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Topic: How do you know when it's time...

Forum: Caring for Someone with Stage 4 or Mets —

A place where family members, caregivers, and loved ones of people having a Stage IV (metastatic) diagnosis can share, discuss, and support one another through the tough times unique to this diagnosis.

Posted on: Oct 12, 2020 01:36PM - edited Oct 12, 2020 04:11PM by PoppyFlower

PoppyFlower wrote:

...to stop and hand over the job to a professional or move her to a facility.

I am caring for someone with fungating malignant wounds on the chest (and now spreading to lower torso and sides), advanced lymphedema with weeping extremities, and possibly beginning stage of ulcer on her bottoms from sitting all day. I change the dressing on her wounds daily, sometimes 2x a day, drain her lungs using Pleurx drainage system (mets to lungs) 2x/week (she gets drained once at her MO's office) give her shower once/twice a week, wipe her for both bathroom occurrences, drive her to her MO's appts weekly, and cook for her.

I can handle all of the above when I'm aware of my limits but I admit; I am tired. I am away from my family and I don't know how long I will be here since her prognosis is so poor but without any definite timeline.

But, if her wounds go deeper and expose those deeper structures, i.e. bone, cartilage, etc. ...or if she can't get up and is bed-ridden, or if she starts having ulcerated wounds on other parts of the body, I won't be able to take care of her, physically and emotionally.

Will her doctor inform of her options, then? I don't have the heart to tell her if/when time comes.

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Oct 12, 2020 03:42PM MinusTwo wrote:

Poppy - so sorry that your friend is having these problems. I don't see any way to stop the ulcers where she's sitting. My mother was lying in a bed for12 years after a stroke. If she wasn't turned several times a day, she would get bed sores (ulcers). And because she was essentially a vegetable, we had to tie her to the bed rails to keep her on her side to give her back some relief.

I'm not stage IV and don't mean to butt in, but honestly it really sounds like she needs to be on Hospice care with you providing back up. I think you need to have a heart to heart with the doc by yourself. If the doc won't talk to you, maybe you need to threaten them that you'll do something drastic - like leave her at the MOs office. Not that you would, but maybe it would get someone's attention.

2/15/11 BMX-DCIS 2SNB clear-TEs; 9/15/11-410gummies; 3/20/13 recurrance-5.5cm,mets to lymphs, Stage IIIB IDC ER/PRneg,HER2+; TCH/Perjeta/Neulasta x6; ALND 9/24/13 1/18 nodes 4.5cm; AC chemo 10/30/13 x3; herceptin again; Rads Feb2014
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Oct 12, 2020 04:22PM PoppyFlower wrote:

@MinusTwo - so sorry about your mom. I am sure bed sores will be next if she ends up being bed-ridden because she can ONLY lay on her right side. I pray to God (forgive me) that he takes her before it comes to that because I don't think 'she' would want that.

I did talk to a nurse practitioner a few weeks ago about this exact issue. I told her that I see the writing on the wall and I hope her office will talk to her, professionally, about the end of life issue when the time comes because I can't do it. And she said, Stage IV is terminal and there's no cure so she should take care of affairs anyway. She also said, she should understand that the treatment she's receiving (Femara and Ibrance) takes time and they won't know how the treatment is working for at least 2 to 3 months.

She's been on them for exactly two months and they don't seem to help. Time is not on her side! And I have a feeling they'll just keep putting off the inevitable...Grrr....If she knew how incapacitated she is right now, and how her condition is deteriorating daily, I don't know if they would continue to treat her as if they're making a difference...I'll try talking to her MO this time and see what he says.

I feel so guilty because I sound like I'm abandoning her. :(

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Oct 12, 2020 04:31PM moth wrote:

If you weren't there to drain her pleurevac, who would be doing it? Are there home health nurses in her area? Is there hospice care? I don't think you should feel guilty. From your previous posts, it seems she's made a choice and has put you in a very difficult position. Can you go home & be with your family even if for just a few days? It might help her and you think more clearly about all of this if you left for a bit. Sounds like you need a break. It's ok to take one.

