Mom spent most of the past week sleeping and her food and
water intake was very small. Then Sunday she woke up and announced that she was
hungry! So she had a “big breakfast” of one scrambled egg and some fruit and a
bit of “Ensure”. A few hours later she had vomited it all back up, twice, and
was in great distress.
The Hospice Nurse came out today and indicated that it could
have been either that her system is shutting down now and it simply cannot
process the foods that she had eaten in the past or it could be that, with as
little as she had been eating, the pain medicines caused her stomach to be so
upheaved that it finally couldn’t take any more… or maybe a combination of
both. Either way, her system reacted by ejecting the food back out and leaving
her weak and in great discomfort.
We have changed her pain meds from the hydrocodone to
morphine now, and she is much more somnolent than even before. We were
administering the Tylenol and Hydrocodone rectally yesterday to allow her
tormented stomach a chance to heal. Now that we have switched to the new
medicine, we are giving it to her in a small syringe, without a needle, directly into her mouth. It is vile tasting, so we try to follow it with
some water to wash away the taste, but she is able to only take the water in very
small sips, also from a syringe.
As her body begins the final shut down, her ability to
regulate her body temperatures is failing. She is going through phases where
she is hot and clammy or down right chilly. We have to keep adjusting her bed covers
to address the changes and Tylenol suppositories help keep her from getting too
feverish.
We are watching for her feet and hands to start getting
cold, which they seem to be doing slightly already, and then turning a bluish
color as circulation to her extremities slows down in order to allow her heart
to maintain the body core. We are seeing her heart rate beginning to rise and
her oxygen saturation to drop. All as expected in the end stages of this
process. Even her skin color is starting to turn sallow and a bit yellow due to
the slow shutdown of her renal system.
All in all, we are working to keep her as comfortable and
pain free as possible. In one of her brief wakeful moments she told my sister
that “He is smiling”. My sister asked her who she meant, was she speaking of my
father. She said, “Yes.” So my sister told her that he has been waiting for her
and is delighted that they will be together again soon. She then told her that
he was probably saying what he had said before many a trip they had taken
together…. “Hurry up and get packed! Let’s get going!” We all laughed at the
shared memory as she drifted, smiling, back off to sleep. Gently and
peacefully, it’s not a bad way to go. As a friend called it today, “The long,
slow good-bye”.
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