My dad

Hi Chabasa,

I am so sorry to hear about your dad. It is something we should never have to deal with. Reading between the lines, I think your dad wants the best for you & mum. He isn't a burden, you must emphasise this to him. 60 years of marriage is fantastic, so mum & dad are the best of friends too. They would do anything to help one another. I believe that they are secretly thinking differently, because I know that your mum wouldn't feel a burden, she would do anything for him. Again, keep repeating that both of you don't feel overwhelmed, that you love him so so much & nothing is too much trouble, 

Regarding the hospice nurses assessment, it does not mean they are looking at "End of Life" scenario's. They may very well want to see what your dad needs regarding home visits, pain medications, & advice when you need it. They look after all of you, because there are days when you or mum cannot cope. So you just phone the hospice & they will listen & try to calm you down, supporting you as & when needed. We have our own hospice nurse assigned to my mum, also terminal. So you would have the same. They have so many great ideas that you'd never think of. But one thing that I really like is if your dad has a bad turn, the hospice can give him a bed, in a private room, & you can visit him with no time limits. Think of it like this, they aren't the old "Last Stop" before expiration, they just want to help your dad get better so he can return home. And these hospices are such beautiful places, not like a cramped ward in a hospital at all. So you get around the clock care as there are as many highly qualified nurses as there are patients. They have an "Out of hours" phone line so you'll always get through.

My suggestion is for you to make contact with a GP referral to the hospice nurses. You will be assigned 1 nurse who will know & see how your dad is during their visits to your home. So essentially you are not passed from department to department, as you would be in hospital. This nurse will have all of your dads case notes from hospital, so she'll have a good overview of what dad has had done.

May I ask is your dad on any form of medication for pain, if you know what this is & it's not good enough to fend off those pains, well the hospice nurse can provide prescribed med's that may be required. My mum was on soluble paracetamol & Oramorph. Oramorph is not very strong, codeine is much stronger. (Do not use Codeine under any circumstances). So our hospice nurse added a Fentanyl patch, about thumb nail size which is much stronger, it's slow continual release & it lasts for 72 hours. You can use this in conjunction with for example 5 ml of Oramorph. And soluble paracetamol too. And you would get the lowest dosage to start with, that being 12 micrograms.

As for being physically sick, ginger is a very good anti sickness ingredient. Ginger beer, biscuits, sweets, & ginger herbal tea's of which there are many variety's. Twinings tea is our weapon of choice for a choice of ginger teas.

Lastly, a catheter will feel painful to start with, but that will soon go, use a fresh one every time you pee. Then discard. Repeated use of the same catheter may cause a bacterial infection which is the last thing you want. I have been using catheters for about 5 years & it feels totally normal, like cleaning your teeth. They come in different diameters, so maybe your dad needs a thinner catheter for ease of insertion.

So, get that referral from a GP at your dad's medical practice, you will not regret it. 

Hope I have given you some answers to take a bit of weight off you & your mums shoulders, & give my best wishes to your precious dad.

Regards,

Graeme.

Thank you so much for all that useful information Graeme, dad does have Co codomol for his pain, but he is one for not taking tablets, he has been like that all his life, he does take them sometimes, I have told him numorous times that he needs to take them regularly for them to have the best affect, but he still leaves them on the bedside table. He is also on tablets for acid reflux as since he had the stent put in it has made his reflux so much worse.  He is also on something to help his bowels open as the co codomol made him so bunged up that it was really painful for him. 

It's good to hear that patients don't only go into the hospice to die, as dad told the nurses those who go into hospices don't come out again. 

They have taken the catheter out now , but he is still really sore, the doctor came out to him yesterday and has pescriped some anti biotics incase it's a urine infection. 

Sadly I live over an hour away from my parents and I have my 15 year old grandson living with me, so I can't be with him everyday but I go as much as I can, and my brother has flown over from canada to help out. 

Thank you for your best wishes, I'm sending my best wishes to you , your mum and your family. It's such a sad, awful disease isn't it?  But you have certainly helped me with your wonderful reply. 

Hi chabasa,,

Movicol sachets for constipation, you'll need a prescription for these.

Do try to see if you can get him some 12 microgram Fentanyl patches, just stick one on the upper arm & it will release fentanyl at a constant rate for 72 hours. So you can then forget about co-codamol, I know a few people who have had adverse reactions taking co-codamol. It's the codeine that can make people feel awful, it really isn't something that the stomach tolerates well.

For reflux acid, Omeprazole is the answer in most cases. GP again. You are most likely aware of this technique, but just in case you aren't, elevate the headboard end of the bed, about 20 degrees. Use solid objects to put under the actual beds feet. This way you will always have an angle to limit acid reflux. 3 pillows will just slip, but the bed won't.

You are so right, cancer is something that everyone fears. It really destroys lives, but we continue to find better ways to control or cure it. 

I hope that my reply gives you a little more help.

Wishing you all my best,

Graeme.