The Fat Lady Is In the Footlights

Jerry's condition has not changed much over night. He still has cancer, and as his organs begin to shut down, his body is less able to move fluid, and so he has a big fluid bump on his head. He graduates today from Morphine to Methadone, and he doesn't even have to stand in line at a soup kitchen. There is also talk today of stopping antibiotics, but Nolie and I haven't decided yet what we think about that. His pulse ox is slowly creeping back up and is now 74%. Not great, but better than 40%.

Sabrina is our nurse today, and she graduated from Texas Tech. She tells me that Horn/Knapp Hall is air conditioned now, and even has thermostats in every room! Back in my day, if we were even lucky enough to have air conditioning, we certainly didn't have thermostats. If you wanted to adjust the temperature in your room you had to stack or unstack textbooks on top of the air vents. Kids today. . .

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.