Dad in Hospice now

vb · Posted: Tue Oct 02, 2007 9:34 pm Post subject: Dad in Hospice now

Hi, i'm new here and had a couple of questions regarding my dad's cancer.

Without giving a whole depressing life story, i'll just quickly state the facts:

-My Dad is 67
- Prostate Cancer 7 years now (diagnosed just months after triple bypass)
- Prostate removed 6 years ago w/ a round of Radiation
- Started Lupron (every 3 months) with Casodex until PSA went down to .01
- Borderline diabetic (2005?)
- Cancer came back last year (June 2006) with mets to shoulder and spine.
- Tumor found in bladder, had a stent put in. (June 2006)
- Had a stroke Nov 2006 - miraculously recovered with no brain damage.
- Radiation (June 2007) on bones only.
- PSA was above 200 (July 2007)
- Tumor more aggressive in his bladder resulting in pure blood instead of urine. (apologies for gross description)
- Needed several pints of blood over the course of 2/3 weeks in Hospital.
- Kidney function extremely bad, but not failing.
- Had surgery (stents put in both sides to relieve kidneys) (Aug 28 2007)
- Doctor's say the cancer is too advanced.. nothing they can do...
- Put in hospice care (at home) Sept 2007 (Stopped all Cancer meds)

The meds he's currently taking are:
Ativan for anxiety/restlessness
Dilaudid for pain
Neurontin for pain
ABH gel (Ativan-Benadryl-Haldol) for delusions/anxiety
Reglan for nausea
and one more med for nausea that starts with an "O" that I can't think of right now..

Sorry, I may have gotten mixed up a little with the time frame, but my mind is pretty warped right now..

Anyway, my two concerns are that he's not really sleeping at night. The nurses tell us to just start the Ativan & ABH gel earlier to get him drowsy, but that's not working. We've even tried herbal supplements like Euro Calm (which gave him weird nightmares - not sure why), and that didn't help with the sleeping either..

I don't want to over medicate him by any means, but is it possible for him to get a sleep aid like Ambien or something like that? Something that's MEANT for sleep, and not just to "relax" him? Or is Hospice hesitant to prescribe something like that because of the side effects and/or interactions with the meds he's on? Every time we give them an update, we tell them he doesn't sleep; he needs a sleeping aid, they just tell us to use the Ativan or pain meds..

My other question is regarding his nausea. He's allergic to Codeine so pretty much anything with Codeine makes him really sick... but most recently, he can't seem to handle ANY pain meds.. he's been on Morphine and even Vicodin (not sure why since it has codeine in it?) But now, he's just on Dilaudid and Neurontin, yet the nausea persists. (We've even tried stuff with ginger, and it didn't help much) I feel bad for him because when he actually has an appetite, he'll crave something that he couldn't eat before (because of the Diabetes and cholesterol) and he'll really enjoy it, only to vomit it up and feel sick the rest of the day. (sorry for the gross information again).. So I guess my question is, has anyone had this problem with nausea and pain meds and tried anything that helped?

The Reglan and other drug he takes for nausea sometimes help, but he still gets nauseated.. it's so frustrating for him.. and for us, because we don't want him to go through this.

ugh, sorry for the long post.. thanks in advance for your help.

In · Posted: Wed Oct 03, 2007 6:07 am Post subject: Re: Dad in Hospice now

Hi Vb,

I'm sorry for your Dad's ill health. WOW , though. He is amazing and so strong. He, as well as you all, Have been through sp much.
Even though i can't help you on the meds etc. I wanted to let you know, I'm following you and your Dad's story. And i do hope that something works out with the medication and sleep. (being sleep deprived, makes everything harder).
Your Dad and your familyare so lucky to have someone like you. You are such a caring person, who knows the ins and outs on all the medications and what you dad is feeling- this alon tells me how close you must be.

Take Care of yourself- and I'm thinking of you and your family.

Inica.
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Thinking of you Inica

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Vee Smith · Moderator Joined: 12 Feb 2006 Posts: 699 Location: UK

I am sorry - it is so hard to have to watch this sort of thing.

One thing that comes across. It doesn't seem that you are being given full information about the various drugs and their interactions. You really need to be able to understand - are you able to talk to the nursing staff or the doctors?

Can you ask for a meeting to express your concerns and ask for a response to them? If you can, then go with your questions written down and write down the answers as they are given. Have someone along who is a good friend but not necessarily close to the situation, who can listen and perhaps take notes as well.

Someone else in the forums may have some ideas about coping with the sleeping and nausea.

brainman · Posted: Wed Oct 03, 2007 9:26 am Post subject: Re: Dad in Hospice now

vb, I too am very sorry about your father's cancer and sleeping problems. I am amazed that he has done so well... a 7 year survivor!! Not many of those around Smile

I agree with Vee... try to talk with your father's medical team about his problems sleeping. Certainly, there should be a solution. The problem with any one of us giving you suggestions is we do not have the training to know what possible drug interactions there might be.

Some pain medications do cause nausea. I know that my ex-mother-in-law has problems with Hydrocodone. This is another issue for you to discusse with your mother's medical team.

My personal opinion, there should be no reason for your father to be in pain or nauseated.

Best wishes.
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Site Administrator and long-term cancer survivor
1992 Astrocytoma grade 2, left motor strip
2005 Recurrence this time said to be an Oligodendoglioma grade 3, same location.
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chrisz · Regular Joined: 09 Apr 2007 Posts: 31

I have had wonderful luck using Melatonin, found at the drugstore in the vitamin isle. Also, a prescription antihistamine called Hydroxyzine aka
Visteral or Atarax. Very benign, and works great for me. Also if the
Ativan could be increased, may help. This stuff to help you sleep. As
far as the nausea ..... the docs are the expert there.

My heart goes out to you. Our family has been going through multiple
long term illness - followed by suffering and death. And it's killing me.

Now I have my own issues with high PSA , 2 biopsy's, but no cancer
found yet. Not good for someone like me who has Panic/Anxiety
disease.

Sometimes I want it to just END !!!! But no long drawn-out illness's as
I have been witnessing. I want to go quick. In my sleep would be nice.
But, doesn't everyone.

Chris

vb · Posted: Tue Oct 30, 2007 12:32 pm Post subject: UPDATE

Hello all,

Thank you so much for your kind responses to my post. In case anyone was wondering, they ended up increasing the Ativan dosage and it helped...

But I thought i'd let you all know that my father passed away on October 17th... he was a fighter up until the very end and I miss him terribly.

This site has helped me a great deal, so thank you very much. If there's anything I can do to help anyone get through this difficult time in their lives, please feel free to ask me anything. My family and I had lots of questions as each day passed and a new symptom would arise, so I would like to help people with their questions if I can.

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