Hi Rosy
that must have been one hell of a tough day, my thoughts really are with you.
So, now you have got a fairly definitive answer, obviously nothing like the one you would have prefered but now you know what lies ahead. I cannot lie it is a really hard position to be in. Mick did not want to know either and once I realised how bad things were, (probably about where you are now) I had to think really carefully about the way I would handle things.
I decided that every conversation regarding his cancer, his treatment and his care would be left open for him to ask anything, but I would not raise issues, just discuss the ones he raised. I found it very difficult to become a listener and to be reactive when my whole life I had been the opposite!
I am certain that Mick new the score but by not making it a direct topic of conversation he could tailor his words and step gently around any issues, he probably got the answers he needed from implication alone. The hospice staff also helped loads as they would talk very carefully with him during his care and gently guided the conversations with him.
I guess it is a bit like if I dont say it out loud it won't happen , or if I can't see the bad things then they can't really be happening.
With regards to treatments then I have heard it said that Abbi and Enza seem to work very much alike, if one fails then it is highly unlikely that the other will work. I do know of at least one person who has switched from one to the other but that was before there was any sign of the original failing. Yes NICE guidelines on this in the NHS sector are quite specific.
Your Onco is probably very reluctant to go with chemo even on a weaker but more frequent basis if it will not really give benefits to outweigh the QOL issues. An Hb below 9 will mean extreme fatigue and tiredness already and chemo will probably make that even worse.
She is continuing to prescribe Abbi and upping the steroids for a while to try and boost his apetite. Sometimes, just occasionally, patients can rally for a while and that prognosis can lengthen. I hope for your sake this happens for you.
Meanwhile all you can do is be there with him every step of the way. At the same time remember to get some quality time for yourself too, a totally exhausted carer is not a good carer as I am sure you already know from your vocational experience.
No doubt there will be some dark days ahead but there can also be some really joyous ones too, so make the very most out of every good moment and try not to dwell on the darker ones.
We are all here for you anytime you need us
all my very best wishes
xx
Mo