81-year-old MIL waiting on biopsy results

biddy

What a difference a day makes.  Two days ago, MIL was feeling human, but the past 24 hours have been diarrhea hell.  Not sure if I mentioned it or not, but MIL (I don't want to use her name because she's much more sensitive to privacy than me) has ambulation problems -- specifically, she walks very slowly with a walker due to a childhood injury and inadequate surgical repair.  So walking the 15 feet from her bedside to the bathroom takes several important minutes when diarrhea sets in.  I put her on liquids -- Gatorade, chicken broth, etc., and Immodium and after being up all night, she's been sleeping for the past few hours.  She's already questioning if it's worth it given her age.  How do I respond?  I just tell her it's her body and only she can make the decision to have or not have treatment.  Before treatment started, I told her the same thing, but added that I hoped she would at least give it a try but that I would respect her decision either way.  What do I tell her now?  I don't want to tell her it'll get better because everything I've read says just the opposite.  I'm just at a loss of how to help her.  If all goes according to the onc's schedule, he wants her getting treatments every two weeks.  So she has next week to recover before she goes  back and starts again.  Oh -- and hair loss has already started.  Should she get a buzz cut or just get it cut short?

biddy

Fever now.  Diarrhea continued today and now she has temp of 101.6.  I called her onc today and they're sending home health out tomorrow to do some labs.  I have a feeling we're going to be heading to the hospital.  She's so wiped out.  And what could cause the fever?

 Bonnie, you asked about the skin mets and what the onc has said -- really nothing, except that the AC will dry them up, which it has.  They haven't gone away, but are dry now.  She said they hurt now though, where she didn't have pain before.  I plan to corner Dr. Nash and get some answers next week -- unless we end up seeing him sooner.

For now, fever is the big worry.  But good news came today too -- her insurance will cover the Neulasta shots as long as they're either self injected or done by a home health nurse (not in doc's office).

How are you Bonnie?  You've been so busy supporting me you haven't mentioned what's going on in your life.  You're in your 40s and have been fighting the battle 4 years, but you didn't mention (or I missed it) how you're doing today.  Have you been on constant treatment of some sort?  Thinking of you --Fran

biddy

Just called the onc and he said pack a bag and meet him at the office in the morning.  Looks like we're hospital-bound for a few days. 

CoolBreeze

Stage IV means it has metastasized so I think you are mistaken about that.  Herceptin along with chemo CAN be hard on the heart but she will be watched carefully and it certainly isn't a guarantee of heart problems.  It is usually reversable if it does happen.  She should have an echo or muga before her first infusion to see her LVF (left ejection fraction) and then each 3 months after.  

Although I'm only 53, I've been on herceptin 2 years and am fine.  I sit in the chemo room and am by far the youngest one there.  Many of the people in that room are in their 70s and 80s - it's amazing. During my first go-round I made friends with a lady who was 77 who was doing the same treatment I was - taxotere, carboplatin and hereptin  - she had way more energy than I did!

Don't assume because your mother is elderly she'll do poorly.  Many do just fine. 

biddy

Sorry I haven't been around for a few days, but after my last post (temp 101.6...), I called her onc and we met at the hospital and she was admitted because her WBCs bottomed out (0.3).  That was Tuesday, and she was discharged Friday with WBCs back up to 7.2.  Platelets and RBCs still low, but not alarmingly so.  She was very sick and so weak she couldn't walk for several days.  Still no let-up from the chemo symptoms, although her onc promised she would "feel like new" these last few days before she gets her 2nd round of chemo Wednesday.  He said he would dial it down this time and admitted she got too much the first time around.  Her mouth is a horrible mess and she won't use the "Magic Mouthwash" or anything else to help the symptoms.  She's living on Ensure and scrambled eggs (and peanut butter milkshakes I make with Ensure). 

The part that scares me the most is that her mental abilities have deteriorated so severely in such a short time.  This is a woman that could balance her own checkbook and handle her own affairs and now she's so confused she doesn't remember whether she's taken her meds.  It's like she's aged 10 years in less than two weeks.  She goes back and forth between continuing treatment and being sick for the rest of her life and giving up treatment and accepting that it's her time to go.  She stays in bed most of the day, getting up only to go to the bathroom.  What kind of life is that?

She couldn't be left alone while she was in the hospital because she kept forgetting where she was and would try and get out of bed to go to the bathroom (she has ambulation problems and needed assistance because she was too weak).  

Thank you for the MUGA scan mention Bonnie -- I missed that on your original post but will bring it up with her Onc Wednesday, IF she decides to go.  

chester2010

I'm so sorry to hear your MIL is having such a rough time with the chemo and side effects.  Everything is so foreign and harsh on the poor little body.  Hopefully the Dr.willl tone it down a bit this time for her, everyone is different and sometimes we can tolerate one chemo and another can have horrible.side effects.  This is the worst part for her and, as Bonnie says, if you can do a count-down to it being over then that gives a light at the end of the tunnel.

Look after yourself too. Thinking of you.

Kathy

biddy

Thanks Bonnie for the ideas.  I'll try the rice pudding and see if that works.  Problem is she's lactose intolerant and that makes it harder buying pre-made foods.  Not a whole lot of lactose free stuff out there...so I make it at home with Lactaid.  I'm sorry you lost friends and had to leave the board, but trust me when I tell you that your support is a big help to others -- if you can do it without hurting yourself in the process. 

