Update: 03/23/06

Medications:

80 mg. Oral Morphine in 3 doses (20-30-30).

120 mg. Extended Release Morphine.

1 mg. Lorazepam in 1 dose (for sleeping/anxiety).

10 mg. Compazine in 1 dose (nausea)

Morning SAT: Oxygen Saturation = 91/Heart rate = 125 (standing, awake 2 hrs.).

Evening SAT: Oxygen Saturation = 100/Heart rate = 94 (lying down).

How Joann’s Day Went:

Joann seemed to be doing better this morning; she seems to have kept her oxygen on all night. I think she stayed more elevated than before, thanks to the extra stability of the new sleeping pad the VNA brought in. There was saliva, but no blood mixed in. "Doing better," is a relative term though. She wasn’t very functional, though she was up-and-about, albeit briefly and slowly. We went to bed at 9:30PM, early for us, and didn’t play evening cards with Bill as we usually do.

Wellness Supervisor Carol came over this morning and we discussed several things, such as action on Joann’s "Dream Foundation" application, providing Joann with a wheelchair, getting her set up on "Rides" so she can have doctor’s appointments if necessary, and bringing in someone to do Joann’s hair.

The Dream Foundation application stalled because Joann’s condition changed enough so that our first choice, making a trip to San Diego to see my father (whom Joann has never met), was infeasible. The second choice was to have him come to see us, but family matters place him close to us in the next couple of weeks. Joann will have to make a new wish now, something she is thinking about. The issue of getting Joann to any doctor’s appointments is moot, hospice patients usually don’t need to see doctors. However, getting Joann set up for Rides as a backup plan is still on the table. Carol also set up a woman to come in and shampoo and cut Joann’s hair. We await her call next week.

Joann’s pain became worse in the afternoon, so I am now giving her 30-mg. doses of breakthrough morphine as opposed to the 20-mg. doses she was taking. The frequency remains about the same, three to four times a day. I think its safe to say that Joann is homebound now. Without a wheelchair, she isn’t able to go anywhere that takes more than a few steps. VNA will bring her a wheelchair and I’ll park it somewhere in the apartment, should she choose to use it.

Carol also brought over a letter that describes Joann’s hospice status and my role in taking care of her at home. She also initiated In-Home Supplemental Services, the agency that will pay me to take care of Joann, and be able to continue paying rent. These are the things I needed to keep our home safe for the time Joann has left. I believe that Joann is under less stress knowing that her home is stable.