Dying On The Low Road

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When I walked into Dad’s room at the nursing home, he was writhing in agony and moaning.  He had succeeded in getting his hospital gown off, and was working on the rest of his attire–his diaper–and had the bedclothes tightly twisted around his legs so they stuck out at an unnatural angle.

I threw off my backpack and ran to him.

“Hi Dad, what’s wrong?”  I unravelled the sheets and put his top back on him.  He grabbed my hand and smiled, kissed my hand over and over, then a pain struck him and he rolled from side to side, moaning.

“Where does it hurt, Dad?”

He managed to get his good hand up to his head.

“You have a headache?”

Nods.  He has a hell of a concussion after his horrid fall a month or so ago.  I can relate, having had several bad concussions.  They give you a headache for a long time.

“OK, let me get the nurse to give you some Tylenol (Acetaminophen, Acamol, Paracetamol, etc.).  That will help your headache.

He looked at me skeptically, but assented with his eyes.

Since his last fall, Dad, who had been having difficulty speaking after a number of small strokes in the speech area of the brain, is now “locked in.”  He can understand a lot of what is said around him, but he is unable to produce meaningful speech.  It’s a horrible state to be in.

The nurse was very busy passing pre-dinner meds, but she knows my dad, and if he says he is in pain, he is.  She crushed up the tablets in applesauce and I fed it to him.  It tasted vile, and he gagged on it.  At least I was able to get some water into him, in the form of big mouthfuls to wash the taste of the nasty medicine out of his mouth.

The Tylenol did take his headache away, but it didn’t fix whatever was causing him to writhe and groan.

I called his nurse, and we made the joint decision to give him his morphine, which he has on order every 4 hours if needed, and it was clearly needed.

Thankfully, the morphine was just a few drops from a tiny syringe.  It seemed to help for half an hour or so, then the writhing and groaning began again.

I searched my mind and looked at the picture with soft vision.  I saw it.  He had to go to the bathroom!

I asked him.  “Maybe,” he says.

I called the Nurse Assistants, and the put him on the commode.  I stepped out for modesty’s sake.  Jewish children are forbidden to look upon their parents’ nudity, as we learn very early in the Torah where Noah gets drunk and takes off all his clothes.  One of his sons looks into his father’s tent, sees him lying there drunk and naked, and laughing, tells his two brothers.  The brothers get a blanket and, throwing it over their shoulders, back into their father’s tent and, not looking at him, drop the blanket on top of him, to cover his nakedness.  So I do not stay in the room whenever the nurses are doing anything that normally we consider private.

Now that we have opened the Jewish Thing, I want to talk about a concept that has been Jewish and Vedic and I don’t know what else, for 5,000 years more or less, that has recently been backed up by medical specialists in the art of assisting dying people.  Yes, there are such physicians.  They minister to hospice patients, for the most part.

The Jewish tradition, backed up by medical observation, is that there are two roads to death: the High Road, or easy death, like people who simply up and die in their sleep, just go to bed like normal and don’t wake up.  We call that “mavet be’neshikah,” or death by a kiss.  Whose kiss?  The kiss of the Master of the Universe, who says, “it’s time to come home now,” and that’s that.  Aharon ha’Kohen and Moshe Rabbeinu both went that way.  I pray that all of us go that way.

People who die like that have finished their soul’s purpose on Earth and will not reincarnate, usually, unless it is into a body that just needs a bit of  touch-up.  These are the babies who die very young, or in the womb after 4 months gestation.

Death on the low road is another thing entirely.  It is a slow and painful death, one that makes the sufferer long for the relief of suffering that death brings.  It seems as if the soul is having a struggle with the Malach ha’mavet–the Angel of Death.  They beat themselves up dying, like a moth beats itself to death on a lightbulb.  It’s not that they don’t want to die, although some of them struggled against Death out of fear of what awaits them on the Other Side.

