Continuing Downhill

Elizabeth's condition seems to be getting slowly worse each day. She is now completely immobile in bed and cognitively very impaired. It is not clear that she understands much of what goes on around her and is mainly unresponsive to questions or comments -- occasionally she will answer with a shake or nod of the head. She does object strenuously to the necessary caretaking routines which probably cause her pain and/or anxiety, but we aren't really sure.

No one really understands the causes of this state -- they could be the effect of the leukemia actually entering the brain, but they could also be due to the toxic mix of medications she has been getting, including steroids, chemo, antibiotics, ativan, IV nutrition, etc. Another possibility is that all of the above have put such a strain on her body that it is simply in the process of shutting down.

Although we will be continuing as now for a few days unless things get suddenly worse, it seems quite possible, even likely, that she will die in a relatively short time. We do not intend to apply extraordinary measures to keep her alive unless there is good reason to believe that she has a good chance for a full recovery given a bit more time, something that seems pretty distant as of today.