help my res. is in severe pain!

[nurse kratchet]

here's my problem. i have a res. which i'm pretty sure has bone ca. a month and a half ago this women [an old RN i might add.] was up excersizing doing leg lifts at the rails in the hallway everyday knew what day her b-12 shot was due etc.. took tylenol q day and on the bad rainy days ultram. now all of a sudden she's c/o R flank pain dx uti. hospitalized 3x's and always came back with the same dx. hospital couldn't run tests d/t her pain came back inconclusive[bone scan] she has lost 30 lbs. thus far and continues to lose weekly. drinks all of her supp. when she downs her pain medication. i have never seen nothing like it she sceams out in excrutiating pain most of the time and when she does she is just jumping all over the place. now i know your going to say kidney stones but none were found. her color is so grey and her eyes are even bulging from the pain. recently had a ct and was seen by neurology suggested a mri. i hope the md agrees because he said no to a emg when asked per pt for another bone scan. have no dx for hospice and today i had the don call him for same he said no because then he could not hospitalize her????? all this women is on is ultam 50 q4 and tylenol. all i want is something to make her comfortable!!!!! can't call medical dir. he's it!! any suggestions because i can't see her like this much longer .

[tex]

Yes you can get it compounded, matter of fact you can get flavors. A pharmacy in Niagaria Falls did it for me. It is so many mg per gtt. I live in NC now and I can get it here also. You need to find also a pharmacy that has the ability to make suckers that are for pain, nausea all in one. Ususally the patient can suck this sucker for around a min or so. It is a beautiful thing Tex

[aimeee, BSN, RN]

INTERESTING! :)

I've heard of the suckers that are a form of fentanyl, haven't seen them myself...but I'm told they are VERY expensive...of course, those are brand name. I'm told they are a BIG nuisance when you have to waste them too. What else have you seen compounded in a sucker? Do they use compazine in them too for the nausea component? And how do you approach dosing if the patient doesn't consume the whole sucker?

[tex]

Forget the suckers if you are able to assess that the patient won't be utilizing it. We did have a name of Gralla, a topical oint that was measured out like nitro. Its sole purpose was for nausea/ You can call in Niagaria Falls, NY the pharmacy that compounds these meds. I will try to remember the name of the place and get back to you. But it is on Pine Ave. The pharm. are sharp. Another source is Niagaria Hospice in Lockport N.Y. you can call them and ask for the pharmacy's name in Niagaria Falls. Hope this helps....Tex

[tex]

The name of the pharmacy that compounds in Niagaria Falls N.Y. is called Pine Pharmacy............these people are great and sharp. Tex

[aimeee, BSN, RN]

Thanks, Tex. That info may come in handy sometime! :)