Mom's PC symptoms changing but are they PC related?

wholesome · New User Joined: 20 Jul 2008 Posts: 2 Location: Boston, MA

I'm a new member of this forum. My mother was diagnosed in early May of 2008. She remained symptom free for about three weeks after that and then became jaundiced. A stent was inserted in the common bile duct to relieve pressure from tumor on the duct and jaundice has gone away. The pain in her abdomen and back became too great to control with medication and a pain block was performed on July 3. It took time to be effective and it did relieve the abdominal and back pain but then she started to feel extreme pain in hip and back. This pain got worse and worse until we had to bring her to ER on July 13. She was admitted to hospital and spent four days there to manage pain and was then transferred to nursing home until pain was under control and she could move well again. Ct scan and x-rays reveal little or no change in the tumor which is located in the head of the pancreas, touching the mesenteric bundle. Doctors cannot seem to determine if pain eminates from the bone or perhaps sacral illiac joint injury. An x-ray today shows no abnormality in abdomen. On Friday July 18 she was seen by her oncologist and had gained 15 lbs in one week! very bloated and swollen legs and ankles. That seems to have subsided somewhat. She had been constipated for 4 days but had bowel movement today and is up and about and ready to go home. Over the past few days she had been very confused and had dry mouth and couldn't speak well, also very sleepy. So, is all this just from the medication requiring adjustment or symptoms of the cancer? We are now awaiting a bone scan on Wednesday to determine if bones are affected by the cancer. She now has a novacaine patch on the painful area of her back which seems to be effective and is on ms contin every twelve hours with morphine for breakthru pain, and a low dose patch for pain as well. She is in great shape today! Should I bring her home or wait to see what happens? She lives alone but has friends nearby and I live an hour away. It's hard to judge where she is at with the disease. When diagnosed she was estimated at stage 3 but ahe refuses to have an MRI and refuses chemo treatment. judging from other postings here, her symptoms are pretty severe. We're prepared for the worse but then don't want to jump to conclusions either. your thoughts would be appreciated.

Peter

brainman

Hi Peter. I am truly sorry about your mother's advanced Pancreatic Cancer. PC is one of the worse cancer we know about since it has such a big impact on a person's quality of life and since there are so free truly effective treatments for it.

I am not sure why your mother is refusing to have an MRI. If it is fear of being in a tight space, her doctor can give her an anti-anxiety pill right before the test. My second time I knew that I needed on and requested it. Now I have had so many that my biggest problem is staying awake for fear that I might move during the test.

I know treatment is a very personal choice. Pancreatic Cancer is so aggressive that, in general, it should be treated as aggressively as possible. Without treatment, I fear that your mother's quality of life will deteriorate very rapidly. After a certain point, no treatment is appropriate.

Your mother is in my thoughts and prayers.
_________________
Jim
Site Administrator and long-term cancer survivor
1992 Astrocytoma grade 2, left motor strip
2005 Recurrence this time said to be an Oligodendroglioma grade 3, same location.
My Story Part 1: http://cancerforums.net/viewtopic.php?p=7350
My Story Part 2: http://cancerforums.net/viewtopic.php?t=8029
Blog http://jimhawkinsport.blogspot.com/

wholesome · New User Joined: 20 Jul 2008 Posts: 2 Location: Boston, MA

Jim, Thanks for your thoughts. My mother doesn't want an MRI, she really hates the confined space even with anti-anxiety medication! After long and carefull consideration, she decided not to be treated. All indications are that her cancer is advanced and chemo would take away from her active lifestyle, even at 82 years old! She was planning to be married this summer to a guy 17 years younger than she! heartbreaking!

Today we are making arrangements for her to leave the nursing home and go back home with transitional care. She has been in the nursing home for a just few days and after adjusting her pain medication has really improved, back to her old self! Her legs are still a bit swollen but her pain is well managed. I'm hopefull that this will last for a while but I'm aware of the nature of the disease and am prepared. I still don't know if the confused state and sleepiness were caused by the medication or the disease, any thoughts on that? anyone? I looked up the definition of ascites and thought her bloatedness might be that but it has subsided considerably, Is that possible? Her oncologist just seems to shrug his shoulders and say he's not sure.

I'm grateful for this site and just writing this stuff is therapeutic for me. I feel fortunate that, although I'm her primary care-giver, we have a lot of help and support from family and friends, I couldn't get thru this alone. Seeing her in such extreme pain last weekend was really upsetting. Thanks everyone out there!

Peter

brainman

My mother also made the choice to not have any treatments except palliative care treatments.

Some of the things your mother should get if she does not already have them are: living will and/or durable power of attorney and a regular will. These will help in making sure that her wishes are carried out. In some states there is a different form... sort of like a living will... required in order to advice ambulance services and other emergency services in the event that one is called to her home. She should take care of these while she is still able.
_________________
Jim
Site Administrator and long-term cancer survivor
1992 Astrocytoma grade 2, left motor strip
2005 Recurrence this time said to be an Oligodendroglioma grade 3, same location.
My Story Part 1: http://cancerforums.net/viewtopic.php?p=7350
My Story Part 2: http://cancerforums.net/viewtopic.php?t=8029
Blog http://jimhawkinsport.blogspot.com/

JLC · Regular Joined: 18 May 2008 Posts: 23

Peter,

I am so sorry to hear about your mother. We went through some similar "confusion" with my mom about some of her symptoms. We didn't know if it was the PC or something else.

You wrote this in your original post: [i]Over the past few days she had been very confused and had dry mouth and couldn't speak well, also very sleepy.[/i] It could be pain meds, but it could also be her liver. My mother was like this and for the longest time we assumed it was the narcotics. But it turned out to be her liver function was poor and was causing all kinds of problems. My mother was also quite swollen in her legs and abdomen. From what you have described it sounds like your mom is experiencing something similar. Without an MRI or CT, there is no way to know for sure as far as I know.

My mom's oncologist did a lot of shrugging too. It was upsetting, to say the least. I got the feeling from her that it was PC, and she was doing all that she could and the end result would be the same no matter what. I suppose they see so many terminal patients that they have to seperate themselves to a degree. But when it is someone you love, it would be nice to get something other than a shrug from their doctor.

I went looking for answers and I didn't find much except from others who had/are experiencing PC.

I will keep you, your mom, and your family in my thoughts.

JLC
_________________
Dad ~ diagnosed with EC in 2001 and cancer free since 2003.

Mom ~ Passed away June 2008 from pancreatic cancer.

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