There’s a new cat in town

I admit, it’s been really hard to start writing here again.  As I went through the hospice process and loss with my MIL, that topic overwhelmed everything else here.  It was hard to write about anything else when that was the biggest thing looming in our lives.  Now that the immediate, tearing grief following our loss is passing, we find ourselves embroiled in yet another very difficult family issue, which, in respect for that person’s privacy, I won’t be chronicling here.  Just know that stuff is still hard and warm feelings and thoughts are much appreciated.

That said, it seemed like a good idea to ease in gently by talking about an easy topic: cats.

We have a new kitty in residence.  When my MIL passed, her faithful feline, AbbyCat, became our responsibility.  Abby is a rather portly grande dame of a cat – somewhere north of 15 pounds and 16 years, with a kidney issue to boot. She’s a mishmash of breeds but I’m guessing a bit of Maine coon in her history, based on her size and very thick coat, with a bit of ragdoll or siamese mixed in somewhere, to explain some of her marking patterns.  She’s lovely and when in a 1-on-1 situation, very sweet and affectionate.

new kitty sitting on chair

There’s a new cat in town and her name is Abby

The problem with Abby is she’s always lived a life that’s all about Abby.  She lived the only cat lifestyle, with a devoted old lady catering to her every whim. I can’t tell you the number of times Dianne would excuse herself from a family gathering to head home because “Abby gets cranky if she doesn’t get her canned food by 6pm.”  This was not a bad thing, frankly. Dianne was devoted to her cat and her cat was devoted to her – the importance of relationships like these can’t be underestimated.

But it’s now a whole new world for AbbyCat.  Abby is no longer the center of the universe; she now finds herself in a home with 2 adults, 2 teenagers, 2 other cats and 2 rather large and pesky dogs.  It’s big, somewhat chaotic, and filled with unfamiliar noises such as dogs barking (at everything!), cats romping, TVs blaring something besides Fox News – all of the hustle and bustle of a typical houseful. Gone are the predictable days where things stayed quiet, food came spot on time, no dogs were allowed and Obama was evil incarnate.  What’s a cat to do?

Surprisingly enough, she’s doing fairly well.  My husband and I had expected her to sort of hunker down in the bedroom Dianne had occupied and slowly wither away.  We’d been through this with another cat – a skittery little thing named Farris. When her best friend, our other cat Carson died, Farris simply stopped eating, hid in a corner and waited to die. Her kidney’s quickly complied by failing.  She was gone two weeks after her friend. But not so thus far with Abby. Abby is clearly cut from more resilient cloth. We moved her out of Dianne’s room and into our own, bringing a few familiar things that would smell like home for her.  She settled in fairly rapidly and now wanders the house.  She’ll eat from the other cat’s bowls and sleep in the sun when she finds it.  She’s still learning how to not be an only animal, however.  She’s made peace with our little brown burmese and Cooper-the-big-dumb-dog but Sadie, our overactive border collie and Mac, the crazy orange tabby are a different story.  Much hissing and growling whenever either of the latter happen to enter Abby’s space (like, the same room – Abby has a very considerable personal space.)  Our hope is to simply hit some sort of stasis where all creatures can be in the same home with a bit less drama.

We don’t know how long we’ll have Abby. She is older with dodgy kidneys buy we’ll do our best to make her time with us pleasant – part of a family. I’m hoping somewhere Dianne is smiling.

How everything still turns to gold (our home hospice experience #5)

It’s getting harder. Much harder.

D. is in a new phase. Her ability to draw breath is deteriorating by the day, leaving her more uncomfortable. With this discomfort comes all sorts of emotions for all involved. For us, it’s sadness, dismay and even incredulousness when she’d choose to go have a smoke even when it took her the better part of an hour to cross the room to the door outside. For her it’s mostly anger and resignation; anger when she can’t do something she wants to or feels trapped by her own body – trapped in a room, trapped by the unrelenting parade of treatments and scheduled medications, trapped by the condition she’s forced upon herself. It’s easier sometimes to be angry at us for pushing yet another breathing treatment or dose of nasty-tasting morphine than to face her anger at herself for getting her here. Or so I presume.

