Another update on my sister (and medical questions)

[JudyJudyJudy]

Thanks for all the thoughts on the other thread.

Things aren't looking good. The doctors are saying that she needs a biopsy. An oncologist came by to see her today, but he doesn't feel comfortable doing the biopsy (this is a small hospital), so they want to transfer her to Medical Center in Macon. However, all of my family is opposed to her going there because a lot of people we know who have gone there have gotten staph, so we have to decide on somewhere else.

Here's my question, though. The pneumonia doesn't seem to be any better. She's still struggling to breathe, so it scares the hell out of me to think about her having a biopsy. Would they do the biopsy when she is still in this condition, or would they work to get the pneumonia cleared up first? I'm scared.

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Update (http://www.breastfeeding.com/forums/showthread.php?p=618748#post618748)

[Amy_G_]

I'm hoping I'm wrong.
But there is a form of lung cancer that causes the lungs to fill with fluid like pneumonia. they drain the fluid and do a biopsy of the tissue and then they can tell.

[JudyJudyJudy]

Does it cause fever?

[JudyJudyJudy]

I just googled and found that it can. :( My sister finally admitted that she has been coughing up blood.

[Amy_G_]

I don't know. My neighbor died from this in June, but she was an OLD woman, and I'm trying to remember what the doctor told me. I was there with Hospice nurses and doctors until her family could arrive.

Basically instead of a mass of cancer, the cancer was very small mass, in the lining of the lung, similar to mesothelioma, but not that. Because it was small mass, it did not show as a mass in the lung on ct, mri, xrays.

The cancerous cells start to leak fluid which causes the pneumonia. Once there is pneumonia, the fluid may become infected, which could give a temperature. And often the body when fighting to breath will have a raised temperature.

Most likely something showed on the xray in her lungs, and they are afraid that until it's resolved, she may continue to have fluid in her lungs.

[Amy_G_]

Diagnosis

Performing a chest x-ray is the first step if a patient reports symptoms that may be suggestive of lung cancer. This may reveal an obvious mass, widening of the mediastinum (suggestive of spread to lymph nodes there), atelectasis (collapse), consolidation (pneumonia), or pleural effusion. If there are no x-ray findings but the suspicion is high (such as a heavy smoker with blood-stained sputum), bronchoscopy and/or a CT scan may provide the necessary information. Bronchoscopy or CT-guided biopsy is often used to identify the tumor type.

Let's hope it's something in this paragraph:
The differential diagnosis for patients who present with abnormalities on chest x-ray includes lung cancer as well as nonmalignant diseases. These include infectious causes such as tuberculosis or pneumonia, or inflammatory conditions such as sarcoidosis. These diseases can result in mediastinal lymphadenopathy or lung nodules, and sometimes mimic lung cancers.Lung cancer can also be an incidental finding: a solitary pulmonary nodule (also called a coin lesion) on a chest x-ray or CT scan taken for an unrelated reason.

[JudyJudyJudy]

Thanks, CM and Amy.

I'm also hoping it's something else, but since she is a heavy smoker, I've always feared this. Several people in my family, including me, have positive TB tests, so it's bad that I was almost hoping for that.

[Amy_G_]

yeah this seriously sucks Judy.
I don't think I can type anything that conveys what I'm thinking right now.

[Amy_G_]

:(

[Amy_G_]

So, to do what you can,
what is the closest hospital that your family would want to take her to?
If it's a good hospital for lung issues, (except for the staph problem)
then consider she should go there.
You don't want her too far from home if she gets a horrible diagnosis.
:(

[madelsmama]

If they're considering surgical biopsy, I believe that they'd have to stabalize her before taking her to surgery, even bronchoscopy.

If they're considering a thoracentesis, where fluid is drained from the lungs, I've seen this done at the bedside even when breathing is difficult.

[JudyJudyJudy]

Amy, I'm truly afraid of that hospital. Two of my cousins and my great-niece as well as extended family and friends have gotten staph there. We're talking about another hospital in that area, though.

Cheryl, thanks so much for that information.

[Amy_G_]

they called it a biopsy, and they also called it "draining fluid" for my neighbor Suzanne to ease her breathing from the pneumonia.
They discovered the cancer cells in the fluid upon inspection. She was 79 and refused any treatment.

[Amy_G_]

A reasonably good hospital is close by? Can you find out a reasonably good pulmonary? doctor that has priveleges at that hospital?

