An Uptick

I was so relieved that we had no doctor appointments today and we did not have to get Dad in and out of the car, wheel chairs, etc.  His fractured hip is a major concern, as any further break would be devastating.  We even wheel him from his bedroom to the living room, just to avoid extra pressure on the hip.  Also, his right arm is in a sling, so he can't put both hands on the walker.

He said he felt a little better this morning, and again as he was eating dinner.  His breakfast and lunch were very light, but he ate a slightly bigger dinner of beef tenderloin, mashed potatoes and gravy, sauteed squash and onions and a salad.  They were small portions, but that's the biggest meal he's had in a week.  He said he had no room for dessert, though if he wakes up later, I'm sure Jon will satisfy that sweet tooth.

Another very positive thing that happened today was that Cherisse, a visiting nurse assistant, came.  Dad asked her how old she is, as she looks young (38) and he told her at least 5 times she has to be careful with his arm.  She has 17 years experience but was not the least bit huffy that Dad was coming across as though he didn't trust her.  I am sure, with her experience, she's run into that attitude before.  By the time his bed bath was over, Dad was in love with Cherisse.  He commented, She really knows what she's doing!  He was washed from head to toe, shampooed, and dressed in clean clothes.  Jon had shaved him yesterday, and he looked nice and fresh.

We moved Dad into the living room so we could change the sheets.  He reclined in the Big Blue Chair, and immediately fell asleep.  All that moving around exhausted him.  His housekeepers arrived and they did their magic, including vacuuming all over the living room, under the footrest of his chair, and he slept through it all!  Oh to be able to sleep that well!

Jon and I had taken a short, 30 minute walk, and I was overdue for my shower.  When I came back all clean, into the clean house with a clean Mr. Green, it felt wonderful.  I filled a basin with warm water and epsom salts, and Dad soaked his feet.  Jon got out the clippers and cut Dad's toenails.  Thank God for Jon!!!  I can do all the duties when I need to, but Jon takes care of so much when he's here.  Plus, I get to sleep at home while he is here.  That will change tomorrow when he leaves.  Boo hoo (about Jon leaving, not sleeping here at Dad's).

Dave also is such a tremendous help.  He made a fantastic dinner tonight - beef tenderloin, sauteed squash and onions, and a great salad.  He has been cooking up a storm and I am so appreciative.  Plus, he's been running all the errands.  I could not do this by myself!

Dad's pills from Hospice arrived today, and it took me about an hour to read the instructions, make a simple chart, then rearrange it according to the timetable of what Dad needs to take when.  Dad's two biggest worries are his eyesight and pill management - if we are giving him the right pill at the right time.  I am sure that concern is exaggerated by the fact he can't see the instructions for himself.

We did more furniture rearranging today.  When Dad wakes up at night, he wants Jon to stay with him (he's been having nightmares) so we moved a loveseat into the bedroom.  At least Jon (or whoever is here) will be able lie down until Dad goes back to sleep.  Jon called the Hospice nurse and told her about the nightmares and anxiety, so we will get yet another miracle drug to help relieve Dad's anxiety.  We want him to sleep well, and to be as strong and alert as possible during the day.

Dad was in a much better mood as he was being tucked in tonight.  He is very appreciate of our help, he had a good dinner in his Buddha belly, and there was a place for company (the loveseat) if he wants it during the night.  We will take the small joys!

Finding the Balance

It was another very busy day.  This evening Jon asked what we had planned for tomorrow. I said "Nothing!"  He said, "We need to do something - maybe we can get Dad out for a ride - on a golf cart?  a pedicab?"  He is a bundle of energy.  I don't think Dad could stand the bumps on a golf cart right now.  Not that we have a golf cart, but we'll be thinking of something!

This morning Jon was up at 6 AM as Dad had an 8:30 AM consultation with the radiologist.  Dave went over to help later, and I took the car over about 7:30.  It was not to be.  Dad just was not feeling well enough to get out of bed.  He had a tiny bit of breakfast then back to bed it was, sleeping on and off.  The Hospice Social Worker arrived about 10, and had a list of things to cover, including what services Hospice can provide in a hurricane evacuation, visits from clergy, a ceremony to honor veterans, and assistance with funeral arrangements.  It was not an easy visit, but necessary.

