March 21 – glioblastoma multiforme progression

Saturday proved to be an awful day for my dad. His condition was dire when we arrived. He was non-responsive for the most part. Occasionally his eyes would flutter open…but they appeared to be glazed over…and he didn’t seem to actually see us most of the time. He had been urinating about every hour…and shortly after we arrived…began to urinate every 25 minutes or so. He had had no fluid input for 24+ hours. He was unable to swallow…so he had not been able to have any of his seizure medication....which was a big concern.

The hospice nurse had been called…and told it was not an emergency…so it took several hours for her to arrive. When she did get there…her assessment told us that it was as we suspected. His condition was the natural progression of things at this stage.

She brought some more meds from the comfort pack…and instructed my step mother on how to give them. She then said that at this point, administering any of his meds except the comfort meds… (Ativan/morphine) is really not important…and if he chokes in the attempt…he could aspirate and complicate matters more.

His vitals are still very strong…so he could conceivably be at this stage for quite a while. We are thankful that he still isn’t in pain.

He roused around late Sunday evening, and managed to drink almost a cup full of water, and a partial cup of Ensure…and eat a small tub of baby food fruit. Then he became so agitated that my stepmother had to give him the Ativan/morphine cocktail. The Ativan is in pill form, so it is mixed with a measure of liquid morphine, then drawn into a syringe and given orally…a few drops at a time.

He slept all night, and is still sleeping this morning.

I had a moment of…flashback sort of panic…as the nurse began to tell us how to mix the morphine/Ativan. The morphine sulfate is also referred to as Roxanol. It is often given at the end of life as a comfort measure. Back in September…as we stood around mom’s bed during the last hour of her life…they had already given her a couple of doses of Roxanol… and the nurse stood by with another dose in a syringe as mom took her last breaths. I will never forget that moment. We were all sobbing…and mom began to vomit a bit as she passed away. My sister pleaded with God to take her…fearing that mom would endure the vomiting consciously...and maybe choke and die horribly. I wiped it away as it came out…and talked softly to mom… stroking her hair and face…reassuring her that we were all there with her…and that we loved her…as did my brother on the other side of the bed. It is amazing what the human mind does with things…all of that sudden…painful moment…flashed back at the mere mention of one word…Roxanol.