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.