But even this phase has largely passed. D’s breathing discomfort has reached a point where she requires ever-increasing doses of the morphine to make breathing possible. And yeah-it seems counter-intuitive to give morphine to someone who can’t breathe but it does actually work. It relaxes her from trying so hard to inhale that she’s tense and laboring and just lets her breathe as best she can. The downside of this is her morphine intake is at a level that she’s largely lost sight of reality. She mostly knows who we are but isn’t entirely sure where she is or why we’re keeping her here. After each dose – every 90 minutes now – she has an hour or so of relative comfort and ease. Then she becomes either paranoid or angry, sure we’re up to no good. She’ll ask questions: “when do I go home?” or “who lives in this place?” Or even “who are you?”. We’ve learned to roll with these questions and answer best we can without trying to inject logic that she can’t process.

And we have our moments of fun, too. Last night, when she was having difficulty orienting herself in her current location, Mike had her at the window and was pointing out the neighborhood homes and who lived where – many of whom she’s met. At that very moment, a couple walked by, (presumably) dressed for some sort of party with shiny silver Mylar wigs on their heads. WE freaked a bit, assuming this was a very bad thing for a morphine-addled person to see. D took it in stride – it was the blinds at the house across the way that had her more concerned. (They were opened just enough for someone to watch her, she felt).

And the guy who treated our asphalt driveway (and has for years) noticed D in her room and all her medical accoutrement and brought a large bag of leaves and dried greens that he called “the herbs from Africa” and a tea made with these “herbs” would fix her up good. Seems it “cures the cancer, fixes the ‘rheumatiz’ and everything else that ails you. Mike asked what kind of plants were in there and was assured it was simply “the herbs – granny sent from Africa”. We have yet to try “the herbs” tea but maybe Mike and I will at some point. If it cures all, why the hell not? 😉

All that aside, it’s safe to say we’re on the downslope of our journey. There will be ever more morphine at ever shorter intervals. At some point, we’ll stop being able to get her to take her other pills and the breathing treatments that give her some increase in O2 intake efficiency. At some point it will be all morphine.

How soon this happens, I have no clue. It does feel like its moving faster – that the snowball is speeding up down the hill. We’ll deal a day at a time.

Thanks to all who continue to read these rambles – means the world to me. Please let me know if you want to hear more or have questions. Or if you’ve been through this, I’d love to hear about your experiences. But most of all, thanks.

And Happy Mother’s Day to D – and all of you moms out there.

Who shines white light and wants to show (home hospice experience #4)

For those just tuning in – this is another entry in my ongoing series about our journey through home hospice (our hone) with my mother-in-law, who is dying of emphysema.

Yes, there's an "elephant in the room" implication with this photo choice too

Yes, I’m well aware of the “elephant in the room” meaning of this photo choice…

Things are coasting right now. D seems to be feeling better by the day. Why? Well, lots of reasons, I think. She’s eating good food and eating well at every meal. This is a big change because she’d been feeling so poorly for so long that her eating habits had really deteriorated. When we weren’t coming over with meals, she existed largely on frozen dinners, cookies, tea and the ever-present cigarettes. Nothing fresh, nothing that’s actually “real” food. She’s getting that now and it’s likely making her feel better. She’s hydrated. Yes, she still drinks a lot of tea but she also drinks a lot of water too so not all of her fluid intake is of a natural diuretic! She’s sleeping. 8-9 hours every night, plus naps here and there. And yes, there’s the drugs. The combo of morphine/xanax/fentanyl keeps her relaxed (!) and the frequent and consistent high dose steroid breathing treatments keep her remaining lung capacity, such as it is, operating as best it can. She’s also regaining her strength – she’s up and around quite a bit, wandering the family room, her bedroom and outside to the back porch. This is all wonderful. It is delightful to see her enjoying her days.

