Thursday, July 9, 2009

What's up With the Doc 64? - Still Learning

Being a cancer patient continues to teach me new things as a physician. The general level of discomfort that I described last week just kept getting worse. As bad as the general feeling of ill ease was the unrelentingness of it all. I just could not get comfortable, no matter what I tried. This resulted in early doses of oxycontin on Thursday and Friday last week, which completely took away the feeling of unease. So Saturday I started taking the oxycontin twice a day and have felt remarkably better ever since. I spoke to my oncologist about it Tuesday and he feels that I was actually experiencing opiate withdrawal during the day because I was only taking oxycontin at night and that taking the oxycontin as it is intended to be dosed, twice a day, I have taken care of that little problem. I feel sort of stupid, but long acting narcotics have not been part of my practice since before oxycontin came on the market, so I’ll try to forgive myself. I have been so skittish about the narcotics that I caused myself more trouble than I needed by trying to keep the dose as small as possible. Now my pain is more than adequately controlled on the lowest possible dose of oxycontin and I am not taking scheduled Ibuprofen any more. This gives me the option of taking either Ibuprofen or short acting narcotics in small doses when I have breakthrough pain. So life on the pain front is very good.

The neck pain is slowly settling down since the radiosurgery (2 weeks ago today) and I am having less and less tingling in my right arm. I have had no more tingling or pain in the left leg since early last week so that turned out to be a curative MRI, I guess.

I saw the radiation oncologist Tuesday and was released from care until I need him for something. I saw the oncologist and had Zometa and Navelbine Tuesday and I’m feeling pretty darned good today. With the pain adequately controlled, my only troublesome symptom is the weakness and I’m learning to live with that. It doesn’t seem to be getting any worse. I’ve learned to rest after stairs, bedmaking, and to limit the amount of standing I do. I use a stool when I see patients during the time I am taking their history so I only have to stand up for the exam. I’ll get a wheelchair for the air travel part of my Texas trip later this month. I’m not having any trouble with daytime sleepiness, just weakness.

My gut problems seem to have resolved with Colace and Miralax every day - but we’ll see if it holds me through this dose of Navelbine. I did develop a sore throat from the radiosurgery late last week and it hurts to swallow but I’m still holding my own on eating with no weight loss.

All in all, this week is better than last. I’m busy planning fall school things with all of my children and enjoying the first real summer weather we’ve seen over this last weekend.

No comments: