O/T seeking feedback about geriatric renal failure

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CRguy
Posts: 10472
Joined: Sun Feb 10, 2008 6:00 pm

O/T seeking feedback about geriatric renal failure

Postby CRguy » Sat Jun 19, 2021 12:57 am

I am just putting this out there to this body of knowledgeable, supportive friends :
I know the science and the medicine of renal failure from my vet career experience.
I do not know the patient centric issues / concerns / impacts /fears and copings ... of being a patient with this,
nor being the caregiver / supporter.

I know all cases will be individual and I am not asking for medical advice.

I am asking for any patients and/or caregivers here, who may have experience with this to share their experiences
'cos HEY ... that IS what we do here !!

The "patient" is my very elderly mother ( 93 this month ) who is just being inducted into the "system" with specialists,
lab tests , more lab tests and offerings of :
1. peritoneal dialysis
2. IV hemo-dialysis
3. conservative / supportive / "palliative ?" care options

She still lives independently in her own home, has manageable "other" geriatric type issues, is VERY realistic / optimistic / strong Faith
and a good support network.

Many thanks in advance for any inputs.

Cheers and Harmony on ALL of our Journeys
CRguy
Caregiver x 4
Stage IV A rectal cancer/lung met
17 Year survivor
my life is an ongoing totally randomized UNcontrolled experiment with N=1 !
Review of my Journey so far

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beach sunrise
Posts: 1027
Joined: Thu Mar 05, 2020 7:14 pm

Re: O/T seeking feedback about geriatric renal failure

Postby beach sunrise » Sat Jun 19, 2021 1:26 am

Goodness, what an amazing woman/mother you have!
I am expecting a reply from my onc about levels of BUN and Chloride on Monday. Do you know her levels? Anyway, I will let you know what he says about those to if it would help.
8/19 RC CEA 82.6 T3N0M0
5FU/rad 6 wk
IVC 75g 1 1/2 wks before surgery. Continue 2x a week
Surg 1/20 -margins T4bN1a IIIC G2 MSI- 1/20 LN+ LVI+ PNI-
pre cea 24 post 5.9
FOLFOX
7 rds 6-10 CEA 11.4 No more
CEA
7/20 11.1 8.8
8/20 7.8
9/20 8.8, 9, 8.6
10/20 8.1
11/20 8s
12/20 8s-9s
ADAPT++++ chrono
CEA
10/23/22 26.x
12/23/22 22.x
2023
1/5 17.1
1/20 15.9
3/30 14.9
6/12 13.3
8/1 2.1
Nodule RML SUV 1.3 5mm
Rolles 3 of 4 lung nodules cancer
KRAS
Chem-sens test failed Not enough ca cells to test

itsfineimanurse
Posts: 9
Joined: Wed Apr 29, 2020 6:49 pm

Re: O/T seeking feedback about geriatric renal failure

Postby itsfineimanurse » Sat Jun 19, 2021 5:04 am

So, as you know, this is NOT medical advice.
However, I am a long term care nurse and we lost my dad to renal failure at 62 (he declined dialysis).

Dialysis takes a HUGE toll on people. Peritoneal Dialysis is nice because it's done in the home. There are downsides too: it requires being hooked up everyday (likely at night for convenience) and supplies that must be maintained and disposed of etc.

IV Hemodialysis also takes a lot out of people. It requires going to a center (generally) and sitting for around 4 hours (average). People return exhausted. We see a general cycle of dialysis-exhaustion-feel better just in time for dialysis. We've also seen pressure ulcers develop from sitting for so long.

Palliative care is a viable option if the goal is quality of life vs quantity. She's 93, so that may be an appropriate route to take.

My dad was young and opted for no dialysis because he had a friend who went through it and they had many discussions and the friend said he wouldn't have done it if he had to choose again. It's a very personal decision and I hope this helped.

Good luck to you and your mom xx
Diagnosed at 34- 2 kids (now 4 and 2)
Dx. T3b N1a RC 01/2020
FOLFOX 01-05/2020
Xeloda + Radiation 06-07/2020
LAR/Diverting Ileostomy 9/2020- Pathological Complete Response!
Clear Scan 11/2020
Ileostomy Reversal 02/2021
Clear Scan 02/2021, 05/2021- graduated from 3 to 6 month scans/labs

User avatar
CRguy
Posts: 10472
Joined: Sun Feb 10, 2008 6:00 pm

Re: O/T seeking feedback about geriatric renal failure

Postby CRguy » Sat Jun 19, 2021 11:28 pm

Thank you both for your replies !

beach sunrise
She has had a consult with a nephrologist and is getting seen soon at the "kidney centre" close by, for initial intake info and consults.
Repeat specific bloods being done soon prior to that visit, so will report back when I have more lab info.

itsfineimanurse
Appreciate the commentary on patient options/choices/reasons !
Sounds exactly like what she has spoken to me about and is determined she will not be :
" hooked up to a machine to keep me alive " kind of mindset.

