Not a great couple of days

Mary is out of it most of the time although she does have periods of lucid behavior. And, we have been able to keep food in her for the past 24 hours or so.  She had a tough time waking up and by the time I left for work at 11AM, she had eaten a few bites of oatmeal. She is not able to walk when she is conscious but really, really out of it--her legs buckle underneath her--so I support her when she needs to move. Reenie is afraid she is not strong enough so I suggested they use the secretarial chair (wheels) to move Mary around.   


We did see the pain doctors yesterday and they were surprised by her reaction to neurontin as well as her possible difficulty with ongoing MSContin.  Frankly, we were a bit disappointed with the position taken by the pain doctors regarding who is in charge, so I called the Manager of the Cancer Supportive Care program today and asked how we can change that situation.  I am expecting a call back from her yet today--we want Mary to have a primary care doc who is in the Stanford system and can integrate all the diagnosis, tests, treatments et al in a timely manner. 


While in the examination room at the Pain Center yesterday, Mary tossed her lunch (albeit an itty bitty lunch) in front of doctor #1, a rambler. He then left to meet with the staff doctor.  When they returned, the saw that Reenie and I had lowered the exam table to be nearly flat and Mary was laying down on her left side which seems to be her most comfortable position. The rest of the exam was conducted while Mary was horizontal--and very drowsy although not near-comatose that drove us to the ER on Saturday and she approached at times on Monday.  


They have ordered another procedure and it is being scheduled.  Frankly, the speed at which the pain doctors move is slow even though they saw what we are dealing with first hand.  I will be calling this afternoon to get that scheduled procedure happening a lot sooner than later.  The procedure is injection of steroids near the area of the spine where the pain is sourced.  I don't remember the technical term nor a lot of the details.  


We did switch Mary's meds again.  The neurontin (gabapentin) is gone and she is now taking Lyrica (pregabalin) and will be ramping up slowly over the next 8 weeks or so. The MSContin remains unchanged.  We will need to monitor for breakthrough pain and then seek adjustment as necessary. And she is back on Zofran for nausea again.  


That is all for now.