My mother in law has been diagnosed with gallstones and thickening of the walls and infection in the gallbladder. Because of her age - 91 years - they have decided not to do the normal surgery, but just to adjust her diet. She eats like a bird anyhow and we can see her getting weaker.
I'm trying to find out what are the likely scenarios from here on out - to know what to expect and maybe what help we may need towards the end.
If she truly has a bacterial infection, that is the most concerning part. It takes a lot of energy for the body to fight an infection, and thus it can sap the body of its reserves very quickly.
She needs to be on a fairly high protein diet anyways. You should speak with a dietician, if possible. But, adding a supplement, such as Ensure milkshakes, to her meals will help.
I understand that an open procedure under general anesthesia would be quite dangerous in a frail lady, but has a laproscopic cholysystectomy (lap choly) under a regional been considered? If the infection gets too out of hand, it will be a big problem. And if surgery is to be considered, it should be done while she is still able to handle the stress to the body. Just a thought.
Again, speak with a dietician to get her on the best diet possible. It takes a lot of energy to deal with this problem.
Thanks for the reply - my feeling is that she is so low surgery is not an option - I think we are looking at the end and wanted a bit of advise as to what to expect - will she have much pain? will it be quick? or lingering? , just so that I can make some educated suggestions to her daughters (delicately of course) I don't know whether we will need to get some palitave care for her as she wishes to die at home and it is a rural area with no hospital etc,.
Any help would be much appreciated.
You are correct, this is a delicate situation and one that should be discussed with her physicians, since they know her and what exactly is going on.
However, in general, infections can be quite painful, especially if there is an abscess under pressure. Also, being febrile tends to sap one's strength and makes one feel lousy. unfortunately, it is really hard to so how fast one will succumb. If a person is very frail, with little reserves, it probably wouldn't take too long. In some cases, the patient may even pass into an almost comatose state.
But, in any event, if it has been decided that this is going to be the end, then arrangements must be made to make sure she is not in too much pain. Though pain medicine can sometimes shorten one's life a little (respiratory depression, pneumonia, decreased attention, etc), most people want to be comfortable and should be made so.
Again, without ever having seen the patient, no one can really give you exact information over the internet. That should be obtained from her physicians. They are the best source of information. But, again, arrangements should always be make to make sure someone is comfortable.