Wednesday 2 July 2008

Peter is not yet home from hospital. The doctor and dietitian think he can come home but Peter is concerned that if he comes home he will not cope or I will not cope. So while I said "yes I can manage him at home" Peter said "no".

He had a fall on Saturday morning at 7.30am before I arrived for the day and that has shaken his confidence once more. Luckily he only sustained some bruising on his back at the lower ribs and the nursing staff heard the "thud" so came immediately to his assistance. But that means he now really wants someone to walk with him to the toilet etc to ensure he doesn't fall again. The reason for the fall, I understand from Peter, is his weakened and deconditioned state, which made him tottery on his legs and made him keel over.

Anyway, the peg tube feeds continue to go well although he has not gained any weight from them. So the dietitian has decided we can try to increase the overnight feed amount from 1 litre to 1.5 litres over a 12 hour period and review that. This increased regimen will commence when he comes home, which I think will be before the end of the week, as long as I can get all the equipment and supplies for the feeds at home.

The plan then is that he will not have any further treatment for the short term and in one month will see Dr Yip again for review, at which time blood tests will be considered. According to Dr Yip and others, the radiotherapy (which continues until 8 July) will take some weeks to months to finally work its way through and finish. At that time they are hoping it will have had a shrinking effect on the oesophageal tumour.

Generally, Peter is not in a good way psychologically at the moment as he cannot see any improvement and he says he is frustrated and I consider he is depressed. He has no interest in anything and is depressed that he is not able to eat or drink anything. He can actually swallow fluids but the problem is that every time he does so it means he brings up a lot of mucous and coughs which exhausts him (but is probably an important thing to do) and so he can't see the point in drinking to then have 5 minutes of exhausting coughing.

I am continuing to shower, clothe, feed, often administer the medication by the tube and attend his needs while he is in hospital. This makes him feel confident I will be able to manage at home and he can see that relatively speaking I am able to do a competent job, which is important. So I think we will manage reasonably well at home especially with the assistance of the palliative and community nurses to change his sterile dressings and pain medication.

Meanwhile I am fine and looking forward to having Peter home again as it is easier to be at home than at the hospital all day. Best wishes to you all. Cheers - Leanne