NCMom Posted September 3, 2014 Share Posted September 3, 2014 This is not a JAWM post. I am so frustrated I am just about to scream the house down and I don't know what to do. Just thinking out loud here. Story... My mother (74, COPD, has had 3 surgeries in less than 12 months) fell a week ago Sunday at 11pm at night. She fell because her femur snapped. They put a rod in that Tuesday. She did ok in surgery. They saw lucency in the bone. She had a CT scan - and really tanked after. She had a PET scan and was definitely improving healthwise. Final diagnosis yesterday (although they pretty much knew before): metastatic lung cancer. She is refusing treatment. The problem is the oncologist. He is being...very persistent. He is insistent that with new treatments she can live longer and I quote "for years". He estimates a year and a half minimum. He says chemo is "easy" now and quality of life will be good. He literally is freaking out. It's weird cause I can't find anything online that lines up with what he is saying. She already has serious breathing issues. The largest mass in her lungs is large indeed. The mets in the bone is in her ribs/sternum/leg and maybe in the other leg. He follows all statements with "although I can't promise anything." Yet he kind of is. He is literally hounding her/us. He called me TWICE today already... Part of the reason she is refusing treatment is probably because of her mental illness; she cannot admit that she has lung cancer because she smoked. He told her last week that she most likely had lung cancer, she told everyone it was breast cancer... :confused1: Same as she pretends she has asthma not COPD. If the primary cancer were elsewhere, who knows. But part of it is that she is old and tired and she had parotid gland cancer 10 years ago and that little amount of radiation (no chemo) nearly killed her. She feels like the pain and discomfort will come no matter what and she would rather do a quick rehab for the leg, then come home and enjoy the fall, when needed move to hospice, and then be done. My mother is definitely is wary of the chemo. I don't blame her; we just watched my middle dd's math tutor spend two years going through this and she was ill nearly every.single.day of the two years. She finally stopped treatment, went on a vacation and came home to hospice. She (the math tutor) passed two weeks ago. Perhaps this is coloring her decision?? NO ONE is supportive of this choice, except the Ortho's PA, who is such a blessing. I swear it's like they are taking it personally. The ortho, the social worker!, and most assuredly the oncologist. The social worker really wants her out now, and has gone from helpful to oh so not interested. I feel like she gets to make the determination as it is her life. Neither way will be easier for me personally. Both ways seem like they will be filled with pain and discomfort because hey dying is not easy. And I will be the caregiver no matter what. I do not know what to do, who to ask for help. Will the drs just dump her? Will the rehab place freak and boot her? She blames her local primary care for not seeing this (was not his fault, she sort of hid the symptoms) so he is probably out. Does anyone advocate for people who make this choice? Edited to add: Do other people even make this choice? Or should we (I have two sisters) try to convince her to do the treatment. It certainly is the path of least resistance. lol Thanks for listening to my rant, Georgia Quote Link to comment Share on other sites More sharing options...
Just Kate Posted September 3, 2014 Share Posted September 3, 2014 No advice. Just a hug. :grouphug: I'm really sorry you are dealing with this. Quote Link to comment Share on other sites More sharing options...
applethyme Posted September 3, 2014 Share Posted September 3, 2014 :grouphug: :grouphug: If your mom does not want aggressive treatment perhaps you could call a local hospice agency and get information from them about their programs. Quote Link to comment Share on other sites More sharing options...
lea1 Posted September 3, 2014 Share Posted September 3, 2014 I am really stunned the doctor and others are hounding her and the family about her choice. I think her wishes should be respected. She has already been through a lot with the surgeries, living with COPD and the recent broken bone. I believe if I were in her situation, I could make the same choice. I just read an article this morning about how doctors tend to go this direction more often then their patients because they see what the patients are put through. If she is very firm on her decision, I think I would probably respect that and I would be very firm with her doctors about it. Maybe you could go ahead and contact hospice and discuss it with them. I would think they could probably provide some helpful advice and would likely be very supportive of your mother's wishes. My mom died two years ago after a bad fall and hit to the head. I know this can't be easy for you either way. I am so sorry you are going though this. ETA: My mom went through chemo due to breast cancer when she was in her late 60's. It REALLY took her down and I would say, based on what I have read, that it was a more short term chemo and was managed well (she was not throwing up every day) than some other chemo treatments. She was never quite the same again after the chemo. She still had to take some meds that really messed with her balance and had other bad side effects. She was never as strong and healthy as she had been and her ability to think logically really went downhill. She very quickly often seemed more childlike after the chemo. I know everyone is different and responds differently but chemo certainly does have it's bad side effects that really hit the elderly harder than others. My mom was really pretty strong and healthy before her chemo. Not sure if this helps or not but wanted to share it just in case. Quote Link to comment Share on other sites More sharing options...
