Delirum

worriedson714

Hello ,

So dad's out of the hospital and against doctors advice here we are planning to go to flint monday for proton therapy . The pallaitive care and oncology doctors are really pushing my dad into hospice here . Saying his health is on the decline with confusion and delirum and the infections and the pain he is in and fevers they now think his tumor is causing . So this got me reading alot online mainly about confusion and delirum and it seems very common in cancer patients . The heartbreaking news for me is it seems it's mainly in the end of life which is so hard to hear .

Dad's vitals are still good and he's getting around better again at home in less pain but still night time is bad for the confusion . He's trying pills but honestly they seem to be making it worse so I am wondering has anyone experienced this and have any idea's how to treat it ?

Like everything doctors just throw pills at this and I am so worried about my dad I don't even dare sleep at night for fear he will be awake alone . Also has anyone experienced this not at the end of life ? I think my dad's doctors are assuming it automatically means that and I am looking for other causes or maybe that's just wishful thinking on my part .

NewHere

My Dad was on pain killer and steroids and he would go out of his mind to the point police had to be called. He would have no idea where he was. Lot's of fun. (Not cancer, but failing health and various drugs in play.)

There are many factors that can cause delirium. The drugs, the cancer, infections and fevers from infections. Dehydration. Infections can mess with blood sugar, which can cause confusion. Blood work can be affected.

One thing you can do is get a list of the medications and ask a pharmacist to review them. There were studies that is people had more than 5 drugs (I think that was the number, I read the study awhile ago, but the was close to a 100% of some issues cropping up from the combinations.

Something else to consider is dosing. Dialing a dose down may help. With doctor's guidance you may be able to figure that out.

It seems that there are still questions you need to get answered. It seems very broad in what you are relaying here. The thing from this end (just reading your posts) is the vibe the doctors are not paying attention much, not communicating enough information and just want to get him moved along to somewhere else.

I would not be accepting conclusions without having as much clarity as possible in how such conclusions were reached. Doctor's are not perfect. Pin them down until you get answers that you and your Dad find acceptable in terms of what is going on and why the recommendations are being made. If you are going to get proton therapy, it sounds like from this end that there are things that a doctor is willing to do to help in some manner. Perhaps that is the doctor to speak with?

Real Tar Heel

Agree with Newhere. I'm up late WORKING so there may be a little delirium setting in on myself, lol. However, think some problems can be caused by drugs. In our case the doctors might throw caution to the wind when it comes to prescribing things that can ease symptoms and say yes to whatever might take away some pain. My own father is aging and he does get confused sometimes but also he takes too many drugs IMO and it clouds his thinking.

When I am under the influence of the cancer drugs, I cannot focus at all. I fall asleep as soon as I sit. I move like a zombie. Without them, I'm a regular dad who has to take out the trash. So it is maddening. Imagine that your dad might be feeling the same way.

As far as proton therapy goes, my family is pushing me to consider this. The doctors who perform as well as my own oncologist and second opinion guy are skeptical. Will proton help? What is it going to do that RFA can't? Is it a matter of your regular doctor not wanting to do surgical interventions? Margins not right? There are a lot of questions for me. I did speak with them and they want to do an MRI before going further even though I have two CT Scans they can observe. Do they just want to charge my insurance?

I do have end of days experience with a loved one. I was relatively young and not around him as much as my mother was, but there were mental lapses and other issues outside of treatment to deal with. One question you might want to consider is how much energy, will and ability to handle these things do you have? Even if you are seeking treatment, is a hospice nurse the right person to be with your father or are you? My mother had the will but neither the energy nor the ability.

worriedson714

Your both right there really is so many questions and honestly i don't think doctors know the answers here . They started out saying the repeat infections were going to kill him and there was no way to stop them . Then next time he didn't have infection so the cancer was source of fevers , confusion and pain . They also say however he has sun downing symdrome and delirum from being in the hospital which could take months to go away .

It is clear there just tired of dealing with my dad cause he can be a difficult patient and they feel like mentally he is just ready for hospice even though my dad is refusing . Since dad has only one tumor the proton therapy doctors are hopeful it can help maybe it is a good idea that I talk to the doctors there

NewHere

I am sorry you are going through this all. Dealing with cancer under the "best" circumstances is difficult. It seems you have a lot of doctors just throwing things at a wall to see what sticks.

It is is good to talk to the doctor when you see him. I would also search out cancer support groups in your area. The American Cancer Society can help find the resources and support you need. Lastly, find the patient advocacy department/human resources in the places your doctors are. Perhaps they can help you.

Organize everything beforehand and go in as calm as possible (I would be spitting nails at this point myself). The major health care facilities address this much more than they used to, or at least they say they do. If a department or doctor gets poor reviews, there can be blowback. Often the upper levels (HR, Administration and so on) want to know.

Though we all try our best here to help, and will continue to do so, sometimes a friendly/helpful face and voice can be of a big benefit. So if ACS, PCA and others that can help and support you locally, in should be a positive addition to the support you get here.

SandiaBuddy

From my perspective, doctors make suggestions and patients decide whether they should follow those suggestions. If your father's quality of life is declining, he might want to analyze carefully what each drug is supposed to be doing, how it interacts with the other drugs, and what alternatives are available. Some people find alternatives like medical marijuana helpful. If things are not working well, it might be worthwhile to seek answers and explore alternatives.

Real Tar Heel

https://csn.cancer.org/discussion/comment/1691146#Comment_1691146

It seems I don't know the details of your father's condition clearly, and so then perhaps I can't offer a helpful comment. But one tumor and they are discounting surgical intervention? Has chemotherapy shrunk others? I was under the impression that the organ was overwhelmed and that was what was behind the reticence.

flutemon

I was curious about where the tumor is, size, etc. Also, how is bloodwork? If it's a liver met, then how are the liver function numbers? My mother-in-law was not a cancer patient, but had cirrosis of the liver. As it got worse, there were mental problems: hallucinating, dementia, anger, etc. She also had problems with itching everywhere. We heard the problems were from the liver starting to fail. I don't know if that's any help at all. Just anecdotal information.

I have had SBRT with proton beams for 3 liver mets that couldn't be ablated or resected. It was effective and killed the tumors. I've also had resection surgery twice and Y90 (radio embolization). The Y90 was last summer. I only got half of the treatment because my liver function numbers shot up too much. We've been waiting to get the other part done. It may never happen, because my liver is not doing well.

I'm sorry to hear you dad is struggling. I hope you are able to work things out and find the answers you seek.