Palace of Care – Yellow Fever

Photo by Vanessa Bucceri on Unsplash

She had told her family about my promise to paint my fingernails to match hers. She had painted her nails to match my bright yellow scrubs. When I examined her fingers the nails were of many different colours. Some were yellow, others were black, pink, and red, all of them nicely painted. She showed her nails and she made us all laugh. This included both staff and her own family. I joked about needing help with nail-painting supplies, as I didn’t usually paint my nails. If I was going to do so then I might as well do my toenails. I shared with our audience that my yellow nails would go down well at the Brazilian Jiu-Jitsu club I belong to. We all shared some more laughs before we came to the serious part of the family meeting.

I provided a recap of what had happened since our patient was admitted. She arrived with terrible pain, nausea and constipation. These symptoms were controlled with adjustments in medication doses over the first week. Well-controlled pain came at a cost. Our patient became confused at times. We had to make dose changes but we wanted to persevere and bring down the pain levels as much as possible.

Overall the pain and nausea improved but the confusion episodes worsened. We tried to prevent further episodes to no avail. I talked about the ongoing changes in her situation. Old problems became worse while new problems developed. We were trying to play catch up with a disease process that wouldn’t stay still. She had been having ups and downs due to medication effects but mostly due to worsening cancer.

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Bedside Lessons – 17. The Carver

Photo by adrian krajcar on Unsplash

How you doing?

Okay, I’m feeling better than yesterday.

They told me you had a lot of pain overnight. Pain can make you really tired.

Yeah, I haven’t been the same since I was in hospital.

When did the mouth get bad?

Since hospital.

And your skin, when did it start getting bad?

Hospital too.

Was that when they started the steroids? Have they helped?

I don’t know, I don’t feel any better.

Anything else wrong?

Heh, my arse is really sore too.

What do you think is going on?

Not much, I’m just really tired.

Your lungs haven’t been so good since you were a kid, then they got worse with the COPD. That wasn’t enough for you? Then you got heart failure and then cancer. That’s a bit greedy isn’t it?

Heh, yeah I guess so.

What did the doctors tell you about your cancer?

It started in my lung, has gone to my tummy, here, here and here. Also gone to my back.

That’s pretty serious, it’s made you lose weight eh?

Yeah, heaps, I just don’t feel like eating anymore.

Anyone else got cancer in your family?

Yeah my parents both died of it, and two of my sisters have it too.

That sucks.

Yeah it does.

Could you try using some more pain relief?

Okay, I’ll try.

Are you a spiritual person?

Yeah, nah, not really.

What’s the most important thing to you in the world.

My whanau/family.

What do you like doing, what keeps you going?

I like to draw, and I’m a carver, I carve bone and wood. My son is a carver too.

Heh, I can carve too…Ham on the bone, leg of lamb, roast of beef. I’ll bring my friend’s wood carving over to show you later.

Sounds good, thanks.