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Re: Chronic PKD pain
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JCRO-@aol.com
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Nov 04, 2009 03:52 PST
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I can't run at this time due to my new kidney but I am walking an hour
everyday.
Rgds,
JC
In a message dated 11/3/2009 10:55:34 A.M. Eastern Standard Time,
craig-@wswa.org writes:
FYI –
A similar story to JC in terms of results, although I haven’t ever
experienced the same level of pain she did or experienced any ruptures to my
knowledge. But I used to have fairly regular achiness bilaterally – especially
noticeable after certain food intake. Then I changed my diet and became
much more active physically and really don’t have that issue any more.
I no longer eat red meat, pork, chocolate, soda’s, chips/pretzels, milk,
potatoes (except for sweet potato at Thanksgiving). No caffeine period. And
I have gradually been reducing my protein intake, sometimes not eating
any chicken or seafood for a day or two in a row. And I drink a glass of
cranberry juice almost daily as well (sometimes mixed with apple or orange
juice for variety and flavor).
I also run/exercise 4-5 times a week – just completed the Army Ten Miler
in DC.
Craig
From: jcro-@aol.com [mailto:jcro-@aol.com]
Sent: Tuesday, November 03, 2009 9:42 AM
To: pk-@topica.com
Subject: Re: PKD-PLD Chronic PKD pain
Dear Diane,
At the beginning of my journey with PKD some 14 years ago, I had a lot of
cyst ruptures, excruciating pain that would leave me bedridden for days. I
was 28 years old. Then, I started reading and searching until I learned
about you, the diets and how to change my diet to improve things. A
lthough, I am not 100% vegetarian, I did changed many items of my diet and added
some others. I can honestly say that I have not had any pain episodes in
years. I can't tell you when was the last time because I truly do not
remember.
Both my natives are larger than they were then but I do not have not had
any more ruptures or pain. I think for me the secret has been: no red
meats, no artificial foods. I also drink nothing but natural juices and water.
I do not drink sodas, whole milk or alcohol and I drink a tall glass of
cranberry juice every single morning and some afternoons for the last 14
years.
BTW...I am reading The China Project. What an amazing and interesting
book. You are living proof that what they found does work. I can wait to
finish reading it.
Rgds,
JC
In a message dated 10/29/2009 7:40:33 P.M. Eastern Standard Time,
Dia-@pkdiet.com writes:
I understand what you are saying JC. Many many years ago, in my hippy
days, I traveled extensively throughout Asia, it was so sad to meet up with
fellow travelers later after they had become addicted to opium or heroin. They
were like walking skeletons.
Opiates happen to be something I cannot take. I just throw up and cannot
keep it down. Following my liver resection surgery the docs got very
creative on what to give me to relieve pain.
There are several with PKD who have written to me that the only way they
can function is by taking opiates to control the daily chronic pain from
PKD.
By removing a cystic PKD kidney this has been shown to lessen painful
episodes. A very observant surgeon developed a denervation procedure of PKD
kidneys as another treatment to lessen severe PKD pain.
There is a PKD pain study underway at the Mayo Clinic with Dr. Marie Hogan
that utilizes an interventional procedure known as - Videothracoscopic
Splanchnicectomy (VSPL) similar to Videothoracoscopic splanchnicectomy done
for pancreatitis pain. For more information on this clinical trial :
_http://www.pkdiet.com/pages/pain/painchronic.htm_ (http://www.pkd
iet.com/pages/pain/painchronic.htm)
I too did not realize how difficult and how severe PKD pain can become
with some individuals until I went to PKD conference and met with a few
individuals using fentanyl patches and more to function.
"FDA announced on February 12, 2008, that PriCara, Division of
Ortho-McNeil-Janssen Pharmaceuticals, Inc.has recalled all lots of 25 mcg DURAGESIC®
(fentanyl transdermal system) patches sold by PriCara in the United States
and all 25 mcg/hr fentanyl patches sold by Sandoz Inc.(See:Sandoz Fentanyl
Patch Recall) in the United States are being voluntarily recalled."
At this same PKD conference there was a PKD pain lecture given by both Dr.
