RE: Simon update--Kathy

[MacKenzie, Kerry N.]

Title: Message

Kathy, once again thank you for your much appreciated reply. (Which I now accidentally seem to have lost, but not before I was able to read it.) Kerry -----Original Message----- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of [EMAIL PROTECTED] Sent: Tuesday, January 11, 2005 2:56 PM To: felvtalk@vlists.net Subject: Re: Simon update--Kathy Michelle,   If you can get the pepcid or reglan in him, it will help with nausea.  A couple people I've been with who had liver cancer were pretty nauseous.  If you can get the meds in, and his reaction to food is from nausea, then he may eat a little again - probably not much, but a little.  Don't stress him out worse getting it into him.  If you can get him to take it, that's fine.  With people, as the get in the last week or two, they often lose their ability to swallow, so it would be safest for Simon if you put the meds back in his mouth, but not so far back that you can't sweep it out with a q-tip if he doesn't swallow.  From the way you describe his reaction to being syringe fed, it's more an end-stage thing than a nausea thing though.  Offer him food if it makes you feel better, but let him decide to eat if he wants.   As long as his breathing sounds clear, and you can sweet talk him into taking fluids subQ, then they can help him be more comfortable - as long as his kidneys are still working, they'll keep him urinating and help keep his liver and kidney values down and prevent nausea (high levels of creatinine make you nauseous too).  When his kidneys start to shut down, more wastes will stay in his blood, and fluid will start to back up into his lungs.  When that happens, you'll hear wheezes, crackles and bubbles.  If he's fighting them, they probably aren't helping a lot anymore, even if they aren't harming him.   Basically, these are his last days.  Help them to be good ones by not doing anything to him that makes him upset.  If he just wants to cuddle and get his belly rubbed, then cuddle and rub his belly - and don't worry about the rest.  I suspect Simon is getting pretty close - meaning in his last couple of days.  Hang in there, and try to get a little rest - even if you don't sleep.  You will get through this, and it will get easier.    What you're describing about how you're feeling is anticipatory grief, it's normal, and sounds exactly like what I went through when I lost my Mom last summer.  I found out she was really going to die about 12 hours before she died.  She'd had a stroke 2 weeks before, but I thought I saw things that hinted that she might get better.  The morning before she died, they did a second MRI on her and found a second blood clot had gone to her brainstem and there was no hope for her.  I was such a mess my teeth hurt - along with every other part of my head - and I had to leave the hospice inpatient unit where Mom was after an hour and a half because I felt like I was going to throw up.  I was able to go back and visit her later, and I'm glad I did, but I wish I could've made myself stay with her like I do for my patients.  Before I left for the night at midnight, I did tell her that I didn't want to see her go - I wanted her to get better and go home to bug Dad, but I knew that wasn't going to happen, and we didn't want her to rush off, but when she was ready to go, it was okay for her to go.  She passed at 5:30 a.m. - with no one from the family with her.  The hospice nurse was there, and called us as soon as she saw some changes that normally happen an hour or two before someone passes.  After she called us, she told Mom to hang on because we were on our way, then Mom speeded up and was gone in about 5 minutes - about 10 minutes before I got there.   The good thing about what you're feeling now is that once Simon does cross over, the grief is still there, but it changes.  You may not feel much like eating for a while, but you won't feel sick to your stomach anymore, and a lot of the head and neck pain you're probably having will go away.  You'll feel a sense of relief that it's over, but still sadness that he's gone.  It just won't be as painful as it is now.   Kathy "Every time you meet a situation, though you think at the time it is an impossibility and you go through the tortures of the damned, once you have met it and lived through it, you find that forever after you are freer than you were before." ~ Eleanor Roosevelt This email and any files transmitted with it are confidential and intended solely for the use of the individual or entity to whom they are addressed. If you have received this email in error please notify the system manager. This message contains confidential information and is intended only for the individual named. If you are not the named addressee you should not disseminate, distribute or copy this e-mail.