Thursday, September 22, 2011

9.22.11

AYNSLEY:
As predicted, Mom did get a great massage today. The PT assigned to us now was a massage therapist before she became a physical therapist and came in today to give Mom a very enjoyable massage. (Mom had PT sessions approved through insurance and since she can't do any therapy now, might as well get a massage!) That may have been the day's highlight.

The lows were many. I spent last night with Mom. She took a Benadryl before going to sleep and slept for 9 hours straight, which made me nervous in the middle of the night. I kept waking up and looking over at her, making sure she was breathing and in a semi-comfortable position. Finally, at 5am, she woke up to go to the bathroom. She then slept in 2-3 hour bursts for the rest of the day, but when awake mentioned that she didn't want any more Benadryl. It knocked her out too much.

This morning was the first morning Mom didn't eat breakfast. Every day for at least the last six months, Mom has had a bowl of Cheerios with a chopped up banana in whole milk. Not an enormous amount of nutrition, but she always ate it all and at least we knew she had eaten something for breakfast. (On occasion, someone would bring her Starbucks oatmeal, which she would eat to mix things up, but most of the time it's the Cheerios). This morning she couldn't manage that. She had a bite of cinnamon bread, but that was it. Two bites of quiche for lunch and three bites of a tuna sandwich for dinner, with pieces of melon and nectarine thrown it. Ross mentioned that he was concerned about her lack of nutrition to NP, who gently said that often when a body is in decline, appetite goes away. Digesting food requires a lot of energy and blood is diverted from the lungs, liver and brain and Mom's organs probably don't want to spare it for a meal.

We were able to double Mom's oxygen consumption (now at 10L) by adding another O2 tank to her room and connecting the tubes to her breathing tube. This helped bring her oxygen saturation up to the low 90 percent, when yesterday and this morning they were hovering in the low 80s. She had another chest x ray and found more pneumonia, which will be treated with a different course of antibiotics starting tonight or tomorrow. Almost as soon as the second O2 tank was hooked up, Mom felt more comfortable. NP gently suggested that maybe it's time to switch our course of treatment to a more comfort-based approach, which comes with a lot more resources and benefits. We'll have a hospice nurse come check on Mom daily and whenever we call and already have had access to more people checking in to see what we need.

I know that hospice care is usually the last step in a person's life. But instead of being devastated by this choice, we all feel relieved and know it's the right path. Mom has clearly been uncomfortable the past few weeks and it's been very difficult for her to transcend the discomfort in her body. The past few days have seen a significant decline; on Tuesday, she was able to walk to the bathroom with a walker and today she can barely stand when being held up. Hospice is the best thing now; once she agreed with NP, which happened instantly, she visibly became more relaxed. As Gary put it, it's really the brave choice. And that's Mom all the way.

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