Just as she was leaving, the Hospice visiting nurse arrived.  She spent quite a bit of time here, first discussing Dad's meds and care and answering questions from Dave and me (Jon was with Dad in his bedroom).  Then she went in to see Dad and talked to him for quite a while, asking about his pain and nausea.  She checked out all the equipment and thought it was good for now.  She said Dad will more than likely need oxygen in the future, but he is having no breathing issues now.

She will be ordering all his meds from now on, and they will be FedEx'ed to us, so no more trips to the pharmacy.  Hooray.  Hospice has been extremely helpful.

Dad is currently on Oxycodone but when this prescription is finished in a little over a week, he will be switched to morphine.

We went to the eye doctor for the injection to dry up Dad's eye.  Hopefully the retina has not become detached, though it's hard to tell at this point.  Dad can barely see anything out of his right eye.  I was thinking he had the same problem in both eyes, but no, the right eye is potentially fixable, but the left eye is not.  He handled it like a champ, as did Jon who has had a similar procedure.  I had to leave the room.

In the meantime, Dave was shopping for and ordering more equipment.  He ordered a landline as Dad's cell doesn't work well in all areas of the house.  He also picked up a booster for our wifi so computers and iPads will work better at Dad's.  Now whoever is staying with Dad can be fully connected.  It's about time to come out of the black hole as Jon says.

Dad's attitude seems to be remarkably calm, and accepting of what is to come.  He has said several times 86 is a long life and he told the nurse he does not want any extraordinary measures taken to preserve life.  Of course this news about his cancer is a total shock to all of us.  The speed of him having problem upon problem seems to be fairly unusual according to the doctor and nurses.  There is a good chance he will plateau and stay at a certain level of health, but no one knows what will happen.  I have to say he is overwhelmed at this point, with a new bed, strangers coming to talk to him, a multitude of doctors and appointments, long times in waiting rooms, and new medications.  As it would be for anyone!!

We doubled Dad's pain meds today, and they really helped, but the downside is that he is sleepy and not as clear headed.  I asked the nurse about it, and she said your body adjusts after a few days, and the drowsiness should lessen, but you don't want the pain to come back.  It's going to be trial and error, trying to find the amount of drugs that allows the least amount of pain and the most awareness.  We'll keep working on finding the balance.

Dem Bones

Jon and I left to take Dad to the orthopedist before the Hospice gear came, so it was a nice surprise to see how Dave arranged everything by the time we got back.  Jon and Dave had moved Dad's bed into the spare bedroom, and Dave had the hospital bed put in its place.  We also received a table and bedside commode and soon we'll be getting a wheelchair.

Naturally, Jon wanted the room to LOOK nice, not just function well.  He was covering up the nasty (clean but ugly) side bars with a coverlet.  He joked about making a bedskirt.  Love it.

Dad had to have yet more Xrays at the orthopedist's office.  Now we know he did not break or fracture his shoulder, but he has a huge hematoma that has caused swelling from the top of his shoulder down to his elbow.  It is bright red and dark red.  It looks awful and is very painful.  What a relief that nothing was broken.  The doc said he may have torn a ligament.  That was the good news.

The bad news was that the abnormality in Dad's hip is a fracture.  The doc wants Dad to stay off his feet, as he has the risk of breaking the bone under pressure or in a fall.  He said he would like Dad to have an MRI so he can think about putting pins in the hip to hold it together.  We told him we have some other issues to deal with, like reducing the shoulder pain, starting radiation and getting his eyes cleared up, and I need to speak to Hospice about the order and timing of all the things that need to be "fixed."  He suggested getting him a wheel chair and wrote a prescription - so Medicare would pay for most of it.  We are to call him back after we talk to the eye doc about his recovery and ability to get around (for the MRI).

I called Hospice when we got home.  They ordered the wheel chair and got their doc's permission to double the pain meds.  A nurse will visit tomorrow to assess Dad's needs, and perhaps bathe him.

Jon gave Dad a malted milkshake as soon as we got home.  Dad immediately fell asleep and slept for a couple hours.  He woke up for dinner - half a taco - then wanted to head for bed.  He FINALLY was able to move his bowels, and boy are we all happy.  It exhausted him.  It took a few tries to get adjusted in the new bed, but we think after all the exertion and more pain meds, he has fallen asleep again.  Let's hope he, and Jon, get some sleep tonight.

