Angry, exhausted, and looking for realistic answers - GBMIV caregiver

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Angry, exhausted, and looking for realistic answers - GBMIV caregiver

by techieChickVa on Wed Oct 28, 2009 03:41 AM

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My mother-in-law was diagnosed in February of this year with an inoperable GBM, stage IV.  She is 60 years old, and is also an insulin dependent diabetic, has advanced COPD, and advanced heart disease.  My husband and I drive four hours each way every weekend to provide my father-in-law with respite care, as the medical bills have left him unable to hire in-home care.  

 

Before I get into this details, let me preface.  I have always thought the world of my mother-in-law.  We have had a wonderful relationship, and have enjoyed many happy times together.  My husband as well, has been very grateful for her presence in both his own and his father's life, as she brought laughter into their home after his mother's very sudden and tragic death when he was teenager.  

 

Since my MIL was diagnosed, she rapidly ceased to be the person that I knew.  The tumor is located in her brain in such  place that it primarily affects her short term memory.  Until this experience I had no idea how much of our indivdual personalities are defined by our most recent experiences.  Most of our visits revolve around what my husband and I have come to call the "litany of the dead".  She gets stuck in the round of questions of who in her family is alive, and who is dead.  This can go on for hours, with the same 20 family members, and attempts to kindly lead her in a different direction are almost always redirected back into the loop.  She doesn't know what day it is, how old she is, where she is (living in the house she's been in for 20 years), she's forgotten my father-in-law and the loving relationship that they have had for these last 20 years and is thrown back into the fear and anxiety that she experienced in her abusive first marriage.  She doesn't sleep at night because she doesn't know whether its nighttime or daytime, and her addiction to cigarrettes compels her to chain smoke as she forgets as soon as one cigarrette is out that she has just had one.  She no longer can cook or sew - two things she dearly loved to do.  She can't do crafts because she can no longer follow simple directions.  In short, she seems to be simply a shell of a person, existing completely and totally in her confusing and terrifying present.  

 

She has had radiation treatments, as much as she can safely be given.  She has been on chemotherapy for 8 months.  We have prepared ourselves for the inevitable end that we have been told by doctors since the beginning would be coming.  My father-in-law has aged 10 years in the past 8 months, and his health is declining from lack of sleep.  My husband and I have put both our careers, hobbies, and other obligations on hold - all the things that make our daily lives enjoyable - and are burned out to the point of exhaustion.  She has been slowly, but progessively declining, all the while trapped in a mind that no longer functions correctly.  I am horrified at myself, because I find myself just wishing it would all end.  

 

We have had no hope throughout this process that she would recover.  The rounds of chemo were simply hoping that she would regain enough of her memory to be able to have SOME quality of life, rather than existing at the whim of her base emotions.  My father-in-law continues chemo against the wishes of her son - an EMT and firefighter - simply because he can't bear to be the one that decides to stop treatment.  Now suddenly, there has been a slight improvement in her memory, although her motor skills have declined and her body's ability to regulate its blood sugar levels - even with insulin - seems to have become wildly unreliable.  Has anyone heard of a GBM, stage 4, inoperable patient, suddenly getting better after 8 months of failed treatment?  Are we looking at a possible remission?  If she does regain her short-term memory, are the memories that she had previously - of her family, of her loving second marriage to my father-in-law, of the weddings and births and happiness - lost completely?  I am fearful that this slight upswing is just a delay of the inevitable... another drain on the already strained resources that my father-in-law has as well as on his own fragile psyche, and more importantly prolonged torture of my mother-in-law.  What have people experienced in the end stages?  How have people coped with the feelings of frustrations and impotence associated with prolonged caregiving?  

 

Thank you all so much for the opportunity to vent, and for any responses you may have.

RE: Angry, exhausted, and looking for realistic answers - GBMIV caregiver

by moms_caregiver on Wed Oct 28, 2009 04:44 AM

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I totally understand what you are going through. My mother also had her tumor in the right temporal lobe. This primarily affects short term memory.  My mother went through many mood swings, especially w/ my father. She honestly believed for some time he was trying to kill her. She thought he was having an affair w/our neighbor. Believe me, he loved her so much, there was no truth to any of this. Luckily I live 6 houses over and he would call me whenever he needed me. She also had a very hard time believing that she was living in her own house, in which she lived almost 40 years. She questioned it so many times, and kept begging me to take her to the other house. I would tell her that this was her house and reminded her that where was where I grew up, and she would look at me like I was lying. She finally stopped asking because she knew what we would answer. I also think her Doc finally changed her meds and she got better.

I understand your frustration of hoping for it to end, although I never felt this, because she was my mom. I think if it was anybody else, I would have felt the same way.

