Swedish Palliative Care and Symptom Management Clinic First Hill
Adam’s Story: Fighting Cancer and Pain
Adam is a 38-year-old with advanced seminoma (a form of testicular cancer). Adam is known as a kind, gentle individual with a positive outlook on life. Dr. Jack West, an oncologist at Swedish Cancer Institute, treated Adam’s cancer with chemotherapy, radiation and surgery. As a result of his cancer and the treatments, Adam experienced pain in his lower back. The pain was so severe that it prevented him from performing his normal daily activities or going to work.
Adam had constant nausea and vomiting. Because he was at increased risk for dehydration, he had weekly treatments at the SCI Treatment Center for hydration. He also took pain medicine orally and through injections to help counter the pain. He felt the injections gave him better pain relief than the pain medicine he took by mouth.
In September 2014, Dr. West referred Adam to the Swedish Palliative Care and Symptom Management Clinic. The goal was to give Adam another level of support and to help him manage his cancer-related symptoms, including the uncontrollable pain. Adam was hoping for a better quality of life through the support of the palliative care team and his partner.
Dr. Ellyn Lee, a board-certified palliative care specialist, saw Adam in the clinic. Her first approach was to increase the amount of pain medicine he was taking by mouth. Although his pain continued to be a problem, he was finding that it was no longer necessary to go to the Treatment Center or the Emergency Department for help with the pain.
Dr. West also referred Adam to an orthopedic surgeon to see if there was a surgical option to help his back pain. Dr. Jeffrey Garr performed the elective back surgery to stabilize Adam’s back.
Adam received palliative care support in the hospital after his surgery. This support included education about how he could control the pain medication he received through an I.V. Adam’s I.V. was attached to a special pump — called a patient-controlled-analgesia (PCA) pump. When he felt he needed more medication to control his pain, he could push a button on the pump. When Adam left the hospital, Providence Infusion & Pharmacy services assumed responsibility for his I.V. and Dr. Lee monitored the level of medication he needed.
Adam continued to see Dr. Lee in the clinic and finally found relief from the pain that had been so devastating to his quality of life. He began to eat normally, have less nausea and sleep better. As a result, his mood improved, too, and he began enjoying his daily activities again. He no longer had to visit the Emergency Department or the Treatment Center for pain relief. In fact, Adam felt so good that he decided to return to work.
After a few months, Adam became so busy with his normal life that he no longer needed multiple visits to the hospital or even the Palliative Care and Symptom Management Clinic. He was enjoying life and requiring very little health care. Eventually, Adam decided he was ready to remove the PCA pump and the I.V. in his arm.
Dr. Lee helped him transition from I.V. pain medication to pain medicine taken orally. This was a slow process to prevent withdrawal. Adam made the transition and has done so well that his oral pain medicine has been decreased further. The goal is to support Adam and eventually see him off all pain medication so he can meet his goal of increasing his work hours. He is now concentrating on his quality of life and will be able to evaluate — in a pain-free way — whether further treatment for his cancer is necessary.
Adam still comes to the clinic to help further reduce the amount of pain medicine he takes. His goal is to stop taking it altogether. The clinic will continue to support Adams palliative care and symptom management needs as he possibly pursues additional treatment for his cancer.
Adam is happy and so is his partner.