Health Update #5: Pain Management and other peripheral issues

Sunrise over Emerson Lake, Branch Township, Michigan, April 15, 2023


Not a lot of medical news this week. I've started on insulin to manage my glucose levels during immunotherapy and I have a supply of FlexPens and needles to administer the insulin. Pretty easy and painless. My PCP also prescribed a DexCom G6 continuous glucose monitor, but I'm having trouble getting insurance to cover it. The company that my PCP ordered the meter through says that they're out of network, so I have a query in to my insurance company about how to get that covered. For now, I'm sticking with the standard finger-prick meter.

I'm scheduled for an echocardiogram early Wednesday morning as standard procedure to establish a baseline before chemotherapy starts. Don't expect anything surprising there.

I have a CPAP fitting on Thursday.  I suspect it should also help with shortness of breath issues while sleeping  on my back. I've felt myself having panic attacks in the night over catching my breath and dealing with pain in my arm and shoulder from bone metastasis, so hopefully this will help keep those panic attacks at bay (as long as I don't fixate on writing up my sabbatical report). 

I contacted my radiologist about pain management yesterday through the MyChart portal. I’m currently unable to use my right arm at all because of pain from wrist to shoulder. I’ve reached the point where I’m nearly unable to dress myself without assistance or use a keyboard or pick up objects of any weight or prepare meals or engage in simple housework. For someone who's not terribly fastidious about housework, it's an odd feeling to be frustrated about not being able to do the dishes or laundry or change the sheets on the bed. The hydrocodone helps to relieve a bit of pain so that it’s not excruciating if I take it every 4 hours with Ibuprofen in between. Any movement brings on grimacing pain, though stillness in certain positions can keep it down to a minor throb (with the pain killers) while I sleep at night. Any attempt to roll over or shift positions at night (and day) is excruciating. I do use a sling much of the time to try to keep that arm stabilized. I find that if I use my left hand, I can position my right hand on the keyboard to do basic typing, but have to use a left-handed trackpad and can't do a lot of multi-key functions. I may have to shift to dictation software.

I explained all of this to Dr. H, my radiation oncologist, and he's referring me to their Palliative Care team.  They specialize in pain management and symptom management for their cancer patients. There may be some tricks with massage therapy and acupressure and general PT exercises that may help in addition to the medication. He also refilled my prescription of hydrocodone so that I can take it more frequently.

I'm pretty sure the pain is both making it harder to eat and decreasing my appetite. I've lost 5 pounds in the past couple of weeks. And it's making it harder to sleep more than a couple hours at a time. Or get out and run errands. I can last about 2 hours running errands before needing to go home and take a nap. Corrine has to put my socks on. And pull up my pants and get them zipped and buttoned. I went to Meijer the other day with a 50% off shoe coupon and bought some Sketcher clogs so she doesn’t have to help so much with my shoes. I’m learning how to move around in ways that don’t cause quite so much pain. But the pain and debilitation and weight loss have put us both in a bit of an existential malaise. 

One small bit of joy the other day came from a lunch-time outing at the Ludington Meat Company on their patio to take advantage of the warm weather and sunshine before the rain and snow hit this week. The brisket sandwich was delicious. 


Corrine's brother, Daniel, came down this weekend to hang out for a few days and help out a bit, which was a nice bit of variety. We watched The Death of Stalin last night and a few episodes of Hot Wings on YouTube. I'm looking forward to seeing some colleagues at the end of the month (once they've all posted their grades). Radiation begins on the 26th. Hopefully, that will bring some relief to the bone mets symptoms.

I'm having second thoughts about renting a convertible. Who knows, maybe once I get through radiation therapy I'll get enough strength back in my right arm that I can get back on the motorcycle.

I probably won't post again until after the first radiation session.

 

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