Medical update, 26 Oct

After rounds, the decision to discontinue IV fluids was made. While they keep Grandma's blood pressure up, they are contributing to the fluid buildup in the chest cavity that is causing her breathing to be extremely labored. The doctors assure us that she will be far more comfortable without the fluids. Dr. Reisfield just met with Dad, Ruth, See-Ing, Lang, King, Sarah and me while Rev. Alan Patz (Dad and Ruth's pastor) stayed with Grandma. Dr. Reisfield explained that Grandma has clearly begun to die: her heart and kidneys are failing and her lungs are filling with fluid. Her time is short and it would be more accurate to measure her time in days or less. Dad asked whether there was a point in transferring Grandma to Hospice. Dr. Reisfield said that is a very good question since Grandma is so critically ill right now, but that the question can only be answered by the family. The advantage to going to Hospice is that the team there specializes in end-of-life care and it is a more peaceful, comfortable environment for the patient as well as the family. The advantage to staying at Shands is that we are already familiar with the staff here. Sarah asked whether there would be a difference in the medical care that Grandma would receive at Shands vs. Hospice. Dr. Reisfield said that since he himself is a Hospice doctor and would be helping coordinate her care here, then no. He did recommend that if we choose to transfer Grandma to Hospice that we not do so until after Uncle Deng and Daniel had a chance to visit with Grandma. (Even though the Morris Center facility is close by, it would be hard move physically for her, being moved from bed to stretcher, stretcher to ambulance, ambulance to new facility, and stretcher to bed.) The family who were present decided to keep Grandma here at Shands. Dr. Reisfield is working with Grandma's medical team about the changes being made to her care. He is having morphine administered as an infusion so that the nurses do not have to disturb us by entering the room every 2 hours. He will be either removing or quieting the monitors. As he said, there is nothing that the monitors will tell us that will change Grandma's treatment plan. Dr. Reisfield is also acting as the go-between for administrative matters so that the family can focus on Grandma and not paperwork.