My last post was that mom was able to get in to Dr. Feng’s office the Monday (6/3) after her last chemo treatment to get some infusions to help her feel better after a very rough weekend!

The next morning, Tues, mom had taken a bit of a slide backwards with what relief she had felt from Monday’s infusions. She already had an appointment the following day with her primary care doc, so we knew she would have another set of eyes on her soon!

Wed at her primary care appt, her BP was still very low, she was lethargic, had an ongoing cough, labored breathing with exertion, and had very little appetite. Chest x-rays were mentioned, but not pursued. The result of the visit was to cut her BP meds in half and take her off of Lasix to ward off more dehydration.

That Friday, Debbie took her to Dr. Feng for her standing chemo appointment. Gina met them there. There was lots of worry surrounding mom at this point. After a visit with Dr. Feng about her symptoms, bloodwork, and an exam, he sent them straight to the ER. He told mom to expect to be there several days so they could get everything back in balance. Vitals were poor, the swelling that had been in her feet for some time had quickly made its way up to her abdomen, and her breathing was very labored. Due to the terrible experience we had last time at Park West, they asked which ER mom should go to. He still recommended Park West as Tennessee Cancer Specialists has privileges there. So off they went, and thankfully there was no wait. I met them at the ER after school. They started with bloodwork, chest x-rays, EKG and a CT of her abdomen. Chest x-rays and EKG were good. Bloodwork was a mess. Most alarming was a very high potassium, high white cell count, high platelets, and BNP. They gave her calcium to combat the potassium, insulin to protect her heart (at least that’s what I think they said the insulin was for), glucose to balance the insulin, and then Lasix to start getting rid of all the fluid build-up. Her BP was low but that’s all they could do in the moment. Her BP should begin to come up as the other things get more balanced. Her abdominal CT showed fluid but they said not enough to risk a centesis, which would be inserting a needle to draw off fluid manually. She ended up getting a room on the oncology unit in the new part of the hospital, which was nice! And I was so very thankful they had an oncology unit! Her first nurse was a Russian lady, Tatiana, and she was all business! But she seemed very knowledgeable and was getting things done. When I left that night, I felt like mom was in very good hands!

Saturday didn’t bring as much comfort to me that she was getting great care, but I stayed most of the day, and Debbie and Gina were there as well. We all made sure she had what she needed. Mom was starting to feel better, her appetite was up, and the top number of her BP was improving. The hospitalist, Dr. Wong, who we met in the ER, had consulted with Dr. Feng in the meantime. He wanted to get her back on a regular dose of Lasix as soon as possible as she has a lot more fluid to get rid of, but Dr. Feng said no more Lasix until that bottom number of her BP comes up. He wanted it at 80, and it was currently at 60. In the meantime, they did an echo as they were still concerned about her heart due to the high potassium levels she had. A fella came and did the echo bedside, and we got to watch! It was actually very fascinating. Not much else happened today so this was the highlight!

On Sunday, one of Dr. Feng’s partners came for a visit, Dr. Ibach, and he was absolutely wonderful! He was the highlight of this day! We chatted about church, chicken salad, and some other things, and then he got to why he was there. Her WBC and platelets have continued to elevate while she’s been in the hospital. The speculation was that this is a result of her chemo and neulasta (replenishes her WBC after chemo), but the hospitalist wanted to make sure. Dr. Ibach told us that is in fact why the labs continue to elevate and that he is not alarmed. He said he will of course continue to monitor this and he also added a couple more lab tests to be done along with her daily labs just to cover our bases. He says both WBC and platelets should come back down within a couple of weeks. Mom asked him the question, if this was your mom in this bed, would you encourage her to continue treatments? He answered well with the response that he would encourage his mom to fight, but not beyond quality of life, and that she is the only one that can determine what quality is for her. He told mom that based on what her chart says she has experienced most recently, he doesn’t think that would be the quality of life he would want for his mother, but that only his mother, and only mom, can determine that. He encouraged her that there are other options and to not cut out treatments yet. He went through her progression of chemo (it was impressive he did this from memory without skipping a beat) and said that she is on a 2 drug regimen now, and that it can be decreased, and that we can still go to a one drug regimen. He says we aren't done yet! 

Her echo results came back on Sunday as well. Her left heart function was at 60-65%, but her heart was pumping normally. It also showed moderate to severe pulmonary hypertension. I don’t think any of us thought about your lungs having a blood pressure, but they do! Mom will have a pulmonology consult for this and she will begin seeing a pulmonologist after discharge as well. She also started PT this day! She got in 2 laps done around the room, which is the most she’s been able to do in over a week!

On Monday, Debbie spent a good part of the day with her. No mention of discharge, but a case manager came by to talk with Debbie and Mom about what needed to be in place when mom was ready to discharge. Mom also had a lung perfusion test, but results came back inconclusive so she is to follow up with her new pulmonologist about that. She also had more PT today, getting out of the room and into the hallways. Debbie said it was a very busy day with people in and out all day!

On Tuesday morning, I got a message she was being discharged! What??? I honestly was not expecting that. None of us were. Yes, she was getting better each day, but we didn’t feel like she was ready to be at home quite yet. None the less, she came home. When I got home from school, a fella with the home health equipment company was already there getting things in order and mom was resting in her recliner. But she said she felt terrible! Why?? She was so much more alert in the hospital, her appetite was up, had only one bout of nausea, and now blah and nauseated again. Well, after some nausea meds and a good nap, she began to perk up. And each day she has gotten better and stronger!

If you have hung in here with me this long, bless you and thank you! It’s been a lot to read I know!

Yesterday, she had her regular appointment with Dr. Feng for chemo. He said, nope, not today! Mom is doing well, but he wants her body to have another week before doing another round, and he is going to cut this next treatment by 5%. 5% doesn’t sound like a lot, but he said any more than that, and the efficacy drops too much.

Today, home health came out to visit. The nurse was wonderful! She stayed for a long time and covered a lot with us. PT is supposed to show up tomorrow for a visit and then OT is supposed to come out on Monday. Home health will come twice a week, but for only 5 visits. At that last visit, we will see how things are and if we think more visits are needed, we can put in a request to Medicare. In the meantime, she strongly recommended we get set up with a palliative care team. They will come out indefinitely once a month to monitor mom and help us navigate this new path.

Again, thank you for hanging in there with me this long! Continue your prayers for mom! For all the things! I know her prayer warriors out there know how to pray best for her and that God knows how to deliver! Much, MUCH, love and thanks to you all!