Cycles

Cycles

Cycles

I am what you would call a light sleeper, the slightest sound on most nights will awaken me, and I am up, no problem.  However even light sleepers have their times when they are in deep sleep.  So when I got a knock on my door at 11:30 in the evening, I guess I was in deep REM sleep.  For I did awaken but felt like I was drug up from a deep tar pit at light speed; so I felt some shock, a feeling I am sure most can identify with.   So I got up, stumbled to the door and was notified by Bernadette that Philip was not doing well and I needed to come and check.  So I got dressed and hurried to the infirmary.

Phillip has been with us for many years, bed ridden for the last five years, weak, and needs to be in a geriatric chair when he is out of bed.   We try to get him up for a few hours in the morning and then for another three or four hours in the afternoon.   We have to use a lift since it is impossible for him to stand on his own, and his back is stiff, so even if he could be lifted, it would be dangerous for both him and the caregiver to try to seat him.  Most days he is peaceful, gentle, with a beautiful smile, and very easy to deal with.  On a few days he can be in a bad mood, then he can be a little more difficult, but all in all, one of the easiest patients we have on the floor; often finding humor in what goes on around him.

He has always had his cycles, and from time to time he would become very fatigued, and sleep and be unresponsive for a couple of days, but not in a way that caused concern.   Lately his cycle has shortened and his episodes have become more serious.   So I was not surprised at being awaken because he was now in distress.  

Phillip seemed to be struggling, clammy, his skin hot to the touch, though he did not have a fever, and blood pressure that went through the roof.   The pulse ox machine showed that his oxygen was 88.   Bernadette put him on oxygen before she came and woke me.  Though he was in distress it was not extreme.   Yet it was different; I could tell that this could be his final struggle, or just another accelerating turn of the wheel.   He has been with us for so long that it was hard for me to imagine that this could possibly be his last night with us.

It was time for his cleaning, so we did that quickly, got his bed straightened up and put him in a reclining position so he could breathe easier; though at the time he was not struggling much with that problem.  After that we put out the light and I sat with him for awhile to see how things would go.  I waited for another 20 minutes or so checked his oxygen level, it was now 77, and he was still hot to the touch.   I decided to get Fr Francis to come and give him the anointing.   I called him and he was there in short order.   We prayed, and give him the holy oils and Fr Francis blessed him.   He stayed for a few minutes and spoke some gentle kind words to Phillip, then left.

When sitting with someone who may be dying, I find that the hours fly by. I don’t know why this is so but it just happens for me that way.   I prayed some, read the 23^rd psalm, but could not get past the first sentence, “the Lord is my shepherd”, and keep thinking on how for Philip, the Lord is truly his shepherd, for he has always been a devout Christian, a gentle loving man.   I stayed until 6:30 and then went back to my room to try to get a few hours of sleep, but, 30 minutes later I was called back in.   When I arrived he was in a sitting position in his bed and struggling mightily to breathe.  It seemed he was most likely dying, though over the years I have learned never to make a statement  like that, too many times there has been a rally, just part of the cycle.    We have Ativian cream here, so I got some and applied over his wrist after I washed it, and in about 15 minutes he was able to relax a bit and fall asleep.  So I stayed with him for a few more hours.  

Rose the nurse arrived, she is a very compassionate woman, and I doubt this place would run without her knowledge, intelligence, and common sense, when it comes to caring for those who are in the last stages of life.   Before she came to work here she worked in hospice, so she was comfortable in dealing with those who are moving towards their exit from this life.  Her heart is also has big as the world, she seems to love everyone.   Even when not at work she is always visiting or helping her friends, which are many.   I just get tired watching her.   Because he could not drink at this time, he would aspirate, we could not give him his liquid Tylenol for pain, he gets it twice a day for his arthritis, and it was acting up.   We have liquid morphine, so Rose gave him small dose, which helped him and he was able to become more comfortable.

Later that morning he became very emotional, not sad, but smiling and crying.   I talked to him about his sister Ada, and that really got the tears flowing, for he loved her very much.   Though as I reminded him how he used to ask me to spend some time with her, because she was so outgoing, joyful, that he wore him out; for he was very introverted.   He laughed at that and cried some more.   I told him how much I loved his sister, and how we used to go out for a meal once in awhile.   I showed him his family portrait, all gone now except for him and his younger brother who is not 80, Phillip is 90, and he smiled and touched it.  After that he slept for awhile.

So he slowly got better and this morning he was bright, alert, or as alert as someone with Alzheimer’s can be.   Though Neda just informed me that he is now getting hot again, and getting pale, so perhaps we are getting ready for another round, perhaps his last, perhaps not, in any case we will be there for this very gentle, kind, and lovable man.