I was hoping this posting would be more upbeat than my last one. Mom continues to have difficulty keeping her medicines down. She seems overwhelmed by the number of pills she has to take each day. She counted them and there are 32 pills. Tonight I plan on sitting down with her to explain the purpose and importance of each one.
Mom’s appetite and oral intake remain basically nonexistent. Yesterday, she ate 6 grapes and drank maybe one can of Boost. Her caloric intake for the entire day amounted to 378 calories. Her caloric intake should be around 1150 calories a day. Right now she is only getting one-third the calories she needs. This has probably been the norm for her the past couple of months when she’s not receiving nutritional support intravenously.
Her oncologist did offer a couple of suggestions to possibly help with the nausea and vomiting. He recommends she sit up for at least 30 minutes after eating food or taking her medications. Even better, he said, would be for her to walk for 5 to 10 minutes. He also said that she should take the medication he prescribed for nausea and vomiting ½ hour before she takes her medications rather than just when she thinks she needs it.
Additionally, there are more aggressive treatments (e.g., celiac nerve block; insertion of a feeding tube) but each of those have drawbacks. It is up to Mom to decide what she wishes to do or not do. The only thing we can do is present the options to her so she can make an informed decision.
We also discussed hospice care. Mom doesn’t believe she wants hospice care at this point. My thinking is that hospice care would help her get stronger so she can better tolerate chemotherapy. Once she’s at that point we can drop the hospice care and begin treating the cancer. There are several conditions that must be met before Medicare will pay for hospice care. Basically, the patient must have a terminal illness and expected to live six months or less. Mom's oncologist said a lot of patients will refuse hospice care because they are unable to acknowledge they have a terminal illness and only months to live. To find out more about hospice care, visit the Missouri Hospice Care website.
Unfortunately, Mom also fell early this morning. Fortunately she did not have any injuries, other than her pride.
I think one of the reasons Mom is having trouble dealing with this illness is that she has never been sick. Her only hospitalizations were to have babies. She has been exceptionally healthy her whole life; therefore, she doesn’t have a reference point to go from as to how sick she really is. This might be a blessing.
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