Initial dx at 50. Seriously???? “Sometimes the future changes quickly and completely and we’re left with only the choice of what to do next." blog: nevertellmetheodds2017.tumblr.... Dx 12/2017, IDC, Left, 1cm, Stage IA, Grade 3, 0/5 nodes, ER-/PR-, HER2- (IHC) Surgery 12/12/2017 Lumpectomy: Left; Lymph node removal: Sentinel Chemotherapy 2/14/2018 AC + T (Taxol) Radiation Therapy 8/13/2018 Whole-breast: Breast Dx 2/2020, IDC, Stage IV, metastasized to liver/lungs, Grade 3, ER-/PR-, HER2- Chemotherapy 3/18/2020 Taxol (paclitaxel) Immunotherapy 3/18/2020 Tecentriq (atezolizumab)
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Oct 12, 2020 07:30PM PoppyFlower wrote:

@Moth

If I wasn't here, she'd have to go to her MO's office 3 times a week to drain. I'm sure there are home health aides but they are very costly. If she refused treatment, then, I assume her MO will recommend hospice. But she's desperately wanting her drugs to work. But on some days, she wants to "end it" and wants to find out about assisted suicide...like tonight. :(

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Oct 12, 2020 11:23PM - edited Oct 13, 2020 02:22AM by NancyHB

PoppyFlower - I'm so sorry you're in this place with your SIL (I think that's what I read before, if I'm wrong I apologize). You sound exhausted, scared, and stuck; as a caregiver of this magnitude, though, you can't take care of her if you can't first take care of yourself. Caregiver burn-out is a very real thing (been there, done that). Your feelings of guilt belie the first fringes of that burn-out, when you want to help her but really need a break for yourself to de-stress.

If I remember correctly from other things you've posted, she sounds very scared and overwhelmed by the situation she's found herself in and is determined to avoid the reality as much as possible. In doing so she's made choices for herself that are greatly affecting you, too, and putting you in a really difficult position. If she has insurance for treatment, will it also cover in-home nursing care? It sounds as though she wouldn't be able to get herself to her MO's office for the pleurex drain 3 times a week if you weren't there to do it, at which time the MO's office would work with insurance and home health to get it done.

Stage IV is not curable and regardless of how the Femara and Ibrance work (or maybe don't) she needs to at least articulate to you what her longer-term plans are. If she can't or won't, then that burden may fall by default on your shoulders - and that's a truly unfair burden for you to bear. It's not fair to you to continue to care for her in a vaccum without some sort of plan; it just adds to the amount of guilt you're already feeling about trying to do what's best for her without any direction or knowledge of what she wants. ETA: While that takes away her choice, it also *relieves* her of those decisions, which, if she’s too overwhelmed by her current situation, she may need help deciding. (I came back to add this comment because it was how things unfolded with my father; he was simply too overwhelmed and scared, and he shut down, abdicating by default his decision-making to myself and my sister)

I wish you luck and will keep you and you SIL in my thoughts. You both deserve some peace.

"Be happy for this moment. This moment is your life." - Omar Khayyam Dx 11/22/2011, IDC, Left, 1cm, Grade 2, ER+/PR-, HER2- (FISH) Surgery 12/5/2011 Lumpectomy: Left; Lymph node removal: Sentinel Chemotherapy 1/19/2012 AC + T (Taxol) Radiation Therapy 6/12/2012 Whole-breast: Breast, Lymph nodes Dx 1/27/2016, IDC, Left, 1cm, Grade 3, 0/4 nodes, ER-/PR-, HER2- Surgery 2/15/2016 Lumpectomy; Lymph node removal: Left Chemotherapy 3/1/2016 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Surgery 7/21/2016 Mastectomy: Left; Reconstruction (left): DIEP flap Dx 1/31/2017, IDC, Stage IV, metastasized to bone
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Oct 13, 2020 04:22AM Sadiesservant wrote:

PoppyFlower, I agree with the others. There are two people suffering here and if you let yourself get completely run down and overwhelmed you won't be in a position to help. Your best role is one of advocate for her. I'm not sure where you are located but would start looking for support from a palliative care team. The system can't assume that someone will just step in and look after someone who is facing such significant health challenges - there have to be some supports out there.