brehon Posted September 3, 2014 Share Posted September 3, 2014 No, your mother gets to make her own decision regardless of what doctors, social workers, etc may think. Other people make this choice all the time. What stage is your mom's cancer? It is completely inappropriate for the oncologist to "freak out" and call you multiple times. I don't think the rehab place (for her femur fx, right?) would kick her out; but, I don't know for sure. I'd call the oncologist's office for hospice recommendations. (You don't have to speak to the doctor.) Or you could ask around of your friends for recommendations. Hospice organizations, at least the good ones (and they aren't all created equal), will be able to help you/your mom with the types of care she wants (i.e., what kind of palliative care, how much, etc) and the necessary paperwork. If you like/trust your mom's primary doc, you could ask him/her for some hospice names as well and just not mention where you got your information to your mom. (I'm assuming the PCP knows about your mom's cancer diagnosis.) I'm very sorry to hear about your mom. This must have been such a shock for everyone. Quote Link to comment Share on other sites More sharing options...
Slartibartfast Posted September 3, 2014 Share Posted September 3, 2014 It is your mother's decision. Regardless of what the Onocologist says chemo is NOT easy and he should not be manipulating anyone into treatment, particularly when the prognosis wouldn't really change. I would tell him he is being inappropriate and that he needs to back off. It is a personal decision and he shouldn't just lie to her to try to get her to change her mind. If he won't respect her decision I would complain to the hospital. Quote Link to comment Share on other sites More sharing options...
Anne in CA Posted September 3, 2014 Share Posted September 3, 2014 My experience with a doctor hounding someone is that they want the person to participate in a study. I would flat out corner this man and ask him if he wants your mother to participate in a study. Quote Link to comment Share on other sites More sharing options...
NCMom Posted September 3, 2014 Author Share Posted September 3, 2014 Because it has metastasized, it is Stage 4 (I think, I'm tired, lol). At any rate it is terminal. She will die, at some point, from this cancer or complications thereof. There is only one hospice resource in our area, but they are very good. I will call them later today, after she is moved to the rehab facility, which will hopefully help her get more fully mobile on that leg. I did not think of calling them. I really don't get it. Why is this choice so out there? Thanks, Georgia Quote Link to comment Share on other sites More sharing options...
Hannahs4 Posted September 3, 2014 Share Posted September 3, 2014 Wow. I am really sorry you are dealing with this. I would be skeptical of the time frame, and the comfort level quoted by the oncologist too. Ultimately it is her choice, but it would be so great to have a supportive doctor and a true view of either option. I would probably seek a second opinion from a different oncologist ... What exactly will be involved? There is palliative chemo that is not as aggressive that could maybe reduce pain involved but not necessarily prolong life that may be an option. I think I would want to know all the possibilities before making a decision. Quote Link to comment Share on other sites More sharing options...
Kim in Appalachia Posted September 3, 2014 Share Posted September 3, 2014 First, :grouphug: . This is a hard time, being made harder by the doctors. Second, yes, there are docs who would/will support her choice, but normally that would more likely be a primary care physician. Specialists push treatments, it's what they do. You need to stay firm with him, just say no. Do find a primary care physician who can help you navigate what you will need, such as hospice. Quote Link to comment Share on other sites More sharing options...
prairiewindmomma Posted September 3, 2014 Share Posted September 3, 2014 It's not so out there. If she already has a large lung mass and mets, I'd be inclined to call it quits, too, if I was of an age where my kids were out of the house and established. The next time he calls, share that you understand the information that he has shared, that she has chosen not to treat because having undergone chemo before she doesn't want to do it again, and she would appreciate a referral to hospice. ----- So, doctor cannot dump her, but if he won't refer to hospice, then you need to find a doc who will sign off on it. It shouldn't be hard, and hospice can probably help you get the hookup. Once you get to the intake appointment, get a plan in place and get the number of the social worker assigned. You will need to be upfront with her about your mom's mental state/illness so that there is clear communication going on as her illness progresses. If you want to chat about end-of-life/cancer/lung cancer--feel free to pm me. I can tell you how it played out for my relative. Quote Link to comment Share on other sites More sharing options...
