Ouch!!
 
Sorry to hear this and hope the breaks are not in the joints.
 
For the itching ask the doc to give you an rx for Zofran (ondansetron). Take 8 mg orally every 4 hours on schedule. The itching should go down considerably within a few hours. Still continue with benadryl 25 mg every several hours, but can be replaced with something like Allegra which will make you less drugged.
 
Make sure you are taking docusate 100 mg twice a day for the constipation. Would spare the use of stimulants unless absolutely needed. Down the docusate with a full glass of water. Docusate will not move the bowels but will help protect against impaction which can be a greater threat.
 
I remember that you are a vegetarian but don't know if you take milk products. These tend to stop things up worse and should be minimized until you are off the narcotics.
 
Wishing you a speedy recovery and relief from some of the narcotic symptoms.
 
John

John
I related your advice to the doctor Unfortunately his response was "Crazy Pharmacist"
He explained that zofran has no effect on stopping the production of histamines or blocking their reaction  It would have no effect on itching plus the dose is twice the limit for its indicated use which is for nausea
Could you look this and were you maybe thinking nausea instead of itching
The doc said he could write for several days of the prednisone steroid if the itching and rash are unbearable.

Not that I dont trust you and I have a friend who has left over zofran still in date Should I try it just to see

Jyoti,
 
The doc is right that Zofran has nothing to do with the release or blocking of histamines.
The doc is wrong about Zofran's ineffectiveness to help with narcotic induced itching.
 
(That's my story and I'm stickin' to it)
 
The dose is not toxic at 8 mg. There may be a concern of prolonging the cardiac "QT interval" in people with certain heart disorders or concomitant meds that do the same. You can PM me with your medication list since don't want you to have to display your medical history on a public forum. If everything looks good and your heart is otherwise healthy, my completely off the record thought would be to give it a try. If you can borrow maybe 6 pills (4 mg each). Take 2 at a time (8 mg) every 4 hours. That should be enough time to see if it works for you. Remember I'm not an MD and can't advise you to do this legally and for your protection. Won't slit my wrists if you decide to go with the prednisone which will not cause too much damage over a few days.
 
Very best,
John
 
oh, and Starise...take the young lady's advice on the two movements she advised for sciatica.
 

I'm just getting over breaking my right arm near the top of my shoulder .
 
Yeah I know pain ..it still hurts and the range of motion issues are ever present as a constant reminder .
 
I was given a script for the ever popular drug that everybody hears about on the news ...
NO KEN DO man ...for the one or two hours I felt good after taking a pill I found out for me it was not worth the aggravation or the trouble to go the traditional PHARMA Route .
In my case , the next day the pain came back with a sensitivity threshold that hurt much more than it did before taking the pills ..  
 
Let me see if  got this right . I take the meds and the next day my broken arm hurts more ....
HHHhmmm don't sound right too me ...yet that is what happens ..
 
The drug itself want's to take a drug once it is introduced into your blood stream  .
The way it gets to do that is it will lower a persons ability to process their pain threshold by making all the natural body's highly sensitive pain measurement tools set them self's to a different measurement threshold ...
 
Example , I am driving my car on a road w a speed limit of 65 mph ...I get pulled over because I'm doing 70 mph ..
The cop see's I'm local , I get a stern warning and he lets me go ...
Since I don't need or want that type of drama in my life I look on the Cakewalk hardware section of the forum and find out how I can hack my speedometer to read 70 mph when I'm actually only gonna be doing 62 mph ....
Sounds crazy I know ...but after running down my explanation  my own doctor said I was in the right ball park ..
He  mentioned people that took that class of drugs did indeed have those type of sensitivity issues and concerns . 
 
Anyway getting to the point . my way around it was I went Green  
I live in an area where it is possible to avail oneself of choices that were formally a closed door ...
I went and purchased some edibles and herbal strains that were cited as pain relief potency ...
Went that route and it worked much better for me , ran it by my doctor they were OK with it ...
 
I will mention this before I close ...what works for me might not work for anyone else ...I'm just putting it out there in case someone has hit the same wall and decided to try a different way ...
 
Kenny

I'm taking codeine based medicine on a regular basis for various pains. On the pharmacy they told me that there are some medicine to help with the connected constipation. I'm not so pro medicine so found another solution. A moderate amount of dry plums (2-3) pr day have worked for me. Also a tube of Enema ? (rectal fluid) can be helpful to loosen things up in an emergency. My sympathies, it's not fun ****ting bricks. 

Haven't heard back from Jyoti and hope I haven't killed her.
 
Couple comments to Kenny and iRelevant.
 
I'm the most anti pharma chemical dude on the planet but have to balance what helps, whatever the origin. Allah has blessed me with the mindset of a pure anti-establishment naturalist with some western medical training, leading to a limited ability to recognize what is needed over the different sides of the debate. Sometimes its herbal tea but sometimes rotgut poison in a pill that will have some benefit to us while we are being taken down with side effects..
 
I remember the graphic details of John Adam's wife (second president of the USA) and what they had to do when she had breast cancer. They tied her down and cut off her breast with a carving knife as she screamed in pain. The operation gave her 2 more years, but I wish I could have gone back in a time machine and set up a fentanyl IV drip to spare the suffering, and a few bottles of hardcore narcotics to give the respected lady for the temporary road back.
 
