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Dad's prognosis is now poor

Steelchuggin26
Posts: 16
Joined: Mar 2013
  • Hello everyone, as you all know, my dad had surgery for proatate cancer one month ago and at that time, it appeared he had a good outlook. However due to suffering bilateral pulmonary emboli from the popilieatal veins, it looks like his life expecatancy is most likely not very good due to complications of the emboli. First i will explain how I found out about all of this

Yesterday dad decided to go to the hospitals he was in and to the Urological surgeon's office to pick up some paperwork to turn in to his insurance, and once we got these, being curious as I am, I decided to read through all the paperwork, including results of the surgical report, initial biopsy report, and findings of imaging and blood tests done in regards to his bilateral pulmonary emboli.

As far as the cancer goes, the pathology report noted the prostate was enlarged and very slightly nodular, though no lesion was visible prior to dissection of the tissue. It was found that the cancer was actually in both sides of the prostate, and perineural invasion was present. The cancer involved 10% of ghe prostate with results being negative for extracapsular invasion. There was one margin that appeared to possibly be minimally focal invassive, but again, even with that taken into account, extracapsular invasion did not appear to be present. His pathologic stage was pt2cnxmx, gleason score remained 6(3+3).  So it appears the cancer was a little bit worse than what the biopsy showed.

 

 

Second part has to due with tests and blood work done to diagnose his bilateral pulmonary emboli. It was noted that his d dimer level was 5000, which was strongly suggestive of pulmonary embolism. X rays and CT scans were taken, and CT scans confirmed extensive bilateral pulmonary emboli. He was thus given heparin through an iv that night in the ER, where he seemed to stabilize enough for transport to a larger and better equiped facility. Their fests, imaging, and blood work also reported extensive bilateral pulmonary emboli and their report stated that the left lung embolism may have caused significant damage to his left ventricle and ischemia was to be considered. Rest of the imaging tests revealed no active cardiopulmonary disease other than the pulmonary emboli. He was continued on heparin via IV from the early morning he arrived at that hospital (May 9) until discharge on May 12, which he has since been assigned to home healthcare(not hospice) and was prescribed the blood thiner xarelto 15mg to be taken twice a day for 17 days, and after that, he will go on 20mg xarelto 1x daily for up to 6 months. Doctors said they believe the emboli were a result of the prostate surgery, mimd you, the Urologist did say this was a potential risk with surgery, and dad of course went ahead and gave consent to do the surgery.

 

 

Lastly a ct scan was done on his head in the hospital he was first taken to, and it said findings were normal, with no mass, tumor, hemorrahging , or further trauma present. I just really dont know how to properly handle all this, I was hoping once the surgery was done, dad would feel better agakn sll. And be able to return to normal activities within a couple months. However, with the pulmonary emboli and the evident damage done to his heart, it appears that this will not be the case, and dad will most likely never be the same again, and more than likley, his life expectancy has been drastical 

Steelchuggin26
Posts: 16
Joined: Mar 2013

More than likely because of damage to his left ventricle, his life exectancy has been drastically reduced, and im at a crossroads now as to where to proceed from here. Should i go ahead and start preparing myself for his declining health and perhaps get him enrolled in hospicr, or shoulf I hold out hope that with time, he can at least recover enough to be around a little while longer. If I lose my dad I will be devastated. He is all I have left.

Rakendra's picture
Rakendra
Posts: 80
Joined: Apr 2013

 If I lose my dad I will be devastated. He is all I have left.------- Perhaps not.  This is a quote from my teacher.  When my oldest son died from a drug overdose, it helped me.  

Love, Rakendra

 

See the dictionary under the letter ‘h’ — only there will you always find happiness. In life things are very mixed up. Day and night are together, so are happiness and unhappiness. Life and death are together, so is everything. Life is rich because of polar opposites. The very idea that one would like to be happy forever is stupid.  The very idea will create only unhappiness and nothing else. You will become more and more miserable because more and more you will be missing your so-called eternal happiness.