Torres [giving the medical aspects of PKD pain relief] and the
laparoscopic surgeon who developed the denervation procedure. I always learn so much
from these conferences, though I have not gone to one since Dr. Torres
stopped going.
Warmly,
Diane
On Oct 29, 2009, at 12:23 PM, _jcr-@aol.com_ (mailto:jcro-@aol.com)
wrote:
I refused to take Opiates at all cost. Part of my work is working with
drug addicted patients and I have seen what Opiates do to a persons life.
It literally destroys them physically, financially, mentally and emotionally
to the point that they can not function. It is very sad. Do not take
them if you can help it. They are extremely addictive.
Rgds,
JC
In a message dated 10/29/2009 2:40:55 P.M. Eastern Daylight Time,
_Di-@pkdiet.com_ (mailto:Dia-@pkdiet.com) writes:
Some members have chronic pain from PLD and take opiods which can lead to
constipation. Here is a new drug to ask your docs about if this applys to
you.
ACG: Compound Eases Constipation for Opioid Patients
By Kristina Fiore, Staff Writer, MedPage Today
Published: October 28, 2009
Reviewed by _Zalman S. Agus, MD_
(http://www.medpagetoday.com/reviewer.cfm?reviewerid=30) ; Emeritus Professor
University of Pennsylvania School of Medicine and
Dorothy Caputo, MA, RN, BC-ADM, CDE, Nurse Planner
<16658.jpg>
SAN DIEGO -- An investigational drug increased spontaneous bowel
movements for patients with opioid-induced constipation, researchers said here.
Bowel movements per week increased from about one at baseline to five or
six, depending on the dose used, Lynn Webster, MD, of Lifetree Clinical
Research in Salt Lake City, and colleagues reported at the American College of
Gastroenterology meeting here.
The drug, NKTR-118, "increased the frequency of bowel movements without a
reversal of analgesia, and it was reasonably safe with no serious problems
in this study," Webster said.
He said constipation is a common side effect of opioid therapy, affecting
about 40% to 60% of patients on chronic or acute treatments.
The investigational compound is a polymer form of naloxone that antag
onizes peripheral opioid receptors in the gut. It can act selectively,
preventing it from reversing opioid pain management, the researchers said.
For their Phase-II, randomized, double-blind, placebo-controlled trial,
the researchers recruited patients on stable regimens of opioids who
consistently had fewer than three spontaneous bowel movements per week.
A total of 208 patients were randomized to either a 5-mg, 25-mg, or 50-mg
dose of NKTR-118 or placebo for four weeks.
The researchers found that spontaneous bowel movements increased
significantly for patients on the 25-mg and 50-mg dose compared with placebo.
Patients on the 25-mg dose increased to five spontaneous bowel movements
per week, up from 1.4 per week at baseline, whereas placebo patients
increased to just 3.1 per week from 1.2 at baseline.
Those on the 50-mg dose had six spontaneous bowel movements per week, up
from 1.6 at baseline -- a significant improvement compared with those on
placebo, who increased to 3.3 per week from 1.4 at baseline.
Spontaneous bowel movements for patients on the 5-mg dose did not differ
significantly from those on placebo, the researchers said.
The median time to first bowel movement was 6.6 hours for those in the
25-mg dose, compared with 48.6 hours for those on placebo (P=0.001). It was
2.9 hours for those on the 50-mg dose, compared with 44.9 hours with
placebo (P=0.002).
Webster said that there was no change in patient pain, and there were no
changes in the amount of opioid used for any patient.
However, dropout rates were significantly higher for the 50-mg dose of
the drug compared with placebo, "probably due to the side effect profile,"
Webster said.
The most sign ificant side effects associated with the drug were
gastrointestinal in nature, and included nausea and abdominal pain.
Side effects were not significantly different for the 5-mg dose compared
with placebo, and there was more nausea in the placebo group for the 25-mg
dose, but side effects were significantly higher in the 50-mg dose compared
with placebo.
There was also one serious adverse event in the 50-mg dose, with a
patient admitted to the hospital for excessive abdominal cramping.
