Yesterday and today have found Mr Kidlung much improved, to the extent that a hip operation might be back on the table.
By Sunday his calcium levels were down to 2.7, where the desired maximum is 2.6. On admission a few days before they had been 4. This was reflected in his much peppier manner. He’s scooting around on crutches again, chatting away and reckons his mental clarity is back to what it was a month ago.
Treatment for the calcium levels is now complete and he feels fit to come home. However, this may take a few days. He’s still waiting for the removal of his lung drain, as that no longer seems to function. After that, it will depend in large part on overcoming the inertia of the hospital system: getting signed off by a doctor, getting a physiotherapist visit to actually happen or be deemed non-critical before discharge, etc.
One of Mr Bishay’s (the hip surgeon) henchmen came round today, making bullish noises about possibly getting him in for the hip op Thursday next week. This surprised me, as I had assumed that door of opportunity had closed. He does, however, seem just as healthy now as he has been when initially scheduled for the operation and it would both enormously improve his quality of life and take away a serious risk of breakage. The load-bearing part of the bone at the top of the right femur is apparently very heavily eroded by the cancer (a 4-5cm hole) – it was emphasised to him today how he should be extremely careful even when moving from lying to sitting. If it were to break then, as the orthopaedic registrar pointed out, they’d have to emergency operate anyway… and in conditions of considerably more pain and stress. So we’re rooting for the op asap!
The Palliative Care team at the hospital have been to visit and they focus on quality of life rather than life extension. The Occupational Therapist from the team (basically a consultant on how to handle the practicalities of life) visited him today. She was good at listening and focusing on what mattered to him, though she didn’t need to say much to us as practicalities are a strong family suit.
The palliative team have also put in place a referral to our local Dorothy House hospice; they have community nurses who can visit us at home and give all manner of advice and support. The palliative people are also experts in pain management and have put him on something sophisticated called Gabapentin, in addition to the Codeine the oncologist upgraded him to. We don’t know whether it’s because of the lowered calcium levels or the new pain meds but he’s reporting substantially less pain than recent weeks.
Hopefully, he’ll be home in a few days. We’ve decided to splash out on a stair lift (a complicated proposition in an old house where corners are never ninety degrees), because the odds are it will come in useful for him at some point later even if the hip op does go ahead.