And Kathy, thank you for your support.  I used the countdown approach with her today and I think it may have helped a little..."after tomorrow it'll be two down and three to go..."  That's just of the AC though.  Her onc plans to do some form of chemo every two weeks for about 5 months before they attempt surgery.  

I did a reality check today with my time off at work and found out I have 5 days off left before our new year starts July 1.  I decided it's best if I let my daughter take her to her chemo treatments (as much as I want to be there to hear what the doc says) so I can conserve my time off and use it when she's sick and needs me here with her.  If I could just win the lottery...but that would mean I have to buy a ticket...and who has time for that?   

Say a prayer that tomorrow goes smoothly and that the days after aren't as hard on her as they were last time around.  And thanks again for your comments and support.  (Bonnie, I still want to hear your story...)

biddy

2nd chemo (AC) went much much better.  Her oncologist cut the dosage in half and she has done much better.  She still doesn't have much of an appetite, but we're learning how to take advantage of the times she does want to eat, and filling in between with high protein/high calorie shakes. 

She has two more AC treatments, then will get some kind of IM chemo shot once a week for 12 weeks.  I forgot to ask the doctor what the med is.  Does anyone know what it may be?   

biddy

Hello Bonnie -- the 12 week will be Taxol.  What's the difference between the two?  Right back atcha with the prayers.

biddy

Where does time go?  I haven't posted in almost a week.  Does that mean I'm coping better or that I'm too busy to think much less stay up late enough to have time to post?  I think it's a combination.  I

Bonnie, MIL is doing much better in terms of side effects, but that's to be expected since they cut her A/C in half after over-dosing her (landing her in the hospital) the first time around.  I can't help but wonder if she's having minimal side effects does that mean she's also having minimal results?  The onc started treatment saying "we have to treat aggressively...it's the only way..." and now we're treating moderately if not mildly.  But all that kind of thought does is make my stomach churn so I try to stay away from it.

She still sleeps a lot, and eats little (although I have been able to keep her weight relatively stable with protein shakes and lots of blueberries and spinach).  She's weak and I have PT coming in to work with her twice a week.  I think I already mentioned that she uses a walker to get around because of a childhood injury that left her with a metal rod in her hip and thigh and one leg 6" shorter than the other.  She wears an elevated show, but can't put much weight on either leg because of deformities that have developed over the years.  So now that we're down to one more A/C treatment, then on to 12 weekly Taxol/Herceptin, I'm starting to think about if/when she gets to the point that she can be operated on this summer and how will recovery from a radical mastectomy w/node removal be when she can't use her walker and get herself to the bathroom or wherever?  

I still would love to hear your story Bonnie...

Hugs and prayers!

Kicks

Side effects have nothing to do with rather or not something is 'working' - our bodies handle things differently.



On A/C, I basically had no SEs at all - head hair came out and nose/eyes poured continually like a spigot turned on and was a bit tired on day 3 and 4 but a nap took care of it. I did loose all sense of taste and appetite but never had any nausea. (I've been told that rather or not you had problems with morning sickness can be a predictor in some as to rather/how bad chemo nausea will be. I had no morning sickness at all and no chemo nausea.) It definately did work as before starting it there was no way surgeon would consider surgery but after A/C,he was able to get good margins. Then on to 12 Taxol followed by 25 Rads.



For me though - 12 weekly Taxol were nasty - complete and UTTER exhaustion. I iexisted either on the couch or in bed the entire time - managed to make it to weekly TX though. A week after last one I started feeling better each day through out the rads (and after).



I was younger than your Mom at the time but not young (63) and very healthy when I started the journey (only 'problem' was arthritis in upper back).

The next time PT comes you might ask for 'small' things you can do with her that will be little exercise. Many years ago I had to be a bit inventive to get Mom using any muscles (she was end stage aneorixia) and I would 'reorganise' the pantry every few days bringing stuff to her to hold or put on the table beside her recliner. I'd give them to her and she had to put on table and then hand back to me - I know cans or boxes of food don't weigh much but any exercise is better than none. When she would start catching on I'd switch to something else (it's amazing how often yard needs to rolled into balls or go back to skeins (hey it's exercise). Daddy and Hubby had the cleanest tools anywhere - they got cleaned often. As I said it's basically no exercise for anyone in any kind of shape but when there is nothing - anything is something. You might also ask the PT about some stretch bands and instructions to use them so she could do a 2 or 3 reps several times a day. I get my stretchy bands frond my LE guy but a PT should have them. You might. Be able to convince her to do some if you say you want to get in shape and she'd be helping you to do it with you.

Don't know if any will help but are ideas to explore and take to another 'place/level'.

nlada

wow, That is so similar to us. My 80 year old mil has been battling breast cancer since the beginning of '10. She had a complete masectomy last year but recently started getting what she though was an infected rash under her arm. We just got the biopsy results back estrday, IBC.We live 2,000 miles away so it is hard for me to wrap my mind around this since I can't go to the doctors with her. She has an appt with her doctor next week. The advanced word is that they will only do surgery which I find strange unless they are thinking pallative. My story with IBC is different than most. Many don't realize that human breast cancer is the same as canine to the point it is dogs they use for research on treatments for it. Back in 1983 I had a dog with breast cancer. After her surgery to remove the lump, (about 3 weeks) it came back as a rash on her back legs and then spread from there. I can tell you it is not pretty at all. It was so agressive that her body couldn't make new blood vessels to supply the cancer with blood and the tissue started dying and went gangrene. She died within a month even though she was under the care of a major medical university conducting research on breast cancer. Neddless to say I'm scared for my MIL!