ocelotmom Posted September 3, 2014 Share Posted September 3, 2014 Because it has metastasized, it is Stage 4 (I think, I'm tired, lol). At any rate it is terminal. She will die, at some point, from this cancer or complications thereof. There is only one hospice resource in our area, but they are very good. I will call them later today, after she is moved to the rehab facility, which will hopefully help her get more fully mobile on that leg. I did not think of calling them. I really don't get it. Why is this choice so out there? Be aware that (to my understanding, anyways) Medicare will not pay for rehab for a patient who is officially enrolled in hospice care. Which sucks, because rehab can still improve quality of life, but that's how it is. She may need to wait until she is discharged from the rehab facility to officially enroll in hospice. She should be able to be on comfort care at the facility, which means she'll receive palliative care and won't be sent to the hospital if anything goes wrong (this is more extreme than DNR, which just means that there won't be an attempt to resuscitate the person if something happens). If she is interested in hospice care, she should consider enrolling as soon as she discharges from the rehab facility. You don't have to wait until you're days from dying to go on hospice, and people who are on it for longer tend to see more benefit (more chance to develop relationships with caregivers and receive counseling and so on). She should be able to receive services in her home, so it isn't a matter of going somewhere else to get care. The rehab facility will have a doctor, and that doctor will almost certainly sign off on a hospice referral. Quote Link to comment Share on other sites More sharing options...
AimeeM Posted September 3, 2014 Share Posted September 3, 2014 I wouldn't push it. Honestly. Even barring mental illness - she's elderly, the time it will buy her is minimal considering her other health issues. My father-in-law is 83. They know he likely has prostate cancer (blood work and just overall considerations). He refuses further testing and I don't blame him. At his age, chemo would likely suck out the "good time" he has left, considering the minimal time chemo *may* buy him, IF he's strong enough to handle it. At this point, this seems to be one of those things it's just better to *not know* the full extent of. Many hugs to you and your family. I'm so sorry that you're going through this. Quote Link to comment Share on other sites More sharing options...
fairfarmhand Posted September 3, 2014 Share Posted September 3, 2014 Call hospice. They have counselors that specialize in this area, helping patients discuss their options and make an informed, healthy decision. They will help you find doctors who will prescribe meds to help with pain and manage her end of life to give her an ending that is as dignified as possible. Please call them. Quote Link to comment Share on other sites More sharing options...
fairfarmhand Posted September 3, 2014 Share Posted September 3, 2014 Also, I am so sorry for this. It is really hard. Quote Link to comment Share on other sites More sharing options...
Maplinmum Posted September 3, 2014 Share Posted September 3, 2014 :grouphug: I agree get the hospice team onboard. My father made this choice when he was diagnosed with a liver tumour at 79, for him it was the right choice and allowed him the dignity of managing the end of his life in his own way. Quote Link to comment Share on other sites More sharing options...
The Girls' Mom Posted September 3, 2014 Share Posted September 3, 2014 I'm sorry you are having to go through this. Having had two parents go through chemo and terminal cancer, I completely see your mother's side to this. I would likely make the same decision if I were in her shoes. At this point, be her advocate for quality pain management and hospice care. Start throwing the harassment word around to that doctor, he is very much out of line. Find a new doctor if you can, and definitely call the hospice program. Quote Link to comment Share on other sites More sharing options...
Jean in Newcastle Posted September 3, 2014 Share Posted September 3, 2014 Another vote for calling hospice. Once hospice was called, my dad's strident doctor (who wasn't nearly as bad as what you describe) calmed down and then was out of the picture. I think in his case that he was afraid of just nothing being done. Hospice is doing something. It is making sure that your mom is comfortable physically and emotionally during this time. :grouphug: :grouphug: I hope your hospice is as great as the one we had for my dad. Quote Link to comment Share on other sites More sharing options...