Yes, she is a very vital, determined, loving, caring and generous person.
The treatment decision WILL be hers alone, ...BUTT ... she will investigate all alternatives
and consider her decision carefully, knowing the seriousness of the implications.

Those who do pray, please keep her in yours.

Love Peace and Harmony to all on the Journey
CRguy
Caregiver x 4
Stage IV A rectal cancer/lung met
17 Year survivor
my life is an ongoing totally randomized UNcontrolled experiment with N=1 !
Review of my Journey so far

User avatar
beach sunrise
Posts: 1027
Joined: Thu Mar 05, 2020 7:14 pm

Re: O/T seeking feedback about geriatric renal failure

Postby beach sunrise » Tue Jun 22, 2021 10:33 pm

I have no info yet to offer. Onc wants to have appt to discuss various things. I'll let you know on my end after appt. I hope your sweet Mom is doing fine.
8/19 RC CEA 82.6 T3N0M0
5FU/rad 6 wk
IVC 75g 1 1/2 wks before surgery. Continue 2x a week
Surg 1/20 -margins T4bN1a IIIC G2 MSI- 1/20 LN+ LVI+ PNI-
pre cea 24 post 5.9
FOLFOX
7 rds 6-10 CEA 11.4 No more
CEA
7/20 11.1 8.8
8/20 7.8
9/20 8.8, 9, 8.6
10/20 8.1
11/20 8s
12/20 8s-9s
ADAPT++++ chrono
CEA
10/23/22 26.x
12/23/22 22.x
2023
1/5 17.1
1/20 15.9
3/30 14.9
6/12 13.3
8/1 2.1
Nodule RML SUV 1.3 5mm
Rolles 3 of 4 lung nodules cancer
KRAS
Chem-sens test failed Not enough ca cells to test

User avatar
CRguy
Posts: 10472
Joined: Sun Feb 10, 2008 6:00 pm

Re: O/T seeking feedback about geriatric renal failure

Postby CRguy » Tue Jun 22, 2021 11:52 pm

Thank you.
Like me she is part Icelandic = Viking ....
so kicks BUTT and takes names !!!!! :shock: :mrgreen:

Best wishes with your doc visits

Cheers
CRguy
Caregiver x 4
Stage IV A rectal cancer/lung met
17 Year survivor
my life is an ongoing totally randomized UNcontrolled experiment with N=1 !
Review of my Journey so far

User avatar
beach sunrise
Posts: 1027
Joined: Thu Mar 05, 2020 7:14 pm

Re: O/T seeking feedback about geriatric renal failure

Postby beach sunrise » Thu Jun 24, 2021 12:22 pm

Got short reply before appt next week. You probably already know this stuff, but anyways.
Low BUN = low protein intake
High side of normal Chloride is meaningless. Cut out coffee and drink water If I feel I need to.
Hope your Mom is still doing good.
8/19 RC CEA 82.6 T3N0M0
5FU/rad 6 wk
IVC 75g 1 1/2 wks before surgery. Continue 2x a week
Surg 1/20 -margins T4bN1a IIIC G2 MSI- 1/20 LN+ LVI+ PNI-
pre cea 24 post 5.9
FOLFOX
7 rds 6-10 CEA 11.4 No more
CEA
7/20 11.1 8.8
8/20 7.8
9/20 8.8, 9, 8.6
10/20 8.1
11/20 8s
12/20 8s-9s
ADAPT++++ chrono
CEA
10/23/22 26.x
12/23/22 22.x
2023
1/5 17.1
1/20 15.9
3/30 14.9
6/12 13.3
8/1 2.1
Nodule RML SUV 1.3 5mm
Rolles 3 of 4 lung nodules cancer
KRAS
Chem-sens test failed Not enough ca cells to test

User avatar
CRguy
Posts: 10472
Joined: Sun Feb 10, 2008 6:00 pm

Re: O/T seeking feedback about geriatric renal failure

Postby CRguy » Fri Jun 25, 2021 10:23 pm

Continues to do well and just waiting for the follow up appts and tests !

Cheers
CRguy
Caregiver x 4
Stage IV A rectal cancer/lung met
17 Year survivor
my life is an ongoing totally randomized UNcontrolled experiment with N=1 !
Review of my Journey so far


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