Wednesday Blues

What a tiring afternoon. I left home at about 1.30pm for University Hospital (UH). The traffic was smooth and I reached the hospital at about 2pm. Finding a parking space at UH is a nightmare but I managed to find a parking lot on the forth floor towards the Eastern end of the hospital. The car park was not equipped with lifts and so you can imaging how difficult it is for me to use the stairs case. Then I have to walk almost half a kilometer back to the main block where the Palliative Care Unit (PCU) is located. Some nurses gave me the wrong direction and by the time I reached PCU, I was almost half dead. After some administrative procedures, I met the doctor, a young but friendly doctor. I updated her on my pain management regime that was prescribed to me by Hospis Malaysia. I also told them I have been off opioid painkillers for about four days now. I am using Ultracet for pain management which gives me no constipation problem. A tablet every six hours and after taking Ultracet, pain score is about 3. For the Hospis pain management regime, my pain score after taking the opioid painkillers is 1. The Hospis pain management regime is more effective than my own. But there is a serious drawback on using opioid painkillers for me. I have constipation problems. There last three days were almost hell for me. My stomach was bloating as if waiting to explode and at the same time, I had bowel movement problems. I was also hungry but could not eat! I took a coffee enema to resolve the problem and thereafter stopped the opioid painkillers for four days, my system cleared up and I was able to have bowel movement. However, the pain scored increased to between 3 and 4, disrupting my sleep and general well being because Ultracet is not effective for moderate to severe pain. I have been on a fruits diet and most days, skipping lunch to give my stomach a rest and to recover. I also discovered I have edema on both my legs.

Anyway, the doctor at UH was later joined by another more senior doctor who told me that only opioid based painkillers are effective for cancer pain. So the main concern now is to managed my constipation. The senior doctor recommended that I continue with the Hospis pain management regime but gave me stronger doses of laxatives such as Lactulose, Forlac and Senna. So my choices are now either to take non opioid based painkillers which will not have constipation problems but suffer more pain OR take opioid based painkillers which will have constipation problems but suffer no pain. The obvious choice is the latter and manage the constipation problem with laxatives. Both the doctors were very friendly and frank. I really enjoyed talking to them for about 45 minutes. I took the opportunity to talk a little about alternative medication and also introduce my blog to them. UH is no longer cheap. Except for the consulting fee, all expensive medications are no longer supplied free by the Government and cancer medications are expensive. A weird thing I observed is that I have to buy my medications from three pharmacies namely the UH pharmacy, the privatised UH pharmacy and an external pharmacy.

I am going to start this new pain management regime tomorrow and monitor the dosage of the laxatives over the next few days to find the optimum dosage which is suitable for me. My doctor has given me an open appointment but will call me in a week's time to check on my progress.

I would like to thank you all for your support and also those who take time to comment on my blog. I would like to inform you that the pageviews of this blog has now exceeded 200,000 as of yesterday.