Saturday, December 27, 2008
Closing out of the Practical Aspects of This Journal
Movement from 12/6/08 - 12/08/08:
- As of December 8, 2008 at approximately 0709, my mother stopped moving. Permanently. It seems appropriate to make note of that here since, of course, the reporting of her movement of necessity had to stop at the time of her death. I am write further posts in the future as I review this material, but don't expect those soon or on any type of a schedule; at least not at this time.
- From Saturday morning on Mom was mostly bedridden, although she had some hours in the wheelchair Sunday morning. Even though she was no longer able to stand up on her own, she thought she'd like to get up for a bit, so I lifted and swung her into, then out of, the wheelchair for that period. She had significant trouble holding herself up in a sitting position, even in the wheelchair, but it helped to have her "blocked" by the bedside table; she even ate a little and drank quite a bit. Once she was back in bed Sunday, though, she remained bedridden for the rest of her life.
- A few posts that more clearly delineate her movement for the last few days of her life are:
- December 5, 2008 @ 02:23: Written some hours after I first administered morphine to her; the immediately previous post here covers that day.
- December 6, 2008 @ 18:24 which describes the hell of a day we had on Saturday attempting to adequately manipulate her morphine and how this affected her movement, all of which was in response to devastating pain.
- December 7, 2008 @ 17:56: Which describes her "up" period in the living room during the first part of her day.
- December 7, 2008 @ 23:59: Which describes the last part of her Sunday, during which she remained bedridden.
- December 8, 2008 @ 10:00: Which describes her death. The two posts immediately previous to that post cover a little about med administration during Sunday morning prior to her death and minor reports on her pain level, which, according to her, was nonexistent and her comfort level which, also according to her, was also nonexistent.
Friday, December 5, 2008
Variation on a Normal Day
Movement for 12/05/08:
- Mom's day started earlier than usual, at about 0830, with respiratory distress. Once that was addressed with .25 mg morphine sulfate, though, in the three hours it took to settle and evaluate the situation I decided, after the morphine was firmly in her blood stream, to go about bed changing, underwear changing and groin cleaning before she continued her night sleep. My first inclination was to do the personal grooming stuff in the bedroom, but Mom seemed alert and mobile enough, so I decided to wheel her into the bathroom and do it all "the regular way". She had no problems with transfers and no problems with standing and turning during groin bathing. In fact, she actually seemed better balanced and more in control of her body during the actual standing/bathing part, which surprised me. Other than that, movement has been minimal. I will, of course, report back about the rest of the "up" part of Mom's day, no matter when and in how many installments it occurs.
- During the second "up" section of Mom's day (1430 - 1730) she decided to walk into the bathroom from the bedroom. Although she was a bit iffy, she was determined and seemed not to notice that she wasn't completely spry on her feet. She considered herself so successful that she chose to walk to the banister and down the steps. She didn't quite make it to the banister befpre the chair looked very good to her, though. I wheeled her into the bathroom for pre-nap prep and to her bedroom for a nap. This is not at all unusual, anymore.
- The last "up" part of her day has been wheeling. She's still feeling "coldish" and on the tired side. I'm sure the evening will not change from this.
Thursday, December 4, 2008
Movement for 12/04/08:
- A thorough movement review for Mom's morning is included in one of today's posts at the main journal. I was expecting some improvement if she recovered from whatever's had her in lock step for over a week, but I didn't expect her to recover as quickly and heartily as she seems to be doing. I'll report back later the after-nap part of her day.
- Considering the title of this post, I should entitle this section Surprise Relapse: This evening she was tired and lethargic. We wheeled it all the way. I'll report more over at the main journal and slip back here to put up a link back.
Movement for 12/3/08:
- Another sluggish day, swollen feet, unusually high BGs regardless of me watching her diet like a hawk; she also complained of feeling "coldish", which she hasn't over the last few days. She was definitely sluggish, but decided to move a bit more than she has in the last few days, saying she felt she "should". Since her movement profile has been so low, lately, it could be said that her movement improved, today, because she walked into the bathroom from the bedroom before breakfast and walked through the dinette and down the dinette steps while heading for her rocker after breakfast. In the evening she gave it the good old college try after her nap when we were due to head into the bathroom but, after standing and trying to take a few steps, she complained that "[her] legs don't feel like [her] own" and I encouraged her to sit back down so we could use the wheelchair. As the evening progressed she had some difficulty standing momentarily for me to remove her pants for her leg rubdown. She transferred fairly well throughout the day, though, with a few blips along the way.
Wednesday, December 3, 2008
Movement for 12/2/08:
- The edema in Mom's feet and legs made it very uncomfortable for her to walk, today, although, trooper than she is, she tried several times then, after a few steps, asked for the wheelchair. She became disgusted with this and persevered for the entire walk from the bedroom to the bathroom after her nap. At this point she actually told me, "My feet don't feel like my own." They don't look like her own, either.
I plan to follow a few of strategies:
- No more furosemide after last night, I think
- Restart the rehab exercises, especially the ankle rocking. We've let those slide.
- If this continues, since no other causes seem prominent, I'm going to ask for a CBC next week to see if how severe her anemia is and, possibly, ask for intravenous iron or, if necessary, a transfusion.
Tuesday, December 2, 2008
Movement for December 1, 2008:
- The only walking she did, today, was from the dinette around the table after breakfast and down the dinette steps to the wheelchair to be wheeled to the rocker. I had decided to insist on wheeling her from the bedroom after sleep sessions, but I didn't need to insist, that was fine with her. She was pretty iffy trekking around the table. I think it's because of the feet and leg edema, which I decided to address, tonight, with 10 mg furosemide after it increased significantly throughout the day. Fluid retention may have been part of the problem with her breathing over the last few days, although she didn't appear to be swollen throughout her belly or in her face until tonight. It will take the fluid off slowly but surely. If necessary, I'll give her another 10 mg tomorrow, sometime.
Monday, December 1, 2008
Doing Some Wondering
Movement for 11/30/08:
- She walked only twice today, both times after having slept. She had significant difficulty with breathlessness and moderate pain in her middle back after walking to the bathroom from the bedroom both times. This happened yesterday, as well. Although I'm not sure if we're having a few more "Bad Cancer Days", nor am I sure if we can expect any "better" days than these two, I'm thinking, at least for the time being, that I'm going to insist on wheeling her just about everywhere and see if I can get approval for boosting her to 6/lpm O2 when moving; and see how she does, moving, at that rate. It's possible that her days of moving much without the wheelchair are quickly coming to an end.