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<DIV>
<DIV>I can't run at this time due to my new kidney but I am walking an hour
everyday.</DIV>
<DIV> </DIV>
<DIV>Rgds,</DIV>
<DIV> </DIV>
<DIV>JC</DIV>
<DIV> </DIV>
<DIV> </DIV>
<DIV> </DIV>
<DIV> </DIV>
<DIV>In a message dated 11/3/2009 10:55:34 A.M. Eastern Standard Time,
craig-@wswa.org writes:</DIV>
<BLOCKQUOTE style="BORDER-LEFT: blue 2px solid; PADDING-LEFT: 5px; MARGIN-LEFT: 5px"><FONT style="BACKGROUND-COLOR: transparent" color=#000000 size=2 face=Arial>
<DIV class=Section1>
<DIV>
<DIV style="BORDER-BOTTOM: medium none; BORDER-LEFT: medium none; PADDING-BOTTOM: 0in; PADDING-LEFT: 0in; PADDING-RIGHT: 0in; BORDER-TOP: #b5c4df 1pt solid; BORDER-RIGHT: medium none; PADDING-TOP: 3pt">
<P class=MsoNormal><B><SPAN style="FONT-FAMILY: 'Tahoma','sans-serif'; FONT-SIZE: 10pt">FYI
–<o:p></o:p></SPAN></B></P>
<P class=MsoNormal><B><SPAN style="FONT-FAMILY: 'Tahoma','sans-serif'; FONT-SIZE: 10pt"><o:p> </o:p></SPAN></B></P>
<P class=MsoNormal><B><SPAN style="FONT-FAMILY: 'Tahoma','sans-serif'; FONT-SIZE: 10pt">A similar story to
JC in terms of results, although I haven’t ever experienced the same level of
pain she did or experienced any ruptures to my knowledge. But I used to
have fairly regular achiness bilaterally – especially noticeable after certain
food intake. Then I changed my diet and became much more active
physically and really don’t have that issue any
more.<o:p></o:p></SPAN></B></P>
<P class=MsoNormal><B><SPAN style="FONT-FAMILY: 'Tahoma','sans-serif'; FONT-SIZE: 10pt"><o:p> </o:p></SPAN></B></P>
<P class=MsoNormal><B><SPAN style="FONT-FAMILY: 'Tahoma','sans-serif'; FONT-SIZE: 10pt">I no longer eat
red meat, pork, chocolate, soda’s, chips/pretzels, milk, potatoes (except for
sweet potato at Thanksgiving). No caffeine period. And I have gradually
been reducing my protein intake, sometimes not eating any chicken or
seafood for a day or two in a row. And I drink a glass of
cranberry juice almost daily as well (sometimes mixed with apple or orange
juice for variety and flavor). <o:p></o:p></SPAN></B></P>
<P class=MsoNormal><B><SPAN style="FONT-FAMILY: 'Tahoma','sans-serif'; FONT-SIZE: 10pt"><o:p> </o:p></SPAN></B></P>
<P class=MsoNormal><B><SPAN style="FONT-FAMILY: 'Tahoma','sans-serif'; FONT-SIZE: 10pt">I also
run/exercise 4-5 times a week – just completed the Army Ten Miler in
DC.<o:p></o:p></SPAN></B></P>
<P class=MsoNormal><B><SPAN style="FONT-FAMILY: 'Tahoma','sans-serif'; FONT-SIZE: 10pt"><o:p> </o:p></SPAN></B></P>
<P class=MsoNormal><B><SPAN style="FONT-FAMILY: 'Tahoma','sans-serif'; FONT-SIZE: 10pt">Craig<o:p></o:p></SPAN></B></P>
<P class=MsoNormal><B><SPAN style="FONT-FAMILY: 'Tahoma','sans-serif'; FONT-SIZE: 10pt"><o:p> </o:p></SPAN></B></P>
<P class=MsoNormal><B><SPAN style="FONT-FAMILY: 'Tahoma','sans-serif'; FONT-SIZE: 10pt">From:</SPAN></B><SPAN style="FONT-FAMILY: 'Tahoma','sans-serif'; FONT-SIZE: 10pt"> jcro-@aol.com
[mailto:jcro-@aol.com] <BR><B>Sent:</B> Tuesday, November 03, 2009 9:42
AM<BR><B>To:</B> pk-@topica.com<BR><B>Subject:</B> Re: PKD-PLD Chronic PKD
pain<o:p></o:p></SPAN></P></DIV></DIV>
<P class=MsoNormal><o:p> </o:p></P>
<DIV>
<DIV>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 10pt">Dear
Diane,<o:p></o:p></SPAN></P></DIV>
<DIV>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 10pt"> <o:p></o:p></SPAN></P></DIV>
<DIV>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 10pt">At
the beginning of my journey with PKD some 14 years ago, I had a lot of cyst
ruptures, excruciating pain that would leave me bedridden for days. I
was 28 years old. Then, I started reading and searching until I learned
about you, the diets and how to change my diet to improve things.