My father is one of these.  He is a World War II Veteran, and saw and did some horrific things.  He is terrified that he will be held accountable for these actions, which he deeply regrets and spends each night living them over (he has classic PTSD), such that sometimes my mother would have to go sleep in the guest room in order to avoid being a partner in hand-to-hand combat.

The unfortunates who get Death on the Low Road suffer and suffer, and experience all of the unpleasantness and pain of slow death, even to the end, where they have the agonies of air hunger, hallucinations, thick secretions, and even seizures.

What does this mean?

In the Jewish mystical tradition, Death by the Low Road means that the apparently unfortunate sufferer is actually engaged in a process that completes and cleanses the soul from the difficult life it’s been through, and the suffering atones for misdeeds done in life, even if they had a good outcome.

For instance, my father once walked up a small hillock that happened to be on the battlefield of Alsace-Lorraine, and on reaching the top, found himself looking straight into the eyes of a German SS soldier.  For a brief moment, the two teenagers looked into each other’s eyes and saw…themselves.  They saw normal young men who liked to drink beer and chase skirts.  In other circumstances, they might have been buddies.  Then the German pulled his duty pistol, and my father ran him through with his bayonet before the other teenager could fire a shot.

To this day my father regrets that action.  He really, really regrets it.  And by taking the Low Road out, that necessary transgression will be cleansed and forgiven, so that his next incarnation will not be dealt with as that soldier was dealt.  We are held accountable for our deeds, for better or worse, and the blemishes in our pure original souls that these deeds cause must be repaired in one way or another.  This kind of Death is one way of doing it, and in the end it is a much more pleasant way of repairing one’s Godly soul.

But we can’t know.  Take me, for instance.  I did some pretty unsavory things as a young person, and even as an older person.  None of these were intentional or premeditated, and most of it was due to my undiagnosed, untreated Bipolar Disorder.  Yet according to our tradition, these blemishes must be cleansed in some way.

With the Days of Awe, from Rosh ha’Shanah  (the Jewish New Year, the Day of Judgement) through Yom Kippur (the Day of Atonement, almost upon us, I am trying to make a Heshbon Nefesh, a close examination of my character and deeds, so that I may, through the Days of Awe repent of my misdeeds, whether intentional, whether accidental, whether hidden or revealed, please my G-d look into my heart and find it clean.

And please, please, Master of the Universe, grant me a judgement for a Death on the High Road, b’neshikah.

As it turned out, Dad’s pain was indeed caused by stomach cramps.  After relieving his intestines of their burden, he fell into an exhausted sleep.

I took my leave then, fiercely warning all of his nursing staff NOT to wake him for vital signs or anything else until the next time they had to turn him in the bed, another two hours.  Whether they did that is anyone’s guess, because Dad can’t tell me.  God help us all.

Enter The Twins, Pain and Aggravation

First I sincerely apologize to everybody to whom I’ve promised various things.  Life is not going in anything remotely resembling a straight line.  I feel caught up in a whirlwind–no, more like the vortex of water flushing down a toilet.

I don’t have a toilet, but other people usually do, if they live in developed nations.

Dad just got home yesterday from the nursing home where mom dumped placed him for six days while she went to visit her relatives.  Dad did not enjoy it, and I ran myself ragged going back and forth to the nursing home, which fortunately is not far away, to my house, to the store to get him things, to therapy an hour and a half away….

Dad was discharged from the nursing home Friday at noon.  Mom came home in the evening.

I settled in for some deep Shabbat rest yesterday, but my phone rang at ten a.m.: It was Mom, sobbing that Dad had fallen and blood was coming out of his head and nose.  He was unconscious but seemed to be breathing.  She had called 911.  Shit.

CALL HOSPICE NOW!  I screamed into the phone.  We are not supposed to call 911 without calling Hospice first, but she panicked and did it anyway.  Now we would be covered up by the fucking millions of Keystone Cops that stand in place of an Emergency Medical Service here in West Bumfuck.

