Not quite ready.
It's been a long and exhausting day. Billy Jo is has been in and out (mostly out) of consciousness all day. The pastor warned me that this end process may take some time and I need to prepare for that possibility. An hour later, the nurses came by to change the dilaudid pump and check up on her. Surprisingly, her vitals are still fairly normal. They said that it isn't easy to determine if this is "it" or not, due to her age. She has almost certainly turned the final corner, but she's so young that her heart and lungs are strong.
I've heard that when it gets near the end that hospice nurses are very accurate at determining the amount of time one has left. They aren't even guessing in this case. This morning, when she threw up 8+ ounces of black vomit (blood) and was mostly non-responsive, I was sure she wouldn't see Monday. Now they say it may be quite a while in this "stage".
The nurses talked the doctor into increasing the dosage of Ativan and reducing the times per day back to four. This is a huge relief, as the every four hours was really fucking me up sleep-wise. Ativan on 4 and Methadone on 6 makes for hell. Now they are both on the 1's and 7's. I'm used to that - I've been doing it for weeks.
This stage is very hard to deal with. There's two things we didn't want to happen during her dying process - a lot of pain or an extended period of time with her "completely out of it". It now seems that this may be unavoidable.
I'm heartbroken. To see her like this hurts me more than I could ever imagine. We are in a conundrum - she's got a choice of suffering in unbearable pain or being so heavily sedated that she's out of it 23 hours 45 minutes a day.
She said several times today that she is worried about everybody and wants to make sure everybody is ok. She insisted that every friend and family member that stopped over come see her, talk to her, and hug her, so she could tell them she loved them and it would be ok.
This is just like Billy Jo - putting everyone ahead of herself. We have told her we will be ok, even better than ok, as a result of having the privilege of knowing and loving her. She will forever be in our hearts and minds.
As my sister was saying goodbye tonight, Billy Jo teared up and said she is going to miss everybody. It's breaking my heart. I have given her so many reassurances, so many promises, so many permissions. I don't even know what I'm saying a lot of the time. I certainly couldn't type it all here. I hope it is providing her some comfort and lessening her fears and sadness, because if that gets added to the mix I'll be really hopeless. Let this girl be in peace.
I think there were over 100 facebook notifications on my wall today. No way will I be able to respond to them all, so I thank you collectively from here. I've read them all, just lack the energy to respond. Thank you so much for continuing to keep Billy Jo and I and our families in your thoughts and prayers. They mean the world to us.