A medical update

Helen is still in Hospice. She and I had a very frank conversation this morning about death and dying. She has been quite lucid over the last 3-4 days (presumably as a result of them treating her UTI)...she is still sleepy and easily tired but much more withit and rational and answers/converses appropriately.
I initiated the conversation this morning because of 3 things: her immobility - likely to lead to lung collapse, pneumonia, skin breakdown and clots in legs and lungs, the anti cancer drug Iressa seems to be causing an itch again which is unpleasant for her but it also seems to be working interms of stopping all the yukky para-neoplastic phenomena and finally because when I went to rub some oil into her legs and feet I noticed her L calf was quite a bit bigger than her R and quite a bit bigger than it was a few days ago. To my mind this means a deep vein thrombosis in that leg is very likely. The other trigger for talking about it (apart from treatment decisions) is that a number of people have commented to me that they think her reluctance to get up, to sit, to move around or try walking are signs that she has "given up fighting" and is ready to let herself die.
When I suggested this to Helen she was quite shocked. She says she is not ready to die although it's true that she doesn't want to do anything in particular and is enjoying resting quietly and enjoying her visitors.
I outlined possibilities such as having further tests on her leg or lungs, having blood-thinning injections again, taking tablets, stoppin her anti-cancer drug to relieve the itch but potentially having more para-neoplastic phenomena emerge. She was clear that she does not mind tests, tablets or needles and clear that she wants active treatment to continue.
I asked her what comes to her mind when she thinks about death or about dying. She said she thinks about the funeral and about what a lovely job Tim (my cousin by marriage) did of organising/speaking at her mother's.

I asked her whether she would like me to ask Tim to speak at her funeral and again she reacted with shock and said "I'm not at that stage yet!".

So...the process continues.

Helen's friend Shirley came for a visit while I was there and showed me a beautiful pencil portrait she has been doing of Helen - still in progress but looking lovely. Shirley feels it is a sad image but I didn't find it so.

The ward round happened while I was there so we spoke with Dr A about all of the above. She thinks a pulmonary embolus/DVT is fairly likely and Helen will have a test soon to find out if this is true - if so probably will restart on Clexane injections. As far as the Iressa and itch goes her skin looks much better despite the itch and I think we will continue with soothing creams and some night time anti itch medication. Apparently the rehab team are interested is a "restorative" admission but this will go on hold till they sort out the leg/lung issues.

Next week I will be away for work for 6 days and Susan will have returned to Victoria so hopefully Louis will be back and able to visit her. This week I am taking a fair bit of time off work and will go out to hospice as often as I can.