In another sign of his increasing frailty, the pope has begun receiving nutrition through a feeding tube in his nose, the Vatican said, acknowledging the pope's recovery from surgery last month has been "slow."
In a statement Wednesday, Vatican spokesman Joaquin Navarro-Valls said John Paul had been outfitted with a nasogastric tube to "improve the calorie intake and favor an effective recovery of strength."
John Paul's brief appearance at his studio window Wednesday was his second unsuccessful attempt to speak to the crowds in St. Peter's Square that week.
After managing just a rasp of his voice, he blessed well-wishers by making the sign of the cross with his hand and withdrew.
On Easter Sunday, the other appearance, mass was tinged with sadness, CBS News Correspondent Allen Pizzey reports. On the day when John Paul usually blesses the world in sixty languages, he could not utter a single intelligible word.
A feeding tube is common in people requiring supplemental nutrition. Implementation involves threading a plastic tube down the nose and throat and into the stomach, allowing liquid food to be fed directly to the stomach.
Dr. Barbara Paris, director of geriatrics at Maimonides Medical Center in New York, said the nasogastric tube might be just a temporary measure to boost John Paul's nutrition while he continues his recovery. But she said it could also be the first step toward having a more permanent feeding tube inserted directly into his stomach.
That procedure, known as PEG — percutaneous endoscopic gastrostomy — involves making a surgical incision in the abdomen so that a feeding tube can be passed directly into the stomach, bypassing the throat altogether.
The nasogastric tube is less invasive and a simpler solution to the PEG procedure, but is not generally used for long-term supplemental feeding, Paris said.
Terri Schiavo, the severely brain-damaged woman at the center of a right-to-die legal battle in the United States, was fed for years by a PEG tube before it was removed earlier this month.
While the nasogastric tube is uncomfortable for the patient, no sedation or surgery is required. John Paul can eat and speak with it in place, experts said.
The Vatican has not said when the tube was inserted; none was visible during John Paul's appearance Wednesday.
In the statement, Navarro-Valls said John Paul is continuing his "slow and progressive convalescence" from a tracheotomy Feb. 24. In that surgery, a tube was inserted in John Paul's throat to help him breathe.
He said John Paul spends "many hours" seated in an armchair, celebrates Mass in his private chapel and has work contacts with his aides "following directly the activities of the Holy See and the life of the church."
But he said John Paul's public audiences remain suspended.
He also said medical assistance is being provided by the Vatican medical staff under the direction of the pope's personal physician, Dr. Renato Buzzonetti — an apparent reference to reports that outside medical help had been called in.