Last night around 11:00, Marshall got very very agitated and was thrashing around and couldn't talk and wanted to get up and he was very difficult to control. I didn't want him to hurt his back but boy, it was difficult. I was able to get hold of the telephone and dial the on-duty palliative care nurse and the first thing she said was, "Sounds like his sugar -- do a sugar reading right now." So I had to put the phone down and immobilize him to the best of my ability and I took the sugar. reading (that was NOT easy). It was 35, very low. She told me to get him some orange juice and then some protein, which I did. After about 15 or 20 minutes. he quieted down and was able to talk and act normal again. (By the way, several days ago he insisted on removing the brace so he did not have the brace on last night when he was thrashing around.)
The palliative care nurse (Kathy) came by today and stayed for hours. She sat with Marshall and me and we talked about everything. She brought up the subject of hospice versus continuing with treatments and we had a lot of very honest conversation.
She said that she now is sure that the past couple of days when Marshall was unresponsive and loopy are totally related to his very low sugar levels. (I must say that I never ever realized what could happen with low sugar.) Kathy said that Marshall should start thinking of making a decision of how he should proceed because if he wants to go ahead with radiation we will need to get the appointment in place. Kathy said she now feels like he could certainly be strong enough for the radiation -- and have a good outcome -- IF he works at building up his strength enough to be able to walk with his walker, especially since the radiation will definitely zap his energylevel. She said he should take a few days to think it over but he shouldn't wait too long or the radiation will not be effective.
He also needs to eat meals regularly in order to keep the sugar levels (and energy level) where they need to be.
After Kathy left, he ate an early dinner and stood up and took a few steps and then laid down and went to sleep. He called me in there a few minutes ago saying he was in a lot of pain -- lower back pain -- and he said it was "big time" pain. I sure hope last night's activity (without the brace on) didn't hurt anything.