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Mike,
If it's any condolence, I know what you are going through.
About a month ago, I had a discussion with my 97 year old Dad who is also going through congestive heart failure and probable prostate cancer. We discussed my sister, his oldest daughter, who at 70 was in hospice due to complications of rectal cancer that manifested into bone cancer. I told Dad "You know Dad, we've always been told that a parent should never lose a child, but when you are 97 and your child is 70, it's kind of like all bets are off. It becomes a reality". I took my Dad to see my sister and they had a good private conversation. Then it was my turn to speak with her. I had not seen her for about 8 months, and to see her then I would not have recognized her as my sister. We settled our petty differences in life in that conversation, "we're good....better than ever good" was the last thing she said to me. 2 days later she couldn't communicate with anyone and my brother and her son stayed by her side for the next 3 days before she passed.
As for the PSA number with your Dad, I wouldn't be surprised. I've heard where a PSA test for a man over age 65 is pretty useless data. In my Dads case, about 2 years ago he scored a 28 on a PSA test at age 95 during his yearly physical exam. He was pretty shaken thinking he had prostate cancer, but being too much of a risk for a biopsy, the oncologist decided to wait a month and test him again. He then scored a 48. A month later he scored a 124. Yes, one hundred twenty-four. He was still getting around at this time, went to the office 3 days a week and living at home alone since losing my Mom 7 years ago. The oncologist suggested giving him female hormone injection treatment, and after 2 rounds of injections over a 6 month period he scored a 6.2--yes, six point two. Success of having a low PSA number came with a cost being the side effects of 1) absolute incontinence and 2) lack of muscle throughout the body. Just last month he went through a bout of having a urinary tract infection that we thought should have been resolved with antibiotics, but after seeing his urologist/oncologist that wasn't the case. He still had the UTI. And his PSA number was 140. Yes, one hundred forty. On that visit, prior to being informed of the diagnosis, the Doctor reviewed his PSA numbers in his chart and how he went from a 124 to a 6.2. I asked the Doctor "that's really a case for a medical journal isn't it?!" And he replied that "yes, it really is." So what do you do. The incontinence isn't going to get any better or worse, but the loss of his muscles is a major concern. Does he want to be able to walk frequently with a walker and continue physical therapy or does he want to lay up in the bed with a low PSA number? "That's a no brainer" to quote my Dad.
The battle of the congestive heart failure continues, as that is what ultimately is going to be the end. Elevate the feet and legs above the heart as often as possible and lasiks to manage the fluid. It's a fine line keeping him hydrated enough for his heart to pump, yet not too hydrated for it to work harder. Too much lasiks and dehydration happens.
Mike, I think we have very similar circumstances with our elderly fathers, my family is not far behind yours, and my thoughts and prayers are with you and your family.
Dave
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