Carrie, 39

Greenwood Village, CO

Symptoms:

  • Undermanaged post-surgical pain
  • History of non-response and adverse effects with pain medication

Clinical analysis:

Breast cancer patient undergoes three surgeries in three months, including 32 lymph node removals and reconstruction. Persistent post-surgical pain and intolerable side effects; given the same opioid analgesic each time with no efficacy.
Result:

  • OPRM1 A118G AG – altered µ-opioid receptor (OPRM1)
  • COMT val158met AA – severely decreased catechol-o-methyltransferase (COMT) activity

 

Dr. Kelly Fobes’ Comments:

This patient has a common mutation that results in altered expression of the µ-opioid receptor, or it’s signaling, which has been associated with decreased efficacy and increased side effects with some opioid analgesics.

This patient also has a homozygous mutation, resulting in a low functioning COMT enzyme that fails to degrade dopamine and in turn may suppress the production of endogenous opioid peptides.

In addition to altering pain sensitivity, this variant has been associated with a trend toward persistent pain after mastectomy, and increased opioid related adverse events, when treating cancer pain.

It’s no wonder she suffered, needlessly.

A substantial portion of preventable adverse drug events have been associated with analgesics, and the majority of patients experiencing post-surgical pain receive suboptimal dosing. Undermanaged post-surgical pain can have significant effects on recovery time and may in turn lead to a variety of consequences, including deep vein thrombosis, pulmonary embolism, myocardial infarction, pneumonia, poor wound healing, reduced immune response to surgery and chronic pain syndromes.

TESTIMONIAL FROM CARRIE:

Thank you Molecular Testing Labs for your insight and expertise about my genes and how they affect how I metabolize drugs.

I can’t help but think that this test would have had changed my personal experience last summer.

I was in the emergency room and while being wheeled back into emergency surgery, the doctor says, “I’ll call in a prescription for Vicodin.” I turned my head and said NOOOOOOOOOOOO.  THAT DOESN’T WORK FOR ME.

I wish she would have ordered this Pharmacogenetic test.  This turned out to be the start of a series of surgeries.  THREE total in three months.   ALL without effective medication including 2 for breast cancer and 32 lymph node removals.

I suffered needlessly.

I can’t even hardly communicate how traumatized I was when I had these three invasive surgeries and was given meds that didn’t work.  I have an optimistic and upbeat attitude but this pain was overwhelming even my sunny disposition.

When I got my gene test back, it confirmed what I already knew about my body.

It does a very poor job metabolizing opioid meds making them ineffectual and prone to substantial side effects.  What’s worse, is that I endured suffering needlessly and I think I may have had a more positive experience of healing had I been prescribed a medication that actually worked.

I feel like I am empowered with this insight and my experience is validated by this test.

I will never take any medication without first checking with my test blueprint. This test leaves me feeling protected from here on out.

Carrie

Greenwood Village, CO

 

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