Postby GrouseMan » Mon May 22, 2017 10:49 pm
OK here is todays update. In less than 24 hours she has now thrown up 6 liters of green bile liquid. 3 Liters at about 10:45 pm last night and again at about 3:15 pm to day. Before she was throwing up small amounts but with the extreme numbers of anti nausea medication (3 to 4) and amounts max dose I think they are giving to suppress nausea she only throws up now when she is so full that she can't suppress the urge to throw up any more. Then she immediately feels fine, no nausea at all. What always precedes an episode is some acid reflux, that can be triggered by drinking water etc. She is usually able to hold down what little she eats, and that seems to pass into her colostomy bag. When she throws up there is nothing in it but green liquid. No solids at all. I suspect its more like GRED she is experiencing. And all the anti nausea drugs are doing is suppressing the gag reflex nothing more until she can't suppress it any further because she is full. Both times it was the same large volume - 3 liters each time.
For the first time in a in maybe a week I have actually managed to be in her room when a doctor has come by. A Surgeon this evening before I was about to set off for home (not even my wife's surgeon, or I suspect one of his residents or partners.) He suggested that we get her nausea under control so she isn't throwing up as much (its now down to twice a day ha ha ha...) and send her home and let her sit around on the couch feeling miserable all day or doped to the gills and out of it receiving IV fluids so she doesn't get dehydrated. Idea being she would be more comfortable at home puking her guts out with a nurse visiting her once a day for a few mins. If my wife wasn't there and I knowing I could have been prosecuted for assault I might have decked him right then and there. They are treating only the symptom not the cause. He says well if its not nausea causing her to throw up it must be mechanical - stomach or colon twisting and un-twisting and any fix would be very dangerous surgery (which I agree in the state she is in now it most likely would be). But I am not convinced this could be the case as she is eliminating into her colostomy bag just fine, though not a lot as she isn't eating a lot. Her blood work looks fine. Temperature is fine. BP and heart rate is a little elevated since this all started, but not as one would expect with a twisted stomach or colon, backing up 3 liters of watery bile. I finally convinced an older nurse that they need to look more closely at how this comes on and not discount the acid reflux preceding the event, and pressure in her lower left abdomen as the fluid starts to build. The night before the nurse wanted to test my idea that it was excess acid by giving my wife some tums. Those came up pretty quick about 2.5 to three hours before the big 3 liter event. But tums usually will not do much for real acid reflux caused by GERD anyway.
They had been giving her IV Atavan which made her loopy! Put her on the edge where she was having sort of wakeful dreams. She get a dose of that and no way I was getting her to get out of bed to try and walk the halls. Today the nurse gave her oral Atavan after the latest 3 liters of green liquid vomit. For a change she stayed alert. I had to leave to come home and take care of the dogs, so I don't know the outcome of this. But the nurse did say - Orally - this drug does tend to sooth the stomach better than IV drug, that goes to work directly on the brain. My wife was able to keep it down and not throw it up so that is something. She did eat a few forks full or chicken, some mashed potatoes and soft cooked carrots. Some strawberry Ensure that she detests (would rather have chocolate or vanilla), some pudding and some left over mint chocolate chip ice-cream I went to Stone Cold Creamery for yesterday (the nurse last night put the cup in a biohazard bag, put my wife's name on it and stuck it in the freezer for her when she wanted the rest). My wife was very amused when I retrieved it. Before I left we walk the halls and made two circuits of them before I left. She was reading the papers as I departed. I've not heard from her this evening. She is likely asleep by now.
My main problem is I can't be there all the time at the hospital, and its hit or miss if I see an actual doctor, especially one that has done more than just read her file. Not a one of them has spent any time actually observing her, examining her before after one of these episodes. No ones sampled what she is throwing up taken pictures or run any tests on it. All they do is measure its volume. First thing I would do is stick a pH meter in in. Another thing is maybe look for some cells. Or something unusual in it. Nurses have seen it but I doubt any of the doctors. The ones I talked to this evening thought it was what she had taken in - I assured them she had not taken in 3 liters of fluids that afternoon and certainly not 6 liter in less that 24 hours - I thought they had measured what she was taking in vers what was coming out but apparently math wasn't his guys strength! I guess I am biased because I was a Laboratory instructor at a university at one time and I had a lot of wishfull thinking potential med students in the classes I taught. I have to say if their performance in freshman chemistry and organic chemistry was any indication I would not want them as my doctors!
Oh well - enough bitching.
GrouseMan
DW 53 dx Jun 2013
CT mets Liver Spleen lung. IVb CEA~110
Jul 2013 Sig Resct
8/13 FolFox,Avastin 12Tx mild sfx, Ongoing 5-FU Avastin every 3 wks.
CEA: good marker
7/7/14 CT Can't see the spleen Mets.
8/16/15 CEA Up, CT new abdominal mets. Iri, 5-FU, Avastin every 2 wks.
1/16 Iri, Erbitux and likely Avastin (Trial) CEA going >.
1/17 CEA up again dropped from Trial, Mets growth 4-6 mm in abdomen
5/2/17 Failed second trial, Hospitalized 15 days 5/11. Home Hospice 5/26, at peace 6/4/2017