Long lag between posts but it's been a busy time and a lot's been happening. The 6 am respite did not last long. Early this morning, we had called in the critical care component of hospice and they sent a nurse out asap. He basically came in and just upped what we were already doing with one addition. Since my brother is no longer able to get the morphine ER pills swallowed, they went rectally with those. Since 8 am, we've been constantly dosing him with increasing doses of sublingual morphine. Add to that the rectal route and more fentanyl and the pain spikes have minimized. He is still tremendously aware at times when the hellish discomfort sets in. He lets us know immediately what he needs. It's a bit of sign language, a bit of interpreting what he's saying, and a bit of intuition guessing what he wants. So far, we've been able to stay one step ahead of the curve this morning.
The plan moving forward is that they are going to have a critical care nurse here 24/7. At this point, it's unlikely they'd be able to get any IV access to him. So we're left with the suppository route, the transdermal route and the sublingual route. So far that seems to be working. And my brother just keeps going somehow. Just over a week ago, he told his wife that 'he was ready to go.' I'm going to beg to differ on that one. He still keeps fighting every breath of the way.