Thursday, December 9, 2010

metastatic carcinoma unspecified



That's the diagnosis on his discharge papers. What that means is that the cancer is rampant in his body, in every organ and bones and they haven't been able to determine where it originated from. They will eventually be able to determine that but it takes time consuming and difficult staining of the cells to examine the insides of the cells which is why the results from the bone biopsy were/are taking so long. Without the test results to back them up, they can't say it positively but they are as positive as they can be without those results that it originated in his lungs. Which stands to reason since he smoked two packs a day for 50 years, starting when he was 10 and only quitting about three years ago.

I left here Tuesday to head up to the hospital so my sister could go home to get a good night's sleep and start the arrangements for the hospice care. She came back to the hospital Wednesday morning to consult with the doctors for the final diagnosis and sign the necessary paperwork. They decided to go ahead and discharge him without the results of the bone biopsy which they still did not have conclusively. When we questioned the need for this final test result since there was no treatment that could save him, they told us they needed it for the death certificate. They gave him three days to three weeks.

I asked how the death process would go. The doctor told me that once home the calcium levels in his blood would start to go up again and he would start to exhibit the same confusion he was experiencing when we brought him in. He would probably go through a period of irritability and then as his organs started to shut down, he would go into a sleep from which he would not wake up. His breathing would gradually become slower until he finally just never breathed in again.

My sister left, while I stayed, to go home again so they could deliver the bed and the other equipment they would need. Unfortunately, they forgot to get her to sign the DNR-in-transit paper so as an 'authorized family member' (one of the options) I signed it. They ordered the ambulance, disconnected him from the monitors, took out his IV and dosed him up with morphine. The ambulance arrived about 6 PM and then I had a long two hour drive home. I was met by my husband with a glass of wine, a good dinner and a blanket on the couch while he did the dishes, a reception made all the more poignant by the knowledge that my sister is losing her partner.

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Family members are coming in. Both my children visited him last Sunday in the hospital. His step-daughter (whom he fathered longer than their natural father) was with her mom and helped get the house ready. His other step daughter who lives in Albuquerque is coming in on Saturday. His son from a previous marriage is due in on Monday. There are other family members from whom he is estranged, all his blood relatives and his daughter (twin to his son), who are not coming and, in fact, have not even been notified. That can wait til it's done.

We are hoping Michael lasts and with some of his mental capacity intact until his son can get here. The hospice nurse who was there last night to receive him from the ambulance service thinks the process has already started. He is losing circulation in his feet and circulation to the extremities is the first thing to go so that the body can put it's energy and resources into protecting the torso and brain but even the brain will be sacrificed for the heart, lungs, kidneys. Hence the confusion of his mental faculties. My sister thinks he is waiting for his son whom he knows is coming. She thinks he won't last past that.


25 comments:

  1. To everyone who has commented and given such love and support, I can only say thank you but that seems inadequate somehow. I'm sorry I have not had the time or energy to respond to each of you individually.

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  2. Oh Ellen, this is such a big story, and a big weight for your family to shoulder.

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  3. I'm thinking of you tonight, Ellen. Love and peace, dear friend.

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  4. love and peace from my heart to your ellen. i saw a friend through this very same process ten years ago. at the time my closest friend. steven

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  5. I wish I could think of something helpful to say. I can't. All of this is awful. I am so sorry you're having to go through this.

    Sending much love, much. Lots. x

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  6. so sorry that your family is going through this. it is such a difficult thing to say goodbye to a loved one. prayers for you all.

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  7. dearest Ellen, there are no words that bring comfort at a time like this. But there are words that hold love and caring. Please accept my heartfelt sorrow for your family and you. This is a hard situation no matter what. Hugs, Linda

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  8. I am so very sad and sorry to hear this. My thoughts and prayers are with you and your family during this difficult time. I have been through a similar situation with several friends and relatives and I understand how very hard it is. Hugs, Marguerite

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  9. Jesus, Ellen, I'm so sorry to hear about this. Here's hoping he makes it through to see his son.

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  10. I am so sorry for this sadness in your family, thinking of you and wishing you peace at this time.

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  11. Oh Ellen, I'm sorry just seems so trite. I will be thinking of you during this most difficult time. My father died of emphysema and sitting by his side during that process was beyond devastating.

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  12. Wrapping my arms around your family tonight - I'll be praying for some stasis until Monday at least so he can see his son & know him.

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  13. Ellen , there is nothing I could say that could take the place of a hug...prayers of wisdom, grace and strength for you and your family during this time.

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  14. Sending thoughts of love peace to you and your family.

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  15. Ellen ~ My Mother and Father both past due to their bodies closing down. Once they are in that state, it is just a time to talk to them and sit with them.

    I am very sorry this has happened and so fast.

    Thinking of you,

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  16. this sucks, this sucks bad! He is a fortunate man to have such a family around and you are an amazing sister! Dang, going out is never easy, is it. Morphine is a lovely thing.
    My thoughts are with you and of you with bubbles and light and a soothing balm for your breaking heart.

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  17. I hope all the family is able to get there in time. What a shocking thing this is, all at once. Sending so much love and care.

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  18. Ellen I am so sorry. I pray for the strength for you all during this. you and your family are in my prayers. I hope all get home in time. Big hug

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  19. Nothing I or anyone can say is of any use to you now, except it tells you that you are not alone and forgotten.

    Only people who have experienced similar know what is involved for the family and even then, it is new and different for everyone when it happens.

    My best wishes and loving thoughts to you and your family.

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  20. I know this is a heavy burden for you and for the family. My prayers and thoughts for you all! I hope his passing is peaceful and pain free.
    Hugging you
    SueAnn

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  21. sending you, and your family, many gentle hugs Ellen

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  22. Ellen, you and your family are in my very best thoughts. Beside me, a feather which I've just plucked from the holder you made and gave to me. I wish your brother in law a gentle flight when the time is best. Hugs to you.

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  23. Until I spent time with hospice patients I never understood the Coleridge phrase, "Death came with friendly care," but now I do. Sometimes swift progression is a gift, even though it never seems that way until much, much later.

    I hope that Michael can say goodbye to his son and accomplish what he needs to be at peace. And that he goes gently, with friendly care. It sounds as if he will. I'm sorry, Ellen.

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  24. Such sadness. Peace be with you & yours and with Mike.

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I opened my big mouth, now it's your turn.