Lung Cancer / Doctor Won't Discuss Life Expectancy

[onlycw]

Hi All,

MIL's lung cancer spread to the brain. she needs oxygen, is paralyzed on one half, has a catheter and MRI confirmed the diagnosis.

The hospital in Udon is understaffed, so family members need to come and wash the patient.

Maybe someone with medical knowledge can hazard a guesstimate about how much time she has left?

It is not possible to hire help to get a patient washed more often? (One of her daughters is a nurse who comes at 5 am for some of the work).

(I was not aware of an acute shortage of staff - unlike a place like Tiflis / Georgia where family must do such care tasks - or else, the patient won't get washed, period).

Closing, what is your take on the career change? Mother was born 1931 and with ongoing MBA e3xams and a good job, I'm very concerned about this. As my wife loves her job and the colleagues at work - but I cannot see them grant an extended leave (no more than 3 holidays in a row for anyone).

Thanks,

Chris

[MisterMan]

Staff Shortage? This is normal. That is why Thais have kids to take care of them when they are old.

This is why they are such natural caretakers.

[PeaceBlondie]

And Thais have not been reproducing in the previous decades - not enough babies. My 76-year old has only two grandchildren. And Thai culture takes 100 years to change.

[WarpSpeed]

Have you considered your wife keeping her job and hiring your own nurse or other to care for her on those occasions. My personal experience with cancer and what you're describing tells me she only has month or 2 if that? But it's important to know the type of cancer but generally speaking a metastasized lung cancer such as this is pretty aggressive. As her cancer tumor grows it will increase her calcium level to the point in which she goes comatose and then it's all over peacefully...You need to request that the doctors not adjust her calcium levels with meds as they tend to do if not discussed or informed, only manage her pain so she is not suffering as adjusting her calcium levels will just prolong her misery as without she will just slip away peacefully..I don't mean to sound callous but the doctors in many cases have their own agenda especially when the patient is terminal and then it becomes a way to milk profits and keep them earning a living..

What is the possibility of you taking her home and hiring a nurse to care for her there? It's a convenient, loving and money saving option as well unless she has insurance that is paying and won't pay at home.. Another option might be to speak with some of the nurses on staff and ask if they would like to earn same extra cash to help you out off of their shift, given how much they make you might get some takers for sure and can have them working shifts..

Sorry for your family's stress and concern at this time it is never an easy choice nor task, been there done that with a past wife. Best wishes to you all..

Edited March 15, 2010 by WarpSpeed

[onlycw]

Many thanks. WarpSpeed, thanks to you there will be a lot to discuss.

Chris

[singa-traz]

We don't know if you are in Thailand at the moment, but if your (family) financial situation enables it, take into consideration the "positive" effect it will have on your wife (and family) is she is near her mother in those circumstances. Difficult decision.

[bina]

i cant see a thai daughter, educated or not, 'abandoning' her mother's last days/weeks for hired help to caretake.... have u spoken about this with your wife? what does she think? cause even if u do hire caretakers and wife stays working, after her mother dies she could end up blaming u for not allowing her to do what she considers her duty as a daughter; and she might not verbalize these feelings (how many thai verbalize these things?) but the feelings would still be there.

the culture i live in now also its very very common for people to stop working to take care of ill/dying family members and its rather frowned upon with those that place work/career before family responsibility... even if a caretaker is hired, the rest of the slack is taken up by family members in rotation: sisters/brothers/grandkids that are old enough..

and even in the best of hospitals here, there is a preference for family members to do some of the more personal tasks like bathing, feeding etc...

bina

israel

[lopburi3]

The fact is that in Thai hospitals there are nurse and nurse assistants that indeed do take jobs such as this on a normal and regular basis and it is how they make a living. But that needs to be your wife's decision knowing the financial requirements involved. The most you can do is make funds available if they want to take advantage of them - family indeed do try to take as much care as they can but they also try to arrange it for those with the most to lose or inability to perform in other ways. Making payments/financial considerations is often one of those ways.

[Sheryl]

Agree with posters who suggest bringing her home and hiring in help if at all possible. For a LOT of reasons: more comfortable for her, easier on family than shuttling back and forth to hospital (assuming they do hire in some help), much better use of funds than on the hospital care, and also avoid what may otherwise be unnecessary and uncomfrtable procedures that only prolong her suffering.

in answer to your other question -- if she has metastatsis to the brain, she has at most a few months unless they treat aggressively i,.e. radiation to shrink the brain tumors plus chemo. Such measures will only prolong her suffering and I personally wouldn't want them for myself or anyone I cared about.

Brain metastasis is actually a blessing compared to other possible scenarios for metastatic cancer. Pressure will build up in the brain putting her into a coma from which she will peacefully slip off. She may have some seizures, which are scary to see although not painful, these can be controlled by medication and should not preclude her going home.

In taking her home, the hospital may prescribe things not appropriate to a terminal situation as hospice-type l care is not well understood here yet. The imporant things are pain killers and anti-seizure drugs. Thai hospitals will usually give oral opates for cancer patuients at home but if (or when) she is unable to swallow this may be a problem. Morphine rectal suppositories are available in Thaland, ask specifically about that. Otherwise you may wind up in a situation where she can't take pain killers by mouth, is in apparaent pain and the hospital says the only thing to do is readmit her. I've known that to occur.

The coma she will go into will prevent her feeling pain from that point on but she may have painful headache in the intervel between before the pressure in the brain reaches the point of becoming unconscious, or have pain in other parts of the body from other sites of metastasis, so well to be prepared.