Managing Mucositis–three days post transplant

• (Update from Lisa)  Roger’s mucositis has worsened since we last wrote.  At first, he says, it felt as though he had scalded his mouth on a piece of hot pizza.  But then the burning sensation did not pass and is now spreading down his throat and into his esophagus.  
•  The docs initially offered a “magic mouthwash” to numb his mouth, but this quickly proved to be inadequate for the task at hand.  So the med team moved to IV pain relief.  Roger now gets morphine (via a patient-controlled analgelsic “PCA” pump) to take the edge off.   The PCA pump lets him release a small dose of morphine as often as every six minutes round the clock.  The effect is better than either 1) needing to call the nurse for pain relief multiple times per hr, or 2) getting a continuous infusion of morphine, which can make patients somewhat dopey and prevents them from controlling their pain management.  (Sucking on ice chips and drinking ice water also seems to help, at least temporarily)
• The nursing staff continues to impress us with their commitment and professionalism.  The individual nurses on this floor typically have no more than two or three patients under their care, and they are really able to focus on the needs of the patients.
• In short, although he feels lousy, Roger is still getting up out of bed and walking the halls (a bit more slowly each day), and making a big effort to continue swallowing liquid nutrition (yoghurt, soup, shakes, etc.) and thereby avoid the threatened tube feeding for another day).  He’s hanging in there, and we are grateful nothing unexpected is occurring.  (Mucositis is very common after TBI.)
• Your messages continue to be a tremendous source of strength.  We are grateful for your support.