I grabbed my knapsack, which serves as my 24 hour kit as well as a purse, threw some food in my bewildered pup’s dish, and ran out the door hoping to beat the ambulance to my parents’ house.  Dad was on the floor, unconscious and bleeding, just like she said.

He looked like he was in the process of checking out, and I didn’t blame him a bit.  But I did lean down to his ear and softly sang, “Shma, Yisra’el, Adon-ai Elo-heinu, Adon-ai Ehad,” which is the central prayer of the Jewish faith:

“Hear O Israel, Adon-ai is your G-d, Adon-ai is ONE.”

Well, damn me if he didn’t start singing it with me!  He was almost drowned out by my mother’s loud sobs, but I heard him, and he started cussing me out for leaning on him, which I might have been.  I sat up and he still cussed at me for leaning on him, so I knew that he was very much alive, although in rough shape.

After a while I heard the screeching siren shriek of the meat-wagon, driven by a team of bozos with spanking new uniforms.  They looked like milkmen on a spree.

They were planning to strap Dad to a backboard, but I talked them out of it, citing his spinal stenosis, so they scratched their heads for a spell and then brought their ambulance gurney into the house and strapped him onto it.  At least it had something that passed for a mattress.

The trouble began when they tried to get him out of the house.

My parents’ house is not built for ambulance gurneys.  A steel spiral staircase blocks access to the only egress in the house, and the bozos couldn’t figure out how to get out, since they had raised the gurney up on its pneumatic legs, and it wouldn’t pass by the stairs anymore.  So instead of lowering the gurney to the ground and picking it up and over the stair rail, they tried to pick it up with the bed part four feet off the ground.  So the idiots actually lifted this thing, with my dad on top of it, over the railing, grazing the ceiling and taking a layer of paint off the stair rail.

I tried to move my car out of the driveway, because I had a funny feeling we were not done with the Keystone Cops.  I was right.

As I was backing up the dirt-road hill that stands in for a driveway, I looked in the rear-view mirror, and glimpsed the gigantic red nose of the county Heavy Rescue truck.  Trapped.  Shit.  Hit the parking brake and cut the engine, since I was out of gas and running on fumes already.

I got out and said “Hey” to the driver and he said “Hey” to me.  Introductions over with, I advised him that heavy rescue was not needed, as my dad was already in the ambulance.  He cut his eyes at me and said that first of all he wasn’t Heavy Rescue, he was just driving their truck, but since he was a First Responder and had heard it over the radio he was obligated to go and check things out.

Suit yourself, I told him, but you’re going to have to move your vehicle so I can get out, and so the ambulance can get out, because there is no more room in the driveway.

Well, the Heavy Rescue truck backed up the hill, spewing gravel, and tried to find someplace to turn his rig around.  I admit that I smirked a little when he backed right into the ditch you have to watch out for on that dirt road.  I backed around him and got onto my own road after negotiating the tricky spot where the road does a wiggle going over a creek.

I’m too tired now to write anymore, so you’ll have to stay tuned.

 

Talking Shop

I don’t know whether you’ve noticed, but I’ve noticed, that I haven’t been posting.

Lord knows I’ve wanted to.

Blogging serves many purposes for me, as I’m sure it does for you: catharsis, self-expression, connection, community, dialogue, intellectual challenge, exercise and sharpening of one’s writers’ craft teeth, etc.

But: things around here have been less than peachy.

Dad had another stroke a week ago, was in a coma for a couple of days.  Then he began his struggle back into This World.  He’s not quite as “with it” as he was before–and he wasn’t too “with it” then either–but sometimes he knows where he is.  Thankfully he still knows who I am.

While we thought he was dying or about to die, there was a certain amount of drama (really?!) on the part of my mother, who actually hugged me and wept on my shoulder for an uncomfortable while.  I do feel sorry for her, but not that sorry.  But it’s not as if I would push my mother away while she’s having a dramatic sad moment, or a sadly dramatic moment, being about to lose her husband of sixty-six years.

