Puss needs more advice re MIL - any cancer nurses/experts please?

[PussinJimmyWhoooos]

MIL is thankfully still holding on.

The diagnosis of a month or two to live was about 7 weeks ago today (bile duct cancer, primary in the bile duct and secondary in the liver with nodules on the liver showing up on an MRI 7 weeks ago or so with poss spread to the pancreas). She is still walking around and on the lower scale of pain management

However, she was non insulin dependent but has now had to have insulin. Her blood sugar levels are fluctuating a lot and yest am were so high the meter did not even register them - what does this mean - short term and long term?

Her liver function tests started to show an increase 2 weeks ago and she is yellow, but whites of the eyes are still ok - this is a good sign her liver isn't too damaged yet?

She also had sepsis with 2 weeks of high grade IV antibiotics which made a small difference but not enough to warrant the invasiveness of treatment so they have now ceased with that and just given oral antibiotics as a placebo for her more than anything. So far the infection seems at bay, although she gets a lot of sweats but I'm thinking thats more to do with the glucose rather than anything else? Will the infection come back and if so, what timescale?

Any help appreciated

TIA

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Hi,
Didnt want to ignore you, but i am not an expert.

The pancreas will affect blood sugar. She will have her sugars monitored, and may need to have insulin to control them. This is a reflection on the deterioration of her condition. It is controllable, with careful monitoring.
Where is the origin of the sepsis?

Sorry if i am not much help, this is very sensitive and i dont want to say the wrong thing.

Deany - no worries about saying the wrong thing. The end is inevitable and have come to terms with that but just trying to make sense of the condition as it is iyswim?

She is on insulin now but I was just wondering what the long term would be of it going off the scale...it fluctuates a lot

They think the Sepsis came from a stent she had fitted as the tumour was stopping drainage or something - am not 100% on all that. However, its been two weeks since they stopped the antibiotics and its remained stable and I'm panicking as worried the infection will just kick off again - just trying to find out more I guess

Can i ask, how often are her sugars checked?
tbh i dont think that her sugars will affect the outcome, but as you rightly say, the symptoms are uncomfortable for her. This can be managed as the sugars settle down.

If she is still on abs then the infection may not come back.

To come will be all sorts of weird symptoms as the liver and pancreas affect so many of the bodies functions. You will tie your self up in knots with it all. My advice is to take it as it comes, let the macmillan nurses (or who ever is caring for her) deal with them & explain them to you.
Sorry i know its vague, its very difficult to not focus on every single aspect,but honestly, you may get your head round one small aspect, and the next will present itself.
Take each day as it comes and spend time with your mil, dont let it dominate your time with her.

Every day - maybe even twice a day.

MIL is in the M.East..DH has just come back from a month with her and is so worried so I post on here for advice for us as making sense of it all, helps a bit iyswim? There are no Mac nurses over there - all the palliative care is done at home by the other two children and DH when he was there...

The antibiotic at the moment isn't high grade - its more of a placebo for her as they have told her the infection has gone...she doesn't know of her condition btw

Hi.
Regarding long term effects of poorly controlled blood sugars for your MIL, I think the idea will be to keep the controlled for general sympom control, rather than perfect blood sugar control, IYSWIM. Long term effects for diabetes tend to be in terms of years, which sounds inappropriate here.

And with regard to the blie duct infection, from a personal level, my father was hospitalised with this when he had metastatic pancreatic cancer. He only had the infection once, but I can't recall if he had a stent in. The oral antibotic they usually use for bile duct infection is very well absorbed, so they may try it again if they needed to.

Hope this helps, and good luck.