Update on Jack

[Guest guest]

Hello,

I posted to the group several times a couple of weeks ago re my brother Jack who

has advanced PCa, and advanced kidney disease. I'm just having time to post

again as Jack has been very sick. I sincerely appreciate all of the former

responses from this group as I learned so much, and more importantly knew how to

respond fairly well to the medical staff involved. I also had read a good deal

of the recommended reading in additon to reading on this site. A bit of Jack's

history: 56 yrs. old, PCa stage 4,radiation, six months later bone scan

revealed bone mets to entire skeletal system, PSA 2500 and w/ 9 months of

hormone therapy Psa was 174 last month, lost around 100 lbs now to 140, and Jack

has frontal lobe damage from an accident when he was 15 years old. Throughout

all of this he was doing fine, just a bit tired, but had a good appetite and

seemed fairly happy w/ his simple life....not ever overly worried about the PCa.

When I first wrote the group, I was concerned that his oncologist never wanted

to discuss, even privately w/ me, how serious this conditon was. With the

responses, I learned that he probably wouldn't live out the year and to get

ready w/ end of life issues. This helped me tremendously, and thanks again!

Finally here's the update: about 6 weeks ago Jack started seeing blood in his

stools. His doctor's office told me to come in for a hemoglobin test if very

much blood was seen. A family member took him to the emergency room where they

admited him to the hospital, gave him 3 pints of blood, did a colonoscopy and

discoverd radiation burns. In the 5 days that he was there, he contacted MRSA

infection and was sent home w/ meds. When he didn't answer his phone the next

day I went to his home and brought him home w/ me. He seemed initally to be

disoriented, wouldn't eat, still had blood in his stool and came rushing into my

room telling me that he needed a toilet, and that he was dying. He lost

consciousnes, ability to walk, and became incontinent all in 5 mins., at around

3AM. Our son-in-law rushed over to help us move him to the hospital that he had

been in since they knew his " situation " , 40 miles away. He had a fractured

sacral bone (can't walk yet), needed a catheter, developed sepsis from MRSA, has

much chest congestion, declares horrid pain, heart was infected w/MRSA and they

placed a stent there to stay for 6 weeks, and he still passes blood. Seven days

later (today)he was sent to an assisted living facility. He seems to be fairly

alert, on and off, still on a 50mg Fentanyl Patch and Oxycodone 15mg every 3

hours for pain. His oncologist says that he just needed to go back home, get

over the infection, and that he would be fine and didn't need Hospice. The doc

in charge at the hospital said that he did need Hospice and would die soon. He

is conscious now and asks me constantly if he is dying. With his mental

condtion, me nor no one will tell him that he is dying. He only knows that he

has the last stage of PCa and I tell him that we need to wait till his bone

heals so that he can walk again, and get rid of the infection. This seems to

placate him for awhile. The conflicting doc's advice has confused a few family

members. His daughter who lives in another state and is not close to Jack

(primarily due to his mental condition) says that she will not sign a DNR for

him, and to keep treating the PCa and all of the other ailments. (She rushed

down and got a power of attorney and we urged her to, however, now I'm wondering

if this was a mistake since it seems so obvious that he is dying. He is very

close to one of my brothers and at this point(while he can still talk) Jack

would change the Power of Attorney if my brother suggested it. He would also

change to me). With the conflicting doctor reports, I wonder what this group

thinks? Also, do we need to get a DNR order - has anyone been through this?

Would the facility medical staff actually break his bones trying to save him,

for instance, if he had a heart attack? I feel that Jack is in the process of

dying, but I do want it to be as peaceful and painless as possible. I realize

that there are a lot of issues in this post, but comments on any one of the

issues will be greatly appreciated.