Cancer on the Weekend: The Initial Trial

By | July 27, 2012

I will continue overcome all struggles in order to find the best care for your pain as well as Nancy’s.


After what seem like an eternity, authorization for a pump trial was received late on a Wednesday afternoon. Again despite our preferences to begin these trials early in the week, Nancy was scheduled for a pump trial on the next day at one o’clock. Due to her previous surgery and the general level of discomfort the lumbar placement of the needle was difficult and while passing the catheter I encountered an obstruction at about T7, well below the level of her chronic pain. Nancy was in so much pain that I did not feel that going on was really an option so I reluctantly accepted the low placement. The infusion was started and Nancy was observed for several hours. While the trial seemed to take the edge off her chronic pain, the response was far short of what I had hoped for. When Nancy returned the next day, it was clear to Nancy and to me that placement was not acceptable, so without an authorization, I decided to attempt a new catheter placement, this time starting in the upper thoracic spine, well above the level of the obstruction that we had encountered the previous day. This time the placement of the needle was easy, but as I approached the level of the previous surgery and radiation I encountered a blockage at about T2-3. Attempts to pass this level caused Nancy extreme pain and again I was forced to accept a placement lower than I had hoped for. Luckily this time the response to the initial test infusions were dramatic. You could literally watch the pain melt away from Nancy’s face.

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