We've been very busy since my last post on Saturday. Remember, we had gotten the lab reports detailing the damage being done to Marye's liver due to the heart failure. She had a rough weekend with a lot of pain, although some of the measures they took to ease the pressure on her heart did appear to be working. On Sunday night, although she was heavily medicated, she was still alert and even talked to her mother on the phone.
By Monday, however, things started moving downward, once again. She was in a lot of pain, and either due to the various internal organ issues, the large doses of pain meds, or both, Marye was fairly unresponsive. The day that Dr. Riley had warned me about had arrived. It was time to worry less about treating the illness and focus more on making Marye comfortable. She recommended inpatient hospice care to ease Marye's transition. It was truly my hope to be able to get her home one last time, but it wasn't meant to be. She needs too much attention. We also discussed dedicated hospice facilities (there are several within a mile of here), but decided that instead of putting her in an ambulance to transport to another facility, they could meet her needs right here at U of L.
On Monday afternoon, we turned off all treatments for cancer, heart failure, liver failure, etc., and began focusing solely on pain management. Marye has a liberal prescription for morphine and ativan, and she doesn't have to fight anymore. By Monday evening, she was even less responsive and we worked hard to get her pain under control. By Tuesday morning, she finally looked comfortable.
As of Tuesday evening, Marye is mostly unable to communicate with me, although I am certain that she can hear me. She sometimes gives me an approving (or unapproving) grunt. She is sleeping, and Dr. Riley is confident that she is not feeling any pain. I hope she's right.