Liz CA Posted September 3, 2014 Share Posted September 3, 2014 I hate to say it..but chemo is a money maker. I obviously don't know this oncologist and cannot judge his motives. I would support your mother. Yes, people make this choice and it is their choice to make. There are other palliative measures or she can even try an alternative method if she is so inclined. Chemo is not to be taken lightly since it can have serious side effects and the most troubling one is that many people's cancer recurs years after chemo treatment. I don't know what kind of system there is in place on the East coast but here I would look for a physician or naturopath who is willing to provide palliative care or anything they can offer that may help. I would not stay with an oncologist who cannot see past the tip of his nose. Quote Link to comment Share on other sites More sharing options...
LostSurprise Posted September 3, 2014 Share Posted September 3, 2014 If a doctor is not supporting a patient decision and you think that's coloring the diagnosis or care, I usually recommend that you talk to nurses or doctors in other care specialties and get the name of someone for a second opinion. If the doctor is just bugging you and you don't think you need further care in this specialty, just cut ties (be very specific with them that you don't want any more phone calls or direction) and move forward on what your mother wants. I can't tell if your mother will need more care with an oncologist (even if its just pain meds and checks). If she will, find a new oncologist. Ask around for one who is more in tune with patients' wishes. It's hard for some people (even doctors) to accept a decision which isn't fight 'til the end. Quote Link to comment Share on other sites More sharing options...
Annie Elle Posted September 3, 2014 Share Posted September 3, 2014 I'm a hospice nurse and based on what you have said, your mother would qualify for hospice. In my experience, a lot of oncologists have a very hard time referring a patient to hospice. I think they consider it a failure on their part. Unfortunately, this may cause needless pain and suffering at end of life. I think it is wise on your part to talk to hospice now. The earlier hospice gets involved, the better. The Medicare Hospice benefit will pay for physical therapy, not for rehabilitation but for palliative care. I have had many patients tell me that they have felt so much better after they come under our services. When the focus is on aggressive/curative care, patients' pain and other symptoms such as nausea and anxiety are under treated. When these symptoms are well managed, the quality of life greatly improves and patients are able to do more than they have in months. It is a misunderstanding that hospice is only for the last few weeks or days of life. Hospice consists of a team of professionals ( nurses, social workers, doctors and chaplains) that can assist a patient and their families through the physical, emotional, financial and spiritual issues that can occur. I'm sorry that your mother and your family are going through this. This is a difficult time and the oncologist is only making it worse. Quote Link to comment Share on other sites More sharing options...
Tap Posted September 3, 2014 Share Posted September 3, 2014 please encourage her to get a second/third opinion. I work in health care and it always surprises me when people make huge, life altering decisions with only the opinion of one doctor to base it on. I had 4 different opinions planning my back surgery. Each doctor I talked to had a very different opinion on how to surgically fix my back. They all agreed thought, that they thought I would end up worse if I had surgery (due to scar tissue pressing on nerves), than if I didn't. Since that is what they all agreed on, that is what I went with. LOL No surgery. My father had lung cancer and lived a healthy 5 more years, due to surgical treatment and radiation. But then, about 5 years later, he had terminal brain, bone and lung cancer (they stopped looking for more at that point), and he declined treatment. He had a very uneventful 6 months of feeling great, and then 4 of rapid decline. I know towards the end he was happy for the 6 months of doing all of his favorite 'one last time' activities. If he had taken chemo, he may have lived longer, but not with any sort of quality of life. He was a very heavy man and mom couldn't help him move around much, so once he was bedridden, they were pretty much housebound. So, for him.....one cancer he treated, one he didn't. I think it is a personal decision and is best made with the assistance of more than one doctor, the informed patient of course, and should depend somewhat on the person who is going to be providing the care during treatment. (ie, don't schedule chemo at a cancer center in another state if you don't have someone there to help take care of you and your travel back and forth). Quote Link to comment Share on other sites More sharing options...
