Kevin is actually feeling much better today. The drowsiness has faded (side effect of opiates, usually lasting about 3 days). He was awake all day when I was there and was pretty good with conversation. The PT (physical therapy) folks had him up and walked a loop around the pod. The break-through pain has even lessened some.
The oncologist came by and gave us some bad news. They saw the preliminary results of the PET scan. Full transcripts take 24 hours so they had only the audio in addition to the images. The cancer has spread extensively throughout his body since his last PET 5 months ago. There are numerous new tumors - the pelvis has significant damage and there are suspicious areas in the lower spine. They really want the MRI results before making any recommendations, but said Radiation Therapy was about our only possible option for the pelvis and spine. The big concern right now is if he will qualify for the radiation since he already had radiation on his hip after the replacement and we were told at the time he received maximum (lifetime) dose. The Drs. need to look into this – is this area far enough away from the earlier area - but first they want the MRI…
The MRI was scheduled for late Monday night (~9:00), but Kevin only made it 30 minutes into what is about a 1.5 hour procedure. Having to stay still on the hard flat table became unbearable even though the nurses loaded him up on Dilaudid before being carted over to the scanning area. Kev said it got pretty ugly with the techs trying desperately into talking him into riding it out, but in the end Kev won and they aborted the test. They now have an MRI scheduled for first thing Wednesday morning – this time with assistance from anesthesia. He will have what they call “conscious sedation” – he’ll be able to breathe on his own but for all practical purposes he will be out.
The Palliative Care team also came to see us today. They are concerned about Kev’s delusions and hallucinations - in the middle of conversations he will mix up reality with dreams-like thoughts; in addition he sees things like cats jumping through his window in his periphery vision. Apparently this is not uncommon for opiates, but normally occurs after prolonged usage, so to see these effects after only a couple days is enough to change the course. They removed the MS Contin, Zanaflex (muscle relaxant) and Lyrica (nerve pain) and are putting him on Methadone, 10 mg every 12 hours. He will remain on the Dilaudid (increased now at 3 mg with no time limit) for a few more days as the Methadone ramps up.
Everything is reassessed multiple times throughout the day, but the guess is Kev will remain hospitalized for at least 7-10 days.
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1 comment:
Wow. All I can say is that Kevin is a real-world Superman to have gone through what he has gone through, and to have maintained the positive attitude that he has. I am humbled by the strength of you and your whole family. If I ever have to face something like this, I hope I could muster even half the strength and positive attitude of any one of you. If you ever need anything from Amy or me, do not hesitate to ask us.
Sincerely,
Eric Falconi
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