A term I never wanted to know

The medical community has a term for just about everything. The latest one added to our vocabulary is "breakthrough pain." It applies to pain that is experienced even though the patient is on a regimen of pain medicine. Starting mid-last week, Mary started to experience breakthrough pain even though she was on fentanyl, Celebrex and Tylenol. Stanford had us increase the fentanyl by 50%, double the Celebrex and more frequent use of Tylenol. These increases had no affect on reducing her pain level.

In the hierarchy of pain meds, Mary's regimen is near the top. The only thing left is morphine. Stanford issued a script for oral morphine on Thursday. Because Mary's stomach was rejecting all intake Thurs-Fri, we had some difficulty getting enough into her. However, the form she was given is designed to go under the tongue and be absorbed into the bloodstream without processing through the stomach. That is what we did and it worked.

By Saturday, the morphine had knocked the pain down. And, that allowed her to eat and hold food. In fact, she has hosted several visitors this weekend including Janie from across the street, MaryR, Ingrid plus lengthy calls with several folks. Once she gets tired, though, she sleeps-drifts for a while.

Today has been so much better, the best day in a week or more. Breakfast, lunch, afternoon snack, dinner and late milk and cookies have all gone in and stayed successfully. And, the back pain has been kept at bay since 5AM today when Mary had her last morphine dose. She is on the fentanyl at normal adult dose, Celebrex at the increased level and no Tylenol today. Good signs, we hope.

Mary's daughter, Lara, is driving up from Pasadena tomorrow to spend a few days. I am so looking forward to having a bit of a break with Lara here to help out.

And, first thing tomorrow (Monday), we'll be on the phone to Mary's three doctors at Stanford to bring their attention to the MRI taken Friday. The previous MRI was Nov 16 so that gives them a ten week difference. Any changes may lead to the cause of Mary's pain which we would hope lead to the solution to her pain problem.