olgah,
It is disappointing to hear about the medical care your father has gotten, his health now, and the health care situation in Greece.
His weakness, fatigue, and memory loss may all be due to the same cause: a lack of oxygen-carrying red cells in his bloodstream. If he could get Epogen again or blood transfusions when he needs them then these symptoms might be reversed.
Epogen is a product of Amgen. I suggest that you contact
Amgen Greece (phone +30-210-344-7000, fax +30-210-344 7050) and ask about their Amgen Assist program, which helps patients pay for Epogen. Their United States assistance program is described at
amgenassist.com. Ask them if there is an equivalent program in Greece. Also ask them what other patient resources they know of. We all know that there's a financial crisis in Greece, but Amgen is an international company with lots of resources.
Greeks as a whole may not have a high rate of blood donation, but you and your sister and other family members could talk to everyone you know personally and ask for help. If you could get 1 dozen, 2 dozen, or more people to agree to help your father by donating regularly (every few months, starting now), you might be able to repay the blood bank for the units of blood he needs. Ask everyone you talk to to help you recruit more people. You could even let them share photos of your father before and after he became sick and ask for help saving his life.
I also suggest that you ask the
Hellenic Red Cross how else you can help your father keep up with his need for transfusions. They may have other ways to help, suggestions, or resources to help you run your own blood drive. And they will know as well as anyone how to deal with cultural issues.
You asked what happens in the final stages of MDS. It depends on which types of blood cells an MDS patient is lacking, just how low their counts are, and other factors like their general health. When MDS patients die, it's not directly from MDS but from symptoms caused by a low red cell count, a low white cell count, or a low platelet count. Without enough red cells (anemia) a patient may suffer congestive heart failure. With a very low platelet count (thrombocytopenia) a patient may die from bleeding into the brain or intestines. Patients with a very low white cell count (neutropenia) are often in the most danger because they are subject to infections and may succumb to pneumonia or other bacterial or fungal infections. If there's any good news in all this, it's that measures can be taken to keep patients comfortable when it's clear that the end is coming, and they may simply go to sleep and not wake up. But having low counts doesn't mean you should give up hope. Some people are able to live with mildly low blood counts, so they don't have to reach normal levels, just avoid critically low levels.
I hope that some of these suggestions will let you and your sister help your father. He might have more resolve than you realize and with help could regain the strength that he's lost. I wish you the best of luck.