This is a case of 31-year-old sfemale, single who was admitted for management of stage IV breast cancer. The terminal stage. She has had left mastectomy (removal of the breast) in 2009. Her family refused to go for chemo therapy and decided to treat the presenting symptoms.
The patient came in with fever and unproductive cough. She has been bedridden since February this year due to pain she experiences when walking. She also complains of constipation, abdominal pain, neck pain and has had episodes of vomiting.
Her lack of appetite has prompted the doctor to place nasogastric tube to serve as an access for her osterized feeding to meet her daily caloric needs.
The cancer cells have metastatized to her bones that cause her excruciating pain especially in the leg. She has been referred to pain management specialist and the doctor gave her Oxynorm round the clock. Her pain was too severe that she needs to be given with Nubain via IV as rescue doses.
There are times that she’s okay and conversant but most of the times, she was disoriented mumbling incomprehensible words.
She’s all being managed for infection in the blood (sepsis). Her white blood count still shoots up despite the protective environment that she has been placed in. Her red blood cells, haemoglobin and hematocrit are all going down. No blood transfusion was made although warranted because their religion, Jehova’s Witness, forbids this.
The family members were primed about the impending loss in their family. Her vitals are all going down at 4:00 pm, she was pronounced dead.
In terminal cases, the medical staff can only offer palliative management and emotional support. Her battle with cancer was over and it is sad that she has lost to it.