The Green Dream

In my recent stint to Emergency Department I had another chance to have a closeup encounter with "The Green Button".

What is the Green Button? Well the green button is called a PCA or patient controlled analgesia.  Its about the infusion of pain relief.  To simplify, the basic idea is that when we need to have pain relief it can be put into us at regular or irregular intervals, however the PCA is all about the patient experience and giving control to the patient as to how much pain relief they get, and when they get it.

So my first experience on the PCA was with Morphine after my surgery in October . I was really all for them getting as much morphine in me as they could at that stage, just give it to me baby, uh huh, uh huh... However they negotiated with me the PCA, so what that meant is that I would sit there with the beep machine, and when the dose became available so I wasn't OD-ing then the light would come on with the green button I was holding, and I would push the button and so get a regulated drip of morphine. Sounds good? I am in complete control, well, some not complete, but some control of the dosage and when. So if I didn't need it, then I wouldn't have it. I like that aspect, as I would prefer not to have if I don't have to, does that make sense?

So the pros and the cons....

I like the idea that you only take what you want, so if you don't need it, you don't get administered it. That's good right? I never like taking too much, whether its fear of addiction, or the worry of longer term effects. You cant take too much in a PCA environment, its controlled.

But what I did find in that initial situation is that I was watching the button. The button turns green when you are "allowed" another shot. Jane said I would stare at the button and as soon as it lit up, so did my eyes and my trigger finger.

The pain is my kryptonite. Once I get to that pain threshold I find it hard to get back from, I spend time settling down, trying to deal with it all, and mostly not dealing with it real well.

In this last visit to ED, I knew I needed sleep, liquids, and buy some time till Josie my Onco came in the following morning so we could sort it all thru. However they urged me, well insisted really, that we go on the PCA, "you will be glad you did, it will make a heap of difference". Well with the pain what it was I just ran with it, not really thinking. It was set at I think 10 or 15 mins, so the green button would light up in 10-15 min intervals, I would watch, wait, click, try and close my eyes, watch, wait, click,... .

So how much sleep do you reckon I got that night, waiting for the pain, clicking the button, and so on.
Get the picture?

The green button is good, in many ways, but gotta think this thru. The situation I was in did not suit, in this case better off would have been a regular dose and then maybe checks every couple of hours perhaps. I think some docs and/or nurses are probably more wedded to the green button than others, I dont know their protocols for pushing patients onto one, but will certainly be asking the question next time its up on offer.

Pros and cons on both sides I am sure, but just got to calmly and clearly weigh those up and make good decisions.

Now into 2016

So after a challenging beginning to the 2016 year I have started chemo full on yesterday with full on FOLFIRI with Cetuximab. Couple of glitches over the day yesterday, feeling the wash of yesterdays chemo, but dealing with it ok. Each day will be better, as tomorrow is always another day.

Love.
Trev.