go figure

I saw my brother again yesterday, with my husband, and my brother is back to his old self, albeit 8 lbs less.  Go figure.

things looking a bit better

So right after I have written my most glum blog ever, my husband and I go to see my brother for our usuall Saturday breakfast.  He's better!  He's not exactlya spring chicken, but he's was a lert and in a good mood.  His walking seemed ok.  His gurgle was gone.


Well, his gurgle was gone except for the last 15 minutes.  We took him to Walgreens because we needed milk and cash, and he decided he wanted deodorant.  I have no idea why, he has never used it before (and he doesn't smell either, most of the time, both me and him are lucky that way).

At the end of the excursion the gurgle/hoarseness started coming back.  Just another reminder to enjoy each day as it comes.

concerned and sad

I am feeling pretty sad about my brother.  I don't know if I am overreacting or not, but I am having a very hard time watching his slow, but unrelenting, decline in health.

I think it was about 10 years ago that I noticed he was having a hard time getting out of his chair.  He simply didn't have the strength to do it easily.

A lot has happened since then.  Both of  our parents have died, my brother developed a-fib, he has gone septic several times, and suffers from pneumonia many times a year.  He has had a stroke, and probably several tias.  He has been in the ICU 3-4 times.   I have stopped counting the times that he has fallen.

Now, since the holidays, he seems that he is more in decline.  He fell around that time, either from balance problems, a TIA, and maybe he hit his head falling, who knows, I wasn't there.

But his processing time is notably slower and he has lost 8 lbs in the last two months.  He has stopped eating lunch.  He says it's for two reasons:  the food is no good, and his various maladies mean the food is not good for him.  He says it is too starchy, which it may be,   Never mind that it's the same kitchen/chefs that prepare lunch and dinner.

I have talked to his nurse practitioner who has run blood tests, and everything shows no change.  She has offered an anti-depressant to increase his appetite, but it will make him drowsy, and I want to avoid that if possible.

I'm also ambivalent about how much intervention to offer him.  I want to offer him as much intervention as anyone else would get, but I also have strong feelings about making sure his quality of life stays as high as possible, which means not asking for invasive procedures if they can be avoided, especially if the test is just to know what the problem is and then there is no treatment available.

I am worried that he might have cancer.  I can't imagine giving him chemo.  If he starts throwing up he will get dehydrated and his blood pressure will drop and he will end up in the ICU.  This is a terrible decision that you have to make for yourself and he is not capable, I know he will want me to decide for him.  I'm hoping the problem is his heart, not cancer.

I have decided to just concentrate on helping him enjoy his life as possible until he has his next crisis that where he ends up in the hospital.  Then we shall see.

not eating

My brother has lost 8 pounds in the last two months.  No one seems to know why.  The nurse practitioner has ordered blood tests for him and they have come back normal except for protein which is just a bit low.

When I take him out for a meal, he eats well.  But he is skipping lunch  a lot. He says it's because he doesn't like the food.  He is a bit crazy about food, insisting that this and that isn't good for people with irritable bowel, heart conditions, etc.  We have gone round and round the track in regards to the fact that he can eat most of anything if he does it in moderation.

He seems gaunt and weaker since the holidays.  Not a huge amount, but it's noticeable.  Right after the holidays, he fell.  I am wondering if he had a TIA or if he hit his head when he fell.   I had him in PT, but that is over now.  He is a bit stronger, but not where he was earlier in the year.

I am reluctant to start taking him on a round of doctors.  I am ambivalent about getting him involved in a bunch of tests that won't lead to any cure.

Some of my doctor friends say it is part of the course of events that people start eating less and less when it is their time.  This is hard to deal with because my brother isn't in his eighties, he is in his sixties.  If you look at him, however, he acts and looks like an octogenarian.

I am still mulling over a course of action.  I am mainly thinking that things just have to percolate until it becomes more clear what the problem is.

My main concern is that if he continues to lose weight, he is going to lose even more muscle mass and end up in a wheel chair pretty quickly.  I realize that because of his cerebral palsy, that is a likely outcome in the long run, but I dread it.  I am thinking about how it is going to be really difficult to take him to places once he is wheel chair bound.