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Wednesday, October 29, 2014

Still working on pain control

When I got here today, around 10:30A, Marshall was doing okay. They had put a lidocaine patch on his back, in addition to the Dilaudid. But around 2:00 the pain was back with a vengeance. So the pain patch only was effective for about 6 hours and it's supposed to work for 12 hours. So around 3:00 they gave him more Dilaudid and in a few minutes he started to relax.

He hadn't eaten at all yesterday and this morning he had a few crackers and some milk in order to take his chemo pill. An hour or so later he threw up. At noon he ate a little bit of chicken soup. An hour or so later he threw up again.

A little while ago he went to the bathroom and had blood in his urine, so they took it to do a urinalysis. The nurse came back later and said it wasn't blood and there wasn't an infection so she assumes it is caused by a medication. Hopefully it will clear up by tomorrow.

Dr. Flaig's nurse just called and said that the University Hospital doesn't work with Parkview so she couldn't send orders here for any blood work that the University would have done today if we had made our appointment. However, she said she was sure that -- except for the PSA -- they would do the same tests anyway. She said to keep her posted.

It is now 8PM and no doctor has been in to see us today. This is quite frustrating. Marshall just told the night nurse how upset he is about not seeing a doctor today. My emotions are sooooooooo fragile right now.

I am going to spend the night here with him tonight. Our dogsitter has agreed to stay at the house as long as we need her.

Hope to have news tomorrow.



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Tuesday, October 28, 2014

Update

I just got home from the hospital. He was admitted mainly so that they could get his pain under control, and hopefully to figure out what is causing it. I could have spent the night in his room but I wanted to get back to my animals and bask in their love and support before hearing any more bad news. So I drove the 60 miles home and I will drive the 60 miles back to the hospital tomorrow morning early.

When I left this evening they had FINALLY gotten him some pain relief. He got so many opiods (I think that's the word) today that he won't be able to go to the bathroom for years! But after moaning and calling out in unbelievable pain all day today, when I left he was actually sleeping (they finally got the okay to give him something called Dilaudid). And they had gotten the okay to keep giving him the Dilaudid every three hours. Very hard core painkiller. Morphine didn't work but the Dilaudid did.

They did a CT scan and took blood, but when I left we still hadn't officially heard the results. I heard one of the nurses say that there was nothing remarkable with any of the tests they did, so now what? I guess that means the pain is definitely just the cancer in the bones and he's going to have to live with it until we can get him in good enough shape to get up to the cancer center and get set up for his radiation.

The emergency room doctor suggested that maybe they could transport Marshall up to the University Hospital so that he could be admitted there and get started on his treatment, but I don't know if that idea will fly or not. If they do that, I will have to scramble to get a dogsitter in place....

And I don't know if a CT scan would show fractures or not, but the way he was acting, not being able to take a big breath without lots of pain, I was thinking maybe he had a fractured rib. But what do I know?

I'll post an update tomorrow.



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911

Had to call 911 for Marshall this morning. He had excruciating pain in his left side and couldn't breathe. I just got to the hospital (1:00). Not sure what's going on. Stay tuned.

The good news is that Westcliffe still has an ambulance service!!  They were there in 16 minutes flat.


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Monday, October 27, 2014

Gearing up for the Cancer Center

Wednesday is our next trip to the cancer center and the anxiety is starting to set in.  And the pain continues.  And taking oxycodone every six hours has brought on another woe -- constipation -- which finally caused an emergency call to the oncologist today.  His nurse called us back and we worked out a plan of attack!

Marshall has been on the chemo pill for over a week now and today for the first time he said there was a lessening of the pain in his hip.  So that sounds great!

Tomorrow will hopefully be a quiet day and then we hit the road early on Wednesday to head to Denver.  I sure hope his pain continues to let up because I do the driving now and it is awful every time I hit a bump of any kind...

Wednesday, October 22, 2014

Keeping the pain at bay

Marshall is having some pretty bad pains in his back and the only thing that will relieve the pain is oxycodone. So he's been taking oxycodone several times a day. We've been concentrating on pain relief, laying low and getting rested.

Nothing else to report right now.


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Monday, October 20, 2014

Radiation

We got up at 4:45A this morning and headed to Denver for our appointment with the radiation oncologist, Dr. David Raben. He and his associate, Dr. Chad Rusthoven, put up all of Marshall's scans and x-rays and pointed out the "hot spots." They took as much time as we needed and we really liked both of them.

