What a surprise
More than a month after the last consultation with Dr D, (about 4 days before my mum's admission to the psychiatric ward), my dad's leg pain occurred more frequently. As a result, my dad was taking more breakthrough than prescribed for. So, we consulted Dr D again:
(1) Dad could take the breakthrough (Oxynorm) up to 6 times a day (we thought the maximum was 3).
(2) She advised us to approach Pg GH's PCU as a walk-in patient and tell them what happened so that they could adjust and prescribe more Oxycontin and Oxynorm until the next appointment. It's much cheaper than getting it at Mount Miriam. She expected that they would double the dosage of Oxycontin.
We went to Pg GH the next day. During the consultation, the PCU specialist took up my dad's suggestion of looking at the PET/CT scan. As a result, he (after consultation with his senior), increased the dosage of Oxycontin (from 10mg twice a day to 20mg twice a day) and also asked my dad to see the oncologist too (1 week ahead of schedule).
The oncologist was agreeable with the PCU specialist's recommended dosage to manage the leg pain. However, unlike Dr D, she said there was no need to remove the two lumps (PET/CT scan didn't point them out as cancerous and that they could just be scarred tissues/folded skins from the surgery more than a year ago). She also said cannot perform radiotherapy on the leg again as it was already done once before. Regretfully, we forgot to ask why (we very nearly missed the visiting hours to see my mum).
I asked Dr D via e-mail (as it was already night and it was her off day that day too) about this. I was pleasantly surprised to receive her response later that night: "I agree.... manage it with pain killers first. Radiotherapy is last resort. Too much radiation to the same area can cause long term problems such as stiffness and brittle bones...that's why it's last resort if pain not well controlled."
(1) Dad could take the breakthrough (Oxynorm) up to 6 times a day (we thought the maximum was 3).
(2) She advised us to approach Pg GH's PCU as a walk-in patient and tell them what happened so that they could adjust and prescribe more Oxycontin and Oxynorm until the next appointment. It's much cheaper than getting it at Mount Miriam. She expected that they would double the dosage of Oxycontin.
We went to Pg GH the next day. During the consultation, the PCU specialist took up my dad's suggestion of looking at the PET/CT scan. As a result, he (after consultation with his senior), increased the dosage of Oxycontin (from 10mg twice a day to 20mg twice a day) and also asked my dad to see the oncologist too (1 week ahead of schedule).
The oncologist was agreeable with the PCU specialist's recommended dosage to manage the leg pain. However, unlike Dr D, she said there was no need to remove the two lumps (PET/CT scan didn't point them out as cancerous and that they could just be scarred tissues/folded skins from the surgery more than a year ago). She also said cannot perform radiotherapy on the leg again as it was already done once before. Regretfully, we forgot to ask why (we very nearly missed the visiting hours to see my mum).
I asked Dr D via e-mail (as it was already night and it was her off day that day too) about this. I was pleasantly surprised to receive her response later that night: "I agree.... manage it with pain killers first. Radiotherapy is last resort. Too much radiation to the same area can cause long term problems such as stiffness and brittle bones...that's why it's last resort if pain not well controlled."
Comments
Yes, she is. When my dad was like certain he wanted radiotherapy there, she urged him to consider doing it at GH. "Uncle, it's free leh. It would be thousands of dollars here" (in Hokkien). She's ok to get for my dad to have it done at there but why waste money :), especially since my dad is an existing patient at GH.