Me again.

Hi. I spent most of last evening at the emergency room. The abdominal pain had become quite severe and, after two or three hours of trying to tough it out, I called both Dr. Richards and the Froedtert palliative care clinic on-call nurse for advice about how I could get to feeling better.

Dr. Richards listened to me describe my symptoms and suggested that the pain was probably caused by more hemorrhaging in the liver. He said it would probably persist for two days and recommended a visit to the ER. He said the ER could provide me with more potent pain relief medications than I currently had at my disposal. The palliative care on-call nurse recommended the same thing. I was willing to do just about anything for immediate pain relief so I happily agreed to do what they said.

Kelly took me to the Froedtert ER. Not only is it widely considered to be the best ER in southeastern Wisconsin, it's also a three-minute drive from my house. We were immediately taken to a room (it's amazing what kind of service you get when you tell the ER receptionist that you have metastatic cancer!) and, after a brief chat with the nurse and on-call physician, I was hooked up to an IV of dilaudid. I had received a dose of dilaudid when I visited the ER earlier in July so I knew that it would work. By the time we left a couple hours later, I felt better than I had felt in a long time.

I returned to the palliative care clinic today for a follow-up. The care team (as they're called) took me off the hydrocodone (aka Vicodin), upped my oxycodone prescription even more, and gave me a new prescription for a pill-form of dilaudid. I'm hopeful that it will help me manage the pain, which in turn will help me manage the fatigue. If it doesn't, the care team said I should plan on spending a few days at the hospital so that they could monitor me more closely and devise a pain plan that works.

So that's the plan for getting my pain and fatigue under control. Now we need to figure out something for Kelly! In the past seven days, she has probably averaged three or four hours of sleep per night. All of my nocturnal tossing and turning, along with her late-night band performances and general anxiety about my situation, have made it very difficult for her to get the sleep she needs. The kids are great help and we've hired some people to handle many of the household tasks that would otherwise fall on her shoulders. Even so, she's carrying a very heavy load these days. If you're in the mood to pray, say a quick one asking God to give her the rest she so desperately needs and deserves.