24 Hours of Agitation

The past 24 hours have been the roughest since Papa came home from the hospital. 

My Aunt Mary and I took turns watching him while the other one shed tears.  It was heartwrenching to see him so restless. I think he has again become intolerant of his pain meds and he is suffering from psychosis.

By now he has to be experiencing sleep deprivation as well, because he hasn't slept in at least 24 hours.  This morning while I lay dozing on the couch near his bed, I jumped up when I saw him trying to get out of his bed, stretching the IV line to it's limit.  The hospice nurse had told me that I would probably have to move him into the hospital bed before long.  Today was the day. 

Mary, Yvette (my sis-in-law) and I, managed to take advantage of him wanting to get up, and we held him up as he walked on shaky, spindly legs over to the hospital bed.  We got him settled with the rails up for good measure.  

At 0740, I placed a call to the hospice on-call nurse, and it was obvious that I awakened her.  We talked about his agitation and restlessness, and whether it was "disease progression" or the accumulation of the drugs due to poor liver function.  After she arrived and examined him, we decided it was probably a little of both.  She suggested that we give him Thorazine to calm him down, but after what I witnessed when he had Ativan and Haldol in the hospital, I was reluctant to agree to any "anti-psychotic."   We settled on Valium.  Of course, they started him off on 2 mg. baby doses.  After 14 mgs. throughout the day, he is still twitching and restless and we are all exhausted.  He expended so much energy while doing all that movement, that his blood sugar got to dangerous levels.  It was so difficult to get it up again and we had to have the nurse contact the doctor, when 4 tubes of glucose gel and one glucose tablet failed to do the trick and get it up past 45.  I think everything we put in his mouth, was just sucked out by the gastric tube. You'd think that the glucose gel would actually absorb in his mouth and start to work a little quicker, but I guess with as sick as he is, everything is screwed up.  

I also talked with the nurse about the fact that Papa has not slept one wink since taking the Valium and Benedry, she asked if I'd be willing to consider the Thorazine at this point.  I told her yes, since I couldn't bear to see him continue like this much longer.  Unfortunately, this little town does not have a 24 hour pharmacy so the hospice nurse had to call it in to one that's 45 miles away.  It's now 1:25 a.m. and we're awaiting my brother's return with the Thorazine and hoping that it will work the way it's intended.  Papa needs some rest.   

I thought this hospice supervised death would be peaceful.  It's anything but at this point.