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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Is Induced Coma Advisable For A Person Suffering With Glioblastoma?

My father was diagnosed with glioblastoma almost 2 and a half years ago. We certainly feel blessed to have this amount of time with him but we are at the end....I am told by Hospice. 4-days ago he was eating, feeding himself, sleeping perhaps 12-14 hours a day. He started having headaches and the increased his steroid dose from 2 mg to 8 mg. He was better for maybe a day and became irritated and had extreme anxiety, walked the house at night, moaning, couldn t sleep and couldn t tell us what was wrong. Hospice felt he was in pain so they put him into a morphine coma and just stopped the steroids. Is this normal? Why wouldn t they increase the steroids to try and manage the headache/swelling of the brain, perhaps give him morphine for pain instead of putting him in a coma? This just happened this morning and I am now told he wont wake up. Please help me understand this sudden change as everything I read of the ending days of glioblastoma, it seems my father was weeks, perhaps still months away.
Fri, 27 Mar 2020
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General Surgeon 's  Response
Hello,

It is the best policy of morphine induced coma for a person suffering from glioblastoma type grave condition when he is already on max doses of steroids. Over limiting steroids beyond certain recommended doses lead to worsening condition with renal failure, immune suppression to great extent and many more opportunistic fungal and bacterial infections in aged person.

It is the standard practice of medical ethics to relieve the pain in a suffering patient at any cost (that includes coma induction as well) after thorough discussion with responsible care taker person of the family when patient is not in a condition to decide his own way of medical management (as in case of your father).

Hope I have answered your question. Let me know if I can assist you further.

Regards,
Dr. Bhagyesh V. Patel, General Surgeon
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Is Induced Coma Advisable For A Person Suffering With Glioblastoma?

Hello, It is the best policy of morphine induced coma for a person suffering from glioblastoma type grave condition when he is already on max doses of steroids. Over limiting steroids beyond certain recommended doses lead to worsening condition with renal failure, immune suppression to great extent and many more opportunistic fungal and bacterial infections in aged person. It is the standard practice of medical ethics to relieve the pain in a suffering patient at any cost (that includes coma induction as well) after thorough discussion with responsible care taker person of the family when patient is not in a condition to decide his own way of medical management (as in case of your father). Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Bhagyesh V. Patel, General Surgeon