It's difficult for me to tell from your post what the longer term prognosis is. Understood that she is stage IV and, as such, we all know it is not curable but treatments can really turn things around. There have been a number of ladies on this site that have been near death and then things shifted. I also had a lung full of fluid at the beginning of my stage IV diagnosis but am doing very well almost four years later. And interestingly, I have had experiences of weird skin lesions that disappeared when on Ibrance (had to stop due to anemia) and then on Verzenio. The cancer can manifest itself in weird ways.

I sincerely hope you can find some support who can help lift the burden off of you. Hugs.

Dx 4/2001, IDC, Right, 1cm, Stage IIA, Grade 3, 1/10 nodes, ER+ Surgery 5/10/2001 Lumpectomy: Right; Lymph node removal: Right, Sentinel, Underarm/Axillary Chemotherapy 6/7/2001 CEF Radiation Therapy 12/17/2001 Whole-breast: Breast Hormonal Therapy 12/20/2001 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Hormonal Therapy 1/2/2007 Femara (letrozole) Hormonal Therapy 10/22/2007 Arimidex (anastrozole) Dx 1/3/2017, IDC, Right, Stage IV, metastasized to bone/lungs, ER+/PR+, HER2- Chemotherapy 1/27/2017 Taxol (paclitaxel) Hormonal Therapy 3/28/2017 Arimidex (anastrozole) Targeted Therapy 4/20/2017 Ibrance (palbociclib) Dx 10/12/2017, IDC, Right, Stage IV, metastasized to other Chemotherapy 10/20/2017 Xeloda (capecitabine) Radiation Therapy 11/15/2017 External: Bone Hormonal Therapy 1/18/2018 Faslodex (fulvestrant) Radiation Therapy 8/2/2018 External: Bone Radiation Therapy 11/5/2018 External: Bone Targeted Therapy 10/9/2019 Verzenio
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Oct 13, 2020 06:30AM - edited Oct 13, 2020 06:31AM by PoppyFlower

@Saidiesservant - I appreciate your thoughtful reply. Ca27.29 it not going down. Her kidney functions are poor. She's also anemic and had Pneumonia. She just finished 2nd cycle of Ibrance and her eating is very very poor. Would you believe she doesn't want to know her prognosis nor does she want me to find out, in fear, that it'll make her give up?

I've been unsure how much I should share what my thoughts are with her. I am reluctant to share because she's been in control of her decisions on her own, by herself, without consulting ANYONE from the beginning and yes, she was foolish and made a lot of mistakes. But at this point, the options and window of opportunities are closing fast and I don't want to be the person telling her what her options are. I think that's her MO's job. Am I burnt out? Maybe. Maybe not. I know my limits and seeing ulcers on her bottom made me realize my limits are nearing soon.

Last night was awful because she couldn't move and made her so frustrated and angry at the situation that she kept talking about ending her life. I just listened and told her I'm the wrong person to talk about that. This morning, I changed my mind and wanted to tell her, I'll respect her decision no matter what (because WA state has Death with Dignity Law so it's possible.) I didn't want her to be scared and be alone at a time like this. I felt horrible saying I didn't want to hear it. But this morning, she sounded optimistic again so I didn't mention anything about last night. This roller coaster of emotions is unbearable for me sometimes. Obviously, she's the one with this horrible disease so I can't complain but I honestly don't know what I can do to help her when she doesn't know WHAT she wants to do.

Sorry for the long reply.

