[RDC1001]

I hope a few more people see this, especially if they have dealt with anything similar.

My grandma had her geriatric appt last week and it was a long, good appointment. Basically we discussed the "unofficial" diagnosis of MDS and reasoning for not doing a bone marrow biopsy. The doctor agreed because at this point in time, any MDS diagnosis isn't really going to change her care. She isn't doing chemo, etc.

She talked to my grandma specifically about what tests she would still want to do and my grandma said none. She said she would go to her regular appointments and get transfusions as needed, but no invasive procedures. She said, "I've lived a good long life."

As hard as it is, I understand where she is coming from. I've been dragging her from appt to appt and she is just plain wore out. So I took her to lunch, we have a very good talk, and I took her home.

Between last Wednesday and Sunday, her appetite went down even more, enough that my dad too her to the ER. Her hemoglobin was 7.5, but they ordered two units for her...perhaps because she has been dropping so low lately? They brought her up to a 10...that is high for her and I will take her back for labs on Friday to see what the difference is.

When I saw her today she does not look well, especially after having a transfusion. She has no appetite still and very tired. She is no longer allowing the visiting PT and OT to come, but just the nurse to take her vitals, and that is me convincing her.

I feel she has went downhill more even since last week. But I have looked for "end stages" (i hate that) and I haven't found a whole lot online. I just want to be prepared. I don't want to be the jerk that brings up hospice if we aren't there yet...but I just don't know.

Does anyone have any advice regarding this? Her first transfusion lasted a month, the second one two weeks...

I hope this makes sense.

Thanks for everyones help.