Since our outing described in yesterday’s blog, Debbi has been hit with dizzyness and nausea leading to two to three episodes of vomiting per day. I really don’t think it is because of the trip to Bed, Bath, and Beyond and I did check things out with our very competent visiting nurse Debbie A. but I heard through Rea that Debbie brought this up at the weekly meeting where the status of all Hospice patients is reviewed.
As Rea told it, Debbie A. (a highly competent nurse practitioner with a gregarious and fun loving personality) exclaimed at this meeting, “Guess where Debbi Buckler went today??? She went to the Mall… Can you believe it?” Meanwhile she did say “Go for it” when I asked her beforehand.
Now Debbi is using two small Scopolamine patches each the size of a dime placed behind each ear. The web says that Scopolamine is useful in the treatment of motion sickness in a dose of about 300 micrograms per day. It also says that an overdose can cause delusions and delerium. Debbi has been experiencing dizziness and Debbie A. says that it is the dizziness that is causing the naseau. Therefore, Debbi is also taking 1mg of Haldol (Haldoperidol) which is an antipsychotic in order to stop delusions. For a few nights now Debbi has awoken in the 2am-4am time span with bad dreams. The Haldol is supposed to help stop this and in addition it has a side effect which is said to reduce severe forms of nausea. The Wikipedia article describing this drug also notes that a side effect is “the release of the hormone prolactin, with the possible emergence of breast enlargement.” If only I had read this 30 years ago!
All in all it seems that the above meds are not having the desired effect on Debbi yet. I am writing at 11pm on Saturday night and we were on the phone with Debbie A. earlier in the evening. Debbi was directed to use one of the special suppositories that is laced with 6 different anti-naseau drugs. Plus, Debbie A. made arrangements to visit us tomorrow and re-evaluate the situation.
Just after Shabbos began, Debbi was overcome by nausea and needed to throw up. Not having the usual basin handy, I handed Debbi a plastic garbage can so that she did not have to rush to get to the toilet. Wouldn’t you know that the bottom edges of this garbage can were not sealed well and a little of the vomitus leaked out and stained the brand new sheets. Maybe I will sneak out to Bed Bath and Beyond and buy a new set. Then I can take off the stained set, remake the bed quickly and she will think it was magic!!
Debbi’s condition at presents dictates that one of us be by her side any time she is on her feet. We, of course, do not want to risk another fall especially one that would instinctively trigger her to put our her left arm for stability and might cause a jarring action to her left scapula.
Speaking of shoulders, I was in contact with Dr. Michael Zelefsky, Chief of Brachytherapy at Memorial Sloan Kettering and well known to readers of this blog. I asked about a palliative dose of radiation for Debbi’s shoulders. Michael said this might be a good idea and I am forwarding him information on contacting Dr. David Lovett, head of the Davenport-Mugar Cancer here at the Cape Cod Hospital. If the doctors agree on a course of action, I would expect Debbi to be discharged from Hospice, re-admitted to palliative care, undergo the radiation treatment, and be re-admitted to Hospice.
I continue to be amazed by the Hospice program. Medications arrive by FedEx, even on Saturday. The Hospice visiting nurses are only a phone call away and they respond to the answering service rapidly. As I described a few days ago, these Hospice nurses know how to get things done. Their confidence and demeanor instill a calming effect on their patients and they certainly have gone out of their way to answer my questions on the benefits of the various treatment regimens they are employing and on Debbi’s well being. Furthermore, the social work dimension of the Hospice equation has been of tremendous benefit to Debbi and especially to the children and to me in keeping a measure of peace and acceptance while still striving to make Debbi as comfortable as possible.
The sky has been beautifully clear and in the sun it is indeed warm but the winds have been very active. Hopefully tomorrow will be the same but without the wind. If so, I would like to help Debbi venture out to see her Hydrangeas growing in the beds that Shira beautifully mulched. Or maybe she will just view them from the front door. So far we have seen that moving slowly and not making sudden turns seems to forestall the dizziness. It should prove beneficial to note any discomfort so that we can more accurately pinpoint any triggers to Debbie.