Hunsicker Returned the call

I did hear from Dr. Hunsicker toward the end of the business day yesterday, and just didn't have an opportunity to post anything. She provided me with the answers to my questions, but doesn't have a positive long-term prognosis at this point.

They did not perform the pleurodesis yesterday. With the amount of fluid that continues to drain, they're concerned that it will just wash out the agent. I didn't quite get it, but I believe that she just referred to it as talc. The talc is supposed to fuse the pleura to the chest wall and prevent the re-accumulation of fluid.

As for the fluid itself, it was tested and did not contain cancer cells, nor did it have signs of infection. She was pretty surprised at this, but the fact that it continues to re-accummulate and drain is a continuing problem. She's not one to offer a lot of additional information, so I tried to ask as pointed questions as possible to get the most I could.

She went on to discuss "end of life" issues and I told her that she had completed a DNR order some time ago. She said that it wasn't referenced in her electronic chart, but that it may be in the paper chart. I talked to Jennifer about this last night, and she confirmed that Mom did complete this, and that Jennifer has some amount of oversight in this matter. Jennifer believes that this was re-affirmed during the hospital admission, but also has another copy of a document outlining this wish. She'll make sure that these wishes are better known as we proceed.

Jennifer did also say that Mom had a pretty good day yesterday, and made a point of drinking some ensure, and even ate some solid food. She was able to have some coherent conversations with her which has been rare lately as she's been sleeping most of the time.

Mom will be getting some visitors soon with Darlene (long-time friend and former sister-in-law) visiting this weekend. Mom's brother Bill and his wife Kathryn will be heading up on Tuesday and spending a couple of days, and I'm planning to head out myself next weekend.

I certainly don't know that the future holds, but unless something dramatic happens, it sounds to me like the hospital is in "do what you can" mode to make her comfortable. They're not pushing the food issue and leaving this to Mom because for one, she can still choose to eat solid foods herself if she wants. Two, inserting a permament feeding tube would be a more aggressive life-prolonging action, and while Hunsicker didn't say this explicitly, that's the feeling I was left with. They want to take action on the most significant, pain-causing items, (i.e. chest-tube to drain fluid) but when it comes to the feeding tube and ultimately the ventilator, they're going to make every effort NOT to utilize those.