Godmother was diagnosed with failure

renerian, BSN, RN · May 29, 2003

Thanks moonchild......I appreciate your kindness and prayers.

renerian

ageless · May 31, 2003

life expectancy depends on her creat clearance...for instance 10 can be borderline. Keep her K low and fluids under control. what is her BUN and creat now?

renerian, BSN, RN · May 31, 2003

Well thanks for responding ageless. Believe it or not the nephrologist said he did not need to see her again since he was not going to treat her. She has not been checked now for about 2 weeks, 1 week or so since her high K+. She is considering going for a second opinion which I am encouraging her to do.

renerian

Allaroundnurse · Jun 2, 2003

I too am so sorry to hear about your loved one. I agree that no time can be lost getting a second opinion. I have seen other patients put on dialysis just to help them breath easier near the end. Our docs look at creat. for females up to 12. Do they have her on Kayexalate to help get her K+ down? She needs labs to follow up: At least Creat., Bun, Basic Metabolic panel which will include her K+ level. NOOO OJ, watch out for banana's and advocado's too all high K+. http://WWW.anna.com has some wonderful articles you may want to check out. Best of luck to all of you!!

renerian, BSN, RN · Jun 3, 2003

Thanks for replying. My aunt is not calling for a follow up. I think she does not want to go and at some level has given up. She said she won't go for a second opinion and she won't let me call the dr now. Thanks for helping though.

renerian:confused:

passing thru · Jun 4, 2003

We had a similar situation in our family. The patient was a 53 year old aunt. She had a spouse and 5 adult children.

Frankly, when it reached this point, her spouse & family were

tired of taking care of her and her many "problems".

The doctor discussed with them: her ""Quality of Life.""

It seems no one wanted to step up to the plate and commit

to the time needed to provide her with the care she needed....

And, the aunt too was tired of the struggle, the years of monitoring, loss of most sight, neuropathies, little strokes, disability, foot sores and debridements, and finally kidney failure-- had taken their toll.

She said she had lived longer than most diabetics,....and didn't

particularly want to give up, but, grasped the situation that

everyone was quite tired of her ...

Sad.........

She entered the hospital and the doctor put her on a morphine drip ""for pain"" and as her kidney function was zilch....she died 5 days later.

I think if a patient has family support....lots of love......the outcome would be/could be different.

The doctors were more than willing to go the dialysis route with my aunt, her family was just too exhausted/busy, etc., to agree

to it....the spouse actually told the doc that it would be "too much trouble" to drive an hour into the city three times a week

for dialysis treatments.

(As it turned out, the spouse had a honey on the side who he married 2 months later.)

There might be a moral here, I'm not sure.

Hope things turn out better or your family Renerian. Sorry to hear about your aunt. Maybe she is considering "letting go."

susanmary · Jun 4, 2003

Very sorry about your aunt. The doctors are all pointing in one direction -- they feel there is not much they can do. She's not "ready" for hospice -- yet she has given up. Ultimately, she does need a doctor to monitor her care. I have mixed feelings about posting this -- but please know that this comes from my heart.

She's end stage -- been a diabetic for 61 years, heart condition, renal failure. The doctor's (several opinions) feel she is at the end and dying. If this were my family member, I'd let them eat/drink whatever they wanted. I'd watch the extra fluids ... primarily because she will fluid overload easily and will have difficulty with fluid retention, breathing, etc. Her fragile body is building up dangerous levels of K+ and other toxins ... the doctor can prescribe something like kayexalate to help her clear her potassium ... which will give her diarrhea. It's up to her to decide how she wants to spend her time left. I would speak to her about her wishes -- what does SHE want? Has anyone discussed DNR status with her? I personally think it's a wonderful thing that she is able to be home with family members at this time in her life.

How can you and your family support her through the end? Does she want close family around? Is there anyone else she would like to see? Is there a clergy member that she would like visits from? I'd make this time about her and her wishes. If she's into denial ... that's up to her. If she wants to eat/drink orange juice and bananas until her K+ finally stops her heart -- that's up to her. You are talking about a very short time.

Enjoy the time you have left with her and celebrate the time you have had with her. Any special pictures you can share with her? Any questions you want to know -- let her share her special memories of your parents, grandparents, her kids, etc. Although this is such a sad time, you are all very fortunate (may not seem so right now) that there is time to be with her and say goodbye.

Let this be less about keeping "vigil" and more about being there to love and support your aunt. God bless you and your familiy.

Sue

babs_rn · Jun 4, 2003

couldn't have said it better myself, susanmary.

Beautifully put.

renerian, BSN, RN · Jun 4, 2003

Wow wonderful posts........very kind and honest. I am going to call her this weekend again and see if we can get to the heart of her feelings. I sincerely appreciate everyone's input....

God Bless,

renerian

lisaloulou · Mar 21, 2004

Sorry to hear this. Hugs to you. Id really push for Hospice,but she may say "no" again.

Ive seen Hospice bring a little victory out of defeat.