Then who is the happy person? The happy person is not one who is always happy. The happy person is one who is happy even when there is unhappiness. Try to understand it. The happy person is one who understands life and accepts its polarities. He knows success is possible only because failure is also possible. So when failure comes he accepts it.  Things are interdependent: failure/success, happiness/unhappiness, summer/winter, youth/old age, beauty/ugliness life/death — all are interdependent, they exist together. And the man who starts seeking one pole against the other pole is getting into unnecessary trouble. It is not possible, he is desiring the impossible; and he will get very frustrated.

Then what should the attitude be? When happiness comes,  enjoy happiness; when unhappiness comes, enjoy unhappiness. When there is happiness, dance with it; when there is unhappiness, cry with it. That’s what I mean when I say ‘Enjoy’. Unhappiness is a must. If you can accept unhappiness as smoothly as you welcome happiness, you will transcend both. In that very acceptance is transcendence. Then unhappiness and happiness will not make much difference to you, you will remain the same. When there is sadness you will have a taste of it; and when there is joy you will have a taste of it. And sometimes bitter things also taste beautiful.  And sadness has something of depth in it which no happiness can ever have. 

 When crying, become the crying, and when dancing, become the dance. Then the ultimate happens to you. By and by you forget the distinction between what happiness is and what unhappiness is. You enjoy both! So by and by the distinction disappears. And when the distinction has disappeared, there arises something which is eternally there, which remains always there. That is witnessing. ----Osho

 

Samsungtech1
Posts: 350
Joined: Jan 2011

What a perfect way to describe life.  Thank you so much for posting it. Been doing something like this for the last fifteen years.

Keeps me balanced.

 

Mike

yankeefan
Posts: 69
Joined: Mar 2013

sorry to hear your story...it does seem like the urologist was very slow to pick up on your dad's post-op condition and let him continue untreated way too long...but that's water under the bridge, unfortunately....sounds like his pulmonary and heart issues are the main thing to worry about now...be as agressive as you can in getting him the best specialized care you can...this is not time for your GP but for heart and pulmanary specialists to be engaged, hopefully they are already. get the best ones you can. btw, I'd get a different urologist if I were you. This should never have gone on as long as it did...my humble opinion.

you are right, blood clots are a known risk to surgery...all the more reason his surgeon should have been on top of this much earlier. Sounds like he had classic symptoms but they were ignored. 

Hope your dad gets better soon, thanks for keeping us informed. 

ncobjim
Posts: 35
Joined: Nov 2010

I had a RP in 2006. 10 days after was hit with a massive PE & DVT in both legs. Had to have clot busting drugs the save me. I am still on blood thinners 7 years later. Your dad must have seen a pulmonologist i would think but if not as yankeefan suggests you need to get a good one now. They would get your dad to the right kind of heart doctor needed. It took me almost a year to get feeling better but they got me thru it and i am sure they will help your dad.

Good luck.

Jim

 

 

Kongo's picture
Kongo
Posts: 1167
Joined: Mar 2010

Brandon,

I am so sorry to read about the continuing problems your father has had since his diagnosis.  Every potential treatment carries risk.  Removing the prostate is major surgery and even at the relatively young age of 63 (I am 62 myself) the risk of emoblism is inherent in this procedure.  Although the downsides your father is experiencing are relatively rare considering all the surgeries done, it is 100% when it happens to you or a loved one.  All cancer patients should fully understand the risks involved with any procedure whether it be surgery, radiation, or some other treatment.  Playing the odds doesn't always work.

Hospice polices vary in different locations.  I dealt with a dying father-in-law last year and in California the rule is that life expectancy is estimated to be less than 6 months although it can be extended if conditons change.  Keep in mind that in hospice they normally do not do corrective or curative procedures but focus on keeping the patient as comfortable as possible.  My gut feel is that that is probably too early for your father but it is always a good idea to gather information and the patient services office at the hospital should be able to provide you with hospice options in your area.

Although I do not know all the details of your interaction with your father's doctors, it is disturbing to me that you had to find out about the seriousness of his conditon by reading his medical record yourself.  I would have thought the doctors would have briefed the family as soon as the conditons arose.  Perhaps your father was informed and he chose not to share the information but it seems that you have been very active in helping manage your father's treatment.

I do hope he recovers oon and quickly.  Best of luck to you and your family.

 

K

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