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Oct 13, 2020 06:42AM PoppyFlower wrote:

@NancyHB what you and your sister did was what I expected to do when I got here. But so far, she still wants to be in control....even though, she complains that she "can't do anything!" And when I tell her, that's what I'm here for, she thinks that just means, every day chores...not about taking care of her affairs. I don't even have a real health proxy still! She just won't relinquish her control and I don't want to force her or create more stress for her, demanding it. I figured, she will come around when she realizes how debilitated she is. It's a control issue and I don't want to make her feel as I'm here to control her. I'll let her decide when to give up her control. It's strange, isn't it? She needs me to give her meds, wipe her butt, change her dressing, give her showers, etc....and yet, she doesn't want me to talk to her doctors.... It's mainly because she doesn't want to face reality...hence, not going to the doctors when she felt the lump initially, thinking, it'll go away on its own. Foolish, I know. But she's continuing to make her past mistakes by avoiding and not confronting what's ahead.

She is terrified but more the reason why I want to help her but she's still not letting go of that control. And I can't get stressed over that foolish thinking. Ultimately, it's her decision and I'm just here to respect her wishes. In some ways, it actually takes the burden off of me.

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Oct 13, 2020 06:50AM moth wrote:

PoppyFlower - I'm going to speak plainly. There's a not so fine line between helping and enabling. I think the issue here is that her decisions are impacting not just her. Go home. Let her go to the dr to get her lung drains emptied or figure out what the options for insurance covered home health supports are. Come back to visit once she's sorted herself out.

Initial dx at 50. Seriously???? “Sometimes the future changes quickly and completely and we’re left with only the choice of what to do next." blog: nevertellmetheodds2017.tumblr.... Dx 12/2017, IDC, Left, 1cm, Stage IA, Grade 3, 0/5 nodes, ER-/PR-, HER2- (IHC) Surgery 12/12/2017 Lumpectomy: Left; Lymph node removal: Sentinel Chemotherapy 2/14/2018 AC + T (Taxol) Radiation Therapy 8/13/2018 Whole-breast: Breast Dx 2/2020, IDC, Stage IV, metastasized to liver/lungs, Grade 3, ER-/PR-, HER2- Chemotherapy 3/18/2020 Taxol (paclitaxel) Immunotherapy 3/18/2020 Tecentriq (atezolizumab)
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Oct 13, 2020 01:14PM PoppyFlower wrote:

@moth I know what you mean. But I look at it as making her comfortable as much as possible while she's alive. But I did look at flights to go home for a week or so. Then, she took a turn for the worse and the blood work came back not so good. I'm not an expert but I'm afraid she'll pass between now and Thanksgiving. So I might have to turn around and come back if that happens. I told her I won't be able to take care of her once the ulcers on her buttocks get worse. I am also seeing cuts and weeping clear fluids on her lower extremities and her forearms. And she's eating less and less. So I don't think she has much time.

Whether her MO talks to me or not, I'm going to call him tomorrow to see what my/her options are since I don't know if MO's just look at blood work to discuss treatment plans or actually gives physical exams at her visits. If he gives her physical exams, he can clearly see the changes on her body at every visit and should give proper treatments or advise her otherwise. And I need to tell him, I can't take care of her if she gets worse than now. I guess I'm hoping he will have a hard talk with her about her options instead of giving her false hope by saying she needs to give Ibrance more time...

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Oct 13, 2020 02:28PM MinusTwo wrote:

Poppy - Please give some serious thought to what Moth said. It really sounds like you are enabling her delusions & fantasies. This is not good for either of you. This is someone who at least needs to have palliative care, if not hospice on board - NOW and not later. If she gets better, good news, but....

