The Fat Lady Is Gargling With Warm Salt Water

The Cancer Van was full today during the short jaunt to the MDA campus. I sat in the very, very, very, back row of the Cancer Van, which is difficult to navigate to, especially with coffee and a briefcase, but I'm happy to ride back there because I can get there. Some people can't. I sat next to a lady from New Orleans so we talked about storm damage, etc. after The Big One of '05.

I arrived at Jerry's room, and Nolie and I had our daily Stand-Up meeting. There wasn't much to pass on. Jerry was the same as I left him last night; restless, coughing, and periodically raising both arms up to the ceiling as though someone was going to pick him up. Gayle said she's seen this before in hospice care.

After Nolie left to go the the hotel to take a shower, Karen, the Advanced Practice Nurse, came in and we talked about Jerry's cough. We decided to order a breathing treatment to see if we could loosen up some of the mucus in Jerry's lungs so he could breath more easily. For the last couple of days Jerry has been coughing very well, but not getting the mucus up far enough to suction out. Joe, the breathing guy, came up and administered the treatment, then pulled out a skinnier suction device than the one we'd been trying to use, and stuck it up Jerry's nose.

The skinnier device looks kind of like a slender, flexible, red garden snake. It can snake farther down Jerry's trachea to remove the mucus than the more rigid tool we were using before. Wow! Remove mucus, it did! Between the Slender Red Snake, and some sterile water to irrigate, we got out a whole bunch of nasty, black, tarry looking snot! Joe went through about six of the Slender Red Snakes because they kept getting clogged, and when he pulled the last one out, it had a big, nasty chunk stuck to the end of it that reminded me of a piece of shrimp on the end of a fishing hook. I actually said, "Ooh. Let's go fishing."

After the traumatic snot sucking, (and it was traumatic) they gave Jerry a little extra Morphine, and some Ativan. His pulse ox dropped to 41% and so they put him on 100% oxygen. His pulse ox started to rise and got as high as 85%, before dropping back down to the 40s. Karen believes he has another mucus plug in his left lung, because he's not moving much air through it. You can tell by watching him breathe, that the left side of his chest is not rising nearly as much as the right. The last time we checked his pulse ox, it was 61%. Pulse ox should be close to 100%. It would be great if Jerry could cough up that snot in his left lung. He would be able to breathe a little easier, and rest some. Anyway, in the mean time, he's on 100% Oxygen and breathing heavily.

Nolie is at MDA tonight, and I am at RIBM.

Burn, Baby, Burn!

Just as an addendum, the Nursing Assistant just came in to empty Jerry's urine. They haven't changed the names on the board since shift change, and I couldn't see her name badge, but her afro is about 6 inches deep, so I'm just calling her Disco Inferno.

The Fat Lady Is In the Wings

I spent the last two nights at the hospital with Dad, and each night he has been less OK than the night before. Last night he never woke up to look at me at all, and so I didn't even have an opportunity to have him suck water off of the Sponge Tool. I was hoping I could feed him some Carnation VHC Drink, which seemed to give him some energy the last time he had some. Three days ago when he had a can of the VHC Drink, he opened his eyes, laughed, and talked a little. Last night, all he did was cough. Alot. All night.

The VHC in Carnation VHC Drink stands for Very High Calorie. It has 560 calories per 8 oz. serving, and is what they give people who can't or don't eat. I like that the name of the product is also the description of the product, because it just makes things easier. One of my pet peeves is going to a Mexican restaurant, and having to read the fine print to find out what the difference is between the Vera Cruz, the Acapulco, the Tampico, and the Guadalajara. The one with one beef enchilada and one cheese enchilada should be called "Enchilada Dinner" and the one with puffed tacos should be called "Puffed Taco Dinner." The fine print below the menu category and above the actual items is OK. This is where it usually says, "All combination platters are served with Spanish rice and refried beans. Burracho or black beans are available upon request."

As I was leaving the hospital tonight, Dad's nurse, Gayle, said that she wouldn't be surprised if we weren't able to transport Dad to Arlington for hospice care. Meaning, that he probably is not going to get better enough to transport, and this may all go down right here in Houston. I think she's right, and it makes me sad because I really would like for Jerry to see Sterling and Silver again. It would be good for Jerry, and it would be good for Sterling and Silver. I would hate for the dogs to think that Daddy just up and left. I have told them in recent weeks that Daddy has cancer, and also that he wouldn't have it if they were better dogs. (Note to my cousin Beth: Don't worry, they aren't that fluent in English. All they heard was, "blah, blah, blah, Daddy, blah, blah.) Gayle's opinion was solicited by the way, she wasn't just yaking. I respect her opinion because she really does seem to care, and because she has worked for M. D. Anderson since 1975. I mentioned that her picure on her ID card looked "youthful" but it didn't come out as I intended. I really need to clip my toenails if I'm going to be sticking my foot into my mouth like that. At least I stopped talking before I mentioned that in 1975 I was in second grade.

