Aligning the Doctors

Mary saw our primary MD today as suggested by the Oncologist.  And, because Mary is still seeing the pain doctors, we arranged phone calls between the pain doc and the primary care doc to establish the rules of engagement.  As a result, the pain doc will be in the lead until we get Mary's pain resolved and then the lead reverts to the primary care doctor. 


Immediately after the two doctors talked, the pain doctor ordered neurontin for Mary.  The use of this drug will build up over the next several weeks and should lead to the reduction of the morphine Mary is on now.  The pain doctor is also focused on getting to the source of Mary's pain and was disappointed to hear that last week's medial branch nerve block had no apparent effect.  


She is set to see him on the 23rd but he expressed interest in seeing her sooner given how much has changed. He saw her when she was on the fentanyl patch and liquid morphine which means she was zombie-like during the appointment.  He was pleased the oncology folks found a 'better' pain solution and he wants further engagement given that change.  


As for me, we are still on plan for the phacoemulsification next Wednesday.  


Finally, Mary's weigh in at the primary doc's office showed her weight loss was about 25 lbs from early 2009 to now.  As a diet program, we don't recommend cholangiocarcinoma so avoid it if at all possible.