2/15/11 BMX-DCIS 2SNB clear-TEs; 9/15/11-410gummies; 3/20/13 recurrance-5.5cm,mets to lymphs, Stage IIIB IDC ER/PRneg,HER2+; TCH/Perjeta/Neulasta x6; ALND 9/24/13 1/18 nodes 4.5cm; AC chemo 10/30/13 x3; herceptin again; Rads Feb2014
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Oct 13, 2020 10:59PM NancyHB wrote:

PoppyFlower, the patient is the driver of treatment. The MO will offer treatment options; they may strongly encourage one over the other or talk about “standard of care” - but if a patient refuses treatment they won’t force or demand. If the patient refuses to hear prognostics or outcomes, they won’t tell them. You said in an earlier post that you promised your SIL you wouldn’t ask the doctor for her prognosis, but it may be time to break that promise, for her sake. You want her to be as comfortable and peaceful as possible which is hard to do when you don’t know what’s happening with or to her.

I encourage you to call the doctor and explain the situation. My experience has been that doctors are willing to share information with caregivers that help them in their daily routines with patients. They may or may not tell you her prognosis; they may suggest whether she’s at a point to need palliative or hospice care. And if they won’t talk with you because of HIPAA, you can still talk with them and they’ll listen. Tell them your concerns and challenges, and they may be able to help sort through some of it. You should be working as a team, for the benefit of your SIL.

There comes a point where we, as well-intentioned caregivers, need outside help to provide the comfort and alleviate the suffering of those we love. I agree with others that at the very least your SIL needs palliative care. That’s another thing you can ask the doctor about.

"Be happy for this moment. This moment is your life." - Omar Khayyam Dx 11/22/2011, IDC, Left, 1cm, Grade 2, ER+/PR-, HER2- (FISH) Surgery 12/5/2011 Lumpectomy: Left; Lymph node removal: Sentinel Chemotherapy 1/19/2012 AC + T (Taxol) Radiation Therapy 6/12/2012 Whole-breast: Breast, Lymph nodes Dx 1/27/2016, IDC, Left, 1cm, Grade 3, 0/4 nodes, ER-/PR-, HER2- Surgery 2/15/2016 Lumpectomy; Lymph node removal: Left Chemotherapy 3/1/2016 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Surgery 7/21/2016 Mastectomy: Left; Reconstruction (left): DIEP flap Dx 1/31/2017, IDC, Stage IV, metastasized to bone
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Oct 14, 2020 04:35AM Chicagoan wrote:

Poppyflower-Sounds like you are a great SIL and have gone way beyond the call of duty. Is there no one else in the family who could step in and help your SIL? As a single woman, my insurance paid for visiting nurse services to drain my catheter-the insurance company balked at first but then agreed to pay upon appeal.

I see two separate issues here:

1) You are burning out on the caregiving-quite understandably. Clearly you need a break-I don't understand why all of this is falling on you. It is too much.

2) Your SIL's prognosis and health choices are still hers alone. I had pleural effusion and a fumigating wound 4 years ago. Ibrance and Letrozole did work for me, so it may be that your SIL and her doctors are not delusional but hopeful. I wasn't as sick as she seems to be but please do not take away her hope. It's really not your call.

3). If your SIL does want to try to see if her treatment works, she needs to find other resources and perhaps push herself to do all that she can. Can she stand up by herself using a walker? Would she consider having a bidet toilet installed? This is the time to spend any money she has left-it's kind of like rolling the dice in hopes of new life. Is she competent enough to order food in-I would suggest she try eating soups and pureed food to maximize her nutrition. If she has money, it does not seem fair for her not to use her own resources, rather than exhausting you.

I wish her all the best and hope that the Letrozole/Ibrance combo will kick in and beat back her cancer. My wound and pleural effusion dried up-I hope hers will too. I know there is much I do not know about your and her situation so forgive if any of my suggestions/comments have been insensitive. I wish you both peace and abundant life.

