My 80 year-old dad with MPCa, broke his leg and now seems to be giving up. Advice on best anti-anxiety meds desperately needed.

[Lemonpower]

Dear PC family

As you will see from my profile my dad in England has been on his prostate cancer journey for five years. He was doing well until March, still actively farming though fatigued, and was due to start Radium 223 in April. Sadly, he broke his leg on March 12 in a fall, was put in a full-leg cast, and told to not put weight on his leg so he became bedbound. His leg was healing slowly, and due to his broken tibia and fibular, the consultant had to postpone his Xofigo treatment as that would prevent the leg break from healing properly. He had been on abiraterone and pred but his PSA had been rising rapidly. Hence the plan to start Xofigo.

Till early June he was healing, going out with a zimmer and doing ok. Sadly over last two weeks he has tanked precipitously and is now almost constantly bed bound. I think his mind has given up. His leg has mostly healed and he can put weight on it. Now he is so weak from nausea, constant fatigue, loss of appetite, and being unable to keep food or fluids down that he can hardly stand up. It seems clear that sadly he’s losing the battle. I myself have had a brain tumor (my mum has advanced complex dementia.) so I know that often with life threatening illnesses a healthy mind help's alleviate stress and pain on the body and might encourage him to eat.

I am in US and have been travelling back and forth to UK for both my parents since December, Today dad's carer took him to his cancer consultant appointments in a wheel chair. However, she said waiting and getting to both blood and oncology appointments were traumatic for her and my father. At both appointments he was out of breath, sweating, and crying. His doctors wanted to hospitalize him and give him a blood transfusion as they were concerned about anemia. However, he refused to stay in the hospital against advice of doctors, nurses, his carers. He’s afraid he’ll die in hospital and wants to die at home on his farm.

Today his PSA was 600. Back in March it was under 50. He asked doctors today if he had a maybe a year to live and they said more like “minimal months”. I take that to mean weeks. They are involving palliative care ASAP.

I will now be travelling back to UK again. I just arrived back in US on June 16th, and am determined to try to get my dad’s mind in a better place. He is having problems swallowing all the meds, fluids, food. I’ve asked doctors to prescribe anti-anxiety meds to help with his panic attacks. He has been refusing them up to this point. He has now been prescribed morphine for his bone mets. His cancer in March was only mets to the bone on a PSMA scan (several ribs and lower spine) no lymph nodes. Hence why he was to be given Radium 223.

Does anyone have any advice on anxiety meds (preferably in liquid form available in UK.) that might help ease dad’s anxiety and make his final months less stressful or even give him some hope. He has watched several close family members die difficult deaths from lung, stomach, and colon cancer. I know he has those images in his mind. I have them in mine. I do want to help blot them out for him

I will be returning to England ASAP to help him to his journey’s ends. I welcome all advice, tips, and of course prayers that will help him and our family through this difficult time.

Thank you,

[Nwdx]

Clonezepam (Klonipin) Benzodizapine class, 2mg tablet but also available in liquid form.

[Alicat1]

Second the Clonezepam advice

[spencoid2]

Do you have anyone who can suggest a suitable cannabinoid? You have to be careful because some may provoke anxiety instead of reducing it. I would suggest something Indica dominant as this is more likely to be sedative. However everyone reacts differently. I am experimenting with CBN for sleep and it does seem to be sedative and anti anxiety.

Smoked or vaped cannabis is fast acting allowing you to judge the effects quickly. Edible is slower acting making it more difficult to see immediate results.

For me, ativan has helped greatly with anxiety but you need to be very careful about taking it together with morphine. I have only taken it a few times to help with anxiety caused by having my head locked in a vise for radiation therapy to my skull. Definitely did calm me down.

[billyboy3]

this is god awe full news, so sorry but pc is one of the worst ways to die. More morphine. I plan to end my life before I get to this point so to all you guys, it is best to really think about your final days and ensure everybody knows your wishes!!

In the meantime make up a bucket list and live large. I just came back from the Mediterranean Sea in Barcelona and it was simply GREAT!!!

Now 72 on my last legs but damnit I did it alone!!!

Stay well troops!!