Life is now a patchwork of caregivers and nurses coming in and out of the house.  That’s good, because I cannot help with physical needs other than the food-related ones.  I can prepare food, and help him eat it; and if he’s too “out of it” to get his food into his mouth, I can feed him.  Some days he’s able to feed himself, and some days he’s just too exhausted.  He’s hungry, but he just can’t manage the eating part.  I never realized how complex the act of eating is, until this experience of watching Dad’s stepwise loss of the mechanical ability to manipulate food, even with his hands, let alone utensils.

Once it’s in his mouth he can usually chew it up and swallow, but sometimes he needs his food “blenderized” and sometimes he just can’t eat at all.  I know that’s part of dying.  And sometimes he absolutely refuses to eat, and that’s part of dying too.

We try to keep him hydrated, at least.  He’s on a medicine that decreases the fluid in his blood, taking some stress off his heart, which does make him feel better but causes increased urination, so getting the fluids into him is important.  I know, it seems paradoxical: on one hand, taking the fluids out, on the other, shoving them in.

The other day we were sitting alone together, watching the afternoon coming in through the brilliant greens of the forest canopy, and he said:  “You and I need to go up into the woods and talk shop.”

I know what he meant.

We have always been best buddies, even when times weren’t so good, even though he served as my own private “Flying Monkey” who tried to explain away my mother’s evil ways.  I always came back, for my dad.  Here I am!

Just about every night, starting from…when?  Maybe after I got back off the road, when I was seventeen–every night when I was visiting and would be staying over, my dad and I would sit up late drinking whiskey and “talking shop.”  We would solve the world’s problems, solve problems for worlds that were entirely theoretical at the time but in fact exist now, and dig deep into authors, poetry, philosophical genres, the nature of human existence, art (of course), artists (same), relationships of all sorts….and now and then my mother would stick her head down the stairway to ask us to please “keep it down.”

I do salute her for allowing us those times together and not throwing a monkey-wrench into things, which she is quite capable of doing.  She knew that those late-night rap sessions were sacred.

The only time my dad and I ever got into a shouting match was oh, around 3 am when we were both three sheets to the wind, and somehow or other we fell into the topic: “Does God have a sense of humor?”

He staunchly and solidly maintained that God does NOT have a sense of humor.  The Holocaust.

I equally stubbornly held that God DOES have a sense of humor, because WE exist and that is the ridiculous proof!

Neither of us would budge, and having put a good dent in a fifth of Bourbon whiskey, the volume worked its way up until we were actually shouting at each other in earnest.  Luckily my mother yelled down the stairs for us to “knock it off down there.”  We sheepishly toasted “to Life” and stumbled off to our respective beds.  We never did resolve that point.

So, we need to go up into the woods and talk shop.  Some more.  Soon.

Here There Be Monsters

When I was a little girl, the space underneath my bed was rotten with monsters.

I had to take a running start to make the three-foot leap into bed, so that a scaly hand or tentacle would not snake out and snag me, dragging me into the dark waiting maw, where they would all fight over my little body, tearing it to shreds, and that would be the end of me.

Now I’m finding that that leap is impossible; it’s futile; the waiting monsters are licking their chops.

My dad is declining rapidly.  He’s been hallucinating, confusing familiar sights and sounds with threatening nebulous images.  Well, he IS an artist, and my favorite show of his was called “Fantasies and Daydreams.”  And now his imagination creeps up on him from behind, casting veils of illusion over his senses.  He dozes, and sudden terrors trigger his fight-or-flight response: he flails with hands and feet, and today twice pitched forward, and would have launched himself out of his wheelchair face-first on the floor, had I not been right there to lay a reassuring hand on his shoulder and tell him it’s OK, nothing is going to harm him.  He wakes from these fits, thank God, when someone intervenes.