Kenny is absolutely right about the rebound pain. The longer you are on narcotics, the more the rebound pain until you cannot get out of bed without being stabbed by pains you never would have felt before.
 
To iRelevant. Don't fear the pharmacist in his/her advice about this. Too convoluted to get into here, but there are medications with minimal side effects that effectively block the constipating effects of the opiates without compromising the analgesic property. You do not have to put up with what you are dealing with. I can advise if you need. And yes, prunes are cool. Even Frank Zappa said so.
 
John

Dear John
Thank you
Thank you
Thank you
Thank you
Thank you
Thank you
I have the "borrowed" bottle of ondansetron and followed your advice  In about three hours the rashes and itching started to subside. Not gone entirely but I have some quality of life back
I confessed my sins to the doctor and re asked for an rx for ondansetron
His first response was "Crazy Pharmacist"
He says that my relief is because of faith and placebo and he could do the same with M&M's if I believe  There is no connection between ondansetron and the histamine storm produced by narcotics
He said with a chuckle that he would entertain your argument if you have one but said that this is something you likely read off the back of a cereal box
He wants to know what medical evidence you have for this molecules and mechanisms  He wants to know what personal experience you have with this seeing it actually work  If convinced he will write a script for ondansetron
Dear crazy pharmacist give this guy hell for me if you can
Love you,
Jyotishvarii

Thanks Jyoti,
 
Too ethanoled at present to get facts and figures for the respected idiot in the detail he wants. Will make for extremely boring reading but gives him the data if he can comprehend and act on it. Crash time for me but will do so tomorrow morn. You got enough Zofran to get you thru a few more cycles?
 
Soon you will be off the narcs.
 
In transition, there is a big big gap between pain control of the NSAIDS and Tylenol versus the narcotics. These things in singularity cap out pretty quick while the narcs can kill any pain often at extreme payback. Once the pain threshold is exceeded for the non narcotics, the raw pain is there.
 
Best bridge for non narcotic pain control is Tylenol, with an an NSAID (ibuprofen more effective for bone fractures) mixed with a strong dose of caffeine. Reaches narcotic pain control levels in combination.
Very best to you dear sister,
 
John
 
 
 

Jyoti,
 
Please cut and paste between the quotes. Request to the doctor.
 
“Dear Doc,
 
I worked in a hospital setting for about 14 years and have ample experience with morphine induced itching. Inpatient, outpatient, hospice. The drug Zofran simply works although I don’t have every piece to the puzzle. We knew for many years that post surgical inpatients who presented with nausea also reported less narcotic itching. Much later we could trace back to the addition of Zofran on the pain protocols to control nausea. We used Zofran as a staple for intense itching in the later years. Oral dose was 8 mg every 4 hours scheduled (not prn). This was a godsend to many hospice patients. It works for most and well tolerated. I would estimate about 75 percent reduction on average.
 
You are correct that most narcotics will release histamines, but this is a minor part of the problem. Consider fentanyl which can cause itching and hives but has no effect on basophil degranulation. No histamines are released. Consider that administration of an opiate antagonist like naloxone resolves the itching as the drug is reversed. Consider that most antihistamines are of little value in controlling itch. Promethazine is the outlier but also modulates other neurotransmitters as well where the effect likely is.
 
Narcotic induced itching has a strong serotonergic component at the 5-HT3 receptor, and likely acetylcholine and norepinephrine are implicated (promethazine again).
 
You are aware of the various classes and subclasses of narcotic receptors.  Of interest is a mu 1 target located in the substantia gelatinosa  in the spinal cord dorsal horn. This structure is an isoform of the mu 1 receptor varying by a few amino acids in the chain. Close enough to be still classified as mu 1.
 
The isoform has dimerized with a gastrin releasing peptide receptor (GRPR). The dimer is called MOR1D. The GRPR segment has no ligand as far as I am aware but is activated by narcotic docking on the mu 1 isoform. The mu 1 pathway is devoid of the common G-protein cAMP reduction cascade leading to analgesia. GRPR circuit is ascending afferent. Where our knowledge at present falls short of the glory is that we really don’t know why this structure is there nor the fine details of the endpoint neural activations. MOR1D has one purpose, to cause itching.
 
Ample evidence is available in animal models with blocking the MOR1D and the reduction in scratching. Speculation is present that we will eventually design narcotics that interact with the other types of receptors but avoiding MOR1D. This will give us a narcotic analgesic virtually free of the itching side effect. Small quantities of an antihistamine may still be needed.
 
Currently, if we block 5-HT3, the majority of narcotic itching will begin to resolve within a few hours.
Thanks for considering this. I can elaborate on any questions or concerns you may have.
 
John Kenn, PharmD”
 
Jyoti,
 
The docs not wanting to give you Zofran has a legal part to it. He has to go “off label” to prescribe for itching and the dose is twice normal. He is protected if he gives you Zofran at the normal dose for nausea but it didn’t work and you missed girls night out at the bar because the nausea wasn’t fixed. Pain and suffering but you can’t sue him.  If he prescribed off label for itching and you showed up late to the bar because the itching wasn’t cured, you could take him down in court.
 
If you think this is happening, casually suggest that he can write the rx without indication, and for the standard dose. Then add “or as directed”.  Other point is to tell the doc you are experiencing nausea.
Please keep in touch and let the good folks here know how you are getting through this.
 
John