The tally:  Cancer everywhere, fractured rib and hip, torn ligament and hematoma on his shoulder, bleeding behind his retinas, constipation, and general malaise.  Hospice is all about making their patients comfortable, in their own homes, and that is our goal for Dad!

Jon is a huge help in so many ways - from helping Dad with everything, to keeping us laughing.  I was about to make up the bed in the spare room, and he asked if I wanted any help.  I said yes.  He handed me a glass of wine.  :-)

Dave also has done so much when I am so scatterbrained and can't organize my thoughts. He had gone to Tybee to see his buddy Jimmy & family, then called to see if I needed anything on his way home.  I gave him my Kroger's shopping list.  Later I called him back and asked him to pick up a prescription for Dad.  It would have saved him many miles if I had remembered the prescription first - but alas, I am happy I remembered it at all.

Dad is sleeping, Jon is doing the NY Times crossword puzzle on his iPad, Dave is helping, and I am tired.

PS The "posted time" on this blog is about 3 hours off, in case anyone wondered why I'm ready for dinner at 3 pm or other strange timing.

Monday 9/27 AM

I'm awaiting a call from a Hospice nurse and thought I'd do a little update.  Please do not read these entries if you don't want to see some gory details.  I think some of you want to know what's happening, some of you don't.

Dad had another rough night.  He gets up every few hours.  We don't know if it is the shoulder pain or the need to urinate or a combination but it was not a restful night.  He would call for Jon when he needed something.  He has had a lot of blood in his urine since Friday night, but it is decreasing.  We stopped the Warfarin Sat. AM so he could have his eye(s) worked on tomorrow.   Hopefully.

Hours later - the Hospice nurse has been here and we made a lot of progress.  A hospital bed, table and bedside commode are arriving this afternoon.  She looked at his pain meds and said they can easily be increased and with his shoulder pain, probably should be.  And now I need to go again.  The Hospice delivery truck is on its way.  Wow they work fast.  What a relief for us.

Sunday Part 2

Oops how could I forget the highlight of the day - Molly brought over her homemade pumpkin bread which sustained us all day long.  No wonder I'm feeling so full tonight - empanadas, key lime pie, pumpkin bread with cream cheese... Everyone has been so generous with their time and talents.  Thank you.

Sunday - A Day of Rest

To write about today, I have to start with last night.  As Dad was all ready for bed and sitting on the edge; he braced himself with his right arm and began to lie down.  Yikes - something popped.  He thinks he dislocated his shoulder.  He was in terrible pain.  Jon was staying with him and tried to make him comfortable.  He came to get Dave, and between the two of them they were finally able to get Dad's arm immobilized and Dad lying down for the evening.  At midnight.  Or so they thought.  Dad was up again at 3 AM and again later.  When I went over at 7:30, both Dad and Jon were awake and we moved Dad this way and that way, trying to get him comfortable enough to sleep a couple more hours.  I went home for my shower, and when I returned, they were both at the breakfast table, having given up on sleep.  They were drinking coffee.  It wasn't decaf.

Dad spent the rest of the day in the Big Blue Chair.  Thank goodness for football (and a win by the Falcons).  He ate his meals there and finally napped in the late afternoon.  He should be tired tonight.  Dave made empanadas for dinner, Jon made a key lime pie for dessert, and I served up the colace and milk of magnesia.

Chad stopped by and after feeling Dad's shoulder, thinks it is not dislocated, though considering the pain, it may have fractured.  He brought Dad a sling for his arm and an ace bandage to wrap it up to keep it close to his chest.  We have an appointment with an orthopedist tomorrow, then we see the radiologist and the retina specialist on Tuesday.

Dad wants to go to bed, so it's time to quit for now.  I will try to write after the appointment tomorrow.

Football Saturday

Jon is staying with Dad, and told me he is an early riser.  I went over at 7:30 AM, to make sure he knew Dave and I were up.  Actually, we were on our second pot of coffee, waiting for him.  I went in, yelled HELLO! but there was no answer.  I walked down the hallway towards the bedrooms.  I could hear Dad lightly snoring in one, and although there was no noise coming from the guest room, I could see the outline of Jon's feet, under the covers, not moving.  I tiptoed out and went home.