fairfarmhand Posted September 3, 2014 Share Posted September 3, 2014 I'm a hospice nurse and based on what you have said, your mother would qualify for hospice. In my experience, a lot of oncologists have a very hard time referring a patient to hospice. I think they consider it a failure on their part. Unfortunately, this may cause needless pain and suffering at end of life. I think it is wise on your part to talk to hospice now. The earlier hospice gets involved, the better. The Medicare Hospice benefit will pay for physical therapy, not for rehabilitation but for palliative care. I have had many patients tell me that they have felt so much better after they come under our services. When the focus is on aggressive/curative care, patients' pain and other symptoms such as nausea and anxiety are under treated. When these symptoms are well managed, the quality of life greatly improves and patients are able to do more than they have in months. It is a misunderstanding that hospice is only for the last few weeks or days of life. Hospice consists of a team of professionals ( nurses, social workers, doctors and chaplains) that can assist a patient and their families through the physical, emotional, financial and spiritual issues that can occur. I'm sorry that your mother and your family are going through this. This is a difficult time and the oncologist is only making it worse. Yes, my mother was in hospice care for over 2 years (they stopped services because she didn;t die. :) ) and the last time, she was cared for by hospice for about 8 months. Quote Link to comment Share on other sites More sharing options...
umsami Posted September 3, 2014 Share Posted September 3, 2014 I'm so sorry you are going through this. :grouphug: I'm wondering if the oncologist is newly trained? Because in my experience, the older docs seem to be more at ease with hospice and refusing treatment than younger docs. They've seen more, they understand that sometimes treating is worse than not. If this is the case (or not), you still have a right to request a new oncologist. Ask some of the nurses for whom they'd recommend, and who would support your Mom's wishes. Agree with calling hospice as well. Quote Link to comment Share on other sites More sharing options...
Twigs Posted September 3, 2014 Share Posted September 3, 2014 :grouphug: :grouphug: :grouphug: Quote Link to comment Share on other sites More sharing options...
trulycrabby Posted September 3, 2014 Share Posted September 3, 2014 Having just dealt with oncologists lately, I would say that they as a group are just so accustomed to fighting for life, and patients who want to fight for life, that it is a tough adjustment when a patient does not want to attempt chemo. He will likely come around, and if he does not, then find a new doctor. I am sorry for the sad news. :grouphug: Quote Link to comment Share on other sites More sharing options...
Moxie Posted September 3, 2014 Share Posted September 3, 2014 I'm so sorry you are going through this. My sister is a hospice doctor and one of her big rants is doctors who 'over doctor' dying patients. Sadly, usually the family is so scared of loosing their loved one, they agree to everything that is suggested and prolonged their loved one's suffering. Quote Link to comment Share on other sites More sharing options...
Little Nyssa Posted September 3, 2014 Share Posted September 3, 2014 I'm sorry. I would really get a second opinion from another oncologist. Because then you will know if the first one is just pushing too hard for some personal reason, or whether a second one might actually say 'we really can fix this.' I wouldn't make a decision without more information. Quote Link to comment Share on other sites More sharing options...
TranquilMind Posted September 3, 2014 Share Posted September 3, 2014 This is not a JAWM post. I am so frustrated I am just about to scream the house down and I don't know what to do. Just thinking out loud here. Story... My mother (74, COPD, has had 3 surgeries in less than 12 months) fell a week ago Sunday at 11pm at night. She fell because her femur snapped. They put a rod in that Tuesday. She did ok in surgery. They saw lucency in the bone. She had a CT scan - and really tanked after. She had a PET scan and was definitely improving healthwise. Final diagnosis yesterday (although they pretty much knew before): metastatic lung cancer. She is refusing treatment. The problem is the oncologist. He is being...very persistent. He is insistent that with new treatments she can live longer and I quote "for years". He estimates a year and a half minimum. He says chemo is "easy" now and quality of life will be good. He literally is freaking out. It's weird cause I can't find anything online that lines up with what he is saying. She already has serious breathing issues. The largest mass in her lungs is large indeed. The mets in the bone is in her ribs/sternum/leg and maybe in the other leg. He follows all statements with "although I can't promise anything." Yet he kind of is. He is literally hounding her/us. He called me TWICE today already... Part of the reason she is refusing treatment is probably because of her mental illness; she cannot admit that she has lung cancer because she smoked. He told her last week that she most likely had lung cancer, she told everyone it was breast cancer... :confused1: Same as she pretends she has asthma not COPD. If the primary cancer were elsewhere, who knows. But part of it is that she is old and tired and she had parotid gland cancer 10 years ago and that little amount of radiation (no chemo) nearly killed her. She feels like the pain and discomfort will come no matter what and she would rather do a quick rehab