I was my mother's primary caregiver, except at night. There was a new challenge everyday. We strived for the day that she would get better so we could have some time to just enjoy her. Unfortunately, she really never got better. My mother was 76. I hope your MIL's age will help and hopefully she does get better, at least so you can share some priceless time w/her. I wiil say this, my mother never stopped loving any of us, not even my dad. She would pray to get better, not for herself, but for her kids. I'm so sorry for all you are going through, you will be blessed. I totally understand what you are going through. I just wish I had more answers. Wishing you all the best, Maria

Lost mother to GBM 10/26/08. Survived 8 months after surgery.

RE: Angry, exhausted, and looking for realistic answers - GBMIV caregiver

by Dstew on Wed Oct 28, 2009 04:52 AM

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I believe that each case is so specific that I cannot answer the specific questions as to what may or may not happen with regards to your MIL.

The end stages:  A little over three weeks ago, I get a phone call to get to my home as my father's vitals are weak and he may only have days if not hours.  We say our fond farewell and then it turns out he was just severely dehydrated.   But the stress of that and caring for him for over a year, to the hospice as the entire right side of his body is functionally useless.  Cognitively, close to 100%.

Then on Wednesday, two days after talking about the environment and cancer and quality of life and ... he has a major seizure and a blood clot.  Hours to live we are told. 

He recovered but then got abusive and agitated to the point he is now heavily sedated and only taking water.  He went from talking to some difficulty to one word sentences in one day.    We have stopped the steroids as they are now only prolonging the inevitable.  My dad is aware of his limitations and felt "trapped by his own body" - a guy who is 70 but was active 275 days a year with biking and golf and ...

 

The only thing that has kept my sanity is going to a therapist to advice on how to deal.  That advice is accept you are powerless to do anything about the inevitable and live in the moment.   You cannot shrink the tumor or decide when or how your MIL will pass but you can be there for her and her husband and be positive and give support.  Today was the first day it really, really hit him that even if my dad bounces back for the fourth time that we are not going to be able to talk politics and philosophy and share a laugh so how I dealt with leave work early, cry in my car the entire way home and then have a nap and go for a run.  I then went back to the hospice to spend some time with my dad and mom and I remembed what a good golf buddy he was.  Day by day, hour by hour. 

RE: Angry, exhausted, and looking for realistic answers - GBMIV caregiver

by heart_and_soul on Wed Oct 28, 2009 05:32 AM

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Truly, it is just a living nightmare. My deep empathies.

One idea: drugs. There may be something that can be given to help terribly abusive people. They are miserable too, and some anti-depressants and anti-psychotics can turn things around. Don't be afraid to tell the doctor how bad it is.

Sarah

mother of Andy 27 dx gbm/pnet 1/09

RE: Angry, exhausted, and looking for realistic answers - GBMIV caregiver

by angelface on Wed Oct 28, 2009 08:12 AM

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On Oct 28, 2009 4:52 AM Dstew wrote:

I believe that each case is so specific that I cannot answer the specific questions as to what may or may not happen with regards to your MIL.

The end stages:  A little over three weeks ago, I get a phone call to get to my home as my father's vitals are weak and he may only have days if not hours.  We say our fond farewell and then it turns out he was just severely dehydrated.   But the stress of that and caring for him for over a year, to the hospice as the entire right side of his body is functionally useless.  Cognitively, close to 100%.

Then on Wednesday, two days after talking about the environment and cancer and quality of life and ... he has a major seizure and a blood clot.  Hours to live we are told. 

He recovered but then got abusive and agitated to the point he is now heavily sedated and only taking water.  He went from talking to some difficulty to one word sentences in one day.    We have stopped the steroids as they are now only prolonging the inevitable.  My dad is aware of his limitations and felt "trapped by his own body" - a guy who is 70 but was active 275 days a year with biking and golf and ...

 

The only thing that has kept my sanity is going to a therapist to advice on how to deal.  That advice is accept you are powerless to do anything about the inevitable and live in the moment.   You cannot shrink the tumor or decide when or how your MIL will pass but you can be there for her and her husband and be positive and give support.  Today was the first day it really, really hit him that even if my dad bounces back for the fourth time that we are not going to be able to talk politics and philosophy and share a laugh so how I dealt with leave work early, cry in my car the entire way home and then have a nap and go for a run.  I then went back to the hospice to spend some time with my dad and mom and I remembed what a good golf buddy he was.  Day by day, hour by hour. 

I do now what you are saying I posted a message yester day Small cell lung cancer and liver mets.

my husband is in end stages and he is doing most of the same things you talk about he is up and down like a yoyo.

