I shared some family issues a few weeks ago and thought I’d give you an update.
I mentioned Jim’s surgery on the last Friday’s Fave Five, but in case you missed it, we got the pathology report back on his kidney, and the mass definitely was cancerous. The good news was that there is no sign of it in the lymph nodes or lymphatic system, so that is excellent, and he won’t have to have chemotherapy or radiation as they are not effective for this type of cancer anyway. We’re told that kidney cancer, if it spreads, usually goes to the liver, lungs, brain, or bone. His liver looked fine on the original CAT scan, and his chest x-ray was clear. He has an appointment with an oncologist this week to determine if he should have scans to see if everything is ok with bones and brain just to be sure. He has a follow-up appointment with the urologist who did the surgery at the end of the month, and if everything is ok on all those fronts, I think we’ll be able to close this chapter. He is still a little tender in the surgical area and can still get tired after a while. They say it usually takes about 6 weeks to completely recover from surgery.
I had written in the last “family news” that my mother-in-law was in the hospital and would have to be moved to a nursing home when she was released. She was in the hospital about a week. The building of the nursing home is a little depressing, but the people there are just excellent. We had had some problems with her care at her last assisted living place, and it is such a balm to know those taking care of her now have the same concerns we do and to see that they treat her gently and kindly. They have been doing physical and occupational therapy with her to see if they can help her regain some strength and muscle tone — we weren’t sure how much of what she lost had to do with the aging process and how much had to do with having been sick. However, it looks like she is not really regaining anything, so the different therapies will probably come to a stop soon.
Sadly, we have seen an even further decline in her condition. She had not been wanting to eat as much as usual over the last several weeks even before getting sick, except when she really, really liked something, like a couple of Mexican dishes we would have here at home. But since she was sick she doesn’t have much interest in food at all and is having trouble swallowing and speaking. They began pureeing her food so she could swallow it better, but of course that makes it even less appetizing. One day while I was chauffeuring Jim back and forth to see her after his surgery, he was helping her eat, and there were three blobs of brown food that all looked like various shades of refried beans. We looked on the menu for the day, and baked beans were listed, but the entree was hot dogs. Can you imagine pureed hot dogs? But they do have some “real” soft foods, too, like applesauce, mashed potatoes, pudding, and ice cream. She doesn’t usually want more than 5 bites or so of food, and they supplement with Ensure.
The problems with eating and lack of appetite have led to discussion of feeding tubes. We’re not there yet, but we’ve been gathering information in order to make an informed decision. At that age and stage of life, it’s more merciful to avoid some life-saving measures that would be employed under other circumstances: CPR compressions, for instance, could result in broken bones and massive complications in the elderly. And many people do not want to be put on a ventilator at that age and stage. She did sign DNR papers for those kinds of things years ago. But we hadn’t considered a feeding tube as a part of that situation: we had seen it in the same light as the IV fluids and antibiotics she received in the hospital. Letting someone die a natural death is one thing: making it happen is another, and withholding food would certainly make it happen. If someone were in a coma with no hope of recovery, it would make sense to us not to disturb them with medical procedures and just let them go. But when someone is still “there” as a person, can interact and communicate to some degree and make their needs known to a degree, can even laugh and tease, then to us it seems inhumane to say that once you can’t swallow any more, sorry, that’s it, no more food for you. One friend said that a feeding tube is “unnatural.” I don’t know — where do you cross the line over “unnatural” medical intervention? Food through a tube? Fluids and antibiotics through an IV? Insulin for a diabetic?
As my husband told a family member who was very upset over the whole issue, it’s important not to judge anyone else’s decision. It’s a complicated situation, and good people are on either side of it at various stages. I’d just encourage people to study it out so you can make an informed decision for yourself and your loved ones. We’re reading up and discussing it with our medical professionals and a couple of friends in the medical field.
The other issue we’re wrestling with is whether or not to bring her home to our house. There are pros and cons either way. As my husband said, we have this romantic notion about bringing someone home to die, but would she even realize where she was, and would she consider this home, or does “home” for her mean Idaho, where she came from? And we have this vision of being with her when she passes, holding her hand and hearing her ask if we can see the angels — but who knows if it will happen like that. We would be able to be with her more, so that would be a big plus. We wouldn’t have medical help at the push of a button any more, and that would be scary. The social worker there at the nursing home is going to give us some information about hospice, home health care agencies, etc., so we have some reading and fact-finding and thinking to do.
And finally, I had requested prayer for a niece’s fiance with multiple tumors. He’s going into the hospital today for the next to the last round. He’s gotten extremely sick with some rounds and his white blood cell count has gone way low, so this time they decided to just admit him to the hospital to keep an eye on him while he undergoes this treatment. The last scan a few weeks ago showed that some of the tumors were gone and others had shrunk, so everything is working, thank the Lord. I’d appreciate prayer for them, as you feel led, for not only the physical but also the spiritual needs. And while you’re at it, you might pray for another nephew struggling with drug addiction.
Thank you so much for your concern and prayers. I never dreamed when I started a blog several years ago that I would find such dear blog friends along the way.
Stray Thoughts 
Such deep issues to work through, Barbara.
Yes, I will pray for you.
I’ve been praying for Jim since you first mentioned the cancer. I will continue to keep him in my prayers. I’ll also add your mother in law and your nieces fiancee.
And hugs and prayers for you too Barbara.
Sending ((Hugs)) and prayers.
A very full post here, Barbara. When it rains, it pours, and it seems to be pouring right now on you all. 😦 I will continue to pray about these situations, too. I know how helpful it was to me when we were in a downpour to know that others were praying for us.
