Wednesday, January 14, 2015

14 January 2015 - 11:00 PM

After some visits from a few doctors, including the "Pain Team", whose job is to help manage cancer pain, they decided to do a few things that have seemed to work.


  1. They increased her PCA dose from .2mg of dilaudid to .5mg.  She can receive this dose whenever she pushes the button (subject to constraints mentioned in the previous post).  This is only step one because she has been on some pretty heavy narcotics for the last few days with no relief
  2. They put her on a continuous drip of Ketamine.  This seemed to help a little better.  One of the nurses said "this drug has a great street value."  We can understand why.  Alisa is having all sorts of vivid dreams and even started singing happy birthday to Sam when she called him (his birthday was yesterday.)  She was a little upset with me that I didn't stop her immediately and tell her it was yesterday (apparently Sam was a little confused), but I couldn't, she seemed to happy.  After 5 days of being miserable and in pain, it was refreshing to see her happy again (if a bit delusional.)  I decided delusional is better than constant un-yielding pain, as long as it isn't permanent.
  3. They gave her some nerve blocking injections.  I am sure there is an official name for this, but I must have missed it.  Basically they injected lidocaine into the nerves in her back (between her ribs) and it magically stopped the back pain (the worst of the pain she has been experiencing).  the doctor told her he could do that every 2-3 days.  She came back from this procedure feeling better than I have seen her since last week.
The last couple of hours have been much better than the previous couple of days and I even think Alisa will get a good nights rest.  The downside is that we are really just masking her pain, we haven't done anything yet to try and address the cause (the tumor).

We have a plan to try 2 things.
  1. Embolization - I think I got this term right.  Basically they thread some wires and other tools up the femoral artery until they get INSIDE the tumor.  They find the blood supply to the tumor and shut it down.  This effectively kills the tumor.  They were going to try this tonight but it requires that Alisa lay still for 4 hours after the procedure, and the pain she was experiencing was not going to allow that.
  2. PD-1 - We are still hoping she can get a dose of PD-1, but they can't do it while she is in the hospital, so she will have to be discharged first.  If her pain is under control tomorrow, we could still get the PD-1 tomorrow afternoon.
The goal today was to get her pain under control.  Success! 

Tomorrow we will come up with a new plan.

-Josh

13 comments:

  1. This is such a relief. I am so glad she is more comfortable. Thank you for the update.

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  2. Thanks for all the updates Josh. So glad the pain is more under control. Tell her she is thought about non stop!

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  3. Much love and prayers that all will go well with tomorrow's plan. You are an amazing example of great faith. Love you!! We are thinking of you and your family constantly.

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  4. I am glad to hear that she is in control of the pain.

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  5. Oh my gosh. Thank you for all the updates. What a terrible roller coaster ride! Praying extra hard!

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  6. Thanks for the updates Josh! You are all in our prayers - about the only thing we can do from 2000 miles way!

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  7. I'm so glad to hear that she got some relief. Thank you, Josh, for keeping us informed and for being such a wonderful support for Alisa. I love you both.

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  8. I'm so happy she could find some relief. Thanks for the updates!

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  9. Pain control is the best step. Sending my thoughts and prayers for the next step and prayers for strength for both you. Josh thanks for the updates you are a good man.

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  10. I'm so sorry Josh and Alisa. My prayers and thoughts are with you constantly!

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  11. Thanks for the update Josh. Along with everyone else I'm glad to know she has some relief from the pain and a plan for the tumor. Lots of prayers and love from our family.

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  12. glad you updates and glad there sounds like a plan of action. I hope she can rest and not be in so many pain... prayers and hugs from our family.

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  13. Thanks for keeping us updated. It's great to hear that she isn't in constant pain. Thank goodness for stuff with 'street value' when you really need it. Keep fighting! We love you guys.

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