What isn’t so wonderful is her strength, her mobility and her delight in feeling so much better means she’s also smoking again with a vengeance. When she first came home to us and asked to have a cigarette, it wasn’t a big deal. She was weak as a newborn kitten and just as dependant. If she wanted a cigarette, she needed my husband to help her into the wheelchair, wrap her in a blanket, wheel her outside, hand her the smoke and light it. She’d draw in a few puffs before she tired of it and asked to go back inside. She only requested it every few days or so. It was largely ceremonial; a “see, I still can”. Now that she can do this under her own power, that’s changed. She’s grabbing her jacket and heading out on her own several times a day – maybe even 8 or more. Is it hard to watch? Heartbreaking? Is it her choice? Yes, yes and yes. Why? I think it’s a lot of things. She’s feeling better right now than I think she has in a year or more. I think that, along with drugs that will naturally imbue a sense of euphoria have maybe given her bit of a “second wind”, if you’ll excuse the expression. A feeling that perhaps it’s all going to be fine and these damned cigarettes aren’t going to kill her after all.

Yep, still flammable.

Yep, still flammable.

On a side note, we did have to have the hospice nurse, during one of her twice weekly visits, give D a stern lecture on the dangers of open flame and oxygen. When we weren’t watching, D would toddle out to the porch, take off her oxygen canula, hang it over the back of her chair – still running full blast – and light one up. How we haven’t all blown up by now, I’ll never know. Even though she’s been on nearly full-time O2 for over a year, D insists no one ever told her this wasn’t the safest of set ups. (Even worse, in her own home, she was indoors and doing this!) Now she has to remove the canula, turn the machine off, go outside, have her cigarette, come back in, turn it back on and start breathing air again. This is tough stuff, especially right after a smoke, so the 15 or so feet from the porch to her bed without her air on takes 6-7 minutes or more. She can’t breathe and has to stop and rest every step or two. Will it slow her down? Probably not. She has the energy and the drive to get out there just fine. She’s not considering the tough trip back in afterwards, just the gratification right now.

We don’t know, of course, what this means for her lifespan. I think it will likely cut this period of relative well-being shorter than it might be. It certainly isn’t doing her lungs any bit of good at all – either the smoking or the time off oxygen smoking requires. Nor is it doing her brain any good either – every moment with diminished O2 to the grey matter makes for another blow to her mental acuity. It’s so painful to watch but it’s her lungs, her choice and her life to spend as she wishes and this is what she wishes. She’ll spend her last days servicing the gods of addiction that are killing her.

I have no idea if these posts mean anything to anyone but myself and a few scattered friends and family. But they do help me to record what’s happening and it’s affects on all of us. (affect or effect? damn, that one gets me every time!) If you have your own stories of this journey, please share. In the meantime, thanks for coming by – even a click of the “like” button tells me someone’s paying attention and cares a bit. Thank you. And I do promise to get back to posting on some less weighty topics soon – this blog, and my own psyche, could use the break!

There walks a lady we all know (home hospice experience #3)

And exhale

Balance is everything

Balance is everything

Our hospice experience continues. We seem to be finally hitting our stride in many ways, these days. We’re getting the routine down – medications, meals, wake, sleep, etc. We’ve met all of the various hospice-provided staff, from nursing aides to social workers to chaplains, and all are lovely and dedicated people. We’ve rearranged the room a few times and are happy with the current configuration. And, probably most importantly, we’re finding the balance of medication – i.e.: morphine – to help D feel comfortable and breathing easy but not too groggy and out of it. And by “we”, I of course mean my husband. He’s leading the way here – I just follow directions. For now, we have a certain balance.

It’s the great unknown – the what happens next just waiting out there to upset our applecart – that haunts us.

Right now things feel good. D is comfortable and happy. She’s fully present and participating in life, albeit from a hospital bed. Yes, she’s a bit muddled from time to time – losing the threads of conversation, for instance – but she is on a steady diet of morphine; however low the dose, it has an effect. She’s eating very well – better than she has in some time, I think. We have a stylist coming in every few days to shampoo and dry her hair so she feels good there too. From where we’re sitting right now, that answer of “you should think in terms of weeks” when we asked “how long” seems way too pessimistic. We’re rocking this whole thing, right?

