped with homeopathic remedies? Nothing you do is going to stop CHF. Just love her for the time she has left, and start preparing for the end. Someone in their 90s deserves a rest. Let her go.

I was the person who would never consider toxic narcotic medications. Then I got a kidney stone and I had to take me morphine to not commit suicide. The morphine allowed me to communicate and be a participant in decision making in my care. Until I surrendered and accepted the medication I was begging them to help me die. This poor soul needs to pass in peace. Morphine takes away the pain improves breathing and relaxes the body offering her clarify and the ability to engage with loved ones in their passing. I am not a fan of medication. I have experienced people in hospice refuse narcotics over and over again in my job. I have also experienced those who have taken the medication. Those who take the medications pass in peace. My experience with morphine is that it really improved end of life. Especially when passing away is inevitable. The will only offer the dose that will give her peace. Hospice is not about being out of it, they are about quality of life until you pass. Prayers for her and you. This is a challenge time.

As a hospice worker and one who has cared for four family members through end of life, please know that morphine can make a huge difference for the better when used wisely. Most hospices use concentrated liquid morphine, which can be given in tiny doses if that's all it takes. You mentioned that codeine has helped her in the past. Codeine is actually converted to morphine in the body; that's why it relieves pain. A small dose of morphine has exactly the same effect, and really is the same active drug. Ask that your hospice use medications at the lowest possible dose to relieve her symptoms. As someone mentioned earlier, morphine is very effective for shortness of breath, which is a very common and very uncomfortable symptom seen in heart failure patients at end of life.