Thursday's Tumbles and Stumbles: The Other Shoe

Well, Murphy's Law strikes again. Just when all is hopeful and sort of rosy. I knew the other shoe would drop, but I didn't know how or when. Now, I know.

Remember, how I was going to organize a car trip for my hubby? That is put on permanent hold as of the nurse's visit Monday after I relayed the events of the previous weekend.

I've seen and dealt with a lot of dying patients in the past. I should have had some forewarning that this was going to happen. Maybe it was just me in denial and not thinking about the would of/should of/ could of, but I should have. Then, the events of the weekend would not have been so disturbing to me.

I hear you. You are all wondering what I'm talking about.

My hubby piped up about noon Saturday with a, "I'm hungry. Woman, get in the kitchen and fix me something to eat." Now, I've known this man for almost thirty years and been married to him over twenty-one years, and never heard him say anything like this before. It was so out of character for him. For a second, I just stood there with my mouth hanging open.

While I was fixing his lunch, I was stewing over what he had said. Part of me was angry because it sounded something like my abusive ex would say. But overriding this was concern. What had changed? What was wrong?

The panko crusted chicken fingers were in the oven, a feta cheese chopped salad was made, and the baby vegetables with cheese sauce was cooking so I went into the living room. I started talking to him. How did he feel? What was his pain level? He had no memory of yelling at me or what he had said. He was busy wadding up a tissue and then wrapping it with tape. He had a whole plastic pencil box of these. He answered my questions just like he normally would.

Nothing was out of the ordinary in his demeanor or attitude. Maybe the outburst was a joke of some kind, I thought, but I didn't get it. Ever since we went through the fiasco with hospice about them canceling aide services back in January, he's had bugs on the brain. Every time there was a moth or fly, I had to kill it. Especially if it was on his bed. The weather has been so nice here the past couple of weeks, the windows are open and so are the doors. So naturally beetles, flies and moths come in every time I open the doors for the animals.  It's kept me hopping on bug patrol. No fleas though.

His was half of this

I served him lunch and he settled down for a nap after eating one chicken finger and a couple bites each of the salad and vegetable as usual. He didn't want to eat dinner saying he wasn't hungry. But I suggested apple cobbler and ice cream, and he agreed. If all else fails offer sweets. He took a couple of bites and was done. He played with the ice cream until it was melted and I suggested he drink it. He did. I was satisfied.

His oxygen alarm went off about three in the morning. It took thirty minutes for it to reset and turn back on. I was glad for the big tanks of spare oxygen I have on stand by. I got him switched over and back again. It happened again at ten that Sunday morning. One tank of oxygen gone with four remaining. I wasn't going to ruin anybody's weekend with a service called unless the machine died. Three more times over the weekend that blasted alarm went off.

Sunday night he decided he wanted an open faced turkey sandwich for dinner. No big deal. I had bought a canister of Stove Top dressing that I could measure portions. The same went for the mashed potatoes and gravy. Just nuke the water and stir. After I clean up the dishes I came back and sat on his bed again. We dine on his bedside table. We were talking about the kids and the grand kids, and he suddenly pops off that he's got proof that he wasn't crazy. He switched gears so fast during our conversation that I was like... huh?

He he was clutching the sheets and blanket close to his body. Of course I asked him what he was talking about. "In this box are a collection of bugs I caught in my bed."

I know something is off kilter. His eyes are unfocused and he's got a death grip on something under the covers. I actually had to pry his fingers loose from it. He issued a stern warning of, "Be careful or they'll get loose."
I disentangle the box he was holding from the bed sheets, "Honey, look. This is your pill box."
"No, no, no. That's the wrong box."
"Okay, which box is it?"
"The blue pencil box. I told you. These bugs are sneaky and escape artists. They are lime green and they are translucent."
Oh geez, I thought. All those crumpled up pieces of tissues had "bugs" in them. "Okay let me take them into the office where I can see them under the desk lamp."
"Here. You'll need this too because you can't see them without it." He handed me the large magnifying glass.

Something was definitely wrong with my husband. But to humor him, I took the box and magnifying glass, and hobbled back to the office. Dutifully, I untaped and opened each piece of paper looking on both sides of the paper. All thirty of them. I toyed with the idea of giving him the liquid Haldol (anti pyschotic) from his care pack. I would of except he knows what Haldol is used for and he'd fight me on it. He was working himself into a state while I examined the tissues. I stopped long enough to convince him to take some morphine and Ativan. It was the best I could do. I almost called the nurse on call. I was that concerned.

Instead, I finished examining the tissues and reported back to him that I found no bugs.
"They must have escaped! I told you they were tricky."
"Honey there are no bugs." I tucked him into bed. "Just relax and take deep breathes. I then took his

vital signs. His heart rate and blood pressure were up. Of course because he was upset. Then I took his pulse/O2 stats. His oxygen level was 72 out of 100. He was suffering from hypoxia (lack of oxygen to the brain). He's killing off brain cells while I was humoring him. How did I miss seeing his increased gray pallor and almost dark grey fingers. I boosted his oxygen level on his concentrator up to five liters and told him in a calm voice, " Breathe deep. In through the nose and out through the mouth. Close your eyes and focus on my voice. In and out."

The morphine, Ativan, and the boost in the oxygen finally took effect. His color was not so gray and his fingers paled. He finally drifted off to sleep. His oxygen levels rose to 80 which is normal for him now. I reduced his oxygen level back to three liters. Keeping it at five might halt his breathing altogether. I was kicking myself as a bad RN/paramedic. I glanced at the clock before I went to bed...2 AM.

Even when his nurse came by Monday, he had an "altered mental status." She suggested giving him the Haldol. I told her his issues and she told me to call whatever nurse was on duty. They would play the heavy with him. So also reminded me of respite care five days a month. I really can't do that to him because he's cognitive of his surroundings 75% for right now. But it's a bargaining chip for me in the battle over the Haldol with him if I need it.

My hubby is losing his grip on reality and I'm along for the ride. Scary, isn't it? This week has been either treading lightly on egg shells or being a bull in a china shop for me. I was hoping for the luck of the Irish with his passing quietly away. I should have known, for me, it couldn't be that simple.

How has your week been?