Feb 09, 2014 - 2:08 pm
I wanted to ask for your kind help.
My mother is 88 years old and has esophageal cancer. When she was initially diagnosed over 3 years ago, the doctors mentioned that the cancer had spread outside of the esophagus near her lungs (not on the lungs but close by) and in her chest.
She received 3 weeks of radiation to improve her swallowing and almost 3 years of chemo.
After each of the last three chemo sessions she had heart problems so the doctor decided that she could no longer get any more chemo.
Since June 2013, she has instead been taking a pill called Tarceva.
The PET/CT Scan in September 2013 showed that the cancer near her lungs and chest area had decreased but that the cancer in the esophagus had increased.
A PET/CT Scan done in mid-December 2013, showed that her cancer had not progressed and was stable.
In late November 2013, she suffered a hip fracture and had surgery on her leg and entered a Nursing Home/Rehab facility on December 1, 2013.
Since entering the Nursing Home, she eats almost nothing.
In fact, not having an appetite and eating very, very, very little has been her main problem over the past year.
But since going to the Nursing home, she eats only an egg for breakfast, nothing for lunch and less than half a cup of soup for dinner. This has been her diet over the past 2 months.
Over the last month in the Nursing home, she also has had persistent diarrhea. She had diarrhea for around 3 days and then it stopped for 2 days, the diarrhea came back again for about another 3 days and went away for 2 days, started again for 3 days and stopped for 2 days, etc. This despite taking anti-diarrhea medicine all the time.
She was also vomiting about once a week (about twice a day).
These developments made her so weak that it was hard for her to even get out of bed.
They eventually did blood tests and took a stool sample and determined that she did not have an infection so they could not understand why she was having diarrhea.
About 2 weeks ago, the diarrhea became so severe and had weakened her so much that she was hospitalized for 2 days.
At the hospital, the tests only showed that she had a urinary tract infection, but the tests couldn’t determine why she was having diarrhea.
She was given antibiotics for 2 days, and since her diarrhea had stopped, they discharged her to the nursing home, and told her to take the antibiotics for her urinary tract infection orally for another 10 days.
However, a few days later, while at the nursing home, despite eating nothing, she started to vomit uncontrollably the entire day.
She was taken to the hospital where the blood tests showed that an infection had entered her blood and had spread throughout her body. She also had pneumonia as a result of the infection. (I think the term they used is “sepsis”).
She was in ICU for about 5 days and treated with 2 strong antibiotics which helped reduce the infection.
She has now been transferred out of the ICU unit to a different section of the hospital where she is continuing to receive antibiotics.
Over the past week in the hospital, she ate nothing except for yesterday when she ate some yogurt and a bottle of Ensure.
She finally had a bowel movement last night and it was watery stools so they are going to take a stool sample since it appears she may once again have diarrhea.
Since her infection is better and she is supposedly becoming medically stable, the doctors want to discharge her soon to the Nursing Home where she can continue to receive antibiotics and, they claim, physical therapy.
However, she is extremely, extremely weak, sleeps most of the day, and can’t get out of bed due to her weakness, so I don’t know how she will be able to do any physical therapy.
I think the source of all her problems is the fact that she has been eating very, very, very little over the past year, and next to nothing over the past 2 months at the Nursing Home.
This combined with the persistent diarrhea she’s had over the past month has made her extremely weak so that she easily gets infections that spiral out of control.
I’ve asked the doctors if they can give her a feeding tube.
However, the doctors stress that her cancer is incurable and that a feeding tube would cause complications.
Since the PET/CT Scans show that the Tarceva medicine has been effective in controlling the cancer, I think that with sufficient and proper nutrition, she can improve.
Could a feeding tube could help my mother?
Is there anything that can be done for her that would help?
As I am truly worried and desperate, I would deeply, deeply appreciate hearing any thoughts, ideas, suggestion or advice you may have.
Thank you very much for your kind attention, time and help!!!
P.S. – I just noticed that on her CT Scan Findings of December 18,2013, it says the following about the area near her lungs: “Multiple other areas of lesser extent groundglass attenuation in the right upper lobe at the distal airways are present. These are nonspecific, but likely represent inflammatory or infectious in etiology and may represent chronic aspiration…Clinical correlation and attention on follow up is advised.”
Does anyone know what this means?
When she was having diarrhea and vomiting in the nursing home over the past month, I called the oncologist several times for help but he kept telling me that since the blood tests showed no infection, nothing could be done for her. However, may be the infection noted in the CT Scan Findings had something to do with her condition?