I tried again an hour later, and there they were at the breakfast table.  Dad had on his Hawaiian shirt and Jon was in his walking clothes.  Dave came over with another pot of coffee.  Dad was feeling a little nauseous after taking his pills, so Dave made him some oatmeal and he felt better.

Later, Jon and I went for a nice long walk around the northern part of the island.  Dad thought he might call Uncle Jack, but also was ready to take a little nap.  When we came back, Dad was at the breakfast table eating cereal and a banana.  I know he was feeling better as getting the cereal, milk, coffee, etc. to the table takes several little trips, and he had done it himself.  We ate a very quick lunch, then Dad settled in the Big Blue Chair for the GA Tech/NC State football game.

Jon, Dave and I went to the soccer fields to watch Chase in his 2nd game of the season.  We met Molly, Mary Ellen and Edward, who are visiting for the weekend.  Chad was refereeing.  We saw Chase score several goals.  Yay Chase!  Coleman was napping at home, with his nursery school teacher staying with him.  I heard he was showing her EVERY toy he had in the playroom.

Dad was asleep when we got back, and said he had a great nap, after turning off the game since GT was losing (boo).  Uncle Jack had called while he was snoozing, so Dad called him back and told him about his situation.  I thought he choked up at one time, but he immediately got control of himself, and got through the conversation with a few jokes here and there.

Afterwards, he told Jon he was thinking of going up to see Jack, but Jon reminded him airline travel is pretty awful these days and it may be difficult.  Dad said, Yeah, I guess I'm not quite healthy enough.

He is looking forward to the WVU game tonight (at 9 PM).  He said if they lose (after GT's 2 losses and UGA's 2 losses) he's going to give up on college football.  Yeah, right.

I found some Ovaltine Malted Milk at the grocery store, and Dad was excited Jon made him a milkshake this afternoon.  Dave is currently in the process of making a veal & broccoli pasta dish for dinner.  I need to fold my mountain of laundry.  I had been invited to a "Bathing Suit Season is Over" party with "Copious Desserts."  I didn't make the party, but Allison brought me a sampler plate afterwards.  Yum!!

Overall, it's been a quiet day, Dad seems to feel better than yesterday, and is in good spirits.

Big Bad Day

The results are in and the news is bad.  Dad has cancer in his lungs, lymph nodes, kidney, hip, and rib according to his oncologist.  There is a slight fracture in his rib, undetected on the initial Xray, but found on the CT scan.  The doctor thinks there is cancer in the bone which made it weak enough to fracture.  Since that's where most of Dad's pain is, the doctor suggested getting that area treated by radiation, which should ease the pain.

He also gave Dad the option of limited chemotherapy, but noted his cancer is not curable.  The chemo may give him some relief.

The growth on the kidney is generally inconsistent with small cell cancer, which is what the rest of the cancer is.  Dr. Luskey said it could be biopsied, to determine just what exactly it is, but considering the extent of the other cancer, it may not make a difference what it is.

Dr. Luskey said if Dad would like to pursue getting his eyes treated, he should do so.  We tend to think that since Dad's eyesight is key to his few hobbies of reading, watching football and painting, we will go ahead with the medicinal injections (sounds unbearable to me, but you do what you have to do).

We have a consultation with a radiologist Tuesday morning to discuss the pros and cons of getting the rib treated.

Tuesday afternoon is Dad's appointment for his eyes.

Dr. Luskey prescribed a low dosage of oxycodone in addition to his current pain reliever, and said he would increase the dosage as necessary.

So the big question was, how long does Dad have?  Dr. Luskey said 2 or 3 months probably, possibly 4 maybe (he stretched out saying m-a-y-b-e) up to 6.  He sounded very doubtful past 3 months.  The chemo might buy him a month or two.

Dad has some options to think about - radiation?  chemo? eye treatments?

He took the news like the Marine he is.  He hasn't said much except that he had wondered if his cancer was back.  We went to a Mexican place for lunch, then home for his nap.

Jon, Dave and I were all in the room as Dr. Luskey delivered the news.  Fortunately, Chad had looked at the reports last night and gave us a heads up.  I'll see if Chad can print the reports for me then maybe I can describe the results more accurately.  Chad's understanding is that the cancer is everywhere, even Dad's brain.  Dr. Luskey didn't mention the brain, and we didn't ask.  We felt Dad had heard enough.

