October 12, 2012 at 2:09 am #65415
Well, husband is home now, but pain is not under control. Took a whole day to get him home, lots of waiting – for doctor’s orders, for home health nurse to bring pain pump, for hospital bed to be delivered and set and so on… A lot of coordination between different agencies. Glad that part is over. Pain wasn’t quite under control in the hospital either. Hospice nurse said his settings on a pain pump are way too low and was going to talk to his doctor tomorrow about trying out morphine 2 times a day (just what you said, Lainy!) + prn meds and/or getting pump settings up – increase the doze. She also said that patches usually work less efficiently on skinny people, as it needs fat tissue to get absorbed, and my husband as skinny as can be right now. So she thought it’d be better to switch him from pump/patches to morphine…We’ll see what the doctor says. She also wants to try dulcolax suppositories for him to relieve stomach pressure (if doctor approves). She seems efficient and pro-active. Not sure if she’d be his main nurse or not – it was after hours visit, therefore it was on call nurse; will find out tomorrow. Not quite used to whole hospice idea, time will tell. Thanks for listening!October 9, 2012 at 11:53 pm #65414
I appreciate it.October 9, 2012 at 10:49 pm #65413marionsModerator
Alla…fingers are crossed for control of nausea and pain. Please, keep us posted.
Tons of positive wishes are heading your way.
MarionOctober 9, 2012 at 8:07 pm #65412lainyParticipant
Dear Alla, I feel you have come to a good decision. It is most important to control the pain and vomit. I am glad that your husband is going home with Home Hospice. There is nothing like being home. Sending a ton of hugs and prayers your way. Be strong.October 9, 2012 at 7:55 pm #65411
Thank you, Marion. I think we found a hospice that would allow TPN. Now checking if insurance would pay for it. That is what he wants as well. Basically he does want to prolong it, but we also discussed that if it gets unbearable, as in vomiting non stop – then we will make different decision. We decided its worth a try. And for my piece of mind, I’ll know we tried it all. Otherwise if he decides to go without tpn, you can’t change your mind later. If it doesn’t work out with insurance, then we’ll continue with home health. In either case, he will be home. There is no hospices here that have in-patient facilities. For now, they removed NG tube completely and we are waiting to see if he can manage pain and nausea. Thanks again!October 9, 2012 at 7:23 pm #7456marionsModerator
Sensitive Sensitive Sensitive
Alla….. I have learned that the use of TPN in bowel obstructions is controversial. In one way it can prove to be life extending; on the other hand though there comes a time when it provides no benefit to the patient in fact, it may prolong suffering. It was difficult for my husband to understand that refusing to let go of the TPN did not prevent the inevitable.
I strongly believe that our loved one has the right to make choices of how he/she wants to proceed with an illness. My husband wanted to do whatever he could as long as he could stay alive.
I honored his wishes. It was only then when all signs of impending death became apparent that I stepped in and made the choice of my heart. I called in Hospice, TPN was removed and the morphine pump was attached. It is important to know that his nausea and vomiting subsided within minutes. He passed the following day.
My husband was at home – where he wanted to be. However Alla, a nurse was with us daily for the last two weeks; physicians checked in on us regularly (he had many friends) and due to the close contact with his doctors, I was able to control his pain well, but the nausea and vomiting became a major issue to the point that even saliva caused him to vomit.
Alla, what are your husband’s wishes? Does he prefer to stay in the Hospital? Are you able to tend to him at home, with Hospice?
It is difficult to see beyond our fears and wishes, but ultimately the decision has to be made as to what is best for your husband and for you. This is a discussion I would have in the presence of the doctor.
My heart is with you,
- You must be logged in to reply to this topic.