It is 1:07 a.m. as I type this post in the Gatehouse of the RIBM, and I haven't heard from Nolie tonight, which is a good sign, for now. I know she'll call if she needs me, and I finally assigned her her own ringtone so I'll know it's her.

Why Map Skills Are Important

The public restroom closest to Jerry's room is out of service due to renovation. Fortunately, the Capital Project & Management Department has posted a map outside the restroom with directions to the designated alternate. Here is a picture of the map, along with a picture of both the out of service restroom, and the alternate.

"The Thickening Gel You Can't Taste!"

Jerry seems better to me today than he did yesterday. He has opened his eyes more, and has spoken just a couple of words. Earlier today when Nolie said, "Jerry" he replied, "what?" And, when I asked him today if he wanted some more water, he replied, "yeah." When I first got here this morning, Nolie went downstairs to get something to eat, and that's when I noticed Jerry kind of sticking out his tongue. I dipped one of the Sponge On the End Of a Stick tools into some water, and he sucked it dry. After doing this more than a few times, I busted out the bendy straws and let him suck down a total of about two cups. Apparently, I broke a rule. Jerry is NPO, and therefore not allowed to have anything orally, because there is a concern he will choke; however, his epiglottis seemed to be working just fine to me. Later in the day he had about another two cups of water, but this time, only via the 1cm x 1cm x 2cm Sponge On the End Of a Stick tool. The doctor now has said that he can have clear liquids, but only by the spoonful, and preferably with a "thickening agent" added. The thickening agent is called Simply Thick, and has the tagline on the package "The Thickening Gel You Can't Taste." It almost sounds as appetizing as "Potted Meat Food Product."

The Fat Lady Is Making Her Way To the Stage

Dad has pneumonia, and has been moved to the palliative care floor. Mom has been talking to a social worker about transporting him to hospice care back home in Arlington. Dr. Siefker told Nolie that she regrets having started him on another course of chemo, because his body just can't take it and he may have had a few months longer otherwise.

Jerry was asleep when I got to his hospital room this morning, and stayed asleep most of the day. He's awake now, but hasn't spoken all day. I know he can see me, and he will squeeze Nolie's hand if she asks him to. He ate yesterday, and has had a few spoonfulls (spoonsfull?) of applesauce today. He is being given two different IV antibiotics; one for the known infection, and another as a prophylactic in case there's an infection we don't know about.

Nolie is downstairs eating right now, and Jerry keeps raising his left hand up to his head, kind of like he's trying to adjust a hat, only he is not wearing a hat. I thought that maybe he wanted his glasses off, so I removed them, but he's still reaching for his head. Occasionally, he coughs also, like a cat coughing up a hairball.

Nolie says that he seems much better today than he did yesterday. He is much worse than the last time I saw him.

It is very irritating to watch t.v. here because there is no TiVo. I really miss the Go Back Eight Seconds button. It must be John Wayne's birthday today or something, because it seems like there's been a John Wayne movie on all day long. I also watched some movie with Geena Davis and some talking mice in Spanish today.

Soylent Foul

As you may or may not know, the RIBM has a complimentary happy hour four days a week, Monday through Thursday. This happy hour includes some kind of snack, that is usually enough to be considered a meal. Tonight's meal was "Crispy Breaded Chicken Sandwich." I knew exactly what this meant: The "chicken" was pre-cooked, pre-breaded, processed, and ready to "heat 'n' serve." I am not a huge food snob; however, I would never seek this particular meal out. But, when accessibility, hunger, and freeness, all converge--it is the obvious meal of choice. I question, though, whether each individual chicken patty even is even derived from the same chicken, and even hesitate to call it chicken. I call it Soylent Foul.

Jerry's Chemo Brain was in full swing tonight, and when we went to eat the Soylent Foul, the manifestation was intense. Nolie went through the serving line to prepare Jerry's sandwich, and brought it to the table. Upon presentation, Nolie asked Jerry if he would like mayonnaise on his sandwich. Jerry countered with, "what is best?" Nolie and Jerry went around and around about mayonnaise, lettuce, tomato, etc, until Jerry finally became very agitated, and said that he wanted the sandwich, "as it was designed to be served." I totally got what he meant, and Nolie totally did not. Many times I have told wait-people that I want a menu item "however it comes." Jerry and I are not picky, and "however it comes" eliminates the need to make a decision, which I know for me, is a treat, since I spend all day long every day making decisions, because other people don't seem to be able to do so. At this point I explained to Jerry that the traditional White Trash Chicken Sandwich is served with mayonnaise and a slice of American cheese on a bun. I squirted the mayonnaise onto the cheese and spread it around by mashing the top bun onto the mayo and smearing it. Jerry seemed to accept this, and ate most of his sandwich. I am both proud and scared that I was able to understand how Jerry wanted his sandwich, because Jerry is brilliant and organized to the point of absurdity, and because some day I will probably be every bit as absurd and cantankerous. It also illustrates other characteristics I have in common with my Dad, for example, procrastination.

