I can't believe how long it's been since I posted an update. Things have been relatively stable - although gradually getting worse. Roland blurps nearly every day. He had 2 of the episodes where he blurps repeatedly over several hours within a 2 week period. We thought it might be the end, but he recovered back to baseline after the second event fairly quickly. Recently he went almost 2 days without blurping, but emptied pretty well tonight. He's clearly lost weight, but is generally hanging in there.