Last week, with Co-codamol providing pretty much zero analgesia, I reverted to Dihydrocodeine (DHC), again. This, as I’ve mentioned previously, can cause pulmonary oedema (it has once before), as well as worsening my general oedema, and both are why I stopped it last time, but generally it takes a while for pulmonary oedema to kick in or for my legs to swell.
So, I went back to DHC, 60mg every 6 hours, hoping to get a couple of weeks of decent pain control out of it. As it turned out, lack of DHC was also the reason I haven’t been able to sleep for the past couple of weeks, which began to return to normal, but what I got was just a few days before it all went pear-shaped.
I woke in the early hours of today, coughing pus and blood in alarming quantities (something you get used to happening occasionally with COPD – doesn’t stop it being scary though), which by daylight had morphed into the characteristic bloody and frothy sputum of pulmonary oedema (sorry if that grosses you out – you should try it from my perspective L ). In addition, I’d noticed the previous day that my legs were already swelling.
Pulmonary oedema is dangerous. Or, rather, it is if you just sit there like a lemon thinking WTF? That way you wind up in ICU on 100% oxygen and i-v GTN and Furosemide. It demands prompt intervention.
Hit it hard and fast, with maximum oral Furosemide (80mg morning, 40mg afternoon), plus a vasodilator (for me, Candesartan provides that function), don’t waste time farting about, and you might get away with it –do not allow it time to establish itself. I added 1,00omg of Amoxyl every 6 hours too, as anything that goes wrong with my lungs is almost certain to trigger an infection and, in this case, apparently has, but while my lungs are still a mess, they’re definitely improved from this morning (note, finishing this on Saturday, and much improved on yesterday; I still feel like shit, but I’m on the mend).
This, though, is my second go-around with DHC-induced pulmonary oedema – I don’t intend there to be a third time. No matter how effective DHC is, and no matter how addictive, it’s history. Withdrawal I can live with, pulmonary oedema, if I keep pushing my luck, almost certainly not.
There is a downside, though – without DHC I just can’t sleep. Again.
NB: Pulmonary oedema normally requires hospitalisation and, for me, that means Arrowe Park Hospital (where, when admitted in January, they made a serious attempt at killing me – connecting me to 2 litres of i-v saline while my lungs where already full of fluid – and I couldn’t even get the drugs which had apparently been prescribed for me – nobody could in my bay), and that’s somewhere I will not go while I’m in full possession of my faculties – those fuckers are dangerous.
So, anyway, twice, now, I’ve pushed pulmonary oedema back down by acting within a couple of hours and not allowing it to become established. If, though, you wouldn’t know pulmonary oedema from a hole in the ground, and you start producing bloody, frothy, sputum, get your doctor out without delay, or, better yet, get an ambulance or taxi to hospital, and go prepared for admission.
Last week, with Co-codamol providing pretty much zero analgesia, I reverted to Dihydrocodeine (DHC), again. This, as I’ve mentioned previously, can cause pulmonary oedema (it has once before), as well as worsening my general oedema, and both are why I stopped it last time, but generally it takes a while for pulmonary oedema to kick in or for my legs to swell.
So, I went back to DHC, 60mg every 6 hours, hoping to get a couple of weeks of decent pain control out of it. As it turned out, lack of DHC was also the reason I haven’t been able to sleep for the past couple of weeks, which began to return to normal, but what I got was just a few days before it all went pear-shaped.
I woke in the early hours of today, coughing pus and blood in alarming quantities (something you get used to happening occasionally with COPD – doesn’t stop it being scary though), which by daylight had morphed into the characteristic bloody and frothy sputum of pulmonary oedema (sorry if that grosses you out – you should try it from my perspective L ). In addition, I’d noticed the previous day that my legs were already swelling.
Pulmonary oedema is dangerous. Or, rather, it is if you just sit there like a lemon thinking WTF? That way you wind up in ICU on 100% oxygen and i-v GTN and Furosemide. It demands prompt intervention.
Hit it hard and fast, with maximum oral Furosemide (80mg morning, 40mg afternoon), plus a vasodilator (for me, Candesartan provides that function), don’t waste time farting about, and you might get away with it –do not allow it time to establish itself. I added 1,00omg of Amoxyl every 6 hours too, as anything that goes wrong with my lungs is almost certain to trigger an infection and, in this case, apparently has, but while my lungs are still a mess, they’re definitely improved from this morning (note, finishing this on Saturday, and much improved on yesterday; I still feel like shit, but I’m on the mend).
This, though, is my second go-around with DHC-induced pulmonary oedema – I don’t intend there to be a third time. No matter how effective DHC is, and no matter how addictive, it’s history. Withdrawal I can live with, pulmonary oedema, if I keep pushing my luck, almost certainly not.
There is a downside, though – without DHC I just can’t sleep. Again.
NB: Pulmonary oedema normally requires hospitalisation and, for me, that means Arrowe Park Hospital (where, when admitted in January, they made a serious attempt at killing me – connecting me to 2 litres of i-v saline while my lungs where already full of fluid – and I couldn’t even get the drugs which had apparently been prescribed for me – nobody could in my bay), and that’s somewhere I will not go while I’m in full possession of my faculties – those fuckers are dangerous.
So, anyway, twice, now, I’ve pushed pulmonary oedema back down by acting within a couple of hours and not allowing it to become established. If, though, you wouldn’t know pulmonary oedema from a hole in the ground, and you start producing bloody, frothy, sputum, get your doctor out without delay, or, better yet, get an ambulance or taxi to hospital, and go prepared for admission.