Loose Strife

Not much to report. Laura is at Cooley-Dickinson hospital in Northampton. She’s just fine right now. I’ve been keeping a record of the time, duration, and intensity of her headaches. Every hour or two, for 5 to 10 minutes, pain between 6 and 10. (Everywhere in the hospital is displayed a row of faces — from happy to crying — to indicate pain on a scale from 1 to 10.) She hasn’t had a 10 since she threw up in the ER last night. That might be luck or good hydration or the toradol IV or something else.
Now that she’s in the hospital she’s assigned a doctor that oversees her coordinated care — which is great. That means that today she saw a oncology social worker and a gastro-intestinal doctor. Tomorrow a neurologist, psychiatrist, nutritionist, and maybe physical therapist. Maybe receive some complementary therapy (read “alternative medicine”) such as acupuncture or Reiki — just because she’s there and it’s free. Possibly more. So even though Laura could come home, by being in the hospital she quickly gets attention and coordinated opinions shared among multiple specialists. Ideally, she won’t be discharged until there’s a plan for dealing with all her symptoms. We’ll see how it actually works out…
We were really expecting that her oncologist would orchestrate this sort of symptom management, but it didn’t happen. Indeed, in my opinion, the oncologist has blown off some critical issues. For example, the oncologist has been told repeatedly that Laura has been on a soft diet almost exclusively of jello and Ensure for months and I’ve asked her specifically about nutritional concerns. The doc has never pursued this angle herself and her responses to me have been modest (e.g., “tell Laura to eat easy foods that are high in protein like eggs.” Never mind she refuses.). But several physicians today said that something needed to be done to ensure that Laura is getting proper nutrition, not losing weight and getting progressively weaker, and should return to normal meals, if at all possible.
Maybe since Laura’s blood work isn’t too alarming and she hasn’t lost too much weight, the oncologist just isn’t very concerned. Her goal is to squash cancer. Perhaps from her focused perspective, the rest is unfortunate side effects that will ultimately pass.
The oncologist is still a major player in the hospital stay, but there are others involved, too. It’s become increasingly apparent that I can’t rely on any one person to do the work of fully managing Laura’s case. We have to actively do it ourselves, including being a squeaky wheel, when necessary, and pursuing specific help. Anyhow, enough ranting.
Laura got a brain MRI this morning and we heard from the GI doctor this afternoon that the preliminary radiology report found nothing. Since a neurological problem is an obvious explanation for the months of vomiting, this MRI report is another “good news / no clues” report.