[helpingdad]

Understanding father's symptoms (possible end stage?)

by helpingdad on Fri May 17, 2013 2:48 pm

My 71 year old father was diagnosed with multiple myeloma in February 2013. This diagnosis came after nearly 2 years of back pain and broken vertebrae. He underwent surgery in July 2012 for 2 fractured vertebrae. His pain and general health didn't improve and he then suffered 2 more fractured vertebrae in November 2012 and ended up in the hospital. The doctors couldn't figure out what was wrong until a new primary care physician took over. He is just finishing his first round of chemo (meaning several shots and many pills since March).

Two weeks ago he broke the top of his pelvis when he stood up from his chair. He spent several days in the hospital and is now home.

Currently, he uses a walker and spends all of his day in bed or in his recliner. He is extremely weak and has lost 40-50 pounds over the last 8 months. My father has shown no visible improvements and I am concerned he is nearing the end. He hasn't had any infections or kidney issues up to this point, but he is so frail.

My mother is his sole care giver and is exhausted and emotionally drained. I am going with them to the next oncology appointment. on 5/20. I am hoping to ask some questions about hospice etc.

Any advice about his current quality of life? I am concerned about him getting all of this treatment if it is not going to improve his daily life. I would appreciate a response from anyone who has a similar experience and can give me feedback about what to expect.

[Dr. Adam Cohen]

Re: Understanding father's symptoms (possible end stage?)

by Dr. Adam Cohen on Sun May 19, 2013 10:44 pm

It sounds like he had fairly advanced bone disease when he was diagnosed, and recovering from multiple fractures like he had can certainly be difficult, especially if he was in a weakened state to begin with. Myeloma is incurable in this setting, and it's never wrong to learn about and discuss hospice. However, with current combination therapies, close to 90% of myeloma patients respond to their initial treatment, so if he's only had 1 cycle and is willing to try, it may be worth another round or 2 to see if he starts to improve, perhaps with adjustments in the doses or frequency of treatments if some of his weakness if related to the medications themselves. It's also important to make sure his pain is adequately controlled and that he's getting adequate nutrition - sometimes supplements (e.g Boost or Ensure or similar products) can help in this regard. There's no right or wrong answer here, but by having an honest discussion with his oncologist about the goals of care and what your father's wishes are, I am sure you and he will come to the most appropriate decision. I wish you the best of luck.