We had a bad night

Around 1am Josh woke me up moaning.  He said his head hurt but it hurt where the tumor was and it was the worst pain ever.  We got some pain meds but I stayed up watching him all night because of his risk for seizures.  His Dilantin level needs to be between 10-20 and his is still about a 9.  Around 4am he woke up again and had more pain meds.  I had Dr. Harron paged and he added 1 large dose of the steroid along with the regularly scheduled doses that he has already been getting.  He also added Motrin to help with inflammation.  Dr. Harron came in around 7 and said that he was going to work with the OR schedule today and see what he could work out.  He also said that the MRI of his shoulder showed that his shoulder was “pretty messed up.”  He put in an order for an orthopedic surgeon to come talk with us.   His shoulder has a “chronic dislocation.”  Josh took a larger dose of Dilantin this morning to hopefully get his level higher.  His coordination is way off.  I think it is affecting him more this time than it did last time.  He had a really hard time swallowing his meds earlier.  He is resting comfortably now and I hope he continues to do so.