Hi guys,
So long story short - my mom has triple negative breast cancer and it has escalated to the point where in the last week she hasn’t been eating nor passing stool. After trying multiple laxative measures at home we took her to the ER Friday and by Saturday morning it was clear she has some kind of inflammation-based blockage preventing passing of stool, but also resulting in gut bacteria spreading in her body which resulted in sepsis. Her blood pressure was very low and continued to worsen and is currently stabilized in the ICU by drugs.
She is on IV drip of:
12 mL/hr of vasopressin
5 mL/hr sodium chloride
9 mcg/min NORepinephrine
Vancomycin HCI antibiotic
And fluids/electrolytes for hydration
Over the first half of Saturday she continued to require higher and higher doses of the drugs just to maintain her blood pressure, but the rate of deterioration made it clear that shortly we will reach max allowable dosage before it cannot be increased without damage to hurt body. Which meant we were hours away from switching her to comfort measures and watching her pass away.
However, mid-day Saturday she stabilized and stopped requiring additional dosages, she’s hovering at the above levels now for about 24 hours without any changes.
While we still think prayers are what she needs the most, I also figure we have some unexpected time with her and therefore time to think and consider any other alternatives.
I reached out to Gaby who kindly provided the following considerations which we forwarded to her Oncologist and will soon stress to the “by the book” ICU staff to try:
Vitamin C and Thiamine for Sepsis and Septic Shock - PubMed
Combined Treatment With Hydrocortisone, Vitamin C, and Thiamine for Sepsis and Septic Shock: A Randomized Controlled Trial - PubMed
Effect of Vitamin C, Hydrocortisone, and Thiamine vs Hydrocortisone Alone on Time Alive and Free of Vasopressor Support Among Patients With Septic Shock: The VITAMINS Randomized Clinical Trial - PubMed
Hydrocortisone, Vitamin C, and Thiamine for the Treatment of Severe Sepsis and Septic Shock: A Retrospective Before-After Study - PubMed
There is a possibility of surgery to investigate the cause of the blockage and to maybe alleviate it if at all possible, but she’s not in a condition to survive this in her current state and we are all staying away from that if she doesn’t improve. If the combination of antibiotics and hopefully soon to be administered protocol of Vit C, thiamine, and hydrocortisone can bring her infection down and allow her body to get control over its blood pressure, we will reconsider other more invasive options.
However, I just wanted to throw this out there to see if anyone has any other ideas as well. At this point if it won’t hurt her, we are willing to try anything (if we can convince the ICU docs to cooperate). I know it’s a Hail Mary and there may be nothing else, but I am just pulling out all stops. This is our mom and the least we can do is try everything we can as long as she gives us the time/opportunity to do so and is willing to fight.
If she makes the decision to depart this world, well we are at peace with her choice in either case. But if she’s giving us indication that she’s still going to try, we will do everything to try along with her.
She also currently has tons of cancerous fluid (acsites) build up in her stomach and edema in her legs that we had drained once every 3 weeks or so over the last few months, but for now we are also abstaining based on the recommendations of her ICU docs to let antibiotics have a chance to work.
So if anyone has any other ideas, please let me know! Me, my brother, and my dad are with her every step of the way, but other than giving her plenty of love and kisses and support, we’re not sure what else we can do.
So long story short - my mom has triple negative breast cancer and it has escalated to the point where in the last week she hasn’t been eating nor passing stool. After trying multiple laxative measures at home we took her to the ER Friday and by Saturday morning it was clear she has some kind of inflammation-based blockage preventing passing of stool, but also resulting in gut bacteria spreading in her body which resulted in sepsis. Her blood pressure was very low and continued to worsen and is currently stabilized in the ICU by drugs.
She is on IV drip of:
12 mL/hr of vasopressin
5 mL/hr sodium chloride
9 mcg/min NORepinephrine
Vancomycin HCI antibiotic
And fluids/electrolytes for hydration
Over the first half of Saturday she continued to require higher and higher doses of the drugs just to maintain her blood pressure, but the rate of deterioration made it clear that shortly we will reach max allowable dosage before it cannot be increased without damage to hurt body. Which meant we were hours away from switching her to comfort measures and watching her pass away.
However, mid-day Saturday she stabilized and stopped requiring additional dosages, she’s hovering at the above levels now for about 24 hours without any changes.
While we still think prayers are what she needs the most, I also figure we have some unexpected time with her and therefore time to think and consider any other alternatives.
I reached out to Gaby who kindly provided the following considerations which we forwarded to her Oncologist and will soon stress to the “by the book” ICU staff to try:
Vitamin C and Thiamine for Sepsis and Septic Shock - PubMed
Combined Treatment With Hydrocortisone, Vitamin C, and Thiamine for Sepsis and Septic Shock: A Randomized Controlled Trial - PubMed
Effect of Vitamin C, Hydrocortisone, and Thiamine vs Hydrocortisone Alone on Time Alive and Free of Vasopressor Support Among Patients With Septic Shock: The VITAMINS Randomized Clinical Trial - PubMed
Hydrocortisone, Vitamin C, and Thiamine for the Treatment of Severe Sepsis and Septic Shock: A Retrospective Before-After Study - PubMed
There is a possibility of surgery to investigate the cause of the blockage and to maybe alleviate it if at all possible, but she’s not in a condition to survive this in her current state and we are all staying away from that if she doesn’t improve. If the combination of antibiotics and hopefully soon to be administered protocol of Vit C, thiamine, and hydrocortisone can bring her infection down and allow her body to get control over its blood pressure, we will reconsider other more invasive options.
However, I just wanted to throw this out there to see if anyone has any other ideas as well. At this point if it won’t hurt her, we are willing to try anything (if we can convince the ICU docs to cooperate). I know it’s a Hail Mary and there may be nothing else, but I am just pulling out all stops. This is our mom and the least we can do is try everything we can as long as she gives us the time/opportunity to do so and is willing to fight.
If she makes the decision to depart this world, well we are at peace with her choice in either case. But if she’s giving us indication that she’s still going to try, we will do everything to try along with her.
She also currently has tons of cancerous fluid (acsites) build up in her stomach and edema in her legs that we had drained once every 3 weeks or so over the last few months, but for now we are also abstaining based on the recommendations of her ICU docs to let antibiotics have a chance to work.
So if anyone has any other ideas, please let me know! Me, my brother, and my dad are with her every step of the way, but other than giving her plenty of love and kisses and support, we’re not sure what else we can do.
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