The hospice nurse brought up the possibility of giving him a small dose of Haldol, a major tranquilizer and antipsychotic, but my mother voted it down.  She’s worked with the elderly for most of her life, and seen Haldol used as a way of drugging “problem residents” in nursing homes, so that they cease to be a trouble to the nurses.  I’ve tried to explain that the idea here is not to drug him into a zombie, but to relieve him of horrible experiences that are eroding the little quality of life he has left by transforming the music he loves into threatening voices, and the beautiful forest where they live, which has always been an inspiration to him, into a hall of shifting and changing faces, leering with evil eyes and gaping mouths.

I think she will reconsider the Haldol shortly, if for no other reason than to relieve herself of the exhaustion of constant vigilance.

Last week he even got out of his hospital bed somehow, in the middle of the night, and must have wriggled across the floor–he can no longer walk, and he can’t control his arms and legs enough to crawl–and ended up wedged between the sofa and a chair.  The only reason my mom found him at six in the morning is that the upstairs bathroom was being worked on and she had to go downstairs to use that one.  And she heard him moaning, and there he was on the floor.

The drill now is that when he ends up on the floor, we call Hospice and they decide whether to send over a nurse, or to call the First Responders to look him over and get him back into bed.  That is what happened in this case, and my mom said they were very rough and literally dropped him on the bed, didn’t bother to get him pulled up onto the head of the bed but left him with his feet hanging over the foot of the bed.  Mom tried to shift him up, but couldn’t do it, so there he lay until the morning attendant arrived.  Dad was so worn out by the whole process that he was unable to even sit propped up that whole day, and besides, he had hit his head again and was really “out of it.”

In the past, when those scenarios occurred, we would call the ambulance and he would be taken to the hospital, and we would spend an anxious and exhausting eight hours waiting for the CT scan and all that to be done, and he would either be discharged home or admitted for observation.  Now that we’re on Hospice, we don’t go to the hospital any more.  We’ve all agreed that we are at the end of Dad’s life, and the aim is to make him as comfortable as possible as we wait for the end.

It’s devastating to see the man to whom I have compared all other men, and found them all wanting, wasting away before my eyes.  I know I’m not the only one to have this experience; and compared to many others, his deterioration is blessedly mild.  He is not in some hospital hooked up to machines.  He is in pain, but it’s controllable, and he’s able to sleep most of the time, day or night.  He still recognizes me, and we still have our “le’chaims” every afternoon.

Today was different, somehow.  I think he was exhausted by the hallucinations and terrors.  He had trouble holding his little whiskey cup, one he had made himself (we always have our whiskey out of these cups), and the liquid didn’t always make it exactly into his mouth.  The right side of his mouth droops from a stroke he had early on in this process, and his food and drink often make their way down the resulting crease into his beard.  My little dog Noga loves to clean his face, if the opportunity arises and no one intervenes–just the way she loves babies, because they usually wear most of their meals on their faces and hands.

Mom has been sick for months.  She’s been very short of breath, breathing at a rate of around 30 breaths per minute.  Normal is 12-14 for an adult.  I’ve been hounding her for months to go get a chest x-ray and pulmonary function testing.  Finally she started wheezing badly and her girlfriends began to make comments, so that propelled her to make an appointment with the “doctor.”  I put that word in quotes because the person who wears this particular MD is, in my experience, completely incompetent.

True to form, the “doctor” ignored the fact that my mother told her (at least, she SAID she told her) that this has been going on for months and months, and possibly over a year; that she has lost weight, and has trouble sleeping because of shortness of breath.  She even has to stop halfway up one flight of stairs to catch her breath.

So she did get an x-ray, results to follow, but was denied the pulmonary function testing that I feel is mandatory under these conditions.  Instead she came home with a prescription for an antibiotic and a course of steroids.

The steroids will make her feel better regardless of the cause of the chest issues, but will not address the underlying pathology.  And it will increase her baseline irritability and labile behavior–not good.

