Increasing pain
Within a week of the pamidronate infusion, dad experienced severe pain twice (5 days apart). He attributed it to the drug's side effect, which is possible, but there was much uncertainty because he had such incidents previously.
Despite the increase in dosage of Oxycontin and Oxynorm, dad was still taking Oxynorm about 6-8 times a day :( Source of pain: the lumps in his right abdomen, and the sides of his legs stretching from the knees to the shins. When the frequency increased to 9 times a day for 3 consecutive days, we decided to do a walk-in on a clinic day.
We learned that constipation can reduce the effectiveness of the opioid and so dad should aim to pass motion everyday. More importantly, to my shock and annoyance, dad once again unilaterally adjusted medicine: Gabapentin twice daily instead of 3 times a day. Grrrr. This is highly relevant because Gabapentin is suppose to relieve nerve pain, numbness and tingling with pins and needles, all of which increased in frequency roughly after he decreased its dosage. Argh! What a waste of time trying to figure out what changed.
When he was asked to rate the intensity of his pain, he rated it only a 3, of which the doctor said it was "mild" (the opioid is supposed to bring it down to 1-2, not completely eliminate it). Fortunately I was there to say that the pain caused him to wince and sometimes cry. Surely it should be much higher? Should be at least 7 if crying, the doctor informed dad. Haiz.
When asked, dad prioritised the numbness over the pain (I'm so surprised) and so he was asked to resume taking Gabapentin 3 times a day. His lactulose was increased from twice daily to thrice daily so that he can pass motion more frequently (currently it was once in 2 or 3 days) and hopefully that would increase the effectiveness of the opioid. Oxynorm (taken on ad hoc basis) was actually decreased from a max of 5 times a day to 3 times a day. Well, I hope dad gave them correct assessment.
The PCU specialist suggested acupuncture to relieve the localised pain but we do not know of any acupuncturist, much less a good one. Luckily I vaguely remember that the Kepala Batas Hospital has such service and so they provided dad a referral letter.
Despite the increase in dosage of Oxycontin and Oxynorm, dad was still taking Oxynorm about 6-8 times a day :( Source of pain: the lumps in his right abdomen, and the sides of his legs stretching from the knees to the shins. When the frequency increased to 9 times a day for 3 consecutive days, we decided to do a walk-in on a clinic day.
We learned that constipation can reduce the effectiveness of the opioid and so dad should aim to pass motion everyday. More importantly, to my shock and annoyance, dad once again unilaterally adjusted medicine: Gabapentin twice daily instead of 3 times a day. Grrrr. This is highly relevant because Gabapentin is suppose to relieve nerve pain, numbness and tingling with pins and needles, all of which increased in frequency roughly after he decreased its dosage. Argh! What a waste of time trying to figure out what changed.
When he was asked to rate the intensity of his pain, he rated it only a 3, of which the doctor said it was "mild" (the opioid is supposed to bring it down to 1-2, not completely eliminate it). Fortunately I was there to say that the pain caused him to wince and sometimes cry. Surely it should be much higher? Should be at least 7 if crying, the doctor informed dad. Haiz.
When asked, dad prioritised the numbness over the pain (I'm so surprised) and so he was asked to resume taking Gabapentin 3 times a day. His lactulose was increased from twice daily to thrice daily so that he can pass motion more frequently (currently it was once in 2 or 3 days) and hopefully that would increase the effectiveness of the opioid. Oxynorm (taken on ad hoc basis) was actually decreased from a max of 5 times a day to 3 times a day. Well, I hope dad gave them correct assessment.
The PCU specialist suggested acupuncture to relieve the localised pain but we do not know of any acupuncturist, much less a good one. Luckily I vaguely remember that the Kepala Batas Hospital has such service and so they provided dad a referral letter.
Comments
Thank you.
I will pray for your strength, and wisdom. SR
Thank you.