Although, I am not 100% vegetarian, I did changed many items of my diet and
added some others. I can honestly say that I have not had any pain
episodes in years. I can't tell you when was the last time because I
truly do not remember.<o:p></o:p></SPAN></P></DIV>
<DIV>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 10pt"> <o:p></o:p></SPAN></P></DIV>
<DIV>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 10pt">Both
my natives are larger than they were then but I do not have not had any more
ruptures or pain. I think for me the secret has been: no red meats, no
artificial foods. I also drink nothing but natural juices and
water. I do not drink sodas, whole milk or alcohol and I drink a
tall glass of cranberry juice every single morning and some afternoons for the
last 14 years.<o:p></o:p></SPAN></P></DIV>
<DIV>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 10pt"> <o:p></o:p></SPAN></P></DIV>
<DIV>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 10pt">BTW...I
am reading The China Project. What an amazing and interesting
book. You are living proof that what they found does work. I can
wait to finish reading it.<o:p></o:p></SPAN></P></DIV>
<DIV>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 10pt"> <o:p></o:p></SPAN></P></DIV>
<DIV>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 10pt">Rgds,<o:p></o:p></SPAN></P></DIV>
<DIV>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 10pt"> <o:p></o:p></SPAN></P></DIV>
<DIV>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 10pt">JC<o:p></o:p></SPAN></P></DIV>
<DIV>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 10pt"> <o:p></o:p></SPAN></P></DIV>
<DIV>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 10pt"> <o:p></o:p></SPAN></P></DIV>
<DIV>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 10pt"> <o:p></o:p></SPAN></P></DIV>
<DIV>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 10pt">In a
message dated 10/29/2009 7:40:33 P.M. Eastern Standard Time, Dia-@pkdiet.com
writes:<o:p></o:p></SPAN></P></DIV>
<BLOCKQUOTE style="BORDER-BOTTOM: medium none; BORDER-LEFT: blue 1.5pt solid; PADDING-BOTTOM: 0in; MARGIN-TOP: 5pt; PADDING-LEFT: 4pt; PADDING-RIGHT: 0in; MARGIN-BOTTOM: 5pt; MARGIN-LEFT: 3.75pt; BORDER-TOP: medium none; BORDER-RIGHT: medium none; PADDING-TOP: 0in">
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 10pt"><BR>I
understand what you are saying JC. Many many years ago, in my hippy days, I
traveled extensively throughout Asia, it was so sad to meet up with fellow
travelers later after they had become addicted to opium or heroin. They were
like walking skeletons. <o:p></o:p></SPAN></P>
<DIV>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 10pt"><o:p> </o:p></SPAN></P></DIV>
<DIV>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 10pt">Opiates
happen to be something I cannot take. I just throw up and cannot keep it
down. Following my liver resection surgery the docs got very creative on
what to give me to relieve pain. <o:p></o:p></SPAN></P></DIV>
<DIV>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 10pt"><o:p> </o:p></SPAN></P></DIV>
<DIV>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 10pt">There
are several with PKD who have written to me that the only way they can
function is by taking opiates to control the daily chronic pain from
PKD. <o:p></o:p></SPAN></P></DIV>
<DIV>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 10pt"><o:p> </o:p></SPAN></P></DIV>
<DIV>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 10pt">By
removing a cystic PKD kidney this has been shown to lessen painful episodes.
