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kimacquaviva's profile
Kimberly Acquaviva 🏳️‍🌈
Kimberly Acquaviva 🏳️‍🌈
Kimberly Acquaviva  🏳️‍🌈
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@kimacquaviva

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Kimberly Acquaviva  🏳️‍🌈Verified account

@kimacquaviva

Preppy @UVA professor striving to make healthcare LGBTQ+ inclusive. Nerdy lesbian. Widow. Quaker. Views are my own & don't represent my employer AT ALL. she/her

Charlottesville, VA
kimberly-acquaviva.com
Joined July 2009

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    Kimberly Acquaviva  🏳️‍🌈‏Verified account @kimacquaviva 2 Aug 2019

    👇🏼Thread It’s been ~48 hours since Kathy last expressed a desire for ice chips or water. Once I stopped giving her dexamethasone, her thirst stopped. 1/

    11:09 AM - 2 Aug 2019 from Virginia, USA
    • 462 Retweets
    • 1,313 Likes
    • Angurghys Jen SLT Olivia Epps Katherine 🌻 💙 Sarah Allen Laura Morrison Kate Cox Rachel Moore, MD, FACS, ABOM Brande Dietrich-McLean
    92 replies 462 retweets 1,313 likes
      1. New conversation
      2. Kimberly Acquaviva  🏳️‍🌈‏Verified account @kimacquaviva 2 Aug 2019

        She’d been taking the dexamethasone for referred pain (pain in her shoulder and back) caused by the liver metastasis. Stopping the dexamethasone doesn’t appear to have increased her discomfort any. 2/

        1 reply 4 retweets 96 likes
        Show this thread
      3. Kimberly Acquaviva  🏳️‍🌈‏Verified account @kimacquaviva 2 Aug 2019

        It’s been about a week since @Kathy_Brandt last asked for food. I haven’t offered any to her after that. 3/

        1 reply 3 retweets 103 likes
        Show this thread
      4. Kimberly Acquaviva  🏳️‍🌈‏Verified account @kimacquaviva 2 Aug 2019

        Hospice and palliative care folks know what I’m about to say but for followers who aren’t #hapc #hpm professionals, I thought it might be helpful info to share. 4/

        2 replies 6 retweets 133 likes
        Show this thread
      5. Kimberly Acquaviva  🏳️‍🌈‏Verified account @kimacquaviva 2 Aug 2019

        When someone’s dying, their body stops wanting food and water. This is basically one of the body’s built-in mechanisms to ensure comfort at the end of life. 5/

        5 replies 42 retweets 276 likes
        Show this thread
      6. Kimberly Acquaviva  🏳️‍🌈‏Verified account @kimacquaviva 2 Aug 2019

        Think of the human body like a car. When you drive your car a lot, you need to keep putting gas in the tank. If your car is just sitting in the garage, though, topping off the tank every day isn’t helpful - gas spills all over the ground. 6:

        4 replies 10 retweets 149 likes
        Show this thread
      7. Kimberly Acquaviva  🏳️‍🌈‏Verified account @kimacquaviva 2 Aug 2019

        When someone is dying, their organs stop sending “gas me up” messages to the brain. Reduced hunger and thirst is the body’s way of saying, “we have plenty of gas to make the trip in front of us.” 7/

        2 replies 18 retweets 241 likes
        Show this thread
      8. Kimberly Acquaviva  🏳️‍🌈‏Verified account @kimacquaviva 2 Aug 2019

        This can be hard for family members to deal with. Food and water are the things that keep us alive. Food is one of the ways we show love to one another. It’s one of the ways we nurture people we love. 8:

        1 reply 9 retweets 225 likes
        Show this thread
      9. Kimberly Acquaviva  🏳️‍🌈‏Verified account @kimacquaviva 2 Aug 2019

        This is why it’s so important to explain to families — in terms a layperson can understand — that it’s an act of love when they listen to what their loved one’s body is telling them. 9/

        2 replies 14 retweets 246 likes
        Show this thread
      10. Kimberly Acquaviva  🏳️‍🌈‏Verified account @kimacquaviva 2 Aug 2019

        Just like gas spills out onto the floor if you try to top off a full tank, feeding and hydrating a dying person who’s no longer hungry or thirsty may cause a cascade of discomfort. 10/

        1 reply 15 retweets 167 likes
        Show this thread
      11. Kimberly Acquaviva  🏳️‍🌈‏Verified account @kimacquaviva 2 Aug 2019

        If the dying person’s body can’t use the food or fluids being put into it, the tank sort of overflows. Fluid can build up making breathing uncomfortable. 11/

        2 replies 12 retweets 140 likes
        Show this thread
      12. Kimberly Acquaviva  🏳️‍🌈‏Verified account @kimacquaviva 2 Aug 2019

        The digestive system of a dying person is basically like a diner 2 minutes before closing time. Anything coming in the door at the last minute is unlikely to get great customer service. 12/

        2 replies 11 retweets 148 likes
        Show this thread
      13. Kimberly Acquaviva  🏳️‍🌈‏Verified account @kimacquaviva 2 Aug 2019

        This isn’t the most medically precise explanation of how the human body shuts down near death but it should give you the basic idea. 13/

        2 replies 5 retweets 146 likes
        Show this thread
      14. Kimberly Acquaviva  🏳️‍🌈‏Verified account @kimacquaviva 2 Aug 2019

        So if you’re ever with a dying person who stops asking for food or water, pause a moment and remind yourself that their body is doing its best to die peacefully. Pushing food and water may prevent their body from doing that important job successfully. 14/

        5 replies 37 retweets 365 likes
        Show this thread
      15. Kimberly Acquaviva  🏳️‍🌈‏Verified account @kimacquaviva 2 Aug 2019

        If you’re reading this and feeling guilty about pushing food or water with a dying loved one in the past, please don’t. We all do the best we can with the information we have in the moment we’re living. /15

        7 replies 16 retweets 393 likes
        Show this thread
      16. Kimberly Acquaviva  🏳️‍🌈‏Verified account @kimacquaviva 2 Aug 2019

        Thanks for listening. ♥️ /end thread

        63 replies 27 retweets 816 likes
        Show this thread
      17. End of conversation

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