The family met today to decide on a course of care for Pam’s father. The options have narrowed critically in the last few days as her Dad’s abilities to function have begun to fail. The neuro-surgery has resulted in physiological damage, leaving her Dad unable to swallow. As a consequence a tube was inserted into his lower intestine in order to feed him.

Unfortunately this too has failed, as his body can no longer perform peristalsis, which is a muscle movement essential to the process of moving food through the intestine. Due to this failure the food backed up into his stomach and then through the esophagus and into his lungs. An emergency procedure was able to clear the lung, but feeding by tube is no longer a viable option.

The family met to discuss the few options remaining, and it was decided to move him to palliative care and seek to reduce the meds enough to possibly produce a level of consciousness which would allow family members to say goodbye. This was a difficult conversation with a number of varying degrees of acceptance and denial. However the family is coming to grips with the inevitable while still praying for a miracle. The outlook is not good. Practically speaking we are looking at a few days more at most.

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