[Lemonpower]

Sadly my dad broke his leg as he's gone skiing every year since his teens. His doctors categorically told him not to get on skis but just to enjoy the hotel, good food, swim. Did he listen?😥 About a minute after he got off the ski lift he fell backwards, and that was it. March 12 he broke his leg. Was in hospital for 2 weeks. In April they were still planning to give him Xofigo just delaying till leg healed up. I was in Uk until June 16 and he was still going out with a zimmer for breakfast. About 10 days ago, he just went south suddenly. Pain got to him, and he went from a few good days, followed by one bad day, to just endless bad days. He started vomiting a lot, and hasn't been able to keep food, fluids or meds down. I'm sort of in disbelief, and broken hearted as I'd gone to the Xofigo appointment in April and consultant said end of May they still hoped to give Xofigo but instructed him not to lose any more weight, and in my dad's words to "eat, drink, and be merry."

I keep trying to buoy his spirits and want him to take anti-anxity meds now, but doctors just haven't done it. He was started on OraMorph yesterday.

[cancerfox]

Back in 2020 I had a bad episode of anxiety. My doctor prescribed fluoxetine (Prozac), and it worked well. I took a pill every day, and don't know if it comes in liquid form or can be used with morphine. It took a week or two to kick in, but it was relatively inexpensive. My anxiety completely went away. After about a year I weaned myself off it and so far the anxiety hasn't returned. 🦊

[Hidden]

As hard as it is, if he is refusing care, beware. Perhaps he sees his current situation as a burden. It sounds as if you are not living in the UK. He can't be the man he wants to be. And probably a mirad of other thoughts whirling around in his head... that said... If you can get it through his head that maybe some anxiety meds is better than dead, would he please give it a try, if not for him, then you...

The stress has you a mess... Maybe you need some too... Mental attitude can preclude the feelings of distress and hopelessness...

I can say that I understand the way he is feeling... Even the strongest feel they are slipping.

From personal experience and where I am at, the Lupron, aberiterone and prednisone, caused me to drone.

I was initially given 37.5 mil Venlafaxine to help with the hot flashes and I am now on 50 mil of it. Bupropion XL150 Mg (24H) to round out the loss of pep and lift my mood...

So far so good.

We loose a lot of strength and become more brittle which leads us to be more physically and emotionally challenged due to ADT. Age is a factor too.

So...what's a fella to do?

Do we ruminate excessively on things no longer possible to do? (That's a sure killer, too.) Or, do we make amends with our past? Recognize youth doesn't last, and move forward...fast...

Some people can not get themselves in the proper mental state to reinvigorate their life! They need a boost.. not a noose!

Best wishes...

Ron

[Lemonpower in reply to Hidden]

I've had brain surgery for a brain tumour. I've been taking anti-anxiety meds and mood stablilizers for a decade. I wouldn't still be here without them. As both my parents are now very sick and I'm back and forth across the Atlantic I've already upped my mood/anxiety meds, because I know that with an unhealthy mind your body will just start breaking down more as well.

[P3Nav]

Here in USA, they're steering patients away from the Benzos, and rightly so. That being said, Cymbalta for anxiety, and Wellbutrin for depression, and lots and lots of distraction (therapy, socialization, forcing myself to do crafts) have kept me out of the rabbit hole pretty well. Can't say enough about how hanging with friends or family and talking (not mutually watching TV) really lifts my spirits.

[Lemonpower in reply to P3Nav]

The medical establishment can say what it wants about benzos, but they helped get me off seizure meds (dilantin) that were making me manic depressive.

I have spasticity in my left side due to my tumour/brain surgery and i have to take diazepam for the spasticity. I'd rather take benzos any day than some of the seizure meds like Keppra and Dilantin (took both,) that leave a lot of people who suffer from epilepsy in a very dark place. With proper use benzodiazepines are crucial, life-changing meds for many.

It's just unfortunate that because they are sold on black market as party uppers or downers that they have gained such notoriety in the medical world.

[Hope422PC]

my husband broke his hip in May. It was in the hospital and very depressed. Is Palliative Care doctor suggested starting on Prozac. He was reluctant, but it hospitalization for nausea and vomiting, led to a mixup, and he was given the Prozac. It actually has helped.

[Lemonpower in reply to Hope422PC]

i know it will help him in his journey's end. His doctor's have been useless though. They're keep saying oh he doesn't "seem to have low-mood." that's becasue he puts on a brave face for doctors.

After his consultant meeting on Tuesday he had a full on panic attack, could barely breathe and was crying. His carer, who went with him, said it seemed like he was having "a panic attack,".

I've faced death myself with my brain surgery, and I would not have made it through without anti-depressants and anti-anxiety meds. Getting this into the heads of some British GP's is almost impossible though.