Fao Sqad- Grandfather's Extreme Ill Health

[kvalidir]

Hi Sqad, or anyone else with relevant experience/ expertise. I wonder if I could have an opinion and some advice please?
Very worried about my Grandfather 76, who is currently residing in one of my downstairs rooms. He has a lot of medical issues ( 3 major heart attacks ( stented complete left bundle branch blockage 2012, 2 further after that), 2 strokes (2015 and 2016), COPD ( since 2007, 2 ltrs oxygen 18 hours + per day), insulin controlled type 2 diabetes with diabetic neuropathy in both legs/feet with tendency to spontaneous diabetic blisters, unstented (because they couldn't get stents in) vascular issues in his groin, large umbilical hernia, slow growing lung cancer, kidney failure (3 or 3b sorry can't remember off the top of my head) and significant Psoriasis so that his skin splits easily. He also has issues sleeping, particularly in bed and is prone to panic attacks when he feels he can't breathe. He has cellulitis in his legs and is usually on some form of antibiotic. He takes morphine for pain control and iron as he's anaemic. He has a Boston Pacemaker fitted and his BP is usually very low around 100/65 ish but is normal for him since his heart issues and hasn't changed recently.
He's lost a significant amount of weight in the last 3 months ( approx 2 stone, from around 15 stone to 13 stone) and has struggled to walk for the last year or so but has been mobile, albeit with difficulty. Noticeable change in him since I got back, now very depressed, very frail and cannot stand unaided or walk at all really. Today he appears weaker than ever. Is there anything at all we can do to improve his mobility, as I feel this has led to him going further and further downhill and I''m worrying about bedsores etc ( has a mattress and cushion to counteract that).He has walking aids etc and a mobility scooter and electric wheelchair but isn't inclined to use them anymore. He sees regular medical professionals, but a new set of eyes never goes amiss, or is this just a normal and natural getting towards the end phase, as I am aware he is very ill?
Full list of medication and dosage below.
Many thanks, feeling so sorry for him today x

Salbutamol 100micrograms/dose inhaler CFC free
One Or Two Puffs To Be Inhaled Four Times A Day When Required
Omeprazole 20mg gastro-resistant capsules
One To Be Taken Each Day
Lantus 100units/ml solution for injection 3ml pre-filled SoloStar pen (Sanofi)
For Subcutaneous Injection (76 Units in the morning).
NovoRapid FlexPen 100units/ml solution for injection 3ml pre-filled pen (Novo Nordisk Ltd)
as directed by hospital
Sitagliptin 25mg tablets
one tablet in the morning
Allopurinol 100mg tablets
Two To Be Taken Each Day After Food
Nebivolol 2.5mg tablets
One To Be Taken Daily
Apixaban 2.5mg tablets
One To Be Taken Twice A Day
Morphine sulfate 10mg/5ml oral solution
5- 10mls to be taken four hourly as required
Docusate 100mg capsules
One To Be Taken Three Times A Day
Laxido Orange oral powder sachets sugar free (Galen Ltd)
One Sachet To Be Taken Twice A Day
Bumetanide 1mg tablets
Three tablets to be taken am, then increased on 23/10 to 2mg pm also
Omnican Fine hypodermic insulin needles for pre-filled / reusable pen injectors screw on 6mm/32gauge (B.Braun Medical Ltd)
For Use With Insulin Pen As Directed
Ferrous fumarate 210mg tablets
One To Be Taken Twice A Day
GlucoRx Nexus testing strips (GlucoRx Ltd)
As Directed
Fostair 100micrograms/dose / 6micrograms/dose inhaler (Chiesi Ltd)
Two Puffs To Be Inhaled Twice A Day
Salbutamol 2.5mg/2.5ml nebuliser liquid unit dose vials
One Dose To Be Inhaled Four Times A Day
Glyceryl trinitrate 400micrograms/dose pump sublingual spray
for angina SIT DOWN spray 1-2 doses under tongue. Close mouth. Wait 5 minutes. If pain has not resolved repeat process. After 5 minutes if you still have pain CALL 999.
Incruse Ellipta 55micrograms/dose dry powder inhaler (GlaxoSmithKline UK Ltd)
One Dose To Be Inhaled Each Day
Diazepam 5mg tablets
1 or 2 to be taken as needed

[kvalidir]

Also Calrithromycin 1x 3 times per day for the cellulitis x

[Eleena]

Blimey kval, poor man.

[Mamyalynne]

My goodness, that's quite a regime and I don't know all of those at all, but have to ask - has his low mood been addressed by the medics?

It may be worth adding something in for that too if not, little wonder he gets down.