In medicine we have this thing called “differential diagnosis.”  It’s a way of sifting through all the things an illness could possibly be, first casting a wide net and then crossing things off the list as they are ruled out, either by the process of logic or by test results, and hopefully a combination of these, along with a dose of clinical know-how, and the faculty of observation.

So in the years that I have been observing the evolution of this process, I have whittled the possibilities down to two:

1. Cancer

2. Cancer

3. Restrictive lung disease

I’ve ruled out COPD (Chronic Obstructive Pulmonary Disease) because that is always accompanied by cough, usually productive of sputum, which she does not have.

She did smoke in the past, approximately 40 pack-years (the number of years smoking times the number of packs per day), but quit about 40 years ago, so smoking-related lung cancer is unlikely.  However, there are lung cancers that have nothing to do with smoking, or are made more likely by a person having been a smoker in the past.  I know the common wisdom is that after a person has stopped smoking for a certain number of years, their risk of cancer is as if they had never smoked, but I have never believed that, having seen otherwise in clinical practice.

Restrictive lung disease happens when, for some reason, the lungs become stiff and cannot move oxygen into the blood.  The late Ralph Nelson, MD, a brilliant physician who devoted himself to medical illustration, dubbed people with restrictive lung disease “Pink Puffers” because they manage to make up for the stiffness of their lungs by breathing faster: therefore they don’t turn blue the way people with other lung diseases do.  My mother is a classic Pink Puffer.

But restrictive lung disease can result from certain cancers that infiltrate the walls of the lung tissue, making the lungs stiff, necessitating an increase in the respiratory rate, and hugely increasing the work of breathing.

I’m feeling sorry for my mom, even though I don’t love her.  I hate to see anyone, any creature, suffer.  I suspect that the process of definitive diagnosis will be a long and unpleasant one.  Believe me, if I were still in medical practice, she’d have her diagnostic workup done, not yesterday, but a year ago.  And then….what would happen to them?  I can’t even take care of my dad alone, due to my own health issues, let alone the two of them.

Tonight I feel as if I’m looking right down the throat of the monster that takes lucky people with two living parents and makes them suddenly into orphans.

 

Just a Hunch

I take care of Dad on Mondays and Wednesdays, from 11:30 till 5.  I give him lunch.  He always has something good in mind for me to construct for him (like sardines, ugh).  It makes my heart full to do anything at all to make his life easier, these days.

On Mondays the Hospice nurses visit.  They are certainly angels come to minister in a bleak and terrifying landscape.  Dad tries to tell her how Mom bullies him, he’s afraid of her.  Now that he’s helpless, he can’t do anything to hold her in check when she explodes.

I see it all the time: the way he looks up, terrified, when his barely-functional hands betray him and he drops food in his lap.  He says “Damn,” as if to let her know he knows he’s been bad; and he scrambles as fast as he can to pick the food up off his bib or his lap, wherever it’s landed.  He can no longer bend over from his wheelchair to pick things up off the floor.  Whenever something eludes him completely and ends up on the floor, he is near to panic.

I miss the obscenely obese old dog they used to have, who eagerly waited under the table for dropped treats.  He became incontinent and my mother had him put down.  I understand that she couldn’t handle my dad and the sick dog at the same time, but it makes me sad, and I miss the dog’s function.

But getting back to the hospice nurse who visits on Mondays.  She always checks Dad’s feet, since he is diabetic and feet are sitting ducks for getting ulcers and ultimately needing to be amputated.  We don’t want that.

He had sandals on, with Velcro straps that had been put on way too tight, probably by the untrained helper who gets him out of bed, showered, and dressed in the morning.  He does mean well, but he doesn’t understand certain things.  One is that Dad’s feet and legs are tremendously vulnerable, not only because of the diabetes but because his heart is failing, and that means his circulation in his lower legs and feet is even worse than usual.

On Monday, when we got his sandals and socks off, his feet were black.  I mean black.

The nurse was emphatic that he see a doctor about his feet ASAP; I didn’t need any convincing.

