Minga survived dialysis well, had a second round on Sunday night, and is feeling better than she has in a long time. She feels that God has sent her a way to live longer, and she wants to follow God’s invitation. Her earlier clarity that she didn’t want dialysis — a judgment formed when she was feeling rather well — has changed in the face of imminent death. Now she does want to live longer, and if that means dialysis, she is willing to accept treatment.
Her clarity will, I think, help her family focus. In our U.S. hospitals, discharge planning is done in conjunction with hospital staff. In Panama, at the public hospital, the responsibility rests with family. Lily and her aunt Ita have been to the relevant agency, the Seguro Social, which is located in another building in another part of the city, to see what support Minga can get. Whatever plan they come up with will have to be in place quickly, as once she is stable, Minga will be discharged to the care of her family.
That Minga has changed her mind about treatment as she was critically ill does not surprise me. I imagine that sometimes critical patients do, and sometimes they don’t. I recall a friend in Rochester who was dying of ALS. She’d made clear to her partner that she wanted to die at home. But in the last hours, when she couldn’t breathe, she signaled clearly that she wanted to be in the hospital with morphine to ease her fear. Off they went, and she died there a few hours later.
Minga’s family now has to go into high gear to plan for her care, as hemodialysis will need to be done every three days or peritoneal dialysis every day, and the clock started ticking with her first dialysis treatment. The path forward is neither easy nor clear. I’ll keep you up to date on how they are managing.
Thank you to all for your continued care and concern for this brave, strong, loving woman.
Lily sent this picture of Minga in the hospital, eating food brought in by her family. The hospital may not provide food, leaving it to family members to provide. I can’t quite figure out the hat — it’s the height of rainy season, which likely means 95 degree temps and humidity approaching 100%. I suspect Minga doesn’t want her hair to look bad, with no chance to attend to it since her ordeal. Or, she may be having chills. Son Matt did a Google search, and chills are common after dialysis.
The gauze you see on her neck is covering the port — Lily called it a catheter — through which dialysis was administered.
She looks amazingly well, given how sick she was only a few days ago.