[kvalidir]

Thanks Lina and Mamya, he was on Lorazapam for a while but that made him really terrified so they took him off it. He's never left on his own and has someone here on call all the time (when I'm not around), we're a large family so there's always someone to chat or watch TV with him or whatever but he's not currently on an anti-depressant just the diazapam for his anxiety. x

[Lie-in King]

I can't offer anything of use, bar my best wishes to him & you for the happiest Xmas possible. If it were me however, despite it almost certainly being contra-indicated by something in that list, I'd want a "large Scotch, keep 'em coming". x

[kvalidir]

Thanks Lie-in-King, he doesn't drink now unfortunately ( people apparently always prohpesied his liver would pack up which seems to be the only thing still working anything like it should). He's normally such a fighter but all his fight seems to have left him the last couple of days. hopefully when a lot of the family rock up on 27th it might perk him up a bit x

[jno]

poor man but also poor kvalidir, expected to know all this stuff at your age; it must take the shine off your Christmas. I hope he pulls through.

[Lie-in King]

If the obvious love you have for him is shared by the family, his spirits will surely be lifted on the 27th :-)

[kvalidir]

Well I don't look after him on my own Jno, although it's my house he lives in for practical reasons, people are in and out all day helping as the family is very cohesive when one of us goes down ill, but I really do feel so so sorry for him, and it's one of the reasons I came back here for Christmas because he was obviously getting worse, but I feel if we could just mobilise him a little more he'd feel better but I'm not sure he isn't past being up to it. I do hope not, he's a wonderful man who looked after my Dad when his own father died (he's not my genetic Grandfather but is for all intents and purposes) so he really doesn't deserve this. x

[Sqad]

A full and accurate history of his medical status and is much appreciated.
With us all in varying guises there is a time, when our time has come.....you grand father's time has come.
Make him as comfortable as possible whatever means seems appropriate..

[kvalidir]

Thank you Sqad, I suspected as much. Having seen a lot of animals age and die, it seemed to me to be a winding down of things naturally and we'll do everything and anything that he takes a shine to having or doing meanwhile x

Thanks again for your honesty, it's very appreciated xxx

[tamborine]

Sorry to read of your sadness and hope ur gpappy pulls thru as 76y is not old.

My ill son paid me a surprise visit today & actually drove himself here, with my elder son supervising. He has put on weight & seems slight recovery. I pray you have same fortune from your gpa. Merry xmas x

[kvalidir]

Oh Tambo I'm so happy about your son, that's wonderful news, so glad he's seeming a bit better and how lovely to have a surprise visit :) x

I hope things go well for my Granda, and if not then I hope they go gently as he gets very afraid when he can't breathe. As he said once 'I just hope one mornin' I wake up dead' ( he's from Belfast- funnier in his accent), but yeah that really for him would be a gentle way to go x
My partner has a flare up of his Sjorgrens Syndrome as well at the moment, probably due to extreme stress, and I can't be there, so not a great Christmas, but I hope that your son continues to improve and is home soon x

[nailit]

kval,
I cant be of any help medically but just wanted to say *BLIMEY*.
What a medical regime that is, that he has to endure. I wish both him and you all the best.
Also pleased about Tambo's son managing a surprise visit (driving as well), good show there.

[tamborine]

Does gpa use a recliner to nap in; theyre good at helping breathing for taking weight off chest in an elevated position.

Thanx for sons good wishes.

[nailit]

Tambo,
does ur sons driving indicate an upturn in his overall heath?

[tamborine]

I hope so but he still has IVs blood & protein feeds. Docs are now blaming formaldehyde (embalming fluid) used in his work in funerals. There is a block on the chemical till further research.

[nailit]

Well, I don't understand all the ins and outs of ur sons condition Tambo, but I am sincerely pleased what I read tonight
about him able to surprise you with a visit (driving at that) :-)
Wish you and ur son all the best Tambo for the coming new year, stay positive!

[kvalidir]

Yeah he's got a disability armchair Tambo that goes flat like a bed then nearly vertical so he can stand up so he naps in that and sometimes if he can't face going to bed ( because he panics about going to bed and finds it hard to breath lying down) he sleeps in it, but I try to discourage that if possible because I don't want the bed phobia to get any worse than it already is.

Thanks Nailit, when he was younger he was a lot of man and was eternally kind and supportive to my Dad both before he lost his father (who was a ***) and afterwards when he really took him under his wing. He so deserves something better than what's happening to him :(

[kvalidir]

Crikey I use formaldehyde when I'm doing taxidermy Tambo, I didn't realised they'd blocked it because I have a huge container of it and only use it as and when I find roadkill.