Went to see the pain dr. on Wednesday and he made some changes to my pain meds. I have been struggling since going off the steroids about a month or so ago (honestly, I can’t remember how long ago that was) for a couple of weeks only to have to go back on them. I never felt like I got really good control of the pain since going off. Mostly because I couldn’t get down from the three breakthrough oral pain meds every 4 hours routine, even with the steroids (and I couldn’t get to the point where lowering the steroids was a possibility either). I have been dealing with sleep issues because of it also, either not falling asleep till the am, or waking up early and having to eat to take meds and then going back to bed because I needed more sleep.
Then recently I have been dealing with the new pain patches, which are a different generic manufacturer and don’t stay on so well, are bigger so require much more real estate on my arm, and are generally less comfortable. With the warmer weather coming they become a visual issue also, they will be quite obvious on my arm and have black letters saying “Fentanyl” and the dose written all over them. Fun.
The other fun thing is the steroids. While they had been having a kind of reverse reaction for me all this time, when I went back on them this time they began to have more normal side effects. My appetite increased, I have gained a bunch of weight (not all of it thankfully) and my face is getting that steroid puffy roundness.
So anyway, I really have been doing okay with all of this, just taking it one step at a time, one day at a time, you know the drill. But I have felt that my pain was going up again and I was at the end of my being able to deal with it with the oral breakthrough meds. He felt exactly the same way and also really wants to get me off of the steroids. He feels an increase in pain meds is much safer for me in the long run than being on the steroids.
Soooooo, now I have three Fentanyl patches. With these new patches that means two on one arm and one on the other. I feel a bit like a freak, like I’m in the hospital with three IV’s in my upper arms or something LOL! I’m currently trying to decide how to approach this. I think I will ask the pharmacist if I have any alternatives in terms of brands and size, but I suspect that if I want to stay with that pharmacy (which I do because he is the only one who keeps these things in stock and it was bad enough trying to find 20 of them a month, never mind 30) I probably don’t. But we’ll see. Otherwise I think I am just going to have to endure my arm being plastered with patches and Tegaderm and possibly pieces of tape (as the patches begin to fall off on day 2 of 3 most of the time and this will likely get worse as the weather gets warmer and more humid, but I try to avoid tape if I can as it can make things worse and is uncomfortable). I already have to wear crops (pants a bit above the ankles instead of shorts) and closed toe shoes/sandals in the warm weather because I wear those heavy and quite obvious compression stockings for my lymphedema, I am not giving up on short sleeves! Thank god for central air conditioning. I don’t care what it costs (me personally or the environment) this summer, I am putting it on and keeping it on whatever temperature I need to keep myself from completely melting down.
So, the three patches have been on for over 24 hours now (they take about that long for an increase to get into your system) and it just amazes me yet again how strong my pain meds are and how I feel perfectly normal. You’d think I’d be a drunken sailor with all these drugs but I am not. My dr. is right in that when your body needs them for pain (in particular cancer pain) (and as long as you are taking the right amount of course and have gradually built up your dose, etc.) that you don’t get altered from them. Tonight I was able to cut back my oral meds by one pill. I am still feeling some pain but I am back down in the low numbers, the kind I can deal with. Yesterday was a bad day, so it feels all that much better being in the low numbers today. It kind of freaks me out that I am at such a level of pain that I can tolerate these incredibly strong medications, and not only tolerate them, but still feel pain in spite of them. It’s mind boggling. According to my dr. it’s not that I have become resistant to the pain meds either. Whew. It is hard for me to believe that I am ever going to get better (since I haven’t so far, in terms of the pain I mean) although my rad onc promised me I would. I just don’t know that I believe her. I try not to think too far ahead, and just keep myself in my day by day mode. If I need the pain meds right now, then I take the pain meds. Kind of like if I need the chocolate right now, then I eat the chocolate!
The other thing is that in about a week I’ll start to decrease the steroids. We are going to do it slower this time, 1mg at a time and at least 2 weeks at a time on each dose. I will be glad to get off of them. Maybe I will get my normal face back, I really do hate the round steroid look. It’s just such a big reminder of what my sister went through the last months of her life. I don’t know how it will affect my weight or my appetite, but I do suspect it will affect my energy. The one nice thing about them is that it keeps my energy level good. When I was off them those two weeks last time I could barely stay awake half the time. I would eat dinner and have my head in my placemat snoring before I could get up from the table every night.
So a new phase, we’ll see where this one goes. In the meantime I am putting my energies into helping A. plan our garden projects (I’ll try to post some pix soon) and other things inside the house. I am seriously considering starting making bread with the Healthy Bread in 5 Minutes a Day cookbook. I have always loved to make bread, used to do it a whole lot before Z. was born, but haven’t done much of it since then. When I do it’s been making the dough in the bread machine and mostly baking it in the oven, but I find that having the length of time I need to complete the whole process just doesn’t work out so I don’t do it. This should make the whole process much shorter (although not 5 minutes, but certainly much less than my other method) so much more doable as you make the dough, keep it in the fridge and then take out blobs of it, shape it, let it set a bit (I would say rise, but it doesn’t really rise outside the oven much) and bake it. I love various types of whole grain breads but the good ones are so expensive and require a trip to the bread bakery. We do this (and freeze some as we’ll overbuy on purpose) but if I can find some loaves we like that I can make it could be good. Z. is a bit fussy though, she’s not a white bread child thankfully (or she wouldn’t get to eat bread in this house as it is quite rare for a loaf of bread or even tortillas made with white flour to be in the house ever) but she doesn’t like “stuff” in it (seeds and grains, which of course is my favorite). So I’ll start with a plain whole wheat and see how it goes. Maybe have two different batches going. LOL, I’m getting ambitious here, I haven’t even made one batch yet, and we’ll have to see if I can manage to stay awake for the whole process once I’m off the steroids!
Okay, it’s late, off to bed now. I will post more about the garden along with pictures soon!