Please read...the good days are gone

When Dick's oncologist told us to look in to Hospice I took it to mean than in his evaluation he had less than six months. We did not inquire for more specifics. We interviewed 3 hospice agencies to find one that would work with Dick's specialized situation. My understanding is Hospice is good at pain management and they will do their utmost to see that your Mother is pain free. You might want to considered interviewing a Hospice agency. They could answer a lot of your questions. Particularly the ones about whether someone should be with her all the time. From what you have said before it sounds like you are also faced with whether your father needs care as your Mother was the one who took care of him. I think we are in the grieving process, there is a phase referred to as anticipatory grief that people have when they know in advance a loved one is dying.
When planning for continuous coverage for your Mother please make sure that the people involved can get sufficient sleep. Julie

Julianne,
I wish I could answer all of your questions. I know how difficult this is, especially when it seems like it is all happening so fast. There are so many wonderful people on this forum that will be able to offer you great advice. You are in my prayers.

xoxo
Melissa

Thanks you guys. I spent the night with Mama last night and the morphine is keeping her comfortable. However when it starts to wear off, the pain returns. The oncologist was in this morning and said that the nodes had grown from the size of a ping pong ball to the size of a tennis ball. He believes this is the source of her pain. Her sodium had dropped to 118 but no one seems that concerned. He did say that as soon as we get her sodium up, she can come home with pain meds. He said it is time to consider Hospice. My question to you guys is, will pain meds at home be able to keep her pain under control? Will she be bed bound? So far, she is either asleep or in pain. It is hard to process that this is happening even though we knew it would. I feel strangely calm right now. Not sure if I haven't completely processed it or if I have been in the grieving process already. My main concern is that she has no pain. Daddy cannot take care of her. SHould we be making plans to be with her day and night?

Julieanne, I am sorry your Mom is in such pain. It does sound like she needs a different level of care. I am not a good judge of when Hospice should be called in. The official guideline is whether the life expectancy is six months or less. For Dick the oncologist seemed to use his weight loss and lack of appetite as a marker to recommend hospice. x-rays later confirmed the tumor in the pleura had grown and the lymph nodes throughout his body were involved. The key will be finding what your Mom needs for pain management and hospice is the expert in palliative care and pain management. Predictions of life expectancy even at this stage is still not exact. People very even with the same symptoms and level of involvement. I wish I had more encouraging words. Julie

Julieanne.......so sorry....looks like your mom has done what she's done before
any sodium level lower than l35 needs fast correction...Hyponatremia
Hyponatremia is the most common electrolyte abnormality in hospitalized patients and is defined as a serum sodium concentration less than 135 mEq/L. Symptoms are due to the relative excess of water that results in overhydration of cells. The severity of symptoms depends on the degree of hyponatremia and the rate at which it develops. A patient with mild hyponatremia (sodium >125 mEq/L) may be asymptomatic or experience malaise and nausea. As the hyponatremia worsens, headaches, lethargy, confusion, and a decreasing level of consciousness may develop. Seizures and coma usually occur only if there is a sudden decrease in sodium to less than 120 mEq/L.
Normal levels of Potassium are 3.7 to 5.2Eg/L.
Her drop may be from the vomiting.
They can correct this electrolyte imbalance in the hospital. I guess since she has done this before they need to determine whats causing the imbalance..renal insufficiency or what?? I'd try to get a clear picture from the attending if possible.
wishing you and mom the best possible outcome........Pat

Well, I knew it would happen and it has. Mama went to the ER last night with severe back pain and vomitting. Long story short, it took 3 rounds of morphine to make her comfortable. Scans show that (not sure how to properly say this) her lymph nodes or tumors have grown significantly and are pressing on her back. Her sodium is 120 and her potassium is 2.6 (what does that mean?). Basically they did a cat scan from the lowest part of her lung to her pelvis. Therefore, there could be more going on as well. We probably won't see the oncologist until tomorrow. My guess is he will order more tests. She sleeps, wakes up and gets more morphine and sleeps again. It is bad. What now? Will she come home? Is it time for Hospice? Really I'm at a loss and need your insight.