It Keeps Getting Curiouser & Curiouser

When I got here Monday morning, mom was sleeping but woke up long enough to tell me she slept well and her pain was minimal.

Starting about 9:10 things got interesting. Dr C, the oncologist, called regarding the planned needle biopsy. A CT Scan from 2008 was located and it appears the tumor we believe is causing the pain was present then. He felt that with this information it was a more prudent decision to do a bone scan than a biopsy if necessary. So nuclear medicine was notified and it was scheduled for that afternoon.

There were several other doctors and groups of doctors representing several disciplines to include physical medicine focusing on physical therapy, oncology hematologists, cardiac and palliative care.

Around 10:30 nuclear medicine came to inject the chemicals for the bone scan stating they would have her transported in 3 hours. Shortly after the injection, Dr Murphy from palliative medicine came in to discuss what are next steps might be. We discussed continuing the pain medicine to keep her comfortable and consider stopping the other medication she takes. There really is not much need for her to continue taking calcium and she felt some of the other meds could be discontinued and would recommend that. We also talked about moving towards hospice care, when we had a definitive diagnosis and prognosis. I explained to her that if the prognosis is 4-6 weeks we would prefer her to be at home, otherwise a residential facility would be used for a longer diagnosis. I requested a Hospice bed at St Anne Mead's, mom seems to like that facility, and I had a discussion with discharge planning/continuing care.

Byron came by around the same time they were serving lunch and we had a nice visit. Before he left the nurse came in to give mom her pain medication before being transported to nuclear medicine. Following procedure prior to administrating the medication, mom's blood pressure had fallen quite a bit. She was also disoriented and non responsive when asked questions. The suspected problem was dehydration and she was given several bags of fluid to bring her BP up. An EKG was also taken and blood was drawn to check cardiac enzymes. The fluids did the trick and her BP started to rise, EKG and blood work were normal. When the blood pressure dropped, CCU was notified for a consult thinking we may be moving. When the CCU resident came down and checked mom out, it was decided she was fine right where she is. In talking with CCU I discovered the DNR we thought was in place wasn't. She spoke with Val, got the appropriate information and will notifiy Dr D to complete the paperwork.

As it stands right now, the bone scan is on hold, maybe tomorrow. This also applies to the biopsy. She's resting and sleeping right now. I expressed my concern that the amount of pain medication could be causing the BP problem and her disorientation.

This just in: the bone scan is on for this evening. Mom had a full bladder and was finally able to empty it, nurse checking with Dr D to reduce oxycontin and possibly catheterize her.

Colleen called about 8 or so to say they took her down for her bone scan and she was leaving. Thanks Colleen. Tomorrow is CT Scan and maybe needle biopsy. Stay tuned!