Julie & Alan:
Thanks for taking the time to give us some updates on Julie's condition. I've been thinking of you all a lot.
I'm concerned about her poor pain control, and having to get morphine injections every hour.
If the option of Patient Controlled Analgesia (PCA) has not been offered to you, please see if you can get it for Julie. I would imagine she has IV lines already, so this would just be an additional line infusing.
What PCA is, is a special pump that is controlled by the patient with a dose of pain medication at the push of a button. In the hospital where I work, there is an Acute Pain Service with anaesthesiologists who are consulted by whatever service the patient is under; and a similar arrangement likely exists where Julie is hospitalized. With PCA, a medication pump is programmed to give the patient an appropriate dose (determined according to the patient's weight) of pain medication when she presses the button. There is a lock-out mechanism so that extra doses cannot be given until a specific time period has elapsed (our patient population usually has a 5-minute lock-out time), which prevents possible overdose. The patient should understand that she is not to press the button except for pain relief. The danger of becoming dependent or addicted when using narcotics appropriately for pain relief is minimal.
I would talk to her nurse and doctor and ask for a consultation about whether Julie would be a candidate for PCA. Good pain control is so important to the recovery process. It helps with getting the patient out of bed willingly sooner; mobilizing early (depending on her rib fractures and lacerations on her lung and liver) helps prevent blood clots from forming in the legs. Good pain control is also important psychologically; she is very likely going to have flashbacks about the accident and things that happened in the hospital, and poor pain control is a huge negative impact that could figure prominently in her memories.
Best wishes to all of you,
Love, Scully