Monday, December 3, 2018

Cancer: Pain Management

Cathy, under the blanket her sister knitted for her. The damn
thing weighs twenty five pounds, I kid you not. It's like a
Thunder Shirt for grown-ups. Cathy loves it. 
I should have known better. It was going so well. In every movie, every comic book, every aspect of cliched storytelling the world over, it's the guy in the war movie who stands up and says, "I can't wait to get home tomorrow to see my baby girl!" that gets taken out by a sniper.

The "we've got a handle on this pneumonia" post must have felt a lot like bragging, because the Stage Three Ovarian Cancer Sniper was quick to remind us that he's still out there, and he's an asshole.

Ever since her diagnosis, and a little before, Cathy has complained of intense, localized lower back pain--think a charlie horse, but up in the middle of your back. We have examined, poked, prodded, massaged and kneaded the area, to no avail. Muscle relaxers? Tried 'em. Yoga? You betcha. Nothing worked. The thing was this: it didn't feel like a back muscle spasm. No knots, no bulges, no tightness, nothing I could feel. The muscles in her back were fine, even in the midst of a 'spasm.'

With her cancer diagnosis, Cathy was quick to report the problem to her oncologist, who confirmed what we knew: not only was there no muscular problems, there was no cancer, either. Not there, anyway. The cancer and its accompanying physiological problems could still be the culprit, however. Neurological pain is complicated, and without being able to isolate something, there could be any number of things pressing down on somewhere else, and the pain receptor in her back is going haywire.

Yeah. This sucks, all right.

The doctor's treatment was very Victorian: morphine, as needed. And Cathy certainly needed it. Mostly for sleep, because the area of the back we're talking about is the part that presses right down on the mattress. And since that causes pain, Cathy has been sleeping in a reclined position most nights. But we were managing it. It was an inconvenience.

I was dealing with theater business when she called me today. I could hear her crying. She said, "I need you," and I did my best Batman impression as I jumped into my 2010 Orange Vibe and floored it for the five minute trip to the hospital. I didn't know what was up; she sounded panicked on the phone. I didn't ask. I just drove.

As I approached her room, I could hear someone wailing, and then someone said, "Fudge-Monkeys!" and I broke into a run. Cathy looked like she was giving birth in the chair. She was surrounded by nurses, all of whom were talking to her, trying to get medicine into her port, and trying to hold her hand and touch her back as she howled like she was being beaten.

I didn't have time to think. I jumped in and started trying to get her to calm down, breathe normally. Through gritted teeth, she growled that it hurt when she took a breath. As soon as I showed up, one of the nurses broke away to get the doctor. I peeled off an called her Oncologist.

It took well over an hour to get her sedated. They couldn't put drugs into her fast enough. Anti-anxiety meds, Demerol, morphine, stuff I didn't know what it was...she was quickly doped to the gills, and I mean, she was gone, Jack. The only thing missing from her personal luau was a fire-pit and a smoked pig. But even that wasn't doing it because she was scared, and freaking out.

Cathy is one of those people who under-reports her pain because she doesn't want to inconvenience anyone. So, when they ask her, "how is your pain level?" and she says, "Oh, maybe a four or a five, I guess," that's a Mark Finn Nine. And it's probably a regular person seven. So when the doctor asked her how bad was it, she stopped screaming to say, "It's like a charlie horse in my back, on eleven!"

Ordinarily, I wouldn't recommend chasing the blues away
with bourbon, but today, I think I'm entitled to a snort. 
Honestly, that scared me more than anything. If she's reporting an eleven, I am sure I would have been in a coma. She's just stronger than me. I did the only thing I could do: I kept soothing her, and told the doctor everything we have surmised about this pain problem. He promised me they wouldn't quit until she was out of pain, and sleeping.

The nurses had more of a handle on things, and the first wave of narcotics was kicking in, leaving Cathy insensible. I made a quick errand to get a bite to eat, and pick up my prescription, and call my mother and blubber to her in the car for about ten minutes.

I went back up and she was even more goofy, sleeping in fits. I got them to turn off the lights and just sat with her, listening to her breathing. It was irregular, but she'd had a hard day. When I finally got up to leave, she stirred and said, "I keep thinking you're here to take me home."

Oh, golly, don't I wish.

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