Reluctant

I was just so reluctant.  Call it weakness or blindness or delusion but I just didn’t want to believe that her pain was worsening. 

This morning she was being watched by two of her friends.  This is usually a recipe for a happy visit.  But on the contrary, Satomi was very agitated-tossing, turning, barking-and in obvious discomfort.  Instead of visiting, Satomi’s friends had to comfort her and administer doses of Oxy and Ativan.

In retrospect there have been signs of more pain for the last few days-Increased back and neck pain, worsening mood and frustration.  Last night I noticed that our normal bedtime dose of medication took much longer to have an effect.

As of lunchtime today, Satomi is now on 100mcg/hr of Fentanyl or the equivalent of almost 400mg of morphine per day.  I am hopeful that this will be enough to comfort her but I was warned that a 25mcg/hr increase may not be adequate to subside her primary pain.  Apparently at this dose level, larger increases are necessary for a similar effect.

We’ll see how it goes tonight.

6:00pm UPDATE:  Satomi is still combative and has some back pain.  She is a bit confused and slow but seems calmer overall.  It’ll be another ten to twelve hours until the patch reaches full potency.  The morning will be very telling.  I really hope she’s not over-medicated.

10:15pm UPDATE:  Satomi was restless but is sleeping now.  Hopefully she’s down for the night.