for the leg, then come home and enjoy the fall, when needed move to hospice, and then be done. My mother is definitely is wary of the chemo. I don't blame her; we just watched my middle dd's math tutor spend two years going through this and she was ill nearly every.single.day of the two years. She finally stopped treatment, went on a vacation and came home to hospice. She (the math tutor) passed two weeks ago. Perhaps this is coloring her decision?? NO ONE is supportive of this choice, except the Ortho's PA, who is such a blessing. I swear it's like they are taking it personally. The ortho, the social worker!, and most assuredly the oncologist. The social worker really wants her out now, and has gone from helpful to oh so not interested. I feel like she gets to make the determination as it is her life. Neither way will be easier for me personally. Both ways seem like they will be filled with pain and discomfort because hey dying is not easy. And I will be the caregiver no matter what. I do not know what to do, who to ask for help. Will the drs just dump her? Will the rehab place freak and boot her? She blames her local primary care for not seeing this (was not his fault, she sort of hid the symptoms) so he is probably out. Does anyone advocate for people who make this choice? Edited to add: Do other people even make this choice? Or should we (I have two sisters) try to convince her to do the treatment. It certainly is the path of least resistance. lol Thanks for listening to my rant, Georgia Georgia, I am sorry you are going through this. Unless she has been declared incompetent, this is HER decision, period, full stop. The doctors need to present their views and back off. I've been in your place, and told them to pound sand, that my Mom was making her own decisions. I also required them to speak TO her, instead of ABOUT her, as if she wasn't even in the room. I do not know if they will dump her. They might threaten to dump her. I had a family member threatened once decades ago, that's all I will say about that. She is in a tough spot if she still needs some services but doesn't want to do everything they suggest. I found the best way to deal with people pressuring you who retain some authority over you in some sense is to delay, not deny. Mom can simply say that she is still considering her options, and has some upcoming obligations, and she will let them know when she has decided. Repeat as necessary. Second opinion is a very good idea. Then you may have some medical support. Quote Link to comment Share on other sites More sharing options...
TranquilMind Posted September 3, 2014 Share Posted September 3, 2014 I'm so sorry you are going through this. My sister is a hospice doctor and one of her big rants is doctors who 'over doctor' dying patients. Sadly, usually the family is so scared of loosing their loved one, they agree to everything that is suggested and prolonged their loved one's suffering. I agree with your sister. LOTS of money to be made on people that can't fight back, and lots of "practice time" treating them for young doctors and surgeons. Pardon me, my abject bias is showing. ;) I'm sure there are doctors who have only the patient's best interest at heart, but I find them to be few and far between. I've met many, many doctors and I can count those altruistic ones on the fingers of half a hand. Quote Link to comment Share on other sites More sharing options...
Jean in Newcastle Posted September 3, 2014 Share Posted September 3, 2014 I agree with a second opinion. Quote Link to comment Share on other sites More sharing options...
PrincessMommy Posted September 3, 2014 Share Posted September 3, 2014 Agreeing with others... I can't believe the drs. are hounding her about this. It is her choice. This makes me mad. The doctor is bordering on being cruel. I know it is too soon as things are raw...but I highly, highly recommend that everyone read "How We Die". The author (a doctor) discusses his own personal epiphany (after some horrible experiences) that doctors often do more harm than good at the end of life. This is in part because they themselves are hounded by the hospital admins. if they lose a patient. Anyway, I can't emphasize it enough.. it's a very helpful book as we all face these issues with our loved ones. Be your mom's advocate... and love her. It can't be easy to say no in the face of such promises. :grouphug: edited to add the book link. Quote Link to comment Share on other sites More sharing options...
Miss Mousie Posted September 3, 2014 Share Posted September 3, 2014 I'm so sorry you and your mom are going through this awful situation. I went through something similar with my mother. Once she became unable to speak for herself, I (as power of atty) stepped in to advocate for what I knew without a doubt were her wishes. Essentially, the docs refused to let her go. Someone upthread said specialists don't like to lose. I agree, but take a more cynical view of it: they don't like to have losses on their records. In my mother's case, it was a relatively new type of surgery, and they don't want the stats to read "70% success rate" or anything like that. They invested a lot in training and marketing for that procedure, and they don't want people scared away by a less-than-stellar success rate. It really was awful how they completely ignored her explicit wishes and were so dismissive of me. Anyway ... all of that aside ... I believe very strongly in the right of the individual to decide these matters however they wish. I would definitely do all I could to support and implement your mother's stated preference. Good luck to you, Georgia. :grouphug: Quote Link to comment Share on other sites More sharing options...
