my dad, no appetite dizzy and wobbly

[stanley]

this is likely to be jumbled and all over the place but hopefully some reassurance or advice may filter through.

my dad 86 years old last month diagnosed with pancreatic cancer can't operate and not up to chemo. we are just looking after him. mum is carer and struggling emotionally. i live close but work and find it difficult when i speak to my mum to work out what is happening and when...

saw my dad last night, hardly eaten a thing, try to say have fortisip drinks if you can't eat, only prescribe 12 at a time so i think my mum may be rationing them out - i would give them to him all day if it helped and i would buy them if they won't prescribe more - is there a restriction on qty?

i guess we want to eat normally but he just says he isn't hungry, no pain no nausea.

he also is having dizzy spells or wobbly moments he says - lack of food maybe? he has low blood pressure has been taken off some tablets he had i think to do with his angina - i don't know his medications

very dry throat have just taken call saying he would like some lucozade

struggles with creon as big tablets but won't empty and take with jam as he is so worried about chewing them - would that be a REAL problem?why?

he is very with it for 86 he is getting upset now too said he should go in a hospice we don't want him to, is this a blip we can get him over through eating/nutritional supplements, or is this him declining? nurse is visiting today..she may have been, he doesn't sleep too well either over night but sleeps a lot in his chair, gets up late (11ish)

please if you have had similar experiences help me know what is best for us to do.

thank you

[pol61]

Hi,

Sorry to hear you're Dad is struggling.

I personally find the Fortisip drinks to be a godsend for my mum, and Ensure, which is a kind of milkshake drink, our GP prescribes 28 at a time. PLEASE don't ration them, if your dad can drink them - they have all the nutrients he needs. Call his GP and order some more for him. Tell the GP he isn't eating anything.

I hope this helps.

Good luck.

Polly

[J_T]

Hi Stanley, sorry to hear about your dad. I'm not a doctor but would say dizziness is due to his low blood pressure.

Definitely get on to his GP re thd Fortisips, we were given two bags full, though they are not often used as Ray's appetite is not too bad.

Have you contacted Macmillan? They are excellent at pain control and supporting both your dad AND your mum. They can offer loads of help and advice.

Julia

[Jwilson]

Stanley, hi. My husband was like this last weekend and ended up in hospital. Blood pressure fell through the floor all due to dehydration. He could not string a sentence together. Your dad needs to drink and drink even if its constant cups of tea. I could not believe what dehydration could cause. If he is very bad two days in hospital on a fluid drip is not that bad.....the difference it made to Bill was amazing plus they checked his vitals every half hour and would not let him go until they were happy. Ring someone in case he gets worse.

June

[PCUK Nurse Dianne]

Hi Stanley,

Sorry to hear about our dear old father. This is such a difficult disease at any time, and certainly sympathy to your parents. Great information included, and I will be brief on this forum, but you may wish to email (support@pancreaticcancer.org.uk) or phone the support line tomorrow (020 3535 7099) and we could discuss this further.

Firstly, if the creon is the largest dose (ie 40,000 units) this may be too much for your father at present, and difficult to swallow as he suggests. We can talk about creon till the end of the earth, there are 2 lower strengths, ie 10,000 and 25,000 units, and these may be more suitable for your father at this point in time until his appetite improves. The trick with food is small amounts frequently, and food that is easy to digest, easy to swallow, does not require a lot of chewing etc. Fortisips should be given in larger prescription, however they can also be given with icecream to make milk shakes if that helps.

The dizzy spells can be related as June has said to dehydration as this can occur quite easily, and especially in the warmer weather. It also may be related to low blood sugar level, especially if your father is not eating well. Also may be related to low haemoglobin, which can occur in patients with cancers, and of course other conditions.

Having the input from a Macmillan nurse would also help, is this the nurse that would have been visiting today? She would be the expert on pain relief and also help with some of the other symptoms. Is your father on any steroids, Dexamethasone is often given to those patients having chemotherapy, and is known to improve the appetite, and also has a 'feel good feeling' when taking it. I appreciate your father is not having chemotherapy, however the steroid may be prescribed for a short term (ie 2 weeks) and see if this helps with the appetite as well.

Dry mouth can be a problem, it would be important to make sure your father does not have oral thrush, this would look like a white coating or little red spots in the back of his mouth and on his tongue, and can be quite painful. Thrush can be treated with an antifunal treatment that is an oral solution called Nystatin. Other remedies for a dry mouth include fizzy drinks ie lucozade, anything with a lemon base as it will often help the salivary glands to produce more saliva, sometimes chewing gum or sucking on boiled lollies may help in the short term. Also consider some of the mouth washes that may also help.

The hospice solution may be your father worrying that he is a 'burden' for your mother, and that may be his way of trying to help her out without actually saying so. If this is something he wants to do, it may be helpful for a short term, so that your mother has a small break and he also may feel better if he has had a short stay with some 'intense hospice input' and then feel back to coming home again.

Stanley, feel free to be in contact as I can most likely give you further support that is too lengthy for the forum.

Kind regards,

Dianne

[stanley]

thank you everyone who replied. my dad collapsed on Friday and was taken to hospital by ambulance with a blood sugar level of around 40! we hoped that getting this reduced would get him back to where he was a couple of weeks ago but despite insulin blood tranfusions saline and glucose other things have taken over and he is slipping away. his blood sugar is down to 8 today but he is now in pain and having pain relief and really isn't with us most of today.

it is horrible to go through this in a hospital ward with 4 other patients some of who know my dad is dying.i want to get him into a hospice, i don't know if we can now. we are back to see the consultant late tomorrow morning. i hate leaving him in the hospital if we was at the hospice i would stay with him. it feels so wrong to leave him there, there is no space or privacy. i feel sorry for the other patients and visitors too, knowing what we are all going through must be hard for them too.

i hope tomorrow we can make arrangements to get him to the hospice...please hope with me x

[J_T]

Stanley, so sorry to hear this and you are right, you should have some privacy, not least of all your dad should have it! Surely, they will put him in a side ward as soon as?

Goodness me, really not on.

Hope you get something sorted for him soon.

Julia x

[Cathy]

Hi Stanley,

I'm so sorry to hear of your Dad.

I do hope they can get something sorted out for him today and that your consultant can give you some reassurance about his care.

Let us know how you get on

Cathy xx

[PCUK Nurse Dianne]

Hi Stanley,

Sorry to hear about your father being so poorly. I wonder if your father was not known to be diabetic prior to this event? It does sound like a bed at the hospice would be more appropriate. Also have you considered looking after your father at home (if that is possible and something that would be agreeable to all) with a care package. If this is something that you and your parents wished to do, this could be arranged hopefully by the ward staff and an emergency discharge package with input from the Palliative Care team as well. It may be worth checking if there is input from the Palliative care team at the hopsital, as they may be able to arrange a hospice bed a little quicker. If you speak to the sister in charge of the ward, she may be able to help you out here.

Regards,

Dianne

Support Team

[LindaH]

Hi Stanley,

My thoughts and prayers are with you, your family and especially your dad.

Linda xx