Just when I thought things couldn't get any worse, they do.

Review: Mom had metastatic breast cancer for 11 years with mets to
the bones and Ovarian cancer for 1 year (new primary). She was living
alone independently with daily home care until two weeks ago when she
got dizzy, fell and broke her arm. She's anemic, low platlets, and has
congestive heart failure down to 25% function probably from the
Herceptin. She elected not to have the surgery and was psychologically
evaluated a week ago Saturday as competent to make that decision. The
hospital she was in was terrible, despite the large sign on the wall,
just about every person who came in would pick up her broken arm and
she would scream in pain! My brother and I looked into options and she
wanted to go to a palliative care center that specializes in terminal
cancer patients. She was transferred there last Wednesday. She was
fine Wednesday night.

New developments: Something bad happened. Pretty much overnight, she
has developed some kind of dementia. She's very confused. I am
devastated. Her doctor said that there could be a number of causes,
like a stroke, or infection, but its most likely brain mets. They will
try to treat it with steroids first and if her response is
sufficiently favorable, then they will do a cat scan to see what's
going on. If they elect to go that route, they will have to do the cat
scan in another hospital because the palliative specialty hospital
she's in doesn't have the equipment. It is terribly cold this week in
New York. He said that if they determine that its brain mets, then
radiation may shrink the mets and prolong her life from 3-6 months,
possibly even restoring her mental function. Although she did improve
a litte from the steroids, she was able to ask for milk and apple
sauce, she reconized me, my brother, and a picture of her mother, she
was able to say she was hot, from what he's seen of her, the doctor
does not think its sufficient to warrant any further action. He thinks
that if she doesn't respond sufficiently to the steroids, there is
little hope for a response from radiation, and moving her to do the
cat scan would be traumatic.

My question is why don't they just assume that its brain mets give her
the radiation anyway and see what happens. Why bother with the
expensive cat scan. I didn't think radiation was that expensive. Isn't
it possible that she will respond to radiation when she doesn't
respond to steroids?

I know I'm going to lose her, and she's being kept extremely
comfortable, and she couldn't be in better more caring nursing hands.
But there is no amount I wouldn't give for just one more intelligent
conversation. I don't know if I should force the issue possibly by
moving her again. I don't know if that would be doing her a favor or
should I just let her go.