Rat Dog

Mary's condition continues to deteriorate.  Saturday morning she was clearly communicative (although not loquacious) and she was even eating a bit of fruit and cottage cheese.  They put the epidural catheter in and the initial result was very good but then the pain started building again.  On Sunday, they did an xray to confirm the location of the catheter and the dispersion of the medicine and everything was perfect. They changed the medication in the catheter and Mary's pain level dropped immediately. 


Mary has acknowledged her visitors, saying hello and often calling them by name.  And, that is about where the conversation stops--except for the grandkids.  She really tries to go a bit further in talking with them, if only an extra phase or two.  


Last night as a group of family members we were visiting and talking, the conversation changed to discuss the new haircut that Shawna, our english cocker spaniel, had been given last week.  I said that when the cockers get their spring "field cut", I call them "rat dog" because of the way they look until the coat grows back.  Sure enough, out of a bit of a drowsiness, Mary pronounces "rat dog".  Fortunately, those were not her last words.  

We had a family meeting on Friday afternoon with the attending oncologist.  It was a surreal scene with grandkids, offspring and spouses, two oncologists and one pain doctor all in this double room configured for one patient. Dr. Allison Kurian (click here and here) did a fantastic job in describing what was happening to Mary and where it would lead.  

A year ago as we began this journey with cholangiocarcinoma, we did file advanced directives and I am very pleased that the Stanford team is honoring Mary's wishes as we continue this journey.  

During the Friday meeting, Dr. Kurian with great consideration and empathy told us that no one can predict what will happen.  However, based on the increasing rate of deterioration during one week in the hospital, the failing status of her liver and kidneys and the likely impact of the retained fluids and hepatic encephalopathy, Mary's remaining time will not be measured in weeks, rather in days.  

As I wrote previously, we'll never be ready for the ultimate result, we won't be surprised either.