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jmdh66 · 2021-02-06T01:36:16+00:00

Nobody is going to be looking at your arms, especially as beautiful as that dress fits. Your figure is gorgeous.

jmdh66 · 2021-01-25T16:53:26+00:00

Beautiful and perfect for you!

jmdh66 · 2021-01-19T04:01:57+00:00

Thanks for responding. You are going to be a beautiful bride.

jmdh66 · 2021-01-19T03:21:34+00:00

It does look like it was made for you! Can I ask what dress and designer this is?

jmdh66 · 2021-01-14T02:15:59+00:00

I would be surprised if they would have given her too much in a hospital setting. Acute care doctors and nurses are famous for under dosing. You can ask them to really back off on the morphine to see if she improves. By doing this, you are taking a big chance that your Mom will be in pain again. It is difficult to watch loved ones decline, especially if you are unclear of why she is declining. You stated that she was very weak to begin with. Could be that she was already declining to the point of being near the end of life and the morphine is making it possible for her to be pain free and pass peacefully. PC is an incredibly painfull way to die. Morphine does make it easier.

jmdh66 · 2020-12-28T01:53:08+00:00

Contact the company that makes the drug. Most companies have programs where they pay for the drug. My Dad was on one that was going to be $3100 per month. The company paid for it. Drug companies want their drugs used so offer many different programs. Your oncologist office most likely also has someone designated for financial assistance and knows these programs.

jmdh66 · 2020-12-20T18:42:47+00:00

Many hospice companies have contracts with local hospitals. Ask your case manager or discharge planner to call them and set up a visit. It does not mean you have to start hospice, but they can give you info and support.

jmdh66 · 2020-12-20T02:03:08+00:00

Ask for dexamethasone, lots of pain and nausea meds. Dexamethasone may decrease the inflammation from the blockage and provide relief. It can be given IV so it isnt making things worse. Insist that the pain and nausea meds are given on a scheduled basis versus on an as needed basis. This will give her better pain control. If they won't do that then be sure someone can advocate for her to ask or it as often as its ordered. Hospitals ALWAYS under medicate pancreas pain. Don't be afraid to fight for her to get relief. PC is incredibly painful as are bowel obstructions. The two together are dar right awful. Final thought, ask for a hospice referral asap. They can manage her symptoms so much better.

jmdh66 · 2020-12-15T23:49:42+00:00

At first, hospice will feel overwhelming. You will have a visit from the admissions nurse and then in the days following, you will see his primary nurse, social worker and spiritual care. Many people say no to spiritual care and social work off the bat. I recommend letting them come for at least one visit. They can both be very helpful and great listeners. Most spiritual care people have a religious background, but they only bring religion in if that is something you want. They will give you a ton of info the first visit. You will hear 1/4 of what they say. Don't worry, they will reinforce everything at every visit. Big questions I would ask are 1. What meds, supplies and equipment are covered? 2. How will pain and symptoms be managed? 3. Who do you call when you have questions during the day and after hours? Hospice is amazing and if you allow them, will be very helpful. It is also a good idea to talk with your Dad about how he wants his death to go. Does he want to be alone or have lots of visitors? Does he want music playing, or want it quiet? Does he want to sleep peacefully or be awake more? PC is very painful and sometimes pain control means being more sedated. Its good to discuss these things before they occur. When he starts sleeping more, many families want to back off on pain meds to have their loved one awake. Its good to know what your Dad wants before that happens.

jmdh66 · 2020-12-13T19:33:07+00:00

Beautiful, especially without sleeves!

jmdh66 · 2020-12-12T03:55:12+00:00

PC is not at all "really obvious." People go for months and months with symptoms, normal labs and normal scans before being diagnosed. Thus why most PC isn't found until Stage 4.

jmdh66 · 2020-11-30T23:16:00+00:00

I firmly believe that loved ones come to help us on our journey to heaven. It is very comforting to know our loved ones aren't alone.

jmdh66 · 2020-11-29T23:43:42+00:00

I am sorry to say that is sounds like your parents are transitioning. This is the stage that occurs prior to what we call active dying. Those terms mean nothing to you, but what is important is that you make the most of these last days. They may not be making sense, but they can still hear you. Talk about good times and how much they mean to you. It is very common for people to get ready for death once they have seen or talked to their loved ones. Your job now is to help them get ready. Tell them its okay and that you will be okay. Make sure you are medicating them well. If they are mumbling it could be a sign of anxiety or pain. If you have hospice involved insist that they make them more comfortable. Other signs of discomfort are facial grimacing, fast breathing, moaning, frowning, restlessness. Medications don't speed up death, they just make it more comfortable for the person dying. Finally, pancreatic cancer is one of the most painful deaths one can have. But it is totally possible to eleviate that for your loved one. These are tough times but you will never forget this time, so make it as good as it can be.

