My Mom was just in the hospital for a low blood count 2-3 weeks ago, and prior to that she was having swelling of her legs and abdomen from low albumin (this is something that's been occurring for the past year off and on) in addition to a bunch of other stuff. The hospital gave her a medication to rid of the excess fluid (it wasn't Lasix, but something stronger that they told me is not to be used regularly as it's too hard on kidneys) and it worked, but now the fluid is back with a vengeance & Lasix is not helping. Her feet, legs, abdomen and hands are swollen and her legs "leak" fluid because it has nowhere else to go. The Dr. at the SNF doesn't seem to be in much of a hurry to do anything about it. Mom is extremely uncomfortable & "bloated" feeling for lack of a better word.
I talked to the nurse & expressed my concerns that this doesn't seem to be resolving. I asked if they were giving her protein supplements, and she said no - that they need an order for that. I then asked why Dr. F hasn't done so, & she shrugged her shoulders. She then told me that I should probably make an appointment for my Mom to see her primary physician for a 2nd opinion (which I took as her not being happy with the way Doctor F was treating her without saying so(?)).
As I was getting ready to leave the facility, I saw the Dr. down the hallway, so I asked him for a moment of his time. I told him I was concerned & asked him flat-out what he plans to do with my Mom & why he hasn't ordered protein supplements...or would those even help or ? He said "I'm just going to be honest here - your Mom's been failing for quite some time now, and I really don't know what else to do for her. Between the diabetes, rheumatoid arthritis, congestive heart failure and kidney disease, it seems like nothing we are doing is helping turn her around." So I asked him if protein supplements would help, and got an explanation about the cause of hypoalbuminemia and how inflammation & the liver plays a role (he thinks from the RA). He mentioned that he didn't think it would help, and then told me that in the condition she is in, she probably qualifies for hospice at this point. I was a little taken aback, but I asked if I can have her see her primary physician for a 2nd opinion, and he said "of course - if he has any tricks up his sleeve that we haven't thought of or done yet, I'd be happy to hear what they are."
I left feeling like i was sort of caught between a rock and a hard place. Protein supplements "might not" help, but it's not like they're super-expensive & it's worth a shot, right? I am a realist...I KNOW she has been sliding downhill for awhile now, and I KNOW she isn't going to do a 180 and be as "healthy" (for lack of a better word) as she was a couple of years ago. I don't believe in prolonging the inevitable for the sake of modern medicine and their statistics, but what do I tell my Mom? All I managed to say to her before I left is that Dr. F said they've run out of ideas on how to treat her & suggested that she see if Dr. Z has any ideas that they haven't thought of. She said "well I sure hope they figure something out - I am getting so tired of this... it's always something." I told her "well, Mom, considering what your body has been through all these years...." she cut me off and said "yeah, I know."
I am waiting for her primary to call me back - but what the hell do I say?? "Dr. F is ready to sign the hospice order...do you agree???" or ???? Worse yet is what do I say to my Mom if both Drs. agree she should be on hospice...or do we not tell her, or do they tell her?? Ugh. Need some advice here....