Panama 2017: Update on Minga

Lily sees her grandmother often, and she is noticing that Minga seems markedly diminished in terms of physical strength and overall engagement with life. I think my going next week is timely.

I’m ready to make a strong push for Minga to go home and receive manual peritoneal dialysis there, no matter how long she has left to live. I’m concerned that I may find, even next week, that she is too frail to undergo the surgical procedure to change the catheter now in her jugular vein to one in her abdomen — a requirement for changing the kind of dialysis she is receiving. I’m not sure what I’ll do then. She has a right to die at home, if that’s what’s going to happen. But I’m not sure how quickly, or how, we can arrange for peritoneal dialysis in the village.

Such a complicated path forward, and such constrained options. I wanted them to have the catheter changed already and the new plan in process, but Lily is reluctant to do anything before I get there and can talk with Minga. I understand — she is navigating complicated family dynamics, and doesn’t want to get too far out ahead of the situation.

I leave next Tuesday, and will keep everyone posted as I assess things with my own eyes.

8 thoughts on “Panama 2017: Update on Minga

  1. Safe travels and love to Minga and you. Her story is one that I have seen/heard repeated too many times. Dialysis, once started on someone of Minga’s age and situation, causes many more problems than it solves, and is then difficult to stop.

  2. for Linda: I don’t have much experience with renal failure, and so this is all new to me. I don’t know too much about Minga’s underlying health, but I know that high blood pressure has been a long untreated problem — likely what caused or worsened her kidney failure — as has high cholesterol. Don’t know what else might be underlying. And, she’s only had medical care of any kind for the last ten years or so. Clearly she’s not doing as well on dialysis as her family hoped. Difficult all the way around, and the lack of palliative care and end of life counseling makes it harder.

  3. I agree living at home comfortable is what most people prefer. As an FYI, most people on dialysis live at least 10 years. She may be tired and depressed. There are meds for depression if need be. It doesn’t sound like she’s at end of life to me.

  4. for Katie: Anti-depressants are hard to come by in the free public health system there — not really available to her. I hope to find she’s not at the end of her life. We shall see.

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