The Ceremony of Innocence is Drowned

Jenny started the folfiri regimen today, the gemabraxane cisplatin regimen cut short by low neutrophil counts. I accompanied her.

Nervous all morning because of pain she has been having in her very lower back down to the bottom of her buttocks, our nerves made worse because today was a scan day. We both were worried that the cancer had spread.  

Good news, the pain Jenny has been suffering with was caused by constipation according to Picozzi, not  the cancer.  More good news, the cancer hasn't spread. However, her tumor has grown, as has the met on her liver, although neither by much. [And, they found a new met].

I was writing this in bed at the hovel of an apartment, but now am sitting at Virginia Mason, after Jenny was transported here at 2:15 in the morning for excruciating pain in her lower back and abdomen, so bad she couldn't walk.  She is a woman, mind you, a woman who passed a kidney stone at the ski lodge and went back on the slopes and who has given birth to two children sans pain killers, and today asked for an ambulance.  Fire Dept came, about 6 firefighters, and they carried Jenny to an AMR ambulance for transport.

After arriving at VM, it was obvious she was in agony. They gave her haldol for the nausea and tried to give morphine. She puked, with the same gurgling sound she made when she vomited during chemo yesterday. They switched to dilaudid and  she is now calm and maybe even asleep.  Its 333 a.m., I'm going to do the same.

Update:

Home just after 8.  Jenny slept for a bit and is up now. We still dont know the cause of the pain.  The ER doc looked at the scan and did blood work, gave her Haldol for nausea and first morphine (stopped administration as it caiaed Jeny to start violently vomiting), and then dilaudid.  Jenny was in such agony that I am certain the nurse did not wait long enough  between administration of the Haldol and morphine for the Haldol to prevent the nausea and vomiting she could get from morphine. We still have no clear understanding of the root cause of the pain.  I emailed the oncology team the following questions:

Dr. Picozzi,

Jennifer was transported by ambulance to the VM ER this morning because of pain in her lower back. She was in such agony she could not walk. The ER doc reviewed rhe CT scan done yesterday and, like you, saw nothing in the scan in that area that was remarkable. She received Haldol for nausea, (she was violently vomiting again--the veteran onc nurse yesterday afternoon said it was the worst she'd ever seen).

The ER doc, as noted, reviewed the scan and also did a blood draw, but that was the extent of the exam. Jen has been prescribed dilaudid.

Questions:
1) This pain, which Jenny described as bilateral from her waist to the end of her buttocks--could it be something other than from irregular bowel movement? She did have one yesterday, but pain remained, in fact worsened. Is it likely PDAC related?

2) Any concerns about med interactions with the prescribed dilaudid?
We are home, and Jenny rec'd dilaudid at 6 a.m. She still has pain.

Also this from last night:

FML