ocelotmom Posted September 3, 2014 Share Posted September 3, 2014 I'm sorry. I would really get a second opinion from another oncologist. Because then you will know if the first one is just pushing too hard for some personal reason, or whether a second one might actually say 'we really can fix this.' I wouldn't make a decision without more information. I agree with this. From the description, it doesn't sound to me like it's fixable, but I am not an oncologist, I don't know the details, and the fact that multiple people at the hospital are reacting badly make me wonder if there isn't more to the story (though I think the oncologist is overstepping is bounds in multiple ways regardless). If treatment would likely allow her to live another 20 years and depression was the primary problem, counseling would probably be in order. A year and a half extra with worse quality of life at her age? I'd probably make the same choice. It's also possible that there are palliative treatment options that would be appropriate, so it would be good to have an oncologist on board. Quote Link to comment Share on other sites More sharing options...
Guest Posted September 3, 2014 Share Posted September 3, 2014 Read THIS: http://time.com/3194806/why-dying-is-easier-for-doctors/ I sent a copy of this to every person who will have a say in my EOL if I am incompetent to do so. I'm sorry you are going through this. Without going into details, I really feel for you. Quote Link to comment Share on other sites More sharing options...
QueenCat Posted September 3, 2014 Share Posted September 3, 2014 Many hugs to you and your mom. I can't help but to wonder if the doctor is pushing the treatments because your mom really isn't what most people consider old anymore. Just a thought...... ultimately, your mother should be allowed to decide. Quote Link to comment Share on other sites More sharing options...
Suzanne115 Posted September 3, 2014 Share Posted September 3, 2014 Hospice was wonderful when my grandmother and stepfather were both very sick. They were a huge help to my mom. I'm so sorry for what you and your mom are going through. Suzanne Quote Link to comment Share on other sites More sharing options...
Cera Posted September 4, 2014 Share Posted September 4, 2014 I would contact a hospice organization. They will be able to direct you to professionals who will support your decisions. They will also be able to provide support to both you (family) and her. Quote Link to comment Share on other sites More sharing options...
busymotherof4 Posted September 4, 2014 Share Posted September 4, 2014 She needs to see a different oncologist. Frequently there are treatments even chemo that can make the end of life more comfortable. She may need radiation for the bone mets as these can be very painful. My husband works in radiation oncology and they do treat many people on hospice for bone or brain mets. I agree that most likely hospice is the right choice. Quote Link to comment Share on other sites More sharing options...
catz Posted September 4, 2014 Share Posted September 4, 2014 :grouphug: I'm so sorry you're put in this position. Your mother is in her 70's and already has quite a few health concerns, and now stage 4 cancer. I think it really should be her call to make at this point. That doctor is being obnoxious and really needs to let you all breathe and regroup and wait to hear from YOU. Contacting hospice is a good idea. But the point about rehab is a good one too. If she wants to do that she may need to jump through a few hoops. Quote Link to comment Share on other sites More sharing options...
ScoutTN Posted September 4, 2014 Share Posted September 4, 2014 I am so sorry. This is so hard. My dad died of lung cancer 17 years ago. He too refused treatment because the cancer was very, very advanced when they found it. He had a few months of feeling good, then a short time at hospice before he died. I think you have gotten good advice already here. I have no wisdom to add, just hugs and prayers. Quote Link to comment Share on other sites More sharing options...
Ewe Mama Posted September 4, 2014 Share Posted September 4, 2014 :grouphug: Quote Link to comment Share on other sites More sharing options...