What we don’t know is how quickly her lungs will continue to deteriorate. She’s getting regular breathing treatments and is on oxygen all the time but her issues are mainly around her inability to exhale effectively, rather than inhale. Having oxygen on doesn’t help significantly because only so much of it can get in because the CO2 in her lungs is taking up the real estate. She’s on breathing treatments regularly that alleviate this somewhat but the damage is already done – it won’t get any better. What we don’t know is how quickly and what will happen. She’s hospice; she isn’t on monitors so we don’t know, for example, what her blood oxygen levels are at but we know they aren’t good. We briefly considered getting a blood O2 monitor ourselves but decided that would only become a number for all of us, especially D, to obsess about. And there is not a damned thing we can do to truly affect it so why go through it?

balanceSo we go, day by day and week by (hopefully) week. We’ll take what comes when it comes and will do our damnedest to be as ready for it as we can be. For now, we have a precious gift of comfort and conversation and we’ll make the most of it.

Thank you to everyone, both friends and strangers, who have taken the time to read these posts and leave me your own words of experience, strength and hope. It means so much.

Our shadows taller than our souls (home hospice experience #2)

Abbie Cat (under the blanket) watching D watch Buster Keaton.

Abbie Cat (peeking out from under the blanket) watching D watch Buster Keaton.

And our hospice experience continues. D has been home since Tuesday afternoon and we’re all trying to get our feet under us and settle into some sort of rhythm. We’ve got the bed and furniture set up and added a few items from her home, including some paintings and personal objects. That’s all well and good but most importantly, D’s kitty Abby has moved into her new home here. How very happy they were to see each other! Abby has settled right in and spends most of her day on the bed with D.

Naturally, there are challenges; each day brings its own set of “OMG, what do I do now?” moments. D is on some serious medications, including morphine and fentanyl, which do a lot to help her breathe easier and ease anxiety but don’t do very much for mental acuity. Combine these meds with the challenges that come from low blood oxygen levels and we’ve got some serious confusion on our hands. Some of it is to be expected – losing the thread of a conversation or being unsure of day, time or location but it also manifests itself in odd ways – sudden anger about things like the order she takes her pills (round ones go first, we’ve learned), for instance. We just roll with it and it all seems to sort itself out. My husband has depths of patience and caring that are amazing to behold.

We did have a fairly big deal to handle early on, though. D is a smoker. It’s her smoking that got her to this condition and it’s her smoking that will eventually bring her to her end. Knowing and understanding this, however, doesn’t mean her desire to smoke has gone away. As any smoker knows (and both my husband and I are ex-smokers) this is one terrible bitch of an addiction – one that defies any rules of logic or common sense. So, it wasn’t too much of a surprise that D wanted a cigarette not long after moving in here. Handling a request like this is certainly not in the hospice handbook! Husband consulted with her doctor and the visiting hospice nurses and their advice was unanimous and unambiguous: give her a cigarette. Their contention was the cigarette itself was not going to do her any true harm at this point but the anxiety and other symptoms of withdrawal certainly would. This was, needless to say, not a popular opinion among all of D’s family but my husband agreed with the experts and bought his mom a pack. Each day, they go outside and she has a few puffs on a cigarette. That’s all, just the one, and she’s so much happier. Hard to argue with this one.

As I see it, our job here is to help her feel as comfortable and anxiety-free as possible. Quality of life and comfort, to the best of our ability. If that means she wants her cat, she gets her cat. If she wants nothing but donuts for a day, she’ll get donuts. (Although we might slip some fiber or vitamins in somehow). It’s about D and her wants – not what we think she should want or what we’d feel better about her wanting. It’s her life and her death – we’re just the back-up singers.

Siobhan in cosplay costume

Siobhan in cosplay costume

Incidentally, while she may be a bit addled about where she is or what she’s doing at any given time, she’s completely on the ball in areas you might never expect. My daughter is an active cosplay fan so hits the “Cons” whenever they’re in town. This weekend brought a ComiCon type event so she dressed up as a character from the online comic Homestuck. My husband asked her to stop in and see her Gran before she left – I wasn’t so sure how that was going to play out – how would the lady who isn’t quite sure who’s currently living in the White House handle her granddaughter popping in wearing a black wig and horns? As it turns out, she LOVED it. No uncertainty or confusion about the horned girl – just delight. And delight is exactly what the doctor ordered.