Palace of Care – No Surprises

Photo by Raychan on Unsplash

Is it the medication making him drowsy, there’s been a big increase in the medications since yesterday, I want them cut back down again.

I’m really worried about your Dad. I don’t think it’s just the medications changes causing him to change. His pain and nausea have worsened a lot over the past three days. It’s a shame as he was doing so well the other day.

It’s not right, he should be getting better, not going backwards. You know he was an alcoholic, I’m worried that he’s become addicted to the pain killers. He hates being confused, that’s what he was like when he drank, he really doesn’t want to go there.

I don’t think that addiction is the problem here, his pain and nausea are worse, I think it’s the cancer causing this. If I decreased his medications now, he would become much more uncomfortable. I don’t want him to suffer.

What about his radiotherapy appointment, that will give him a boost right?

He’ll get the side effect right away, but the benefit might not occur for some weeks. I’m really not sure if he has weeks left to live. I’m worried that if he keeps on deteriorating at the same rate, that he might only have days left to live. We usually say if you are changing over months, you might have months left, same applies to weeks and days.

Really, you think he might only have days left?

Yeah, so I’m not sure that he will be well enough for radiotherapy. I know he wanted it and so do all of you, but I’m not sure that he will be well enough to make the appointment.

The young doctor at the hospital said he might only have months left.

How long ago was that?

Months ago.

That doctor may have been right, this might be your Dad’s end of life we’re dealing with.

Can we do some blood tests, to see what the cancer markers are doing?

Yeah, we can, I think that they will show worsening disease, and I’m worried about organ failure. I will look for things that might be reversible, but we may find that there is nothing we can do. No surprises. I don’t want there to be any surprises between us, you need to know what is going on. No matter what happens your dad’s comfort is our top priority of care. My bottom line is that I will not let him suffer.

He’s always bounced back before. They told him 20 years ago that he only had a few years left to live, but he did really well, through all the treatments. Even the one that cost $30000, really kept him going. But he’s been bad the last few months.

Yeah, he started falling over didn’t he?

Yeah, and went off his food, he’s always loved his food, but the nausea was so bad. It’s been a struggle at home for Mum especially, trying to look after him, I’m worried she’ll get sick too.

So are we. I’ll arrange for some blood tests, I need to change his medications to try and make him more comfortable. Let’s review things one day at a time, we’ll see if he is well enough to have the radiotherapy or not. It all depends on what happens over the next 48 hours.

He’s always been there for me, and I’ve been with him every hospital stay. I just want him back to his usual cheeky self. Look I’m not trying to challenge what you are trying to do with him…but

I understand, you just want to do the best by your dad, and I want to do my best for him too. I’m sorry that things are changing so fast. I will try my best to make him comfortable, and to try to clear his head, but I’m not able to guarantee that it will work. We will keep on trying.

Okay, I need to get some air, I’m going to go and have a walk.

Okay, I’m going to make the changes now, and I’ll review your Dad again later this afternoon.

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