* Dr. Flaig says there is no reason we need to kill ourselves to get up to see him this week. He says there is nothing going on that can't wait a few weeks. He thinks we should go home, try to relax and regroup and then make a followup appointment. So the hospitalist says that if the pain is still relatively controlled today and tomorrow morning when Marshall wakes up, we will go home tomorrow.
* Dr. Flaig has also told us to discontinue the oral chemotherapy for a few weeks to see if that could have conceivably caused any of the recent problems.
* The palliative care doctor suggested a radioactive drug called Strontium and another one called Xofigo. Both of them hone in on cancer in the bones. We have been asking about Xofigo for quite a while. He spoke to Dr. Flaig and between the two of them they decided that since they think Marshall's main pain right now is low back pain, the Strontium and the Xofigo would probably not help.
* The severe back pain Marshall is having is most likely related to simple low back pain and no matter how they look at the scans and x-rays they cannot relate that pain to cancer. (Marshall has had back problems all his life and had back surgery in the 90s.) The suggestion for that is to use a heating pad and perhaps try alternative things like electrical stimulation or acupuncture. Our chiropractor has a wonderful electrical stimulation gizmo and we will get an appointment with him
* With regard to the other pain Marshall is having (in his right side), the palliative care doctor that spent most of the afternoon with us has recommended 60mg of morphine every 8 hours and then liquid morphine for breakthrough pain.
* They took him off of the IV this evening to be sure he can do well without it so that he can be discharged tomorrow.
* With regard to depression, the palliative care doctor is prescribing Remeron which he says works well with the Venlafaxine Marshall is already taking.
* I spoke with Mario from Sangre de Cristo Palliative Care. He has now received the paperwork from our doctor to get us in the system for care. He says as soon as we get home and get rested, we should call him and he'll come out and we'll go over everything.
* I also spoke with a patient advocate today and she has suggested that we switch our cancer care from University of Colorado (180 miles away) to Rocky Mountain (Dorcy) Cancer Center (60 miles away). She believes that we are at a stage in this disease where the treatments are fairly routine and the lab work can certainly be done in Pueblo so that it really doesn't warrant that long trip (and often hotel stay). She believes that Dr. Flaig could still be our oncologist but give his instructions through the Rocky Mountain Cancer Center. Somehow I don't think it would be that smooth, but it would be a huge relief to stay close to home.
* And lastly, we need to see our primary care doctor (Dr. Bliss) and have him go through the gazillion medications Marshall takes to see if they are all absolutely necessary. With the cancer treatments Marshall has had, for example, his diabetes medication really needs to be overhauled. We have gotten so many prescriptions from so many doctors that it really is time to step back and take a look. It is conceivable that one or more of them could be causing problems. I run them through Drugs.com from time to time, but that doesn't tell me much.
In the meantime, the contractors were at our house today to start laying the floor. Gina says they got there late, took up the carpeting and then left for the day. So what else is new....
Gina will have to leave tomorrow to care for her dad and Marshall and I should be getting home close to when she leaves so that the animals won't be alone all that long, if at all. Here's Gina with her girls (Baby and Annie) and my cutie (Coco).
I think this covers everything. I am so relieved that we now have a little breathing room. I hope all of this has us moving to a calmer, pain-free future.
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