Need Help For A Novel - Terminal Illness For Young Man

[thejesterman]

Hey,
Sorry if this sounds mad but I have been searching for a while and I am stumped. I am not very well versed in medical knowledge.

I am writing a book in which the main character is terminally ill in hospital. I just can't pick an illness and need some help. I just need some examples/possibilities that I can then research. It is not the main point of the book but it can't be swerved.

The man is in his early thirties. He needs to be spending the rest of his days in hospital (whether they keep him there for care or tests/treatment it doesn't mater, but they are sure he won't make it) but can still be somewhat active, walking, talking etc. It also needs to be progressively worse and debilitating towards the end.

Cancer won't really work either. Does anyone have any suggestions? I apologise again for the weird post.

 

[Evo]

How quickly does he need to die?

 

[thejesterman]

How quickly does he need to die?

Ideally, about a year. But that can go from 6 months to 2 years, would just need a little re-write.

 

[berkeman]

Hey,
Sorry if this sounds mad but I have been searching for a while and I am stumped. I am not very well versed in medical knowledge.

I am writing a book in which the main character is terminally ill in hospital. I just can't pick an illness and need some help. I just need some examples/possibilities that I can then research. It is not the main point of the book but it can't be swerved.

The man is in his early thirties. He needs to be spending the rest of his days in hospital (whether they keep him there for care or tests/treatment it doesn't mater, but they are sure he won't make it) but can still be somewhat active, walking, talking etc. It also needs to be progressively worse and debilitating towards the end.

Cancer won't really work either. Does anyone have any suggestions? I apologise again for the weird post.

Why won't cancer work?

I'd suggest checking out the House episodes if you want something exotic. They go through lots of potential terminal diseases before saving the patient at the end of each hour. There's probably an online web page somewhere that has info on House episodes.

 

[thejesterman]

Why won't cancer work?

I'd suggest checking out the House episodes if you want something exotic. They go through lots of potential terminal diseases before saving the patient at the end of each hour. There's probably an online web page somewhere that has info on House episodes.

Not really going to work if he has to go into chemotherapy, it might do but it could make things awkward. The less round-the-clock treatment needed, and the more time he can spend on his lonesome, the better. Plus I need him smoking to find an excuse to leave the building.

Never seen House - heard of it certainly - will have a look into it. Cheers

 

[Evo]

My former brother in law was recently diagnosed with pulmonary fibrosis and given 2 years to live. Smoking would certainly make things worse. I guess you could throw in some other problems to keep him in the hospital until he dies.

 

[thejesterman]

My former brother in law was recently diagnosed with pulmonary fibrosis and given 2 years to live. Smoking would certainly make things worse. I guess you could throw in some other problems to keep him in the hospital until he dies.

Thanks for that, I am sorry if I brought up any bad memories/thoughts with that post.

I'll keep that one in mind. It does say commonly in over 50s, but not always the case I guess and the symptoms will fit in with what I want. Aside from the smoking of course.

 

[Andre]

I guess that's a tough one, no patient (here at least) is going to spend months in the hospital. It's simply too expensive. Beds are urgently needed for other patients.

However if somebody needs constant medicare for a prolonged period, they'd probably send him to a nursing home.

You could try maybe http://en.wikipedia.org/wiki/Cystic_fibrosis

 

[adrenaline]

Lou Gherig's disease or ALS
right age group
or other 100% mortality neuro conditions like Huntington's?

 

[thejesterman]

I guess that's a tough one, no patient (here at least) is going to spend months in the hospital. It's simply too expensive. Beds are urgently needed for other patients.

However if somebody needs constant medicare for a prolonged period, they'd probably send him to a nursing home.

You could try maybe http://en.wikipedia.org/wiki/Cystic_fibrosis

Yeah, they wouldn't keep them long here either. I'm in the UK and the book is set in the UK, the NHS are packed to the rafters with patients.

I might have to consider Cancer (that sounds like a very weird thing to say). They do keep cancer patients in long term don't they? I had an elderly relative who was terminal with lung cancer but she spent her final days at home in bed, although I think that was her choice...

 

[hypatia]

They normally move long term cancer patients to a hospice or home to die. Its just to costly to keep them in the hospital.

I vote for Lou Gherig's disease.

