Yellow

Two days after Dr J's visit, the hospice nurse turned up with a GP (I think she visited dad before). She noticed that my dad's left leg was a little swollen. After she heard from us that he also had mild fever that regularly came back these past couple of days and that his left leg was sensitive to pressure i.e. painful even with gentle massage, she was concerned that might be abscess in the leg. She advised us to bring dad, via ambulance, to get him checked by an orthopaedic or at least an oncologist. We decided follow-up with Dr P at Penang Adventist Hospital.

Meanwhile, my b-i-l noticed that my dad's skin had turned yellowish. Upon query from the hospice nurse, we also found out that his eyes were slightly yellowish and urine was either dark red (if a lot) or dark yellow (if little) but started after taking methadone syrup.

Dad's bedsores worsened, partly because of watery poo :( The wound was deeper: coul see inside flesh. 😱

To our suprise, there wasn't enough methadone syrup till the next appointment, despite

• my dad's maid following the prescription on its label, and
• the total amount labled should have been enough.

Only other explanation was that the pharmacist miscalculated? So strange......

Because the hospice nurse was very busy and only Penang GH can prescribe the syrup, my sister had to go to the hospital to get more. Following Dr J's advice (message given to us via the hospice nurse), she told the nurse in charge of registration that there wasn't enough medicine and that she was asked to see Dr J specifically for it.

• Skin colour and eye colour (just noted only..guess it was normal)
• Urine colour: methadone should not be the cause of it because it doesn't effect the liver. She theorise that the growth at the side of his tummy was causing the problem
• Watery poo: just stop Lactul and continue taking Senokot on alternate night
• Bed sore: eventhough it looked so terrible she actually said not too bad. Why? Because it didn't have puss. She said some covered wound tends to have puss growing inside. She said dad's one looked clean. She would message the hospice nurse to teach us the best method to change dad's diaper. My sister told her the pharmacist said that if there's open deep wound, then use gauze inside. She said don't put in but just put on top (this is thick gauze). It doesn't do much but might lessen dad's pain. She still mentioned about dad needing to air his buttocks area by turning sideways but I told her it was painful for him to do that. Prescribed Lignopad to replace Salonpas which was no longer effective
• Eyes open when sleeping: can cause dryness/infection. Normally PCU woul tape the eyes shut but only for patients who are already unaware of their surrounings. So not applicable to dad. Can try wearing night eye mask when sleeping at night. Use normal eye drops when dad says eyes are dry
• Dr P: she didn't feel the need to see him and it might cause dad more pain by shifting him around. But she said since appointment already made and ambulance booked, just go ahead. Update hospice nurse once we know the results