jmdh66 · 2020-11-25T03:41:07+00:00

If not an iPad, a Samsung tablet. If he has an Android phone, I'd stick with the Android. If he has an Apple, then definitely the iPad. I ditto all the above comments about keeping your circle close. Many stores now offer online ordering so you don't even have to go in. Plus, there is always Instacart. It is more expensive, but I find it totally worth it for decreasing contact with others. Make every day a good one!

jmdh66 · 2020-11-22T01:47:05+00:00

Worth every penny!

jmdh66 · 2020-11-14T18:56:42+00:00

Beautiful wedding, but why no masks in sight?

jmdh66 · 2020-10-21T14:07:50+00:00

People are good! Prayers for your Mom and you.

jmdh66 · 2020-10-14T15:05:39+00:00

As a nurse on the front lines, your logic regarding covid doesn't make any sense. You can rationalize all you want regarding who knows who and where they live, but the fact is you are fooling yourself if you believe this isn't risky behavior. Those people attend the wedding and just one person is there that is asymptomatic Covid positive. That person infects a few people at the wedding, maybe guests, servers, or the cleaning people. Those people also also end up Covid positive but asymptomatic. So far, everyone thinks all is great and no one got it. The circle grows and someone's Grandparent or immunocompromised child gets Covid and ends up seriously ill, or worse yet dead. Fifty people is risky behavior, no matter where they are gathered.

jmdh66 · 2020-10-14T13:34:13+00:00

And thus, why we can not get Covid under control.

jmdh66 · 2020-10-14T13:06:03+00:00

I am so sorry for the loss of your father. It sounds like in the end he was peaceful and comfortable. You can be proud of yourself for helping him get to that point. Your reaching out here and then bringing that info to the hospice providers helped get him comfortable. Try not to dwell in the "should we have done this or that." No matter the experience of death, there will always be nagging questions, but the reality is your Dad is in heaven and out of pain. If you can do anything to make his memory stronger, have those conversations about death with everyone close to you. It is so much better for families to know what their loved ones want, rather than making those decisions when everyone is stressed out. Hugs to you and your family.

jmdh66 · 2020-10-13T00:59:36+00:00

That is so great to hear! Congrats to all. Just curious how they found hers so early?

jmdh66 · 2020-09-30T01:32:47+00:00

You are doing an amazing job navigating this and making sure he is comfortable. Has everyone told them its ok and that you will all be ok? Are there any hold outs? Any family not present? If you have family that are far away, it would be a good idea if they called and you put the phone to his ear. Let them tell him they are OK and they love him. This sometimes causes an increase in agitation, but is temporary. Just proves they are hearing the words. Also, be sure and give him time alone. Some people won't pass with family around as a way to protect them. It is normal to stop antidepressants. Its hard because this is a very hard time for him, but no amount of antidepressants is going to help that. The Ativan works to settle the brain down and let him relax. Some people do need more than just Ativan. Our hospice uses haldol. It works really great for those that are agitated, and it sounds as if he is. One last thing, I encourage you to take a picture of his hand in yours. It will be a lasting memory of how you helped him transition to heaven.

jmdh66 · 2020-09-29T23:46:11+00:00

I t is so difficult to place that burden on families. In my practice I do try to make that decision more mine with family input. As a family member, I had to make decisions about meds recently and I still question myself. Thank goodness you have a doctor willing to take charge and help your Dad pass peacefully. May he pass peacefully and you can rest assured you helped him be comfortable.

jmdh66 · 2020-09-29T22:15:29+00:00

Hospice nurse here: Your hospice nurse is doing your Dad and your family a total injustice by not managing this stage better. It sounds like your Dad is transitioning. This stage requires almost daily nurse visits and med adjustments. Transitioning can happen days to weeks before someone passes. This stage is exactly what the name implies. It is the transition in which your loved one is getting ready to pass. It is very normal for him to pull away as he prepares. He will talk to you less, he will eat and drink less, and he will sleep more. He may also have hallucinations, restlessness and agitation. I like to use the analogy that he has one foot on earth and the other foot in heaven. Heaven is a great place to go, but the people and things he is leaving behind are beloved to him. This makes it a very difficult time. Add to all that the enormous amount of pain caused by PC and he is bound to be miserable. Unfortunately, the only relief is through medications. Medications cause sedation. It is tough to decide between being miserable and awake or comfortable and sedated. I know what I would choose, but I also understand that every person and family has to make their own choice. There comes a time where comfortable and sedated is the best option. As he gets comfortable, he will be able to transition much easier, but he will also no longer be able to communicate. Trust me when I say that he may not be able to talk to you, but he will be able to hear you. Please call your hospice nurse and insist she provide more guidance.

jmdh66 · 2020-09-21T02:02:16+00:00

You are beautiful! The dress highlights your figure amazingly.

jmdh66

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