I also have been told that he has days to go and then he just keeps comeing back and then i think is this in my mind is this realy happerning from day to day i dont no what to tell people.

the drs have told us now 4 to 5 times thay do not think bill has long may be a few days but bill proves them wrong every time. my heart in in my mouth not nowing how this will end but i do no bill who i love dearley is hanging on he has no pain and i am happy for god to take his time.

   love and blessing to all          Suzette

RE: Angry, exhausted, and looking for realistic answers - GBMIV caregiver

by pegblau on Wed Oct 28, 2009 12:10 PM

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My husband and I were in the process of separating when he was diagnosed with an inoperable GBM July'09. I made the choice to stay with him and support and take care of him until the end. He is currently getting Avastin (he has had 3 infusions to date) and seems only to be getting worse. I have essentially put my life on hold to take care of this man who shows little appreciation. His daughter (from a previous marriage) and I are not on speaking terms despite my efforts to overcome our issues for the sake of her dying father. She contributes virtually nothing to help with his care. I have heard through the grapevine that she is critical of the fact that I don't do enough, I control his money, etc. all very negative stuff. The rest of his family have conveniently dropped off the face of the earth, leaving me holding the bag. It is truly a nightmare to watch the progression of this disease. Like dementia or alzheimers, the caregivers suffer more than the patient since we are acutely aware of what is happening. I have terrible guilt feelings about wanting this to end sooner than later. I believe these Avastin treatments are not working. Actually my husband seems worse as a result of the treatments. Is there someone who has had a similar experience with Avastin? Thanks, Peggy B.

RE: Angry, exhausted, and looking for realistic answers - GBMIV caregiver

by onemorehour on Wed Oct 28, 2009 02:34 PM

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My husband's tumor was in his right temporal lobe, and he has some ST memory problems, too.  His confusion is a bit milder than what you describe in your MIL, but I definitely understand what you're talking about.   As for coping, you go one little bit at a time...one crisis at a time...there's an old saying that goes "You eat an elephant one bite at a time."  You learn to get through the immediate, try to just cope with one incident at a time.  (I know they're often back to back, and you don't get a chance to breathe...)   It is very often frustrating and heartbreaking because you want the person you knew back. 

My husband (one year out from surgery) is a bit more himself these days, with his old sense of humor emerging, and he is more interactive with us.  He still has major mobility problems, but mentally, he has improved.    There were plenty of foggy/hazy days. Sometimes I tell him I am going to the store, and he calls me to ask where I am. He misinterprets what I say.  He forgets constantly. He can't find the remote 100x a day and it is sitting right next to him.  It's agonizing to watch because he was and is an extraordinarily intelligent man, and it is painful to see him unable to do some of the simplest of tasks.

I'm so sorry you and your family are dealing with this.  I wish I had a lot more helpful advice other than taking it one baby step at a time.  It's an enormous burden, and you are not alone in sometimes wishing it was just all over with.  I think MANY many many caregivers have had that thought. It's not really about wanting the person gone, it's more like you kind of want to fast forward, like skipping pages in a book, to see how all of this ends up. Will it all be okay and everyone will find a way to get through? Will things fall apart more than they already have?  It's such a nightmare.  The uncertainty and the fear...I know it well. 

Also, it's worth a try for your FIL to get in touch with the social worker at your MIL's oncologist's office.  They sometimes have ways of getting respite care- insurance is not the only way, and you never know what help is available, sometimes they have resources at their disposal that really can be of help.

Best of everything to you and your family. 

 

OMH

RE: Angry, exhausted, and looking for realistic answers - GBMIV caregiver

by pegblau on Wed Oct 28, 2009 02:59 PM

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Thank you for your words of empathy and support. Fortunately I do have good friends who are supportive. You are correct however when you say that at the end of the day it the primary caregiver whi cannot go home. I like the expression shituation! Peggy

RE: Angry, exhausted, and looking for realistic answers - GBMIV caregiver

by onemorehour on Wed Oct 28, 2009 03:31 PM

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LOL I love the eating an elephant analogy. It has helped me in my life.  There is always too much to do, and this is how it gets done. 

There are times when getting to the other side of all of this seems impossible. I know that once it's over, my children and I will have a very difficult struggle to move ahead and make a new life, but we will. We are not the first and we won't be the last family to lose dad.  That sounds terribly blunt and cold, doesn't it?   Looking ahead is a cruel reality, but I'm determined to make the best possible life for my boys that I can.  I've come to terms with the fact that our old life is permanantly gone.  This does feel like limbo, being let down one notch at a time.  Like a roller coaster in slow motion.  

How is Andy?  I hope feeling better and the Avastin is kicking cancer's sorry butt.   We have our next MRS on Nov. 5th and we will know more about the two suspicious spots- one is old, the one on the cerebellum is new. Dreading it.

Lorraine

RE: Angry, exhausted, and looking for realistic answers - GBMIV caregiver

by Joe_Joe on Wed Oct 28, 2009 03:36 PM

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Dearest Lorraine..

I do not have any answers..Sorry:(

But I do have time, a shoulder and a wealth of respect for your courage and bravery.

Remember to be kind to yourself...

Hugs and light

jojo

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