Finding the Goldilocks Zone

In astronomy, the Goldilocks Zone is that distance from a sun where water would stay liquid, and therefore, potentially sustain life. It is the range that is not too hot to burn off water and not too cold that H2O would be frozen. Think Venus, "This planet is too hot;" Throw in Mars, "This planet is too cold;" and then consider Earth, "This planet is just right." A challenge for astrophysicists is to find an exoplanet, one not in our solar system, that is in the Goldilocks Zone of another star.

We have spent the last week trying to get Faina to the analgesic Goldilocks Zone. She has a whole solar system of potent medications in her orbit, Reglan, Ambien, Adivan, and Zofran. Other medications, such as oxycontin and oxycodone have passed by like comets or, like meteorites, burned up in her atmosphere. On Tuesday, she could not get enough dilaudid to be beyond the range of pain. That was a long, unpleasant day. The pills, that she now seems able to get down, help create a pharmacologic constellation. Her North Star (Polaris) is the PCA pumped, patient controlled, Dilaudid. These doses come two ways, a base dose that is continuously pumped and boluses, a sudden rush when the button is pushed. I spent a lot of time on the phone with Hopkins Home Health Care (HHHC) services, resetting the pump and over the course of the day, yesterday, her base dose was changed three times, from 2 mg/hour to 3 mg per hour to 5 mg per hour. The bolus was also changed from 1.5 mg with a 6 minute lockout to 2 mg with a 10 minute lockout. This progression took her from being in almost constant pain to what became, on the up side, a good night's sleep and, on the down side, a day of being alarmingly over sedated. She was as lifeless as the moon. Her speech tended toward incoherent. Today, I once again worked with HHHC, lowered her base dose to 4 mg. After a few hours she noticeably regained some of her sparkle. At about that point Jamie came home from her first night's performance in Atholton HS's production of The Drowsy Chaperone. Faina followed up the earlier "Break a leg" with a congratulations. The pharmacist tells me that it takes hours for the body to adjust to the new settings. Let's see what one more revolution of this world brings us along with a new dawn.