[JudyJudyJudy]

Amy, to be quite honest, I'd feel better if she came to a hospital in Atlanta. It would also be a lot closer for me, but it would be a lot further for most others. Even in Atlanta, though, I don't know how to pick a good doctor. I might be able to talk the family into it if I knew one.

My sister will be 50 on February 10th. She has two sons, ages 17 and 19.

[foxinsocks]

I would go to the bigger hospital to get the medical advice of the oncologists that are there.

While the staph is a risk, the risks of having it untreated because of being in a smaller hospital are greater, I think. The bigger hospital will have more resources to treat your sister.

I hope she is OK.

[JudyJudyJudy]

The family was finally able to talk to the doctor this morning. The issue is that there is not a pulmonary specialist in the hospital she's in now, which is why they're moving her to Macon. My sister, like the rest of the family, doesn't want to risk the staph hospital, but both the pulmonologist and oncologist go to both hospitals. I'd still feel better if they'd take her to Atlanta, but that's not my call, especially since she has no insurance.

My sister asked my nephews to clean her house. She said she doesn't want to die with her house in a mess. :( She has felt bad for so long that she hasn't felt like keeping her house in order.

[JudyJudyJudy]

It's time for me to start, and I'm not handling this well.

[Tiffers]

I'm sorry to hear your sister isn't doing well. I don't have any advice or info, but I hope she turns it around soon. You'll all be in my thoughts and prayers.

[Amy_G_]

Judy,
I'll ask you straight up,
can I paypal you some money to help pay for a house cleaner for your sister's house?
I don't have much extra $, but if a clean house is what she thinks she needs, whether she lives or dies she needs a clean house.
with your environmental allergies it is too much for you to do right now,
it's something I could do to help.

[JudyJudyJudy]

Amy, that's very sweet of you. Her boys are supposed to be doing it. Of course, one of these boys is the one who had a heart attack last weekend. We'll see how this goes.

My car is still torn up, so I haven't been able to go down yet. Depending on dh's work schedule, we're going down tomorrow or Monday.

[Amy_G_]

Go today with a friend,
or go tomorrow.
You need to see her.
can I send you money for cab fare?

[Amy_G_]

knowing teenaged boys, see if you can get someone else in the friends or family group to check uo on them and the house.

[JudyJudyJudy]

Thanks, Amy. I'm almost four hours away, though.

Another sister is supposed to be checking on the boys. Maybe they can at least get the "junk" cleaned up, so then all that will be left is routine cleaning.

[Amy_G_]

Don't wait too long to visit her.
If she isn't transferred soon for more testing, she's going to be even more exhausted trying to sleep in a hospital, which may make her feel worse and then she might not want visitors.
I'm hoping she gets her testing done soon, because the wondering and worry is just too much to bear for her and you.

[Tweet]

I'm so sorry,Judy..I want everything to be ok so badly for you all. You'rein my thoughts.

[Amy_G_]

If you know she's not been doing well for a long while, you should go see her ASAP.

[MoonBound]

You and yours are in my thoughts and prayers. Hope you get good news.

[JudyJudyJudy]

Thanks for the thoughts.

She can't breathe through her nose, so they're having to put the oxygen over her entire mouth, which bugs her when she tries to sleep. They gave her an Ativan last night to help her rest, but it did make her more depressed today. (I'm sure she'd be depressed regardless.) My other sister said that she seems a little stronger today, and her color looks better. Her temp was down to something like 99.2. This morning she even ate a little and was asking her husband (the jackass who is now kissing her ass) to bring her something to eat when he comes tonight.

Dh, ds, and I are going down tomorrow.

[MiMi_of_4]

Judy, I'm so sorry. And I'm really sorry I've not yet commented on any of these threads, but I'm having a hard time finding words to say what I'm feeling. Just know you've been in my thoughts the past few days ~ I know this hasn't been easy for you and I'm afraid it's not going to get any easier. I'm glad you, Jacob and your DH are going to be able to go see her tomorrow. And although she is very, very sick, I'm hoping for the best.

[Laurens_Mom]

My thoughts and prayers are with all of you!

[Wolverine]

I'm sorry, Judy.

[cc1003]

How are you Judy?

[ColleenF30]

Judy I am so sorry. How are you doing?

[JudyJudyJudy]

Thanks for the kind thoughts.

I'm hanging in there. Honestly, I'm worried sick, though.

I'm very frustrated as well. I think we're being lied to. For starters, my sister and our family were told that there are no pulmonologists that go to the hospital where my sister is. I now have proof otherwise. Then the hospital people claimed that two of the hospitals in Macon have accepted my sister but that they're both full. I think they're full of shit. I think no one wants to take her because she has no insurance. What can we do?