Reefgazer Posted September 4, 2014 Share Posted September 4, 2014 I'm sorry for your troubles; elderly parents and their issues can give us a difficult time. My parents are handfuls when it comes to making decisions that affect their well-being, and it drove me bonkers for a while. I had to let that go and accept that whatever decisions they make, those decisions are theirs to own. So ultimately, this is her decision and she has no one else to please but herself. So while I would try and discuss this rationally with her, I would not pressure her to make a decision that someone else wants, even if she chooses to sign her own death warrant. What I have noticed with my parents and other elderly relatives is that when they get old (although I really don't look at your mom at 74 as old), they tend to look at death through a different lens; they tend to look at it as just the next life stage. and not get as freaked out about it as us younger folk do. As far as doctor pressure goes: I *really* despise the way many in the medical community insist that a patient takes their advice when the patient has clearly listened to their options and chosen another route. It's disrespectful to the patient's autonomy, IMO. So I personally would not pressure a loved one into a decision for doctors who probably do take it personally when someone rejects their opinion on treatment. I myself was on the receiving end of that pressure and it's given me a super-bad attitude toward most doctors. That said, these doctors may feel so strongly about the matter because your mom really may have a very good chance at a decent quality of life after treatment. Is it possible to get a second opinion so that your mom can discuss this with someone else or another medical team, while at the same time respecting her decision to refuse treatment? Quote Link to comment Share on other sites More sharing options...
LibraryLover Posted September 4, 2014 Share Posted September 4, 2014 I'm so sorry. Quote Link to comment Share on other sites More sharing options...
NCMom Posted September 15, 2014 Author Share Posted September 15, 2014 Thank you for the support! Update: She is in the rehab nursing care center (yikes, that place is scary) and can walk more or less with a walker. She is not to put full weight on the leg yet of course so it is very slow. She has very little pain and is fully functional. So I have medical power of attorney now and she has a living will in place. This week she will have a palliative consult through Hospice and hopefully see an oncologist (referred from Hospice) who is NOT affiliated with the nutty oncologist who was from the Levine Cancer Institute, or at least so he said. One sort of wonders, though. :laugh: That doctor has NEVER contacted her again, nor has she heard from his office, etc. I guess if you don't pay for that chemo then you get nothin'... :glare: I had to talk to the Hospice places in two counties about setting up services and they were both aghast at his behavior. No kidding... Things are going as they go I guess. Georgia Quote Link to comment Share on other sites More sharing options...
NorthwestMom Posted September 15, 2014 Share Posted September 15, 2014 :grouphug: :grouphug: :grouphug: Good job, Georgia. You've done hard work getting things set up so that won't happen again. Hospice was wonderful for us and I hope you have a good experience too. This stage of life is so heartbreaking. Best wishes to all of you. Quote Link to comment Share on other sites More sharing options...
Miss Mousie Posted September 15, 2014 Share Posted September 15, 2014 So I have medical power of attorney now and she has a living will in place. I am so glad to read the above. And it sounds like you and your mom have each achieved a sense of peace. More hugs to you and your mom, Georgia. Quote Link to comment Share on other sites More sharing options...
BlessedMom Posted September 15, 2014 Share Posted September 15, 2014 ((Hugs)) Sounds like you are making some positives progress. Quote Link to comment Share on other sites More sharing options...
VeritasMama Posted September 15, 2014 Share Posted September 15, 2014 My experience with a doctor hounding someone is that they want the person to participate in a study. I would flat out corner this man and ask him if he wants your mother to participate in a study. This was my first thought. Prayers for you and your family, may your mother' s wishes be respected. Quote Link to comment Share on other sites More sharing options...
ILiveInFlipFlops Posted September 15, 2014 Share Posted September 15, 2014 Thank you for the support! Update: She is in the rehab nursing care center (yikes, that place is scary) and can walk more or less with a walker. She is not to put full weight on the leg yet of course so it is very slow. She has very little pain and is fully functional. So I have medical power of attorney now and she has a living will in place. This week she will have a palliative consult through Hospice and hopefully see an oncologist (referred from Hospice) who is NOT affiliated with the nutty oncologist who was from the Levine Cancer Institute, or at least so he said. One sort of wonders, though. :laugh: That doctor has NEVER contacted her again, nor has she heard from his office, etc. I guess if you don't pay for that chemo then you get nothin'... :glare: I had to talk to the Hospice places in two counties about setting up services and they were both aghast at his behavior. No kidding... Things are going as they go I guess. Georgia I'm only just seeing this thread for the first time. I'm very sorry for what you're all going through, but I'm so glad to find this update. I'm also appalled at the oncologist's behavior!!! I would be writing a very thorough letter to his office, and I think I'd consider writing some online reviews or maybe reporting his behavior to the appropriate state agencies. This is the kind of information people want to know when they're looking for a doctor, ESPECIALLY one who's most likely going to be working with them through potential end-of-life issues. That's just horrible :( :grouphug: Quote Link to comment Share on other sites More sharing options...
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