A very observant surgeon developed a denervation procedure of PKD kidneys as
another treatment to lessen severe PKD pain.<o:p></o:p></SPAN></P></DIV>
<DIV>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 10pt"><o:p> </o:p></SPAN></P></DIV>
<DIV>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 10pt">There
is a PKD pain study underway at the Mayo Clinic with Dr. Marie Hogan that
utilizes an interventional procedure known as - Videothracoscopic
Splanchnicectomy (VSPL) similar to Videothoracoscopic
splanchnicectomy done for pancreatitis pain. For more information on
this clinical trial :<o:p></o:p></SPAN></P></DIV>
<DIV>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 10pt"><o:p> </o:p></SPAN></P></DIV>
<DIV>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 10pt"><A title=http://www.pkdiet.com/pages/pain/painchronic.htm href="http://www.pkdiet.com/pages/pain/painchronic.htm">http://www.pkdiet.com/pages/pain/painchronic.htm</A><o:p></o:p></SPAN></P></DIV>
<DIV>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 10pt"><o:p> </o:p></SPAN></P></DIV>
<DIV>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 10pt">I
too did not realize how difficult and how severe PKD pain can become with
some individuals until I went to PKD conference and met with a few
individuals using fentanyl patches and more to
function. <o:p></o:p></SPAN></P></DIV>
<DIV>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 10pt"><o:p> </o:p></SPAN></P></DIV>
<DIV>
<P class=MsoNormal><SPAN class=apple-style-span><I><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 9pt">"FDA
announced on February 12, 2008, that PriCara, Division of
Ortho-McNeil-Janssen Pharmaceuticals, Inc.has recalled all lots of 25
mcg DURAGESIC® (fentanyl transdermal system) patches sold by PriCara
in the United States and all 25 mcg/hr fentanyl patches sold by Sandoz
Inc.(See:Sandoz Fentanyl Patch Recall) in the United States are
being voluntarily recalled."</SPAN></I></SPAN><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 10pt"><o:p></o:p></SPAN></P></DIV>
<DIV>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 10pt"><o:p> </o:p></SPAN></P></DIV>
<DIV>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 10pt"><o:p> </o:p></SPAN></P></DIV>
<DIV>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 10pt">At
this same PKD conference there was a PKD pain lecture given by both Dr.
Torres [giving the medical aspects of PKD pain relief] and the laparoscopic
surgeon who developed the denervation procedure. I always learn so much from
these conferences, though I have not gone to one since Dr. Torres stopped
going.<o:p></o:p></SPAN></P></DIV>
<DIV>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 10pt"><o:p> </o:p></SPAN></P></DIV>
<DIV>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 10pt">Warmly,<o:p></o:p></SPAN></P></DIV>
<DIV>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 10pt">Diane<o:p></o:p></SPAN></P></DIV>
<DIV>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 10pt"><IMG SRC="cid:X.MA1.12-@aol.com" border=0 width=113 height=97 DATASIZE="34041" ID="MA1.1257335542" ><BR> <o:p></o:p></SPAN></P>
<DIV>
<DIV>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 10pt">On
Oct 29, 2009, at 12:23 PM, <A title=mailto:jcro-@aol.com href="mailto:jcro-@aol.com">jcro-@aol.com</A>
wrote:<o:p></o:p></SPAN></P></DIV>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 10pt"><BR><BR><o:p></o:p></SPAN></P>
<DIV>
<DIV>
<DIV>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 10pt">I
refused to take Opiates at all cost. Part of my work is working with
drug addicted patients and I have seen what Opiates do to a persons
life. It literally destroys them physically, financially, mentally and
emotionally to the point that they can not function. It is very
sad. Do not take them if you can help it. They are extremely
addictive.<o:p></o:p></SPAN></P></DIV>
<DIV>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 10pt"> <o:p></o:p></SPAN></P></DIV>
<DIV>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 10pt">Rgds,<o:p></o:p></SPAN></P></DIV>
<DIV>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 10pt"> <o:p></o:p></SPAN></P></DIV>
