What are your thoughts regarding how to address her pain? Do you confront the doctors, work with the patient, the social worker, the chaplain?
Scenario: a 40 y/o female was Diagnosed with CA of the Liver about 1 week ago. Preliminary findings suggest that the CA has not spread. She is hospitalized today because of severe abdominal pain which is not relieved by any type of OTC analgesics. Current treatment consists of possible surgery if CA is localized, chemo and radiation. She is still undergoing evaluation of what is the best approach for her.. Her team of physicians cannot agree on the plan of action regarding pain control. Some say Oral Tylenol # 3 another says Demerol while another believes in a more natural integrated approach…. such as biofeedback, pain meds, Nutritional changes, Mind Body Spirit Approach, spiritual counseling. The patient is angry with the Dx. She cries and becomes very angry intermittently. She is demanding that her pain be addressed and is very dissatisfied with her CA team members.
Question: At this point, no one knows if the CA is terminal. What are your thoughts regarding how to address her pain? Do you confront the doctors, work with the patient, the social worker, the chaplain? Should the pt be given heavy-duty analgesia so soon into her CA Dx? What about addiction, or resistance to stronger meds down the line?