An update

A Monarch butterfly I saw while on a walk last week

As I write this, I’m sitting with Pam in the Palliative Care Unit at Riverview Health Centre, not too far from our house. She is resting with her eyes closed so I thought it would be a good opportunity to update the blog. As well as being a way to send out news to our friends and family, I find the writing somewhat therapeutic as well.

For some time this year Pam’s legs and lower abdomen had been very swollen and getting worse. This was apparently caused by internal blood clotting around her IVF filter, a small device that was installed below her heart and lungs in 2010 to help prevent catch stray blood clots from her lower body and prevent them causing more serious problems. It seems that the filter has done its job maybe too well, because a recent CT scan revealed that the massive swelling was caused by poor return of blood to the heart caused by clotting in and around the filter, and through the inferior vena cava. Pam was started on dalteparin and lasix to try and dissolve those clots and purge water from the lower body.

This course of treatment didn’t work that well at home as the swelling got worse and Pam’s weight increased to almost 145lbs (!) Finally her breathing was getting bad enough that her palliative care nurse recommended she go to the ER. This was on July 5.

Pam spent two weeks in the hospital but it really was beneficial in addressing the swelling. Aggressive treatment with injected lasix and dalteparin resulted in her losing 25lbs of fluid weight, and she came back home last Sunday, July 19.

Last week was not bad and although Pam was pretty weak from two weeks in a hospital bed, she wasn’t gaining anymore weight. Last night we had her sister and family over to the house for pizza from Tony’s (it was excellent) and a visit.

This morning Pam woke early and was terribly sick and dizzy, retching like crazy and unable even to stand - a real shock considering she’d been feeling relatively good the previous evening. It was bad enough that we phoned the on-call palliative care nurse and she recommended Pam come in to a bed so they could try to sort out the problem. So she went by ambulance to Riverview this afternoon.

We really don’t know for sure where we go from here. The idea is to try and get Pam’s meds sorted to address the dizziness and nausea. We reckon that these are being caused by the advancing brain tumours and since no treatment to address those directly is possible, the steroid that’s being used to treat the symptoms might need to be bumped up a bit. If that works out then she’ll be able to return home. In the meantime the palliative care unit is very comfortable and quiet with a private bedroom, and the staff are wonderful. Since all of the cancer treatments have now been discontinued the objective is to address these issues and try to have Pam be as comfortable as possible.

As promised last time, here are some little friends Pam has knitted recently