<DIV>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 10pt">JC<o:p></o:p></SPAN></P></DIV>
<DIV>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 10pt"> <o:p></o:p></SPAN></P></DIV>
<DIV>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 10pt"> <o:p></o:p></SPAN></P></DIV>
<DIV>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 10pt"> <o:p></o:p></SPAN></P></DIV>
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<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 10pt"> <o:p></o:p></SPAN></P></DIV>
<DIV>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 10pt">In
a message dated 10/29/2009 2:40:55 P.M. Eastern Daylight Time, <A title=mailto:Dia-@pkdiet.com href="mailto:Dia-@pkdiet.com">Dia-@pkdiet.com</A>
writes:<o:p></o:p></SPAN></P></DIV>
<BLOCKQUOTE style="BORDER-BOTTOM: medium none; BORDER-LEFT: blue 1.5pt solid; PADDING-BOTTOM: 0in; MARGIN-TOP: 5pt; PADDING-LEFT: 4pt; PADDING-RIGHT: 0in; MARGIN-BOTTOM: 5pt; MARGIN-LEFT: 3.75pt; BORDER-TOP: medium none; BORDER-RIGHT: medium none; PADDING-TOP: 0in">
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 10pt">Some
members have chronic pain from PLD and take opiods which can lead to
constipation. Here is a new drug to ask your docs about if this applys to
you. <o:p></o:p></SPAN></P>
<DIV>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 10pt"><o:p> </o:p></SPAN></P></DIV>
<DIV>
<DIV align=center>
<TABLE style="Z-INDEX: auto; WIDTH: 375pt" class=MsoNormalTable border=0 cellSpacing=0 cellPadding=0 width=500>
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<TR style="HEIGHT: 30pt">
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<H1><SPAN style="FONT-FAMILY: 'Georgia','serif'; COLOR: #003399; FONT-SIZE: 14.5pt">ACG:
Compound Eases Constipation for Opioid
Patients<o:p></o:p></SPAN></H1></TD></TR>
<TR style="HEIGHT: 30pt">
<TD style="BORDER-BOTTOM: #cccccc 1pt solid; BORDER-LEFT: medium none; PADDING-BOTTOM: 0in; PADDING-LEFT: 0in; PADDING-RIGHT: 0in; HEIGHT: 30pt; BORDER-TOP: #cccccc 1pt solid; BORDER-RIGHT: medium none; PADDING-TOP: 0in">
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<TABLE class=MsoNormalTable border=0 cellPadding=0>
<TBODY>
<TR>
<TD style="PADDING-BOTTOM: 3.75pt; PADDING-LEFT: 0in; PADDING-RIGHT: 0in; PADDING-TOP: 3.75pt">
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 8.5pt">By Kristina
Fiore, Staff Writer, MedPage Today<BR></SPAN><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: #666666; FONT-SIZE: 8.5pt">Published:
October 28, 2009</SPAN><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 8.5pt"><BR>Reviewed by <A title=http://www.medpagetoday.com/reviewer.cfm?reviewerid=30 href="http://www.medpagetoday.com/reviewer.cfm?reviewerid=30"><SPAN style="COLOR: #000099; FONT-SIZE: 9pt; TEXT-DECORATION: none">Zalman
S. Agus, MD</SPAN></A>; Emeritus
Professor <BR>University of Pennsylvania School of
Medicine and<BR>Dorothy Caputo, MA, RN, BC-ADM, CDE,
Nurse Planner</SPAN><SPAN style="FONT-SIZE: 8.5pt"><o:p></o:p></SPAN></P></TD>
<TD style="PADDING-BOTTOM: 0.75pt; PADDING-LEFT: 0.75pt; PADDING-RIGHT: 0.75pt; PADDING-TOP: 3.75pt"></TD></TR></TBODY></TABLE></TD></TR>
<TR>
<TD style="PADDING-BOTTOM: 0.75pt; PADDING-LEFT: 0.75pt; PADDING-RIGHT: 0.75pt; PADDING-TOP: 7.5pt">
<TABLE style="WIDTH: 1.25in" class=MsoNormalTable border=0 cellPadding=0 width=120 align=right>
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<P style="TEXT-ALIGN: right" class=MsoNormal align=right><SPAN style="FONT-SIZE: 8.5pt"><16658.jpg><o:p></o:p></SPAN></P></TD></TR></TBODY></TABLE>
<DIV>
<P style="LINE-HEIGHT: 11.25pt" class=MsoNormal><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: #151515; FONT-SIZE: 9pt">SAN
DIEGO -- An investigational drug increased spontaneous bowel
movements for patients with opioid-induced constipation,
researchers said here.<BR><BR>Bowel movements per week
increased from about one at baseline to five or six, depending
on the dose used, Lynn Webster, MD, of Lifetree Clinical
Research in Salt Lake City, and colleagues reported at the
American College of Gastroenterology meeting here.<BR><BR>The
drug, NKTR-118, "increased the frequency of bowel movements
without a reversal of analgesia, and it was reasonably safe
with no serious problems in this study," Webster said.