Dx 9/21/2016, IDC, Left, Stage IV, metastasized to bone, Grade 1, ER+/PR+, HER2- Radiation Therapy 9/27/2016 Hormonal Therapy 10/5/2016 Femara (letrozole) Targeted Therapy 10/27/2016 Ibrance (palbociclib)
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Oct 14, 2020 07:30AM - edited Oct 14, 2020 07:59AM by PoppyFlower

@NancyHB I intend to talk to her doctor. I discovered a beginning of an ulcer on her buttocks from her sitting so much. And that's my limit. She's fighting with me about NOT sitting because that's the only position she feels less pain and restriction. She wants to try some home remedies and wants me to spray her bottom 3 times a day, etc...I can't. I'm already stretched too thin. There are so many other things she demands and i just can't do one more thing. But I feel guilty when I say that and I shouldn't but I feel bad that she can't do what she wants. But I can't either so she has to understand my situation too. So I made her to make an appointment with a wound care center.

I do believe her health decision is her decision. I will respect her decisions (even the past foolish ones she made) and I will follow whatever she decides but at some point, she'll have to acknowledge her limitations, including mine.

And her doctor needs to know the details around her care at home. I don't know what her options will be in terms of home health aide or home nursing care but it needs to be addressed for sure. And deep inside, I think she knows it too but she isn't taking any actions yet.

It may be time.

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Oct 14, 2020 08:19AM PoppyFlower wrote:

@Chicagoan I'm so glad Letrozole and Ibrance worked for you! That's amazing! I hope it'll work for my SIL too but so far, her signs and symptoms haven't improved too much after 2 cycles. Initially, it looked like it worked but I'm not sure if it is. Her Lymphedema 'seems' like it's getting better but the skin is getting very fibrotic and tough and her mobility is worse. She has very severe lymphedema on all the extremities and while the edema on her upper extremities are going down, the skin is changing to very tough fibrotic tissue which doesn't improve her mobility. So even her breathing, even after Pleurx drains 3x/week, is bad. I only describe this because if it wasn't for lymphedema, it would make her more independent.

1) I am the only possible caregiver for her.

2) Her doctor may know a lot more than he's sharing with her as she refuses to know her prognosis or even what type of subtype she has! As NanyHB mentioned, her doctor will respect what the patient wants to hear and won't share with her the details. He told me the diagnosis that I assume he shared with her but that's about it. And I didn't ask for more because she didn't want me to ask. I respect how she wants to manage her health. And because he's not telling her the details, she is hopeful and yet, disappointed that she feels worse at times and gets angry and frustrated that she wants to stop everything. It's a constant battle of emotional see saw for me to console her and encourage her while wondering if he's being totally honest with her. Maybe I am wrong and maybe this is why she doesn't want to know the truth. But I just don't know how to be around her when she gets pessimistic. She's said, I know everyone is telling me to be positive because they don't want to tell me the truth....and when she says this, it really hurts.. :(

3) I actually installed Tushy on the toilet for her in the bathroom that she used to use. But now, she's moved to the first floor and shared the bathroom with her elderly parents that have a raised toilet seat and Tushy won't reach that high. Besides, she can't maneuver the dials anymore because her hand doesn't go back that far. I got her a Bottom Buddy - a stick that you can grab tissues to wipe - and she was able to use it for a week and now, she can't even maneuver that anymore either.

You see? She's deteriorating fast and I just can't tell what all of these signs and symptoms mean.... :(

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Oct 14, 2020 08:34AM Chicagoan wrote:

PoppyFlower,

It doesn't sound good. Her next scans will tell the story likely. In my experience, doctors are not shy about recommending hospice when it seems like treatments aren't working. If you were not able to help her, what would happen? Maybe it is time for nursing home care or the hiring of home care workers since the workload now seems overwhelming for one person. I hope that the right course of action for you will soon become clear.

Dx 9/21/2016, IDC, Left, Stage IV, metastasized to bone, Grade 1, ER+/PR+, HER2- Radiation Therapy 9/27/2016 Hormonal Therapy 10/5/2016 Femara (letrozole) Targeted Therapy 10/27/2016 Ibrance (palbociclib)
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Oct 14, 2020 09:22AM JavaJana wrote:

PoppyFlower, I'm sorry for your stress. I agree with what the others have said, you've done above and beyond. I hope you can get to talk to the doctor, but I would not be so quick to assume the doctor has Not told your SIL the truth of her prognosis...she clearly doesn't want to talk about it, and possibly has decided to ignore it and not tell you. Hopefully the doc will hear you out and give referrals for home health or hospice.

