Something I should be worried about?

jen2012 said:

My husband is on pretty high

My husband is on pretty high dose of fentynal (275) and dilalaud ( up to 12 mg every 3 hrs)  hes had a lot of twitching.  Painful with his femur fracture.  They put him on a nerve med..neurotin? and also baclofen as a muscle relaxant.  It seems the baclofen really  knocks him out.  He stopped taking it and had more pain so he started it again yesterday and slept all day.  Deep sleep and hallucinating.   I hope they are giving you answers and help.

You know what i am going through, you are going through it yourself. I do hope he finds some comfort.

devotion10 said:

Hypercalcaemia ...

Sometimes doctors don't explain everything very well and I am sure you have not felt much like researching yourself, so here is some information about elevated calcium levels. I always think the more we understand, the more we are prepared to deal with and face challenging complications. Sometimes it seems our helpless feelings come from not having sufficent information to understand what is happening in a crisis ... at least this is the way it was for me as a caregiver. My heart goes out to you, it is extremely challenging to watch your loved one transition away from you. Hold tight and try to be in the present moments as much as possible, as difficult as those present moments may be. Push the doctors to do what they can for her ... being armed with information about her condition and potential treatments will help you advocate for her. You did exactly the right thing to seek help for your wife and now her doctors can help her feel better. Sending strength your way. 

Peace. ~ Cynthia

Why people with cancer get hypercalcaemia: Between 10 and 20 out of every 100 people with cancer develop hypercalcaemia. This usually happens in the advanced stages of cancer. The cancer makes calcium leak out into the bloodstream from the bones, so the level in the blood gets too high. The cancer may also affect the amount of calcium that your kidneys are able to get rid of. Dehydration or having diarrhea may also increase calcium levels. If not treated, hypercalcaemia can make one more and more drowsy until they are sleeping nearly all the time. 

Symptoms of hypercalcaemia: 

It is not always easy for a doctor to spot hypercalcaemia. One may not have any specific symptoms; it may be just feeling a bit unwell or very tired. And the severity of symptoms doesn’t always match up to the calcium level in the blood. People with a slightly high calcium level can have very severe symptoms, and people with a very high calcium level may only have mild symptoms. Many of the symptoms are common in the advanced stages of cancer, even in people who do not have hypercalcaemia.

• Feeling weak

• Extreme tiredness and lethargy

• Not wanting to eat much 
• Constipation
• Loss of concentration and interest in doing things
• Mild confusion

If the hypercalcaemia is not treated the symptoms become much worse and can include

• Feeling and being sick
• Drowsiness
• Passing large amounts of urine
• Feeling very thirsty
• Dehydration
• Confusion
• Agitation
• Muscle spasms and tremors
• Bone pain and weakness
• Irregular heart beat
• Difficulty thinking and speaking clearly
• Coma, if not treated

Because calcium plays a role in the normal working of the brain and spinal cord, patients with severe hypercalcaemia may also

• Have seizures
• Be unable to coordinate muscle movement, which can affect walking, talking and eating
• Have changes in personality
• Have hallucinations

Managing high calcium: The main aims of hypercalcaemia treatment are to lower the blood calcium levels and to relieve the symptoms. One will need treatment from their specialist and might have to spend a day or two in the hospital to get calcium levels down. The main treatments for high calcium levels are

• Fluids: through a drip to help flush the extra calcium out of the system. Drinking plenty of fluid will help too, if one can manage it. 
• Bisphosphonates: are very effective drugs for helping to get calcium levels down. One has to have some of these drugs through a drip into a vein, but others come as tablets. Which needed depends on how high the calcium levels are. 
• Calcitonin: another drug that may help stop the breakdown of bone. This drug is an injection. One may also have drugs to help relieve hypercalcaemia symptoms, such as sickness, constipation, pain or confusion.  

Deciding on treatment: The type of treatment depends on how high the calcium levels are and how severe the symptoms are. Moderate to severe hypercalcaemia, or severe symptoms, the doctor will need to treat it urgently with fluids and bisphosphonate drugs. Mild hypercalcaemia, will still need treatment but less urgently. If one is able to drink plenty of fluids, they may just need the bisphosphonate treatment. 

 

Treatment relieves some symptoms more quickly than others. For example, sickness, constipation and thirst are much easier to relieve than tiredness and loss of appetite. If cancer is very advanced and in the terminal stage, it will probably not be possible to control the hypercalcaemia permanently. But the doctors will do all they can to help make one as comfortable as possible.

Follow up: Once blood calcium levels go back to normal, the doctor will want to be watchful and do regular blood and urine tests to make sure the treatment is still working. If at any time the symptoms of hypercalcaemia come back, it is very important to see the doctor as soon as possible. Even if something else is causing the symptoms it is better to see the doctor to find out for sure.

One may worry about eating foods that contain calcium if they have hypercalcaemia or think they may be at risk of it. But cutting down on these foods will not help hypercalcaemia that is caused by cancer. It will not make any difference to the calcium levels. Do talk to the doctor or nurse if you are concerned about diet. And make sure to check with the doctor before taking any vitamin or mineral supplements.

 

that is extremely helpful. You gave me much more info than the doctor. I truly appreciate this.

UncleBuddy said:

How is she doing today?

I hope you get your answers and she starts feeling better.

Lin

She slept much better last night. Not much twitching and no talking in her sleep. It was a long day at the doctors yesterday. The IV medicine for her high calcium levels must have worked. She looks a LOT better this morning. Thank GOD for that. And thank you again for asking. This place helped me SO much yesterday. There are awesome people here!

Chelsea71 said:

That's great news.  Hopefully

That's great news.  Hopefully she will continue to improve.  Very unsettling feeling for the spouse/caregiver when we see these problems and don't know what to do.   Steve developed a lot of complications and I spent countless hours on line trying to figure out what the hell was going on.  Very frustrating and scary.  Not knowing if you should make the dreaded trip to the ER etc...  Although I miss Steve terribly I can honestly say I don't miss those situations.

I totally understand. I hate that helpless feeling.