180 Degrees

 9am, 10/17/12

I knew this would happen. Knew it. As good as Billy Jo was yesterday... getting the CADD pump dosage adjusted right, walking around the lake a few times, up and alert all day… she’s the complete opposite today.

See, it is customary that patients poop before they’re released. Billy Jo isn’t your common patient. I mean, the whole reason the hospital discharged her into hospice is because she didn’t poop for two weeks despite everything they tried. Sure, she pooped a few times once she was home, but nothing regular. Waiting here until she poops is nothing more than a prison sentence with a warden that wants to pick fights with me.

Yesterday , the doctor seemed confident she could do what the others couldn’t - make Billy Jo poop. She changed the laxative regimen to add Senna and Milk of Magnesia.

When we left the hospital, they told us that for her comfort to only stick with Colace. Senna, MoM, Miralax, would prove to be too harsh and could cause her unneeded discomfort and even possible bowel perforations.

Last night she began with the Senna and MoM. Overnight she felt even bloated, more uncomfortable, and in more pain. When I got here this morning she looked like a ghost. Of course, no poop had occurred.

The nurse this morning asked her to try some magnesium citrate, and said that if it didn’t work then she’d advocate for her to go home.  We are frustrated that we came here for pain management, not because she couldn’t poop.  They’re still not convinced the swelling is due to ascites and think it’s impacted stool. I’m not sure how you go from “normal” (Friday night) to 8 months pregnant (Saturday morning) in less than 12 hours when you ate two bites of soup the past 24 hours, but then again, I’m not a doctor.

Billy Jo agreed to try it, as long as this nurse would have our backs to get us home. I put the over/under at Billy Jo vomiting after drinking some of it at 60 minutes. Under pays. Nine minutes. Nine. She was puking everything back up - bile, liquids, a bit of last nights small dinner.

This was no surprise to me. I mean, I’ve read enough the past month to get a good idea of what is going to end up killing her, and have come to the conclusion that the way she will die is permanent bowel obstruction as a result of tumor spread. It certainly isn’t an uncommon way for an ovarian cancer patient to die.

So as I type this at 9:35am, she has been given a BDR (Benadryl/Decadron/Reglan) suppository for nausea, and has passed out. I am pushing the CADD dose button for her every 10 minutes for the next hour.

I appreciate the doctor trying, and it was Billy Jo’s say to give it a shot, but it didn’t work. We need her pain and nausea back under control like yesterday, and we needed to go home, where Wrigley can bark her balls off every time someone comes to the door. I mean, the ONLY thing that has gotten Billy Jo to poop in 37 days is having her roof over her head and toilet under her ass.

UPDATE FROM AFTER DOCTOR VISIT:

After seeing her this morning and what the attempts to get her to go have done, the doc is convinced the swollen abdomen is mostly tumor. It is now hard as a rock. She mentioned that there is quite likely a full bowel obstruction now, fairly high in the intestines. She thinks there was a partial closure that was letting very skinny bits through, hence the small, skinny BMs once every few 4-8 days. Now the partial closure has become a full closure due to either invading tumor or shifting bowels.

It's now time for her to go home for full concentration on pain management and I was taught how to give the BRD suppository if she needs that for out of control nausea.

In order to try and prepare myself,  I asked the doctor what she’s thinking time-wise now. She of course cannot predict an exact day but said unless the obstruction clears (at least partially) we have moved from the “1-3 months” stage to the “month or less” stage.

But she's home now and sleeping comfortably on the love seat, dog right below her on the floor.

I’m exhausted and I am also going to take a nap for a few hours.

Edit: I'm not flipping out. I'm ok. A little stunned, but OK. Don't worry about me freaking out. I haven't even needed a xanax.