8 Sep

Dad had his CT scan and blood tests done on 3 Sep, and oncologist added an ultra-sound scan on his left arm to check for any vein blockage that may be causing the water retention/swelling.

We went back for his regular follow-up at NCC on 8 Sep. The atmosphere was kind of solemn. I dunno why, but just didn't feel good. Usually the registrar will see us and then check with the senior oncologist if there's need for additional medication or not. But this round, the senior oncologist saw us himself.

I think I ever grumbled about this senior oncologist not very willing to talk to family members, preferring to talk to patient directly. But this round, he spoke quite a bit with me. And unlike the usual where he'll pull out the CT scans onscreen and compare with the previous scans, he didn't this time. This really make me feel very uneasy.

Anyway, he asked about the side effects Dad got from Tarceva again. And explained that they really didn't expect Dad to react so badly to it. Most patients had little or zero side effects and the drug helped eliminate most of the symptoms for them. He asked Dad if he would want to try it one more time, but Dad rejected flatly. Guess he's totally shakened by the experience and wouldn't want to go thru it again. He disclosed that the recent blood tests also showed that Dad's kidney function is weakening and that could also be a possible reason why Dad reacted so badly to Tarceva. This made me recall why the polyclinic doctor always emphasized that Dad has to maintain very good glucose readings so that his kidneys will not weaken. Hmm...

The senior oncologist said that with Dad's kidney condition, they will not be able to put him on other chemo drugs, oral or intravenous. So the only thing they could do for him will be palliative care already. He will refer Dad's case to the Hospice Home Care service and their nurses and doctors will visit on a regular basis to determine what drugs to prescribe to treat whatever symptoms Dad may have going forward. He'll see Dad again in Nov for follow up, but there's no CT scan required anymore.

What is hospice and palliative care?

Hospice and palliative care is a holistic approach that cares for patients going through the last stages of their lives. It aims to meet all needs - physical, emotional, psychosocial and spiritual, in order to alleviate suffering and maximise quality of life for patients and their loved ones. Staff and volunteers work in multi-professional teams to enable patients to live fully and provide support to these patients and their families.

Palliative care is a form of specialized care that focuses on pain relief and pain management for pain caused by illnesses or treatments. Such care is provided in both hospitals and hospices. Hospice care focuses on the emotional, mental and spiritual wellbeing of the patient on top of the physical wellbeing. It includes services that not only cater to the individual patient, but also facilitate bonding between patients, friends,
families and volunteers. Hospices function on the belief that each individual should have a pain-free and dignified death, and that the family of the dying should have support during this difficult period.

Hospice and palliative care is not restricted to any one type of life-limiting illness. Although cancer is the most common ailment of patients receiving hospice and palliative care, a patient with any condition that is terminal and life limiting can be cared for properly under hospice and palliative care. An important point to note about hospice and palliative care is that it is generally provided for patients who have been diagnosed as having just months to live, and not years.

When I explain to Dad about the Home Care arrangements, he seemed to understand what that all means. He seemed calm, and resigned. Felt so lost. sigh...