 

[thejesterman]

ALS does seem like a good one. It did take him two years to go from diagnosis to death I suppose. Would rather have one that made him violently ill (more dramatic), with sickness, spitting blood, mucus from both ends etc,. Messy but fits in. The disease is not the main focus but he is the main character.

Thanks a lot for taking the time to help by the way:-) Really appreciate it.

 

[Q_Goest]

Some kind of parasite? Alien creatures burrowing under your skin are always fun.

 

[lisab]

Maybe AIDS?

 

[thejesterman]

Maybe AIDS?

That had crossed my mind, he is written up as a former drug addict and Morphine/Heroin user, so it wouldn't he hard to write that one in. Not a commonly quick killer though, can be elsewhere where they don't have the resources apparently...might have to do some more reading to see if it can kill that quickly. There is sure to be complications.

There is also a drug/treatment called PEP, the side effects of which would tie in very well with the way I want this guy to go.

 

[thejesterman]

Some kind of parasite? Alien creatures burrowing under your skin are always fun.

This guy had barely left the house, so probably won't work without a big rewrite.

Thanks again for the help guys:-) Have yet to look into the TV program House as suggested, just popping on here whilst I take breaks, should be able to check through later when I have time.

Anyone watch it? remember any of the disease by any chance?

 

[adrenaline]

ALS does seem like a good one. It did take him two years to go from diagnosis to death I suppose. Would rather have one that made him violently ill (more dramatic), with sickness, spitting blood, mucus from both ends etc,. Messy but fits in. The disease is not the main focus but he is the main character.

Thanks a lot for taking the time to help by the way:-) Really appreciate it.

End stage ALS can die of aspiration pneumonia, they spit up mucous, sometimes blood if it becomes and empyema and erodes into a blood vessel, the antibiotics can cause clostridium difficille colitis ( known complication of antibiotic therapy) in which case they have horrible dysentery, and if they develop megacolon from c diff colitis it is a miserable ending ( usually needs surgical resection...)

 

[thejesterman]

End stage ALS can die of aspiration pneumonia, they spit up mucous, sometimes blood if it becomes and empyema and erodes into a blood vessel, the antibiotics can cause clostridium difficille colitis ( known complication of antibiotic therapy) in which case they have horrible dysentery, and if they develop megacolon from c diff colitis it is a miserable ending ( usually needs surgical resection...)

Thanks for that:-)

Certainly bumps that one up. Sounds like a pretty horrible way to go, nasty to think of but just what I need.

 

[magnusrobot12]

ALS or Huntington Disease are the way to go.

 

[fedaykin]

"In the Multicenter Hemophilia Cohort Study median survival after a single AIDS-defining condition ranged from 3 to 51 months for the 10 most common conditions."

source:

http://www.hiv.va.gov/vahiv?page=pr... Issues&tpage=prtop03-00-rr&pf=pr-kb-pf&pp=pf

 

[Bigbio2002]

Super-AIDS.

No, seriously. HIV superinfection (a condition in which the individual contracts multiple strains of HIV and progresses rapidly to AIDS despite treatment) is rare, novel, and might be what you're looking for. However, I'm not a doctor, and I don't know if a realistic depiction of the illness would allow him to live for a year or more. But it's worth looking into.

 

[Evo]

Thanks for that:-)

Certainly bumps that one up. Sounds like a pretty horrible way to go, nasty to think of but just what I need.

I would go with adrenaline's suggestion, she is a doctor, so knows this stuff.

 

[Astronuc]

Ideally, about a year. But that can go from 6 months to 2 years, would just need a little re-write.

Acute Myelogenous Leukemia (AML) would probably work.
http://www.marrow.org/PATIENT/Undrstnd_Disease_Treat/Lrn_about_Disease/AML/index.html
http://www.mayoclinic.com/health/acute-myelogenous-leukemia/DS00548

It took about 11 months from diagnosis for my brother to die. He received chemotherapy, and was able to leave the hospital to go home and be sick. He received treatment about once per month. He also received a lifetime's worth of radiation.

He lost his site briefly. In the end, he was given a new drug that basically shutdown what was left of his liver. That was a terminal condition. He lapsed into unconsiousness (as organs failed and toxins built up in his blood) 5 days before he died.