About the feeding tube stuff: you are so right that it’s a complicated issue and no one should judge another’s decision. I’m sure you’ll make the best decision for your m-i-l’s situation. When my mother quit eating altogether, we did not put her on a feeding tube, and she died in a matter of weeks. I don’t second guess our decision because we felt in her unconscious way she was telling us she was tired of being here and wanted to move on. But each person and circumstance is different, and the choices you and Jim make will be Spirit-led, I’m certain.
Blessings to you, friend, as you continue to walk a hard journey. Glad you have many who are walking with you. Count me in that crowd.
I have been keeping up, but have not been able to leave a comment recently. But I’ll keep praying!
Your heart must be so heavy at times as you give up your concerns and loved ones to God. I will be praying for your husband, your MIL and decisions…and peace about all of them, and for your niece’s fiance.
Hugs.
Oh, Barbara, I’m so glad that I “dropped in” today. You might remember, June, 2011, I had a tumor in my right kidney removed. It was benign, but I ended up in the hospital for 70 days! I had to have a second, emergency surgery because the original surgeon nicked my duodenum and that caused me to become septic. I almost died several times. They put me in a coma, and I was in ICU for 25 days! I had a feeding tube, as well as oxygen mask, a tube down my throat (that was removed too soon and then replaced), 7 pints of blood, etc. etc.
I had signed a Living Will and requested DNR. My husband ignored it! Although I am grateful to God to be alive, I am disabled, and I struggle with a good bit of pain.
The end result? I do wish that my wishes had been honored. Just think: I’d be in Heaven now.
Bring your MIL home, if you can. Call Hospice so that she will not suffer unnecessarily.
I hope this helps a bit.
Oh my.
WELL! You guys have a lot on your plate to think about.
I’ve been praying for Jim’s continued recovery. I will pray for everything that you have before you…that God would grant you great wisdom and that you two would feel peaceful about wherever it is your decisions take you!
Will continue to pray for all the above. I know what you are going through, as with my father things had to be decided and it is an individual case for sure.
Please pray for my Son on March 26th for temporary custody of his kids (4 of them) at a pre-trial. He has not seen them in 5 months. One son (14 yr) is very depressed on not seeing his dad. She has not allowed it and legally he could do nothing without filing for custody. She fled to 2 states and he tried marriage counseling, but she would not show up. There is really no reason he should not see the kids other than to hurt him. It has caused anger in families of course. Trusting the Lord for His will. Just Pray, he so loves his kids and wants to put them in public school. His 12 yr old can hardly read. These have been some of the disagreements. He has no problem with Home schooling as long as you do it.
Nina
The news on your husband sounds better than it could have been for sure. Hard decisions to be made with your MIL–each case can be very different.Praying for wisdom for you all.
So many hard questions on your plate right now, Barbara. You and the family are in my prayers. I did smile when I thought of all the unappetizing results of pureed foods. Cooking for roomie’s mom when she could only eat blended soups was an eye-opener for me. Anyway, I pray that God will give you all wisdom when the time comes for your MIL’s home going.
Will definitely pray, Barbara – not only just for Jim, but for you too. I know you must feel a certain level of anxiety too. I will pray that you will still function and attend to the demands of daily life as you minister to your husband, your mother-in-law and you kids as they must need assurance and comfort from you right now.
Hang in there… and with God’s help, you will for you will do all things through Christ who strengthens you.
Praying you and Jim make the best decision for your MIL! I know it is absolutely a gut wrenching decision having been there ourselves and I pray that God leads and gives you peace about what to do.
I will keep you and your family in prayers, Barbara. God is with you in these situations. How is Jim feeling now?
Thank you for the update, Barbara. I have been paying for Jim, but will continue to lift your entire family up in prayer.
As a dietitian in long-term care, I often worked with families who were having to make difficult decisions regarding feeding tubes. Something you might ask the speech-language-pathologist who is working with your mil is whether she is currently at risk of choking (obstruction) or aspiration (breathing food or fluids into her lungs). My experience is that people at risk of obstruction are often uncomfortable if their textures are liberalized (back to a regular or ground consistency, for example). People at risk of aspiration may find that they still prefer to eat “regular” textures, even though that increases the risk of aspiration (and of the accompanying aspiration pneumonia). If it appears that your mil is at the end of life and that she is still capable of eating by mouth, I would generally tend to discourage feeding tube placement, since it often decreases quality of life among those who are dying and raises complicated questions of continuing or discontinuing artificial feeding at the very end of life. In this case, I would talk with the speech therapist and dietitian about liberalizing her diet texture to whatever she is most comfortable with eating and/or willing to eat (you may be asked to sign something indicating that you understand and accept that the risks of choking or aspiration will be higher on the more liberal texture). On the other hand, if your mil is incapable of and uncomfortable with eating by mouth (that is, if the act of eating makes her uncomfortable because she constantly feels like she’s choking and a speech therapist has confirmed choking or aspiration risk and recommended that she not receive any food or drink by mouth) and her physicians feel that she is likely to live for more than a year if a feeding tube were placed, a feeding tube may be a good option to maximize her comfort at her life’s end.
Please feel free to email me if I can assist your family in any way through this process. I will continue to be praying for you all.
I’m sorry I’m just now getting around to reading this update. I’ve had your family on my prayer list for weeks, and I was wondering how your niece’s fiance was doing. I’m glad the tumors are shrinking and some are gone! I’m still praying for his and your niece’s salvation through this.
So many decisions for your dear MIL! Praying also for you and Jim and any other family members involved in decisions for her. There sure are a lot of things to consider!
Pingback: A look back at 2013 | Stray Thoughts