Nurse Nancy, the Hospice nurse, brought very good news today. First, to alleviate the worst tendency over the last few weeks, the rapid increase in pain, she called Dr Ellison, my palliative care doctor from Geisinger (Danvile), and he made the following changes:
Base dosage (every 8 hrs, unaffected by breadthrough doses)
20 mg Methadone -> 35 mg Methadone
PRN (breakthrough) doses, not to exceed every three hours, unaffected by base doses.
7.5 mg Methadone -> 10-15 mg Methadone, set at 10 originally by Nurse Nancy.
20/8 –> 35
7.5 –> 10
The progression of the cancer is what it is, of course, but this should make it liveable for a decent period of time.
It wasn’t just the progression, but the location of the pain. It went from displaced to the hips straight to the lungs — that is, the back. Think a metal constriction band squeezing until it crushes your vertebrae and ribs. That’s an accurate, if slightly less intesnse, description.
The control of the pain isn’t just meds. It’s posture. One thing repeatedly that has been recommended is an air mattress. The Hospice found one of imperfect size (long enough, but not wide enough), and we’ll try it.
All but one approval has flown through for a motorized wheelchair. Only one more, and I will, once lifted into it, be able to fly up and down the halls.
Finally, I met the Orthodox chaplain of our Hospice, a Fr Stephen (AOCNA). Sure, I know, I already have two priests and two deacons who see me regularly, but I figure the more, the merrier.
All in all, good news, I’d say.