Xgeva 9/2/2020. History: 2 Borderline Serous Ovarian Carcinoma TAH/BSO, 0/15 nodes - 2/18/20. Benign Papilloma/ADH Left breast, excisional biopsy 10/11/2016 Dx 10/1/2019, IDC, Left, <1cm, Stage IA, Grade 2, 0/1 nodes, ER+/PR+, HER2+ (IHC) Dx 10/23/2019, LCIS/DCIS, Right, 0/1 nodes Surgery 11/19/2019 Lymph node removal: Sentinel; Mastectomy: Left, Right Dx 3/25/2020, IDC, Stage IV, metastasized to bone, 0/2 nodes Chemotherapy 4/8/2020 Taxotere (docetaxel) Targeted Therapy 4/8/2020 Herceptin (trastuzumab) Targeted Therapy 4/8/2020 Perjeta (pertuzumab) Hormonal Therapy 8/13/2020 Femara (letrozole)
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Oct 15, 2020 10:30AM PoppyFlower wrote:

@Chicagoan @JavaJana

Her MO wants me in the office with her for tomorrow's appointment. I informed one of his staff who manages the prescriptions about issues with her pain meds and etc., and she told the doctor about my concerns. So I will be going into the office with her for tomorrow's appointment. I hope he'll be straight with us and tell us where she's at. Tomorrow's appointment is supposed to be about chemo therapy that she wanted to start, But I think she's rethinking that options since she's deteriorated so much since Monday. She can barely sit now (ulcer is worse this morning) because of pain and not being able to breathe due to fibrosis on her chest... And she said, "I'm going to be bed-ridden...sigh" I think she's thinking the inevitable and very scared. :(

Thank You all so much for your advice. I'll report back what happens tomorrow, if anyone wants to know.

I feel your bravery and strength. I don't know if I'd be as strong as you.

<3

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Oct 15, 2020 10:51AM - edited Oct 15, 2020 10:52AM by JavaJana

PoppyFlower, I'm glad you are going to the appointment. I know it won't be easy {hugs}🙏

Xgeva 9/2/2020. History: 2 Borderline Serous Ovarian Carcinoma TAH/BSO, 0/15 nodes - 2/18/20. Benign Papilloma/ADH Left breast, excisional biopsy 10/11/2016 Dx 10/1/2019, IDC, Left, <1cm, Stage IA, Grade 2, 0/1 nodes, ER+/PR+, HER2+ (IHC) Dx 10/23/2019, LCIS/DCIS, Right, 0/1 nodes Surgery 11/19/2019 Lymph node removal: Sentinel; Mastectomy: Left, Right Dx 3/25/2020, IDC, Stage IV, metastasized to bone, 0/2 nodes Chemotherapy 4/8/2020 Taxotere (docetaxel) Targeted Therapy 4/8/2020 Herceptin (trastuzumab) Targeted Therapy 4/8/2020 Perjeta (pertuzumab) Hormonal Therapy 8/13/2020 Femara (letrozole)
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Oct 15, 2020 12:57PM Chicagoan wrote:

PoppyFlower,

I will be thinking of your and your sister tomorrow. I have a feeling the doctor will recommend hospice. It might be a relief to your sister, given her pain and rapid deterioration. Let us know how the appointment goes.

Dx 9/21/2016, IDC, Left, Stage IV, metastasized to bone, Grade 1, ER+/PR+, HER2- Radiation Therapy 9/27/2016 Hormonal Therapy 10/5/2016 Femara (letrozole) Targeted Therapy 10/27/2016 Ibrance (palbociclib)

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