Pain Management 101

Dear Family and Friends,

I've been struggling for some days with the great desire to see Francis pain free, yet nagged by warnings to be very very careful with narcotics, esp. toward nighttime since people can go into a coma. I can still appreciate what another friend wrote -- "the more a person gets, the more he needs, so trying to take fewer meds rather than more" is advised.

But Lynn's sister Mary Kay, a doctor in Ohio, broke my ambivalence. She told Lynn and me that nerve bone pain -- from bone cancer -- is some of the worse pain known to humans. For this kind of pain there's a "need to push it."

She explained over the phone there are two schools of thought on pain management. One, -- like the one I was influenced by, and the other, which she holds, -- that if too few meds are given and the patient "gets into a bad place," even MORE meds must then be administered to break the pain! In other words, there's "less swing if enough meds are given in the first place." The ideal is to keep control constant. That way, in the long run, the patient gets less medication. She also told me that coma is not a concern in a hospital setting. They'd be able "to catch it,",...even to administer a reversal.

I found her argument very convincing. But it's when I talked with Francis on the phone shortly after and heard him say his pain was "diminishing," -- and I could hear a big difference in his voice! -- his experience corroborated her theory for me. I saw how those meds in the last two days had worked to give Francis a reduction of pain, and a much better day today! This certainly doesn't mean he's totally pain free, but whereas he used to have to lie down to get relief, now he stands and walks around with his walker to get it, along with naps.

Speaking of naps, I'm closing the computer now. I got my first 8 hours of sleep in a month last night, and what a blessing that is! To be fresh for Round 2 coming up, I must learn how to let go the exaggerated part of my need for order, -- to give priority to my sleep! Even if I have to leave the dishes in the sink!

Good night dear friends,
Elaine