Monday, September 2, 2013

One LONG Week

What a difference a week can make! We started off last Monday with Mom slowing down on her food and water intake and we have come around to starting this Monday with the Hospice team suggesting that any family members who want to see her, do so sooner rather than later. In one week’s time, we have gone from status quo to here we go, and I don’t think I’m ready for it.

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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