Wearing Thin

After the midnight meds, I finally went to sleep on the sofa.  I knew I had to wake up at 4 to do another dose, so I set the alarm on my cell phone.  Having had broken sleep (and not much of that) the night before, I slept pretty heavily.  I don't remember waking up and turning off the chime, but I must have, as I was jolted into consciousness when Brian came clumping down the stairs at 5:30 to make coffee.  It put me in a panic - I was late on the meds, and dreading a repeat of yesterday morning's episode of restless thrashing.

I ran upstairs.   There was no movement, but Peggy's chest congestion seemed more pronounced, and with every exhalation came a short, whimpering moan.  I quickly prepared the syringes and dosed her, then sat with her for a few minutes.  The moans are agonizing- the sound travels through my ears and into my heart, squeezing.  Although I do not think she is in any physical pain,  I sense that something is going on in that distant place inside her mind.  Somewhere in there, a terrible battle is raging - one side fighting to hang on, the other fighting to let go.

I stroke her forehead lightly and say to her, even though I know she cannot hear me, "It's okay.  It's okay to let go.  You've done everything you need to do here.  We'll be okay.  Everyone will be all right.  Just let go.  Grandpa is waiting.  Your Jimmy is waiting for you.  It's okay to go."  The moaning becomes a little louder.  Perhaps she hears me after all.  I continue to stroke her head, and she begins to settle.  For the first time in four days, my tears flow unabated.

I know that I cannot afford to fall apart today.  But I am down-to-the bone exhausted, and the more tired I become, the harder it is for me to hold it together.  The outer crust cracks and the marshmallow inside comes oozing out.  I go downstairs to the comforting arms of Brian - at times, he is the glue that holds me together, at other times, he serves as the release valve that makes it okay for me to fall apart - whatever I need, he will provide.  Right now I need the glue.  It will be hard not to have him here today.  I know he would stay if I asked him to, but I'm not going to ask.  With Grandma's illness, I have taken on fewer contracts in the last couple of months, and we need the extra income from his overtime.

After he left for work, it is useless to try and sleep - the adrenalin rush I got from oversleeping on the meds was enough to jolt me into wakefulness.  I go up again to check on Grandma - she seems a little less agitated, so I know the meds are taking effect.  She has slumped over slightly in the bed, and the position does not look comfortable.  Her chin is resting slightly on her right shoulder, and there is a puddle of drool (light blue - perhaps the food coloring was not such a good idea) pooling on her nightgown.  I try to wipe it away with a tissue, and I can see it is mostly saliva.  Our hospice nurse Toni had told me that the morphine would be absorbed through the lining of the mouth.

I try to move Grandma to make her more comfortable, but she's dead weight now, and I'm not strong enough to shift her by myself.  I call the hospice 24 hour hotline - within a few minutes, the on-call nurse calls me back.  I tell her the situation, and she asks if I need her to come right now, or if I would prefer to wait until Toni comes on duty at 8.  I decide to wait for Toni.  Since she has been working with us and is familiar with Grandma, I feel more comfortable having her come to help, rather than trying to explain everything to a new person.

My stomach is too sour from my lack of sleep to drink coffee, so I make some tea - a sweet, spiced chai blend, to which I add a liberal helping of milk - and it's back to the computer.  Creating these posts is also providing some glue to help me keep it together.  As I type, I have an internet player tuned to BBC Radio 7.  I studied for a while in London, and have always been something of an anglophile.  Although I have not been there in many years, England is the one place where I felt the most at home, and I enjoy listening to the live radio broadcast.  It almost makes me feel that I am there - a convenient and welcome escape.

Radio 7 is my favorite BBC station - it is the radio equivalent of television (without the pictures of course, or the commercial advertising that clutters the airwaves of most American radio stations.)  The programming is a mix of comedy, drama, science fiction and mystery series, dramatizations of classic novels, short stories, and plays, and variety programs.  This morning they have delved into the archive and are rebroadcasting an episode of the Goon Show, a wild and wacky comedy series that ran in the 1950's.  I had heard of the Goons, even though their series ended long before I was born - their work is considered groundbreaking, and most British comedians who are old enough to remember them (like the Monty Python gang) credit the Goons as one of their seminal influences.  The member of the Goons who is best-known in this country is the late, great Peter Sellers - the crazy characters and voices he created in his films had their foundation in the Goon Show.  I had never heard a Goon Show broadcast until I started listening to Radio 7.  They always make me laugh - and this morning I really needed to - another layer of glue applied.

Time for another Grandma check - Toni should be calling soon.  The Hospice people are really outstanding - I don't know how we could manage this without them.  The tag line on Toni's business card, which I keep next to the phone, reads "Love in Action" - and that's exactly how they come across. I am so grateful to have this kind, compassionate and professional support.  I wish Peggy was aware of what great people are helping to care for her now.  I know she would love them.

I go to her room, and she is much the same, still moaning softly with every ragged breath.  Toni calls a few minutes after 8 and advises me to go ahead with another does of meds, even though it's been less than 3 hours since the last one.  Once again, I complete the ritual: crush the Lorazepam, add a few drops of water to dissolve, load the syringe.  Load the other syringe with the neon blue morphine.  Insert them, one at a time, at the corner of her mouth, which will open slightly, involuntarily.  Push the plunger to dispense the liquid.  Wait to make sure it doesn't dribble out of her mouth.  Wipe the drool from her face. Wait a few more minutes.  Rinse the syringes and the spoons and put them away.  I can almost do it in my sleep.

I go back and sit with her a while longer, trying not to listen to the moans.  Chauncey comes in for what has now become his ritual - front paws on the bed, nose reaching out to sniff, find some skin, kiss Grandma.  This morning he licks her right on the nose. For the first time in nearly a day, she opens her eyes, and sees her "Doggie," then closes her eyes again. She is smiling.