We haven't talked much about the treatments yet.  Dad has not brought up the subject, so we'll give him a day or two.  He is handling it very well, and enjoyed a visit from Chase and Cole this afternoon.  He seems fine this afternoon - from all outward appearances.

Dr. Luskey suggested we talk to Hospice, and I will do that.

Starting Out

I had to come up with a name and address for this blog -- here's my logic:  People often use the phrase 24/7 to mean 24 hours a day, 7 days a week.  I may be thinking of things to write about Dad 24/7.  BUT, his birthday is 7/24, so, here we are. www.jimgreen724.blogspot.com

Wednesday 9/22/10

I guess everyone is up to speed about Dad's recurrence of lung cancer.  I was going to wait until after his CT scan and oncologist visit so I could tell you something definitive, but things happen so quickly, and I end up telling people different things, depending upon when I talk/write, so I'm resorting to a one-message system so everyone will get the same info.  

A quick history:

In August, Dad was doing extremely well.  He was walking or riding his bike over a mile a day, and stopping at the Club for a beer as his reward.  At the beginning of September, Dad had lots of pain in his hip, which came on suddenly.  He thought it may have been a result of riding his bike.  His doctor gave him a cortisone shot and an ointment to rub on his hip.  It did not seem to improve so a week later we went back to the doctor and Dad got prescriptions for steroids, anti-inflammatories, and pain pills.  Last week Dad complained that he felt like he had broken ribs, with bones rubbing together, so on Friday 9/17 he had a chest Xray.  I got the radiologist report Monday, which said:

-No rib fracture seen.

-Numerous nodules in the lungs bilaterally likely metastatic disease.

Dad also complained of a loss of vision.  At first he said he needed more light, then suddenly he felt he was going blind.  The opthamologist was able to see us today.

The opthamologist said it looked like Dad had a detached retina and we needed to see a specialist asap.  She sent us right over to a retina specialist who not only looked into his eyes several times, but also did an ultra sound and a scan after injecting dye into his veins.  He has eye bleeding in both eyes, but especially his right eye (his good eye).  It is putting pressure on the retina and causing his "blindness."  The doc wants to inject a medicine to dry up his eye, but also needs to have Dad's blood thinner medicine reduced, to help stop the bleeding.  He said we can wait until next week, so we have an appt. Tuesday.

We'll get the CT - whole body and bone scan - tomorrow, then see the oncologist Friday and hopefully have an idea of what we're dealing with, how serious it is, etc.  Also, to see if his blood thinner can be adjusted to help stop the eye bleeding.

Dad has an appt. with an orthopedist Monday, about his hip, and the retina specialist Tuesday.

He is not feeling well tonight and says he feels like he has a fever.  He didn't get a nap, and I think he's a little dehydrated.  Molly brought a chicken stew and biscuit dinner for him, which he devoured, and had ice cream and chocolate sauce for dessert.

We talked about his cancer today in a round about way.  He told me about a friend at Savannah Square that decided he was through living and quit taking his meds and started drinking.  We laughed.  I know he must be thinking about how hard the chemo was last time.  He has said twice now, "I'm not going to take this any more."  I'm not quite sure what he was talking about.  I told him people have choices about their treatment, and that I will make sure any pain he has is dealt with.  At this point, his pain seems to be related to his arthritis and muscles, and it helps to keep moving.  That was about the extent of that discussion.

Well, he wanted me to come back at 8:45 to do his bedtime routine, so it's time for me to go.  I'll write again when I know anything.

Thursday 9/23/10

It was another long day at the hospital, but Dad was up bright and early so we had enough time to stop at McDonald's.  Dad had his usual hotcakes and sausage.  I had my usual Carbmaster yogurt (what a name) and walnuts, brought from home.  

Dad had a CT scan of his lungs and abdomen, after getting injected with dye, in the morning.  He had a full body bone scan in the afternoon.  He was exhausted and when he got home, took a pain pill and leaned back in the Big Blue Chair for a nap.  I told him I'd be back at 6 pm, so I need to go.

Dad, Dave and I are all looking forward to Jon's visit this weekend!  He arrives at 8 pm tonight.