<o:p></o:p></SPAN></P>
<DIV>
<P style="LINE-HEIGHT: 11.25pt" class=MsoNormal><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: #151515; FONT-SIZE: 9pt"><o:p> </o:p></SPAN></P></DIV>
<P style="LINE-HEIGHT: 11.25pt" class=MsoNormal><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: #151515; FONT-SIZE: 9pt">He
said constipation is a common side effect of opioid therapy,
affecting about 40% to 60% of patients on chronic or acute
treatments. <o:p></o:p></SPAN></P>
<DIV>
<P style="LINE-HEIGHT: 11.25pt" class=MsoNormal><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: #151515; FONT-SIZE: 9pt"><o:p> </o:p></SPAN></P></DIV>
<P style="LINE-HEIGHT: 11.25pt"><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: #151515; FONT-SIZE: 9pt">The
investigational compound is a polymer form of naloxone that
antag onizes peripheral opioid receptors in the gut. It can
act selectively, preventing it from reversing opioid pain
management, the researchers said.<o:p></o:p></SPAN></P>
<P style="LINE-HEIGHT: 11.25pt"><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: #151515; FONT-SIZE: 9pt">For
their Phase-II, randomized, double-blind, placebo-controlled
trial, the researchers recruited patients on stable regimens
of opioids who consistently had fewer than three spontaneous
bowel movements per week.<o:p></o:p></SPAN></P>
<P style="LINE-HEIGHT: 11.25pt"><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: #151515; FONT-SIZE: 9pt">A
total of 208 patients were randomized to either a 5-mg, 25-mg,
or 50-mg dose of NKTR-118 or placebo for four
weeks.<o:p></o:p></SPAN></P>
<P style="LINE-HEIGHT: 11.25pt"><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: #151515; FONT-SIZE: 9pt">The
researchers found that spontaneous bowel movements increased
significantly for patients on the 25-mg and 50-mg dose
compared with placebo.<o:p></o:p></SPAN></P>
<P style="LINE-HEIGHT: 11.25pt"><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: #151515; FONT-SIZE: 9pt">Patients
on the 25-mg dose increased to five spontaneous bowel
movements per week, up from 1.4 per week at baseline, whereas
placebo patients increased to just 3.1 per week from 1.2 at
baseline.<o:p></o:p></SPAN></P>
<P style="LINE-HEIGHT: 11.25pt"><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: #151515; FONT-SIZE: 9pt">Those
on the 50-mg dose had six spontaneous bowel movements per
week, up from 1.6 at baseline -- a significant improvement
compared with those on placebo, who increased to 3.3 per week
from 1.4 at baseline.<o:p></o:p></SPAN></P>
<P style="LINE-HEIGHT: 11.25pt"><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: #151515; FONT-SIZE: 9pt">Spontaneous
bowel movements for patients on the 5-mg dose did not differ
significantly from those on placebo, the researchers
said.<o:p></o:p></SPAN></P>
<P style="LINE-HEIGHT: 11.25pt"><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: #151515; FONT-SIZE: 9pt">The
median time to first bowel movement was 6.6 hours for those in
the 25-mg dose, compared with 48.6 hours for those on placebo
(<EM><SPAN style="FONT-FAMILY: 'Arial','sans-serif'">P</SPAN></EM>=0.001).
