"Your mother is very upset. She doesn't know what to do. You need to stop pressuring her about treatment. Dick is dying and the doctors told her he doesn't need all these tests. You should not go down to visit today."
Decision-making for caregivers has become a tremendous burden in the wake of physician-assisted suicide and cost-cutting measures. You don't know who to trust. My mother was pushed to her limit and my aunt was frustrated watching it happen. I prayed I could give them peace.
"The hospitalists don't know Dick that well. We will talk to his oncologist who knows him and his condition far better. He wanted the CT scan to start him on radiation treatments." All of this happened over the weekend when they could not easily reach the doctors they trusted and I was at work, so it all spiraled out of control. "Let me talk to the doctors directly and I won't put any pressure on Mom." I said a prayer of thanks for these two tremendous women in my life.
When I arrived, Dick was dressed and the nurse was going over his discharge medications with Mom. My aunt told me his oxygen level had dropped too low when he was walking with the physical therapist for him to go home. Dick, meanwhile, could not wait to get back home. A resident arrived at the door.
"His heart is in normal rhythm, his blood count is better after the transfusion, but he is still hypoxic (has low oxygen levels.) Maybe he needs his effusion tapped."
Dick has a collection of fluid in his lung lining caused by his lung tumors, and that fluid makes it harder to breathe. The amount of fluid has been stable, and the resident said it still looked the same on x-ray, though he admitted that was not the best measure of it. A tap is done to drain the fluid and make it easier to breathe. He went to discuss it with the attending physician who came by soon after.
As it turned out, the hospitalist knew he was on home oxygen and so she presumed his oxygen saturation (a measure of oxygen in the blood) was below 88% without oxygen; he was at 91% now. But he had not been using the oxygen, and his saturation was 97% at the oncologist's office just before he was admitted. "Maybe he needs a tap
During the conversation she mentioned my mom had been very upset that morning. "That's because a hospitalist over the weekend told her that they were not getting the CT scan because it wasn't going to change his treatment. His oncologist plans to start radiation."
"I was on over the weekend," she said. "I told her it wasn't going to change his treatment while he was in the hospital."
"That's not what she heard." I paused a moment and said with some sympathy, "Well, let that be a lesson learned."
Dick went home with an additional appointment with is thoracic surgeon in two days to see if he needs his lung fluid drained, which can be done in the office. His CT scan will be scheduled soon.
Thank you for your continued prayers.
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