Pain management.

In terms of her arm/shoulder/neck pain Kaplan does not recommend further diagnosis (spinal tap). Since it's likely cancer in the spinal fluid, you can't radiate it and chemo is only option and since she's on chemo anyway (her blood counts were ok and she's hooked up as I write this - happily munching a roast beef sandwich) he felt like additional testing wouldn't alter the treatment.

In terms of her back pain, the area she is feeling pain is in an area already radiated by Tomotherapy. Which can't be radiated again. So not much point in scanning it. Have to hope the chemo works and that the prior treatment is still working. So in meantime he's bumped the dose of the nerve pain med and added to the general pain meds. Of the non-narcotic variety.

So a lot of hopes pinned on the chemo and radiation. Both of which have historically very low success rates, sometimes slowing the cancer down for a while.

The disconcerting info is that where the pain is now, is where it will be in the future, barring treatment success. So pain management could be huge moving forward. Including having to move up to morphine. Which means a host of issues to address on a long term basis - nausea, loopiness, fatigue.

She's trying not to think about all this.