Since Mom was out, the nurse asked me to convey this to Mom as soon as she returned.

However, I know what happens whenever I do anything like that: “You make a big deal out of everything.  You’re always overreacting.”

I asked the nurse if she would please call my mother and tell her.  Mom would take her word of authority.  The nurse did that.

After the nurse left, I got Dad settled with his feet up on a cushioned chair, where he fell asleep.  I inspected his feet further, and as I did, I got a whiff of an odor I have smelled many times before: the sickly-sweet smell of dying flesh.  Tears wet my cheeks, made their way into my mouth, and I had to run for a tissue to catch the snot.  I always snot a lot when I cry.

After the nurse’s phone call, Mom did scramble to get an appointment with the podiatrist.  It’s now Wednesday, and he saw the podiatrist this morning.  A fungal infection, he said, and prescribed some cream.  I took a look at the feet today, and there are some bubbles; somehow I don’t think it’s fungus, but I will be very happy if I am indeed over-reacting.  I guess I have seen too much, and amputated too many feet during my time in practice.

Monday night I got take-out Chinese food for them.  I made an exception to my strictly Kosher diet, and ate some vegetarian fried rice.

Dad has been having dreadful, painful coughing fits, especially when eating (which takes more effort than you would think), and coughing up clear and/or frothy fluid: congestive heart failure.  The heart does not have the strength to pump the blood through the lungs and out to the body, so the blood stagnates in the lungs.  Fluid from the blood makes its way into the airway, causing cough and shortness of breath.  The person is literally drowning in their own fluids.

Dinner on Monday night was dicey.  He was coughing and eating fried rice, and I was afraid he would inhale it.  He was afraid he would drop something in his lap.

Although Tuesday is supposedly my day to catch up on errands, etc., I had a hunch I’d better stop by the house.  They were having lunch when I arrived.  Dad was really having trouble eating.  It seemed as if every bite he took cost him a coughing fit.  Finally the coughing overcame his will, and he succumbed to it.  He couldn’t catch his breath at all, and turned absolutely blue.

Hospice has provided us with an emergency med box, containing everything from Tylenol suppositories to morphine drops, to, frighteningly, drops to put under the tongue of a dying person to thin the agonal secretions and relieve air hunger.

Fortunately, the box also contains a few tablets of Lasix, a diuretic (water pill) that magically sends extra fluids to the kidneys, where they leave the body as urine.  That’s what was needed, to get the fluid out, and fast.

I rummaged in the box, found the Lasix, and then felt that I should at least call Hospice and let them know that I had pillaged the box.  Most Hospice family members are not doctors, and I thought it would at least be courteous to let them know I was going to use one of the contents of the box.

The nurse on call was not one I knew, and she didn’t know who I am.  She disagreed with my plan, and suggested I give him some morphine for comfort.  I explained that he had been on Lasix previously for his heart, but it had been discontinued because he was incontinent of urine, which made my mother mad.  Now she’s used to it, especially since other people change his bed and diapers, for the most part.

At that the nurse agreed.  I gave him the pill, and half an hour later he peed the fluid out.  He’s been mostly OK in the respiratory department since then, although I notice today that he’s starting up again.  I had our regular nurse call us in a prescription, so we’ll have a supply of Lasix for when we need it.

It’s Wednesday, and I spent the day with Dad as usual.  He’s been hallucinating a lot, and was pretty scared.  His feet were swollen again, so I wheeled him over where he could put his feet up on his hospital bed.  He took a nap for a while, and I read, until 3 o’clock when he woke up a bit restless.  He wanted the Westerns channel on TV.  I put that on for him, and suggested a l’chaim.  He lit up at that.  So I got us each a Scotch, and we toasted each other’s happiness, wherever our paths might lead.  Then we drank likker and made a running commentary on Bat Masterson and Wyatt Earp, he with his feet up and me sitting on his bed, happy as a couple of cackling crows.

I’m really, really going to miss him when he goes.