It was 2.9 hours for those on the 50-mg dose, compared with
44.9 hours with placebo (<EM><SPAN style="FONT-FAMILY: 'Arial','sans-serif'">P</SPAN></EM>=0.002).<o:p></o:p></SPAN></P>
<P style="LINE-HEIGHT: 11.25pt"><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: #151515; FONT-SIZE: 9pt">Webster
said that there was no change in patient pain, and there were
no changes in the amount of opioid used for any
patient.<o:p></o:p></SPAN></P>
<P style="LINE-HEIGHT: 11.25pt"><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: #151515; FONT-SIZE: 9pt">However,
dropout rates were significantly higher for the 50-mg dose of
the drug compared with placebo, "probably due to the side
effect profile," Webster said.<o:p></o:p></SPAN></P>
<P style="LINE-HEIGHT: 11.25pt"><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: #151515; FONT-SIZE: 9pt">The
most sign ificant side effects associated with the drug were
gastrointestinal in nature, and included nausea and abdominal
pain.<o:p></o:p></SPAN></P>
<P style="LINE-HEIGHT: 11.25pt"><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: #151515; FONT-SIZE: 9pt">Side
effects were not significantly different for the 5-mg dose
compared with placebo, and there was more nausea in the
placebo group for the 25-mg dose, but side effects were
significantly higher in the 50-mg dose compared with
placebo.<o:p></o:p></SPAN></P>
<P style="LINE-HEIGHT: 11.25pt"><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: #151515; FONT-SIZE: 9pt">There
was also one serious adverse event in the 50-mg dose, with a
patient admitted to the hospital for excessive abdominal
cramping.<o:p></o:p></SPAN></P></DIV></TD></TR></TBODY></TABLE></DIV></TD></TR></TBODY></TABLE></DIV></DIV>
<DIV>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 10pt"><o:p> </o:p></SPAN></P></DIV></BLOCKQUOTE></DIV>
<DIV>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 10pt"> <o:p></o:p></SPAN></P></DIV></DIV></DIV>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 10pt"><o:p> </o:p></SPAN></P></DIV></BLOCKQUOTE></DIV>
<DIV>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 10pt"> <o:p></o:p></SPAN></P></DIV><PRE><SPAN style="COLOR: black">--^^---------------------------------------------------------------<o:p></o:p></SPAN></PRE><PRE><SPAN style="COLOR: black">This email was sent to: craig-@wswa.org<o:p></o:p></SPAN></PRE><PRE><SPAN style="COLOR: black"><o:p> </o:p></SPAN></PRE><PRE><SPAN style="COLOR: black">EASY UNSUBSCRIBE click here: <A title=http://topica.com/help/unsub.html.Y3JhaWcu href="http://topica.com/help/unsub.html.Y3JhaWcu">http://topica.com/help/unsub.html.Y3JhaWcu</A><o:p></o:p></SPAN></PRE><PRE><SPAN style="COLOR: black">Or send an email to: pkd-unsu-@topica.com<o:p></o:p></SPAN></PRE><PRE><SPAN style="COLOR: black"><o:p> </o:p></SPAN></PRE><PRE><SPAN style="COLOR: black">For Topica's complete suite of email marketing solutions visit:<o:p></o:p></SPAN></PRE><PRE><SPAN style="COLOR: black"><A title=http://www.topica.com/?p=TEXFOOTER href="http://www.topica.com/?p=TEXFOOTER">http://www.topica.com/?p=TEXFOOTER</A><o:p></o:p></SPAN></PRE><PRE><SPAN style="COLOR: black">--^^---------------------------------------------------------------<o:p></o:p></SPAN></PRE></DIV></FONT></BLOCKQUOTE></DIV>
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--part1_c2f.5c35f2fe.3822c4f8_rel_boundary--
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