I had posted this the other day but was no where near concise enough so I deleted and want to post again, but the cliffs notes version this time

Female, 41, 5’ 5”, obese but losing weight through hard work (down roughly 35 pounds in 5 months), natural redhead

Complex medical history but pertinent is mitochondrial disease, systemic lupus, dystonia, and severe anxiety; wheelchair dependent; weird genetic processing of medication that makes me very difficult to sedate and rather impervious to the sedating effects of medication

Medications are akin to a small pharmacy but relevant ones are Norco 7.5-325mg every 6-8 hours, Valium 5mg once daily PRN, and Baclofen 20mg 4x day

I receive treatment through palliative care (not hospice but just palliative care) where we are focusing on quality of life as much as quantity of life (because honestly if life is miserable it’s not worth the tremendous fight). My pain medication was recently switched from PRN (where I could make a 1 month supply last 2-3 months) to scheduled after a rapid decline in the mitochondrial disease precipitated by Covid. I take Baclofen 20 mg 4x day for severe muscle spasms and dystonia. And Valium was added in as needed for a tremendous increase in anxiety and panic attacks (I am already taking Rexulti, Lithium, Buspar, Clonidine, and Trazadone for mental health). The Valium also has an incredible side bonus of helping a bit with the muscle spasms. Given that I am in palliative care with a host of serious illnesses that will likely be life limiting, is this an acceptable treatment approach? I am undergoing the process to see if I qualify for a Baclofen pump for better long term management and am being assessed to see if I have myoclonic dystrophy in addition to everything else.

Thank you for reading my still too long post!