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Compassionate Care Consulting

Patient Stories

Real patient stories shared with me by patients and the family and friends who support them. These stories show the impact of palliative care on their lives.

Patient Stories | Dr. Holly Ahner | Palliative Care Consulting

Help Talking
with His Family

Within one month of his 68th birthday Mr. A learned he had prostate cancer. Six weeks later, he still has not made any decisions about his next steps.

Read the whole storyThe initial shock of being told he has cancer hasn’t yet worn off and the combination of unfamiliar medical terms, uncertainty over prognosis, and seemingly contradictory information about prostate cancer treatments on the internet and from friends has left him feeling overwhelmed. His wife and daughter think he needed to make a decision weeks ago and are worried that further delays in starting treatment is allowing the cancer to spread. In palliative care consultation, Mr. A was able to start talking with his family about what mattered most for him and to map out a treatment plan that also included support for his family and advance care planning/healthcare power of attorney/living will.

Patient Stories | Dr. Holly Ahner | Palliative Care Consulting

Integrating
Natural Treatment

Ms. B used to be able to say she hasn’t seen a medical doctor since the birth of her youngest child over 30 years ago until she discovered a lump in her left breast. Her doctor is telling her that she is going to need chemotherapy, surgery, and radiation.

Read the whole storyShe has rigorously kept with a vegetarian diet and prefers to use herbs and supplements rather than prescription medications and is considering trying alternative, natural treatment first. In palliative care consultation Ms. B learned how she could use physical activity, nutrition, mind-body practices, and acupuncture to maintain well-being while undergoing cancer treatment.
Patient Stories | Dr. Holly Ahner | Palliative Care Consulting

Choosing Life
Sustaining Treatment

Mr. C was 54 years old when he was diagnosed with ALS (amyotrophic lateral sclerosis). At the time of diagnosis he said he would not want to live with a feeding tube or mechanical ventilation but over the past 6 months he has been having more swallowing and breathing problems.

Read the whole story In palliative care consultation Mr. and Mrs. C revisited the topic of life-sustaining treatments and chose to have a percutaneous gastrostomy tube placed and started using  [non-invasive mechanical ventilation/ BiPAP (bilevel positive pressure mechanical ventilation)/breathing support] at night.  Subsequently, he has been sleeping better and able to use the feeding tube for hydration and has had more energy during the day. He continues to work with palliative care for symptom control (pain, muscle spasms, secretions, communication), nutrition, and to coordinate sources for support for family members.
Patient Stories | Dr. Holly Ahner | Palliative Care Consulting

“Give It One More Try”

Mrs. D has been living with colon cancer for almost 8 years. She now has metastases in her lungs causing shortness of breath and in her liver causing pain. She has had multiple surgeries and chemotherapy regimens.

Read the whole story She is not sure if the burden of more treatment would be worth it, but is reconsidering because she thinks her daughters want her to “give it one more try”.
In palliative care consultation, Mrs. D and her family were able to come to the understanding that the decision to forego treatment is not necessarily choosing death, but rather choosing life without over-burdensome medical treatment.

Choosing Quality of Life

Mr. E has chronic viral hepatitis C. He had been hoping for a liver transplant but has been found to have hepatocellular carcinoma/liver cancer. His fatigue, anorexia, and weight loss have gotten worse and he is starting to need help with bathing and dressing.

Read the whole storyHe spends about half of the day resting in bed. His oncologist and hepatologist have advised him that he is not currently a candidate for anti-cancer treatment because the adverse effects of treatment would be more likely to shorten his life expectancy. Mr. E thinks this is “giving up.” In palliative care consultation, he was able to establish different goals focusing on quality of life with symptom control, support for family members, and home care.
Patient Stories | Dr. Holly Ahner | Palliative Care Consulting
Patient Stories | Dr. Holly Ahner | Palliative Care Consulting

Discussing His Preferences

Mr. F  has severe emphysema and has been hospitalized three times in the last year with breathing problems. This past episode has been the worst so far and lasted over 1 week. The doctors were talking about putting him on a ventilator but his condition started to improve before this was necessary.

Read the whole story
    After 2 weeks of rehab he is back home but must now needs to use oxygen continuously. He is worried about what will happen if he gets sick again. He knows he does not want to die in a hospital on a ventilator but he does not known how to talk to his family about this. In palliative care consultation,  Mr. F and his family were able to discuss his preferences to avoid treatments that would merely keep him alive but with no hope of making him better.

Exploring Treatment Options

Mr. G has had diabetes, hypertension, and chronic kidney disease for many years. On his most recent lab tests his kidney function was nearing the point where hemodialysis might be necessary and Mr. G is considering starting hemodialysis but he does not want to put his family in the position where “they are going to have to pull the plug on me.”

Read the whole story
    In palliative care consultation, Mr. G and his surrogate/MPOA/family were able to explore a range of treatment options including hemodialysis, to discuss what is and is not an acceptable quality of life, and to complete advance care planning documents to direct surrogate/family/MPOA in making medical decisions for him should he be unable to make decisions for himself.
Patient Stories | Dr. Holly Ahner | Palliative Care Consulting
Patient Stories | Dr. Holly Ahner | Palliative Care Consulting

Bridging the Hospice Care Gap

Mrs. H  has Alzheimer’s disease but no other major heart, lung, kidney, liver, or vascular disease. She is able to transfer from bed to wheelchair without assistance and but able to walk only about 10 feet with a 2-wheeled walker. Her appetite is fair and although she is under-weight her weight has been stable over the past 6 months.

Read the whole story She was hospitalized once in the past 2 years, briefly for an uncomplicated urinary tract infection. She needs help with bathing, dressing, and toileting because of frailty and limited range of motion in her shoulders because of osteoarthritis. She lives with her daughter who describes her as “pleasantly confused”: Mrs. H is talkative and loves to look at her photo albums and tell stories about the pictures. Her primary care doctor referred for home hospice services but she was not accepted because she did not meet criteria for having a life expectancy of less than 6 months. A palliative care consult helped bridge the gap between usual care and hospice care.

Palliative Care Consult

Palliative care consultation can bridge the gap between usual care and hospice care when patients do not meet criteria for hospice, or when patients are eligible for hospice but not ready to stop treatments that are prolonging survival, such as artificial nutrition, mechanical ventilation, or hemodialysis.

Patient Stories | Dr. Holly Ahner | Palliative Care Consulting

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We like to think that we will always be healthy and able to make decisions for ourselves, but one minute you are a normal person with normal problems and the next you are a person with a serious illness.

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