Kellie,
that is correct -they will increase the patch up to 300mg. There is a balance between the breakthough pain meds and the patch. If she is using more of the breakthrough meds, then they increase the patch.

The reason I ask about Mayo is it is ALWAYS better to be treated at a comprehensive cancer center. This disease will not tolerate screwups in diagnosis or treatment - it can be extremely unforgiving.

I kept a journal as to what worked and what didn't. Kept notes on meds, food & water intake, temperature, etc. I also worked closely with an oncology advice nurse and a nutritionist to solve some of the swallowing and nausea problems. I still ended up in the ER twice for rehydration. I polished my teeth like glass from all of the vomiting.

I had fair days to horrific ones. I wouldn't wish this treatment on my worst enemies (well ok, Osama Bin Ladin maybe) The good news is that it does get better. It's got to be tough to sit around and watch a loved one go through it and feel helpless.