Why Hospice?

Dear Dr Wells

 Apparently, when Harley was talking with Tiffany this morning, Tiffany said you didn't remember talking with me about hospice. I've made an appointment with you for week after next, but I'd like to try to get my thoughts out on paper, if that's ok.

I feel like I'm moving a step down in my progression on my diseases (and on my body just being worn out.) At this point, realistically - 

-    My cancer is dormant, mostly. It's not growing... hasn't grown in years, and that's terrific, but it's also affecting me every day.

-     Catheter issues. It would be good, since I'm reliant on the catheter, to have it checked more often than is usually done on home health.

-     Liver issues - I'm having days (three, so far, but it seems to be trending) where I dry heave for six to eight hours straight. Nothing comes up other than very bubbly mucous (lots of it). I've been feeling more and more generalized pain, especially cramps in the abdomen, and bad excess flatulence, all of which I suspect mean I'm going from the compensated stage of cirrhosis to uncompensated. While trying to set up an appointment with a hepetologist in the city, I realized that there was no way I was going to be able to drive over to the city - I'm having serious issues just getting into the car, let alone driving 300 miles just to be told to change my diet. I've changed my diet. I've tried PT. My body is worn out. I'm worn out. I don't have it in me to fight much longer - at this point, I would like to switch over to comfort care, rather than trying to fix me. 

-    I am, at this point, experiencing severe agoraphobia, so leaving the house leads to panic attacks just getting into the van, which I can not do by myself, and which can take 5 minutes or so even with a couple of people trying to get me in there. I don't know how I'm going to get to Dr Potters on Monday - he is requiring an in person visit, and I honestly don't know that I can do it. I am at the point in my life where I don't want to work on my issues, or try to get better. I just want to be able to be comfortable and slip away as safely as possible. While I really enjoy seeing you and talking with you, I think that I need a different approach - I think I need to step up to quantity care, if that makes sense. I don't want to have to wait a week to talk to you about a UTI that I have or that I'm dry-heaving (again). I need help keeping my skin clean and rash free, which for me requires a shower every couple of days, and I'm at the point where I need help with showering. I need help organizing medication. 

Anyway - I just wanted to try to explain myself in an organized clear fashion.