notes from 4-29-09

Since my last post, my pain level has continued to increase. Last Wednesday 4-22, after having pain spikes every minute or so at a pain level 9 with a base level 7-8, I went to the ER at North Memorial Hospital. I was given 2 mg of Dilaudid IM injection, which got the pain level down to a 7 with spikes at 8. Then I was given 10 mg Morphine IM injection, which eliminated the spikes. I left with level 6-7 pain.

On 4-23 I was prescribed Dilaudid, 4 mg every 3-4 hours. Without this and other meds, may pain level is 7-8 with spikes at 9. I also am slowly increasing my dosage of Neurontin (Gabapentin) up to a maximum 7200 mg daily, taken in 3 equal doses. For pain management, I now take:

Dilaudid 4 mg every 4 hours
Percocet (Oxycodone/Acetaminophen) 20/650 mg every 4 hours
Ultram (Tramadol) 100 mg every 4 hours
Neurontin (Gabapentin) 1800 mg three times a day
aspirin 320 mg one daily

I also soak my foot in cold water once or twice a day for 10-30 minutes, which also seems to help. I can get my pain level down to a 6-7 most of the time, though it increases as the medications wear off.

From what I have read, Dilaudid should have a much larger effect than it does on me. From what I remember about Morphine injections from 2 years ago, they had a larger effect than the Dilaudid injection did last week.

I noticed my right foot and ankle was swollen on 4-24 in the areas of pain. I started wearing my support hose (30-40 mm compression) to minimize the swelling. See the pictures I have included.

I am trying to get an appointment with Dr. Miles Belgrade, a pain treatment specialist working from the Pain and Palliative Care Center in Minneaoplis. I have heard very good things about him. I really need a doctor that is willing to work with Dr. Leitch and me on the treatment of this condition and the associated pain. I hope this is the doctor for me.