[cc1003]

Thanks for the kind thoughts.

I'm hanging in there. Honestly, I'm worried sick, though.

I'm very frustrated as well. I think we're being lied to. For starters, my sister and our family were told that there are no pulmonologists that go to the hospital where my sister is. I now have proof otherwise. Then the hospital people claimed that two of the hospitals in Macon have accepted my sister but that they're both full. I think they're full of shit. I think no one wants to take her because she has no insurance. What can we do?

How far are the hospitals from where she is?

I would go the where she is, pick her up, and drive her there myself. They CANNOT turn her away. This is infuriating. If I were there, I would do it for you. You need to DEMAND that she go there and if need be, threaten legal action.

[JudyJudyJudy]

cc, she's still in ICU. I'm afraid it would be dangerous for her not to go by ambulance. The hospitals in Macon are about an hour away, and the ones in Atlanta (where I prefer) are closer to three hours away.

The thing is that when people say that hospitals can't turn someone away, it is correct that emergency rooms can't turn people away. However, specialists don't have to accept them as patients.

[cc1003]

cc, she's still in ICU. I'm afraid it would be dangerous for her not to go by ambulance. The hospitals in Macon are about an hour away, and the ones in Atlanta (where I prefer) are closer to three hours away.

The thing is that when people say that hospitals can't turn someone away, it is correct that emergency rooms can't turn people away. However, specialists don't have to accept them as patients.


I know, that's why I was hoping that she was pretty close so that you (or someone) could drive her to the er. Can y'all get some oxygen to bring along? This is so frustrating.

[JudyJudyJudy]

cc, I'm beyond frustrated and worried. I don't know what to do that would be safe. I really need to quit looking at hospital ratings, though; it is stressing me the hell out. I've been looking at the HealthGrades website, and the one she is currently in is rated poor for pneumonia in Inhospital Mortality (Survival) and Inhospital +1 Month Mortality (Recovery +30). Worse, yet, the Medical Center (the one I call the staph hospital) is rated poor in Inhospital Mortality (Survival), Inhospital +1 Month Mortality (Recovery +30), and Inhospital +6 Month Mortality (Recovery +180).

[cc1003]

Oh gosh. I'm sorry you're dealing with this.

[Amy_G_]

Judy you have to remember that if it's a poor area of town/city/state, mortality may have little to do with quality of care, and more to do with people coming in without having basic medical care/treatment due to lack of insurance and money, until they have reached the point, like your sister, where they are in extremely dangerous condition. If a person goes without preventative care and ignores symptoms for long enough, and then goes to the hospital, you can't expect the hospital to save them. Of course, you'll think if something bad happens, "if only we'd taken them to the better hospital." At this point, she needs the services of a hospital, pulmonologist and oncologist that will accept her without medical insurance. Can she qualify for ANY state aid?

[JudyJudyJudy]

Amy, I seriously doubt she'd qualify for any state aid. Her family is in that category that makes too much for help but doesn't make enough to cover the family for private policy health insurance.

[foxinsocks]

My hospital is non profit and offers free care for those who make too much for state aid but don't have medical insurance, in some cases. Its worth looking into.

My thoughts are with you and your family.

[nikkifaith]

I am so sorry, judy.

[PiccoloRose]

I'm so sorry, Judy.

[MiMi_of_4]

checking for an update after your visit...

[Bellaelle]

I am so sorry, Judy. )=
County health departments are great resources for help.
I found this for Georgia.

http://health.state.ga.us/programs/cancer/index.asp

They have programs to help those who cannot afford treatments etc.

[Bellaelle]

Found this:
http://www.georgiacancer.org/treat-aid.php

[Bellaelle]

another site:

http://www.communityconnection211.com/211.htm

[Sameach]

Judy, I'm thinking about you this morning.

[MiMi_of_4]

So am I. I'm working today, but I'll check in later. (((((Judy)))))

[_MrsC_]

Thinking of you...

[MoonBound]

Me too... hope you are okay.

[RedMamaBear]

O, Judy, what a nightmare for you and your family. I'm so sorry!! **BEAR SNUGS!** Please keep us updated and know that we're thinking about you.

[3girls2luv]

I'm so sorry you and your family are dealing with this. You are in my prayers.

[_Gypsy_]

I'm sorry Judy :(

[Bellaelle]

Waiting for an update. I pray all is well. )=

[MiMi_of_4]

Judy, please let us know how your sister AND you are doing. (((((Judy)))))