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Update on Pam

tabur's picture
Posts: 71
Joined: Jul 2009

Hello everyone. Pam is at the hospice center and I came home to do a quick load of laundry to take her some clean clothes. Waiting for the dryer so I thought I'd give you an update.

Last week, 2 things started happening at once. The distention in her abdomen got worse and the vicodin became less and less effective in pain control. The nurse arranged for a morphine prescription and an appointment at the hospice center this past Tuesday. A weekend with Pam on morphine was quite the experience. She had no pain but I had a hell of a time dealing with her. She had hallucinations and kept getting out of bed on her own. I finally had to put her bed rails back on. The last night at home I got about 1 hour sleep cause she kept yelling for me to check the oven because my cake will burn! People, I have never baked a cake in my life and I sure as hell wasn't baking one at 3am!

On Tuesday, the clinical director of hospice examined her and it was decided to try to drain any fluid in her abdomen that may be causing the distention. He also changed her pain medication to the Fentanyl Patch.

On Wednesday, the surgeon informed me that there was very little fluid in her abdomen and the distention is due to her enlarged liver, tumors and bile ducts. Damn.

After 24 hours on Fentanyl, she has zero pain but is still very confused. Now they suspect High Ammonia Levels and the symptoms seem to fit. They drew blood this morning and I hope to hear the results when I return.

Sorry this update is so choppy but I haven't gotten much sleep in the past few days. I'll update again when I get time. Please keep her in your thoughts.

I've been off the grid for a few days...has anyone heard from John23 yet? Man I'm worried about him.


jararno's picture
Posts: 189
Joined: May 2010

I am sorry to hear about all the problems. You are an angel here on earth. Know that you are doing all of the things that you can.

Will be thinking about both of you. Try to get some rest.

Take care,


Posts: 3692
Joined: Oct 2009

I want to send you + Pam hugs. I am so sorry for what you are both going through. You are taking good care of Pam. We haven't heard from John23 yet.

idlehunters's picture
Posts: 1792
Joined: Apr 2009

I had very high amonia levels a while back and they had to cart me off in an ambulance to the ER.... I was out of my mind crazy.... I don't know what high amonia levels does to the brain but I was out of it....just like you are describing Pam....only worse... I lost control of all body functions...it was a mess!! But as soon as they realized what it was it was an easy fix..... got back to normal immediately.

Keeping you both in my prayers. I am so worried about John23 too. Sure wish we would here something.


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angelsbaby's picture
Posts: 1171
Joined: May 2008

You are a wonderful husband and i will be thinking of u and pam .


pepebcn's picture
Posts: 6352
Joined: Aug 2010

Take care of you too, sending my prayers for Pam, hoping she is not suffering any more!.

geotina's picture
Posts: 2123
Joined: Oct 2009

I am so sorry it has come to this. May Pam have a peaceful and pain free end to her journey here on earth and may you find peace and comfort in knowing that you did absolutely everything you could for her.

I will keep both of you in my thoughts and prayers.

Hugs - Tina

lisa42's picture
Posts: 3661
Joined: Jul 2008

Hi Al,

Thanks for giving us the update on Pam- I just wish it was better news. I'll be thinking of you and praying also for you both.
Don't have any advice- sorry, wish I could be of more help or encouragement. Interesting about what Jennie wrote about her experience of having high ammonia levels- sounds like that could fit Pam's symptoms too.

You take care & try to get some rest now-

herdizziness's picture
Posts: 3642
Joined: Apr 2010

I hope they can help with the being out of it more, would be nice if it was the ammonia quick fix. I'm so sorry to hear about how Pam is doing, you both are in my heart, and all the cyber hugs I can said both your ways, I am.
I've pm'd John23, (we've had a lot of pm discourse over time about his TCM ways), and he hasn't opened it. So indeed, I've been worried, and could just kick myself in the arse for not having more information, like normal email to write and ask him or his wife how he is doing.
Take care, and keep away from that baking.
Winter Marie

Patteee's picture
Posts: 950
Joined: Jul 2009

Oh Al
I am so thankful that you are there for Pam and relieved you allow us to be there for you. Thank you to all the powers that be that she is pain free! I so hope in the upcoming hours and days that you both can find and maintain some peace. It is time for that, eh?

Crow71's picture
Posts: 681
Joined: Jan 2010

Thanks for the update. It sounds hard. Keep up the good work - the GOOD work. Get some sleep. Pam's lucky to have you.
Take care. Roger

Nana b's picture
Nana b
Posts: 3045
Joined: May 2009

I'm sorry to hear this! I'm thinking about you! Dang it!

tabur's picture
Posts: 71
Joined: Jul 2009

Thanks for the replies and well wishes. I just got back home to catch a few hours of sleep. Well, Pam's ammonia level is 45. Normal range is 32 - 34. However, 45 is not considered dangerously high.

Jennie: Do you recall what your level was?

They put her on a medication to try to bring the ammonia levels down. She is still very confused and lethargic. A little trouble breathing so they have her on oxygen also. The other thing they did was to cut in half the dosage of the Fentanyl. These new (to her) pain meds may also be contributing to the problem. The good news is she is no longer in any pain, at all.

Now for a 4 finger bourbon and off to bed. Bless you all.


tootsie1's picture
Posts: 5065
Joined: Feb 2008

I'm so sorry. Wish things were so much better.


tabur's picture
Posts: 71
Joined: Jul 2009

Had a long, private talk with the doctor yesterday. He was very compassionate. There is not much more they can do for her except keep her comfortable. Her appetite is way down and she is incoherent most of the time. He estimates she has 1 to 3 weeks left. We are still at the hospice center but I plan to bring her back home on Monday. Thursday, March 3rd will mark our 32nd wedding anniversary. As long as she is comfortable, I sure would like her to achieve that milestone with me.


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Posts: 3692
Joined: Oct 2009

Thinking of both of you during this difficult time. I hope you will get Pam home + that all goees beautifully for your 32nd anniversary.

Lovekitties's picture
Posts: 3372
Joined: Jan 2010

So sorry to hear your news about Pam.

You are a very good husband and caregiver bringing her home to spend what time is left together. I pray that she will find peace of mind being there with you and that you have that anniversary together.


Marie who loves kitties

JoyceSteele's picture
Posts: 146
Joined: Nov 2010

Al, have read all the posts and just want to say I am praying for you and your wife. What a blessing for her to have a devoted husband like you. I hope you can get her home and spend this anniversary with her. God Bless you both. You are in my thoughts. Joyce

Lori-S's picture
Posts: 1286
Joined: Sep 2010

I am sending you love and prayers. May you get pam home so that you can have your milestone together in your own home. HUGS

schnauzerheads's picture
Posts: 53
Joined: Jan 2011

Very new here, but wanted to say that Brooke (my wife) and I will be thinking about you. I can't tell you how much it means to me to have such a supportive wife as I travel along this road of confusion and uncertainty, and I truly believe that your being so supportive of Pam has been an incredible source of comfort for her. Please give her a hug for us and know that there are many people here who care deeply for you both.


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