Into the ER

The pain in Kev’s back and legs has continued to bother him – some days were better than others, but mostly it was manageable. The x-ray results a couple weeks ago didn’t show anything that could explain it so he just continued on, taking the pain meds (hydrocodone) when needed. On Friday he was scheduled for his 2nd treatment of Ipilimumab, but we never made it - ending up in the ER instead.

MDA has a standard pain chart – 1 (smiley face – no pain) to 10 (unimaginable pain). At every appointment he is asked about his pain level. Of course it’s all relative and each patient would rate the same pain differently, but none the less it gives them something to start with. Usually Kev responds 2-3; and even when the cancer invaded Kevin’s hip bone and he was unable to put any weight on his leg, his rating never exceeded 7. On Friday he told the ER staff his pain was at 8-9. He received a bed pretty quick and they had him set up with an IV of fluids and some fast acting pain meds (dilaudid). New x-rays were run, but again they didn’t show anything so it was decided to go ahead and admit him.

Unfortunately the hospital was full and there were people in the ER that had spent the previous night there because no beds were available upstairs- they were in the queue ahead of us, but luckily we did get a room later that night at about 9:00pm. Kevin’s oncologist was not in on Friday due to a “family emergency”, so we have not seen him yet. But the Dr who works with him spoke with us yesterday and today. In addition, the palliative care Drs came in today to assess his pain meds and increased things a bit (currently taking MS Contin 30mg every 8 hrs & Dilaudid 2mg every 2 hrs). He is fairly comfortable now (albiet pretty heavily sedated) with pain level ~5. There’re a couple theories as to what’s causing this being tossed around – one is that this is progression of the cancer with possible new tumors in the lower spine; the other is that there may be something amiss with his intestines (likely caused by the Ipilimumab treatment). They took scans this afternoon for the intestines (no results yet) and they’re planning on running a PET and MRI of his lower spine on Monday. He still has no appetite but he’s getting all his nutrition through IV now so no one is too worried about that. Nobody is giving us any timeline beyond getting scans, but there have been hints he may be here for at least a week.