NGs, IVs, PEGs, and GIs

Dr. Repka, the oncologist, stopped by late this afternoon. The upshot:

• Dad did not respond well to chemo. The first round was about as hard a dose as he could take, and it did NOT help him in any substantive way. Dad is leaning toward not resuming chemo at this point. He would have to have round after round of chemo in order for it to have an effect on the cancer - and even that is uncertain.
• Nutrition won't help him right now, nor will having nutrition significantly affect how much time he has. The cancer is the problem - it is suppressing his appetite, and it is what will "get" him, not lack of nutrition. It would be nice if his "gut" (as she called it!) started working again, so he could eat, but that's more for quality of life than to prolong things.
• When they removed the fluid from his abdomen (outside the stomach) today, I think our hope was that he would get great relief. However, they only were able to take out 1 liter of "stuff" - good, but not enough to give him the kind of relief we were hoping for.

Best options at this point for managing the symptoms are:

1. Keep him hydrated, which has to be through IV at this point.
2. Keep stuff from building up inside his stomach, especially if it continues not to function. An NG tube is doing this now, but we'll meet with a GI doctor tomorrow to look at possibly getting a PEG (peritoneal something gastroectomy or some such thing) that would allow him to drain his stomach as needed without having a tube sticking out of his nose.
3. Keep stuff from building up outside his stomach - like it was today - as needed.
4. "Manage" his pain and nausea through all sorts of interesting drugs.

1, 2, and 4 can all be set up to be done at home with the help of Hospice, so I'm assuming tomorrow or the next day we'll start looking at options for getting him home sometime here.

For the time being, I'm planning to hang about the place and continue plaguing doctors with questions. (Don't worry - Amy says she is thrilled - and she's helping me type this!).

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