Looking back, it is no wonder to me that I seem to have a gift for procrastination. I can even remember Jerry telling me that I was a procrastinator when we were living in the Old House. My childhood memories are divided between Old House and New House. We moved out of the Old House when I was three. He would tell me I was a procrastinator when it would take me an hour or so to get around to taking my bedtime bath. Well, just let me tell you this story about procrastination.

When I was very young, (New House, but still young) I remember going with my parents one weekend to some antique store in Arlington, where some man showed my father a very nice, very expensive, newly restored, antique roll-top desk. Jerry paid the man for the desk, and then called a different man with a truck to pick the desk up, take it to his shop, strip it, dismantle it into each individual component, and then deliver it to the New House. The plan was for Jerry to "re-build the desk" and be able to say, "I built this desk myself." It was a very nice desk.

The desk sat in the garage of the New House--unassembled--for nine years; after which Nolie called a different man, with a different truck, to pick the desk pieces up from the New House, take them to his shop, re-assemble them, and return them to the New House. It really is a pretty desk, and I suppose some day it will be mine. I suppose it's more about the story behind the desk, than the actual desk itself.

I really had a good couple of days in Houston with Nolie & Jerry. Later in the week I'll try to find time to tell the story of the Chair Feud Nolie is having with the neighbors at the RIBM.

Jerry Eats a Muffuletta

Well, Jerry decided he wanted to stay at the RIBM and sleep instead of venture out with Nolie and me. We brought Jerry back a muffuletta from Jason's Deli, but she and I actually ate at a tapas bar called Mi Luna. Nolie thought it was going to be Mexican, but it turned out to be Spanish. I knew when we looked at the menu that it wasn't what she expected and that she wouldn't like it, and after some debate about whether or not to leave, we decided to stay. Nolie had some kind of meat on a stick, and I had snails. The sauce with the snails was really good, but the snails themselves were kind of gritty. I like my snails clean.

Jerry just woke up to take his medicine and eat his mufuletta. He had a slight fever earlier today, but it is gone now and he says he feels, "pretty good."

Nolie declined to be photographed for this post due to her Silver Yarmulke.

Happy Mother's Day

Jerry's hair is starting to come back, just in time for more chemo. His first round was Thursday, and only took four hours, and he got to go back "home" the same day. I am now able to recognize the "chemo brain" that Nolie talks about. It takes Dad just a little longer to retrieve words, but he eventually does if you just give him time.

There is talk of a Mother's Day Meal at Jason's Deli today. I like the idea because it doesn't require me to wear anything that is dry clean only, and Dad likes the muffulettas. Before we eat though, we're going to go sit in the lobby so the Room Attendant can clean the room. We told her we'd be out at dos en punto, and I think it's funny that Nolie is learning what I have known for a long time, and that is that if you are speaking English to a non-English speaking person, then follow up with "do you understand," the response is often "yes" even when the real answer is no. The same apparently applies to asking chemo patients if they have to go to the bathroom before boarding the Cancer Van. The real answer is usually yes.

Maybe Lung Spots Aren't Always Cancer

Whew! Has it really been since my Grandmother's 93rd birthday that I last updated the Blog? Here's what's new:

Jerry in in pain again, and taking the super-duper pain pills. He has two kinds of pain pills. The regular ones and the super-duper ones. The pain pills make him say funny things, but I really do think it's the pain pills and not Dad losing his mind. According to Nolie, he used the word "autograph" when he meant to say "audience" and "advertisement" instead of "hand towel." At least he came up with a word. Sometimes all I can get out is "doo-hickey" or "squiggly thing."

Jerry met with Dr. Siefker again today, and now, she's not so sure the suspicious spots on the lungs are cancer after all. They haven't grown, and some of them are gone. The original bladder tumor, however, is still there, and large again. Dad will start a different chemo drug tomorrow which will be administered every other week as an outpatient. This drug takes four hours to administer as opposed to the couple of days that the last one took. It is weaker than the last one, and if he tolerates it well, she may try a stronger one.

Nolie thought she had found a place to get her hair and nails done in Houston, so she made an appointment. However, when she showed up it didn't meet her cleanliness standards so she turned around and walked out. It's just like when we would stop at a Dairy Queen or something on a road trip when I was growing up. You can always count on Nolie's Restroom Cleanliness Report.

I think those are all the key points. I wasn't able to visit Jerry last week, but hope to visit soon and get better, first-hand information. I am somewhat relieved about the lung spots though.