Althought he appeared to be close to remission, the leukemia cells seemed to find ways to spread, e.g., spinal chord, cranium, and ultimately femur and pelvis (sarcomas).

If one is so ill that one is in hospital, I don't imagine one is going out of the hospital periodically to smoke.

 

[Moonbear]

Not really going to work if he has to go into chemotherapy, it might do but it could make things awkward. The less round-the-clock treatment needed, and the more time he can spend on his lonesome, the better. Plus I need him smoking to find an excuse to leave the building.

Never seen House - heard of it certainly - will have a look into it. Cheers

What about emphysema? Fits with smoking (and yeah, many patients won't give up smoking even if they know it's going to kill them). Can still be out and about with an oxygen tank for a while, and then progress into an end-stage disease (maybe ineligible for a lung transplant or can't find a donor match) when you're ready for the character to die. Or, perhaps add in complications of a rapidly progressing lung cancer developing later in the disease progression.

Do you need your patient to be completely hospitalized, or just in the hospital a lot? A diabetic with renal failure in and out for frequent dialysis is likely to also have cardiovascular complications, so when it's time to get your character to die quickly, a heart attack or stroke is what finally does him in.

Another consideration...does it need to be a traditional hospital setting? Someone recovering from a stroke or serious head injury might be in a rehabilitation center/hospital-like facility for a prolong period of time while regaining full function or learning to compensate.

Someone with a severe limb injury requiring amputation could be in a hospital for a long period of time while undergoing multiple surgical procedures to treat infections and allow the stump to heal and then get fit for and trained to use a prosthesis. They might come and go in a wheelchair for a smoke, and could either rapidly worsen from an antibiotic-resistant infection (after long prior courses of antibiotic treatments) that becomes septic, or die on the table from anesthesia during one of the many surgeries required. Even an injury not requiring amputation, but in which there is a large wound requiring reconstruction could fit this criteria.

 

[2cen]

Why not cirrhosis of the liver. My dad was a brewer, and drank a good bit of beer. Then he took a job as a writer for a group that produced conventions. They drank the heavy stuff which killed my cousin's husband. He had asthma, and just dropped dead with a martini in one hand and his inhaler in the other. In the meantime my dad got arthritis and had a friend in the pharmaceutical business who supplied him with cortisone that helped with the pain, but destroyed his liver and his spine. At the end he looked like a snail, all bent over. Standing was very painful. But before the end my mother developed arthritis, and he rubbed her down with DMSO. He knew he couldn't use it, because it would effect his liver, but he didn't realize he was absorbing it through his hands. In the end he had 2% of his liver going for him. The physicians had him on a diuretic, lasix, and on coumadin (which is a blood thinning rat poison). Later my mother was given lasix and her blood pressure dropped 40 points. My dad would ride his lawn mower, and then suddenly, when he was on his feet, his legs would give out and he'd plump on his bottom. Obviously the blood pressure dropped.
The next day, he'd go into a coma--for a couple of days. One day he didn't come out of the coma. He just faded away--the body gradually turned from pink to gray.

I don't know how you can write anything about a person dying or having a terminal illness
without being intricately involved with the process. Disease affects everything a person does, including the way they see the world, including whether or not they see themselves as a victim or as a chance to battle it. I would suggest getting a job as a paramedic and as a nurse or orderly and get to watch a dozen or so people go thru the process of dying.

The family is also affected. You can think about dying in front of your keyboard, but it ain't nothing like that. You might want to read people like Deepak Chopra--Quantum Healing--and other books that deal with people who cure their diseases as well as the ones who are defeated. Caroline Myss has some interesting stories too. There were two women she advised, telling them to get out of their relationships. Both had cancer. The one who left her husband defeated her cancer; the other, the one who laid down before the bathroom door and had her husband step on her as he left the bathroom couldn't muster up the power to leave him--she died. He had total contempt for her. Apparently she didn't have much value for herself either.

Anyway, good luck! Momento Mori!

 

[adrenaline]

volunteering at a hospice would be the way to go , as a ex paramedic I never saw dwindling,slow deaths, and nurses on hospital floors usually treat acute illnesses. Hospice nurses can really give you a good feel for what people go through with terminal illnesses. Hospice social workers can give the social,psycological aspects of the disease. Hospice medical directors can also give you a good idea of the many psycosocial as well as physical aspects of dying.