Monday, November 01, 2004

Busy Week That Finished Strong

In a week with constant running around it seemed I accomplished little. In reality, I took care of many small errands that were piling up, leaving time to devote to bigger projects. I was able to transfer my stereo from the pick-up to the Explorer and install an alarm in the Explorer for the insurance discount. I also worked in the yard finishing up a needed Fall clean-up effort. It will be necessary in the next two weeks to redo the racking a bit as the sycamore trees have not yet shed their leaves entirely as well as finish up the trimmer work so everything looks neat at least. This will help highlight the landscaping a bit and make the yard look better for potential buyers as well. In all, it was a productive week.

Of course, the week was not total work as I was able to visit Pop four times during the week and Saturday. Pop is hanging in there at present not really complaining about his bed sore nor his feet, but both do not look any better. One good thing is that they have managed to prevent infection which is very crucial. If Pop develops an infection it would not only make his health worse but also effect his mental state and general level of discomfort. The staff have been administering a set of sedatives and pain meds to not only help his pain but level off his mood a bit. Not to make it sound like they are drugging a dangerous animal, these meds help with his mood in order to make him more agreeable to treatments. Otherwise, Pop will be more than likely to refuse everything out of sheer stubberness and anger/confusion over his situation. So far his appetite is below average but is a lot better than it was the last two weeks. It has been explained to me on numerous occassions that even though medications seem to be helping prevent infection in his bed sore ultimately nutrition has to play a role in the healing process. I guess it can be said that, barring infection, the bed sore is not healing like the physicians would like it to. This is a touchy situation, indeed, but I hope that at the very minimum the infection can continue to be thwarted.

Another set of issues that the physicians and staff have begun to address are the long list of other ailments that are starting to draw attention. First, Pop's circulation in the extremedies conitues to be poor as his legs and feet are continuely wrapped to treat ulcers that are still forming. Pop constantly touches his own hands and fingers because he is losing sensation there. Spots on his feet indicate that the arterial circulation is starting to fail - not a good thing. It has not been mentioned yet but if this gets worse I'm sure the subject of amputation will arise. I'm not looking forward to hearing this although I am preparing myself nevertheless.

Second, Pop's PSA levels are elevated in light of his recurring prostate cancer that was found back in April of this year. Rising PSA levels indicate that the prostate is growing, in other words the cancer is no longer in remission. This was one of the causes for Pop to become urinary incontinent, although at present he is completely incontinent. Pop needs to receive treatments for this in the form of hormone therapy and/or radiation, which will be another challenge for the staff to manage.

Third, a recent chest X-ray has shown that Pop is again starting to collect fluid within the plural space in his chest. The plural space is the space between the lungs and the thoractic cavity. The plural space fuinctions to help maintain the proper internal pressure to keep the lungs inflated. If the membrane surrounding the plural space were to puncture the result would be a lung that deflates or "collapses." In this particular case, however, if the plural space fills with too much fluid it would exude pressure on the lungs to remain inflated during breathing. Less air would be able to get in resulting in less respiration, in turn resulting in lower oxygen saturations in Pop's blood. Basically, his brain and other organs could be restricted from receiving the oxygen necessary for them to function. Not a good situation. Back in April 2004, Pop's plural space had to be drained for this same reason. It looked like the doctor was tapping a keg. The fluid even looked like beer because it was straw colored and had a foam which developed and rose to the top similar to the "head" in a glass of beer. Nearly two liters of fluid was drained in minutes because the pressure was that great within the plural space. It looks like they might be looking at doing this again. The doctor did mention that a CAT Scan would be used to determine just how much fluid is present determining the severity. Another strike against Pop, indeed.

Lastly, Pop needs to go back to the hospital to receive an endoscopy to follow up on his ulcerated esophagus and stomach. I saw the photos taken in the hospital about 8 weeks ago and they were not pretty. It basically looked like someone shot the inside of Pop's esophagus and stomach with BBs. The wall of the gastrointestinal tract was this greyish-pink color and each ulcer was a bright red spot. It was quite a disturbing set of pictures to see. Pop has been taking medications to treat this condition and a follow-up endoscopy will hopefully show some improvement. I might get the films scanned at my local photo lab and I will show a before/after set to give the issue true justice. I know this might be objectionable to some. Being a science buff, I have always found medicine interesting. In no way am I looking to produce a "shock value" in showing the films.

As far as Pop's condition is concerned, there seems to be more rough road ahead. Hopefully, his comfort level can be maintained and he will not become too agitated with the upcoming procedures that must be done. In the back of my mind I am always thinking of Pop's quality of life. I hope this can be salvaged as much as possible through our efforts. I feel much better knowing that there is a team I can work with en lieu of how it used to be when I was managing Pop's care all by myself.