It started on Wed. night, the pain did. I took a half a pain pill, narcotic, and I don't like taking narcotic meds because of the nausea I feel. The pain was worse than I had felt for a long time and it was in the lower back. It had also moved laterally to the hips as well and down to the knees. It seemed to start from the point of the Bone Marrow biopsy location in the back to the right of the spine, in the hip. By 3 am it was worse and I took an additional pill and at 6 am I took another half and the pain spikes were still shooting up to a 10 out of 10 pain level. It was not working and I was having trouble just getting around. There was no position that was comfortable. I woke Lynne up and woke Isaac up and it was decided we would need to go to MDA E.R. since we were not sure where this pain was coming from. So Lynne and I headed for the E.R. and got there about 8:30 and the place was empty. I thought to myself that should mean we get seen and get some answers fairly quickly. Not so, Oh so not so. I think by 10:30 or 11 we were seen by Dr. Davies and got some IV pain meds. He ordered an MRI since the previous CT scans were clear. It took until 3:30 before I got to the MRI and they have 13 of the MRI machines and it took 'til almost 6:00 to get the results. When Dr. Davies came in with the results he wanted to admit me to the hospital. He said there had been additional damage to the vertebrae and that the area around the spinal column was narrower at the base and more damage could result. He also ordered a consult from Neurosurgery and from Chronic Pain Service. Neuro made it and did not concur on fresh injury and suggested these were old injuries and consistent with back problems I had had for some time and at this point would not recommend surgery. Dr. Davies was recommending the Kyphoplasty for treatment and that is the same back surgery that I had for the 3 fractures I had a year ago Feb. This surgery has since been questionable and according to one report Medicare would no longer cover it. It also did not seem to have benefited me for the other injuries. Chronic Pain Service could not make it and would see me in the hospital tomorrow. So we are left with a choice and when we had talked it over we were questioning why it would mean an admission and why not manage this from home and I really wanted to pass this by my Stem Cell Transplant team first especially the notion of surgery at this stage of the post transplant. So we chose not to be admitted and manage this from home. It did not seem to sit well with Dr. Davies. At 8:30 we were released, 12 hours after getting there. It puts a new face on Emergency Medicine. I was telling Lynne that at each step it was leaving us feeling frustrated and finally angry when we left because that choice was a difficult one to make and the Dr. seemed to have a great deal invested in having us do what he wanted us to do and when I asked him what advantage there was to being admitted his answer had to do with, if we were in an auto accident it could be serious and I would be safer in the hospital. I could not make that same connection and anything could happen in the hospital as well and I would not feel safer in the hospital
So we are at home and the issue of pain and what to do about it will come up today as we try to unravel this. I have not had any additional pain meds and I also have no more of that sharp pain. It has not returned. Isaac is of the opinion that the issue of graft vs host plays into this as well and that needs to be addressed with Dr. Khouri's team. So Thursday I will manage this from home and keep you posted as we go along.
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