There were two hot spots that they said need attention now. One in the spine and the other in the left hip. Both are places where Marshall has been having some pretty bad pain which has caused him to be on every-six-hour oxycodone.

Dr. Raben is going to talk to Dr. Flaig to see if they think it's necessary to see an orthopedic guy first to check the strength of the hip area before radiating it. He said his opinion is that the area is strong enough to handle the radiation without fracturing but he wants other opinions on that.

Assuming we don't have to see an orthopedic doctor first, we have an appointment for next Wednesday with Dr. Raben to get the radiation areas "mapped" and start preparing for the actual treatments. Then, if everything goes as planned, we will be given our radiation schedule. Dr. Raben says it will be between 5 and 10 treatments (to be determined later) given daily (not sure if that includes weekends or not). So we will just move up to the hotel for that period of time because it is right across the street from the hospital.

If anyone remembers Marshall's last radiation sessions two years ago, you will remember he developed severe radiation colitis which put him in the hospital for three days.  Dr. Raben has promised us that won't happen this time....

Also next Wednesday, we will get lab work done and then we see the Nurse Practitioner to get the results. They want to keep close tabs on the blood counts now that Marshall is on the chemotherapy pill. And I am guessing they will also check the PSA again to see if the chemo has had any effect yet.

We asked if getting chemo and radiation at the same time could cause any problems and both doctors said no, that was actually a really good approach.

So far, Marshall has been experiencing EXTREME fatigue, but no other side effects of the chemo have shown up. Let's hope it stays that way. And we are told that the radiation will probably also add even more fatigue to the mix.

Now we move on to our older dog, Marlee. He is deaf and partially blind and he has some doggie dementia. He walks into corners and can't figure out how to back out of them, when he goes outside he can't figure out how to get back in the house, he falls a lot, etc. etc. But he does not appear to be in any pain. We've done a bit of crying over this because it probably won't be very long before we have to make a decision about him. It is heartbreaking. We're going to get him to the vet this week to have her check him out. It just kills us to leave him behind when we are in Denver for long periods of time because we want to spend time with him.

That's the story for today. It was a very long and emotional day. I had to ignore my job today and I thank the gals who covered for me even though they were already being pulled in ten directions.


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Sunday, October 19, 2014

3rd day of chemo

Marshall has now taken the chemo pill for three days (and the prednisone was reduced to 4mg twice a day instead of 5mg twice a day -- I think they may wean him off of the prednisone) and so far the only possible side effect he feels is fatigue.  But he's had that all along with the other medications, too, so not sure if it's the chemo or not.

The pain he was having in his back has let up.  He didn't take any oxycodone today at all.  So it probably was stress related.  He does still have the hip pain when he moves in certain ways.

Tomorrow we need to get up at 5AM to hit the road back to Denver to see the radiation oncologist and find out what our plan of action is going to be.  Boy, I wish we could just say "Beam me up, Scottie" for these trips to Denver!

Tonight we got on the internet to see what rent costs are in Denver so that maybe we could rent an apartment and we could take our animals with us on these trips rather than agonize over trying to get a dogsitter.  But the rents are pretty high so that may not be an option for us.

Through an interesting series of events, we were able to get a second opinion on Marshall's treatment.  Our oncologist is Thomas Flaig.  Dr. Flaig's boss is Dr. David Crawford at the University Hospital.  It turns out that Dr. Crawford knows Fred (my boss).  A few weeks ago Dr. Crawford was coordinating a big charity golf tournament to benefit prostate cancer research and I got a call from Wendy, a gal who works with him.

Wendy and I talked a lot while coordinating Fred's foursomes for the golf tournament and last week when we were at the cancer center Wendy met us for lunch.  She brought Dr. Crawford with her!  So I couldn't resist asking his opinion.  He said he would check Marshall's records and let us know what he thought.

He sent me an email last night saying that he agreed with Dr. Flaig's plan of action but there was one other drug that he might suggest to add to the mix.  He said he would talk to Dr. Flaig about it and they would get back to us.  That was kind of cool.

And it turns out that Wendy is a patient advocate for many doctors and medical facilities so she is going to be a huge resource for us.  She brought us a ton of information when we met.  We were very fortunate to make her acquaintance.

Off to bed -- tomorrow will be a long day.