Food, swallowing and the breath

Today driving home from the hospital, I did NOT buy an ice cream cone.

The mental comment that my father-in-law had going in my head has been the one I've heard ever since I've known him. He'd say that he ate hamburgers, ice cream, or whatever he liked because he watched his own father not be able to eat once he got colon cancer. Later it would be his own wife he'd watch starve to death from the same cancer.

My father-in-law now has colon cancer himself and has been hospitalized for the past 2 1/2 weeks with no food, unless you count IV fluids and a nasal feeding tube with his "milkshake." The only thing by mouth he's had, has been the barium liquid for radiology tests.

Since the abdominal surgery to remove a tumor, he has been one very sick guy. First there was a surgery that he did not want, followed by a sluggish recovery, then sepsis less than a week after the surgery, with shingles cropping up after the infection. He's been in bed weakening for over three weeks.

Today was the first attempt to feed him "solid" food.

I went to the hospital after lunch not knowing that today they'd be trying to feed him. Apparently, he had choked when trying this first meal.

After a quick swallow study and a consult with a speech therapist (who not only work on speech but also swallowing), we learned that the study indicated that he could eat pureed foods fine. But liquids would slide into his lungs. No problem, give him thickened drinks.

The speech therapist left. The nurse said the family could feed him. She was too busy trying to give meds out to feed him. The speech therapist wouldn't be back until tomorrow to work with him.

My step-mother-in-law looked at me and suggested I feed him. I think she believes that this requires special training. But I also sense that the physical care of him is too emotional and difficult for her to do.

I know how she feels. I have been working in geriatrics for over 20 years, but when it is someone you love, the emotional side kicks in. I wind up feeling drained and overly sensitive after visits with him.

There is also the knowledge that he'd just choked an hour or so before, which left me feeling like I hoped to God he didn't choke on me either. What if I killed him?

All of this brought up bad memories from almost 30 years ago.

I was visiting my grandmother's uncle at a nursing home after he'd broken a hip. He was like a father to her.

My grandmother had the idea that when she hugged him last that his neck was stiff and that he was already dying on her. I'm not sure why she thought that, but I didn't think that it was right to leave him alone in the nursing home.

The next day, I stayed with him for the day. He probably was dying. There was a yeasty smell to his breath that I have never smelled before or since. His breath was labored; he rattled when he breathed. He was dying.

When I came back, an aide was feeding him. Why? And then, he inhaled a spoonful of food into his lungs. His eyes opened wider and he struggled. I said why were you feeding him? She said because she was told to. Then a nurse came in and told me to leave.

He died shortly afterwards. Exactly when, I don't know because I wasn't in the room.

I'd grown up on a farm and saw lots of animal deaths. I'd seen dead people in funeral homes laid out. I'd seen a dead old man on my 13th birthday laid out on Rt 15 after a tractor trailer had hit his car - only a little blood trickled out of the nose and ears of his lifeless body. There was no doubt that he was stone dead.

But, I hadn't seen the struggle of suffocation in humans until the aide fed my dying uncle's lungs.

Working in geriatrics. I've seen lots of elderly with impaired swallowing function inhale their drinks, food, saliva, medication, etc. It is a horrible way to live. It is such a struggle for them to exist with this agitation.

Residents in nursing homes hate to watch others gasp with their choking as they try to eat at their table. They lose their own appetite.

As I've been writing this, I keep trying to clear my throat. I imagine my throat constricting. I cough a little. Sinus drainage exaggerates all of this.

I no longer need to eat for my father-in-law since he is back to oral nutrition. But now I find myself wanting to breath without aggravation for him.

I'm not sure what the prayer is for him at this point. Maybe this is a good time to meditate on mindful breathing... and swallowing.