Service Details

Today, we picked up Angela's ashes.  Tomorrow is her memorial service, 2:30 at Red Bluff SDA Church.  Sunday, we plan to scatter her ashes from the Golden Gate bridge, and Monday we'll start home.  We have a friend who is doing an estate sale, starting today.  She had an amazing amount of stuff in her house.  We're staying tonight with another friend out of Redding.  It was sad, this morning, watching strangers leave with her stuff, but I told myself to remember that those people were being blessed by her even now.  This weekend will be hard, I'm sure, but the sorrow is for ourselves, missing her, and not for her, since she is waiting for Jesus and when we see her again she will be in perfect health, without any limitations.  May that day come soon!

Sleeping in Jesus

Angela passed away this morning.  There were just too many things going wrong for her to overcome.  It is comforting to know that the next time we see her, she will be in perfect health.  Praise God for that hope.

Challenges

Sabbath, Sunday, and today have not seen many lucid moments.  On Sabbath, Angela pulled her NG tube out.  She has been drinking quite well, including a smoothie that I make her each morning, packed with everything healthy I can think of, including wheat grass at her request.  Because of its strong flavor, I decided  yesterday to see if I could hide Lactulose in it today, and it worked.  She hadn't had any since she pulled the tube, and her ammonia level just about tripled.  If this doesn't continue to work, we're down to reinserting the NG tube, which I fear will require sedation and/or restraints, trying to get a stomach tube put in surgically, or just providing her with comfort care and letting nature take its course.  Placing the stomach tube will require someone (I'm not sure if it has to go to a judge or just be signed off by two physicians) to agree that she is incapable of making her own medical decisions as she told the doctor that she does not want one. She has also told me she doesn't want to die, but she is convinced that she doesn't need her medicines and/or someone is giving her the wrong ones.  One of the doctors she has seen for years came by today and said she's just got too many things going wrong, and he doesn't think she can pull out of it.  I understand but I'm not ready to stop fighting yet.  I'm not convinced that everything can't get balanced and give her a reasonable life for another while.  But it is hard fighting for her when that means fighting her.  This confusion is not fun to deal with.  I've stopped asking God to heal her and have started asking him to do what He knows best.  I only want her to have peace.  Some of her confusion has been anything but peaceful.  I'm so glad for the hope of the resurrection, when she will have a perfect body and mind, but if it is God's will, I'd like her around here a while longer first.  Mike is considering flying down for the long weekend.  It would be nice to have him here.

A Good Day

Today was the best day Angela has had since last Thursday.  She was mostly not confused, ate better, and worked hard at physical therapy.  I'm trying not to get too excited, as I try not to get too down when things don't go so well.  But I am thanking God for the progress she has made.  She is wanting the NG tube out, but is not convinced yet that it is in her best interest to take all her medications.  This, however, is not new.  So, for now at least, it will have to stay in place.  I hope we'll be able to have a happy Sabbath.  Her roommate went home today, so unless someone else moved in tonight we may have a "private" room, though I'm surely not counting on it.  We found last weekend that the Physical Therapy gym is a quiet place when no one is there (they close for Saturday and Sunday).

NG Tube

Yesterday, when I arrived, Angela was herself, for the first time in several days.  But it didn't last long, and she refused her Lactulose.  After a battle of about an hour, I only was able to get half of it down her.  We tried the Geodon again since the last time it made her take the Lactulose, but this time it didn't have that effect.  I really don't want to do that any more, especially since it isn't working.  This morning, she was still very confused, but she did eat a good breakfast.  But, she still continued to refuse her meds.  The dietitian told me again yesterday, and I think this time it stuck, that she needs more protein for healing, but without the Lactulose dietary protein turns into ammonia.  So I consented to a feeding tube this morning.  They will also start the 2-3 day process of getting her a PEG tube, for feeding and meds directly into her stomach.  It takes that long for scheduling and evaluation, I am told.
I continue to be amazed at the way our bodies, when they are healthy, balance everything so easily because when someone loses that balance it is so difficult to regain it, and so many factors that need to go into that process.
We also found out yesterday that her UTI is VRE (Vancomycin-Resistant Enterococci), and the best antibiotic is one she is allergic to.  So, that is also undoubtedly contributing to her confusion.  They are using another one I'm hopeful will work.
We are blessed to have a competent and compassionate team with many specialties to guide in her care.  I continue to believe that this is a bump in the road and not the end of the road, and I am hopeful that getting her appropriate nutrition and medication will get her over it.
Of course, she continues to be in God's hands, and there is no better place.

Some "down" days

After Thursday's wonderful day, Angela spent Friday and today in a confused mental state.  This morning, she was so out of it that she only drank part of a protein shake for breakfast and I had difficulty getting her Lactulose down her.  She has also developed a urinary tract infection, and one thing caused by that is confusion.  I think that's #5 of things attacking her brain.  Anyway it's being treated and apparently responding.  Her ammonia level was high again.  Her CO2 retention does not appear to be the primary issue at this time, so I'm hoping that with a few more doses of Lactulose her confusion will abate.  We shall soon see.  At any rate, it appears that Lactulose will be a big part of her life from now on.  She had a couple of visits from her friend - Friday night she seemed to be calmed and cheered, but today she didn't pay as much attention and didn't even sing along with her friend much.  She spent most of the day in her wheelchair, using her arms to move herself around the corridors - excellent exercise, I believe.  I hope she sleeps well tonight.  She hasn't been, saying she is afraid to go to sleep.  In her confusion, she thinks someone is swapping her meals with someone else and giving her medicines she shouldn't be taking, so it's been a challenge to get her to eat and take her meds, but God is good, and so far she is doing at least an adequate job of both.

A Wonderful Day

Wednesday wasn't a good day at all.  Angela spent nearly the entire day confused and the doctor was asking us to think about a plan - should we put her on a ventilator, etc.
But Thursday was a complete turnaround.  She spent the entire day lucid, walked (with assistance) a couple of times, did exercises at PT, played games, showered, started a new breathing therapy that seemed helpful, and met a dietitian who has expertise at using foods to complement medicines and their side effects.
I really don't like this roller coaster, but it is comforting to know she's in God's hands, and I do feel blessed with a day like yesterday.  We'll see what this new day holds.