Three team tagging

The last few days have seen 'triangulation' as one doctor called it, as the three different teams concerned with Carol have been collaborating.  The medical, neurological and palliative teams.  Rob was due to return to the US early Monday but heavy snows in NY meant his flight has been delayed until early tomorrow (Thursday). For me this has been a real bonus because all three teams have spoken with us these last two days and Rob has been able to weigh in with significant questions along the way (as well as be with me each evening as we reflect on Carol's decline). Sadly, decline it is and this has meant serious collaboration.

One area of discussion was the feeding tube. Because Carol is no longer eating solids (which has been true for much of this year) the medical team has been keen to fit a feeding tube (as I mentioned in the last post).  Admittedly unpleasant, they have seen it as necessary to stop Carol wasting away. However, the neurological team has been concerned that Carol's lessening cognitive ability means that she no longer has control over her swallowing.  It is hard to imagine the mental state of someone who cannot remember how to chew and swallow.  Actually,  I don't want to imagine it.  It was ultimately agreed by triangulation that the feeding tube is not going to improve her situation and could actually cause distress.  So it's not happening.

The result of this is obvious. Carol is entering a time with no food and minimal drink. This is where the palliative care team is attempting to track the progress of her disease - though we still don't know a diagnosis.  Is this sudden?  Most definitely. Everyone is surprised that she has become so unwell so rapidly. The long-awaited MRI scan is due to take place on Friday but it is agreed should Carol object (and her  claustrophobia is likely) they will not pursue it. 

I remain so grateful for the love and prayers of our many friends. Please forgive me that I have been unable to reply to so many of you.  I deeply appreciate your kind words. Thank you all.