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Journal entry by Steven McGee

Recovered from "soy sauce" event.  Going back to sleep.
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Reverend Kathy Graves Shaman, Circle of the Sacred Earth e-mail following a conversation we had today: 

"God dream a bigger dream than I can dream for myself.." "Both you say that as much as you can.... Put on stickies or cards around the house...." R KATHY 
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04:44 Mini "soy sauce" event mitigated with a purple towel laid over Tammy's fresh shirt.  Hyoscyamine under tongue. Tammy took a sip of water... will note when 8 Oz of water drank since around 11:00 PM last night.  Water bottle nearly drank. This portion of water was Miralax to encourage a bowl movement as per discussion / action plan with Nurse yesterday afternoon.

05:30 Tammy drank another several Ounces of plain, non Mirilax water

05:37 Coughing episode over (was a minor one with a minor "soy sauce" event mostly caught in tub and a very minor spit up of soy sauce caught by purple towel.  Reclined Tammy back and angled pillow to keep head more centered to aid rest.

07:40 Tammy drank four ounces of plain water on her own after I placed the cup in her hand.  Nurses aid due @ 8:00 AM. Will change lay flat Fitright diaper.  Change shirt..  minimal jostling today.  Bedding and chucks changed yesterday.

11:30 Update Nurse's aid squared Tammy away.  Very pleased.  Shawna and Social worker arrived around ten.  Morphine administered @ 8:00 and 11:00. Lorazipam (sp) relaxer administered by Shawna around 10:00 -- I crushed up the pill so that solution could be administered under the tongue (teamwork). Tammy reached for and drank more liquid from the spill resistant straw container and has consumed about 8 Oz of fluid since wake up.  

15:13 PM Tammy took another big swig of liquid -- with me holding the non - spill straw drink container

15:30 PM Tammy took another drink of liquid with me holding the cup.  Her hands are clasped behind her head again.. sort of awake... exhausted...  water tank replacement is here from Eatontown TV and Appliance.  When he looked at the tank, he said "this is weird, the tank exploded from the top instead of the bottom" -- apparently that is the opposite of what usually happens

15:37 Tammy took another drink of liquid with me holding the cup.

17:59 Tammy is still autonomic ally drinking out of the straw cup. She is "peaking" though..  Tammy's brother Vern is inbound from Arizona. I'm finishing filling out the forms to activate weekend nurses aid coverage with Always Best Care Inc.

Journal entry by Steven McGee

06:23 Poured water from 20 Oz bottle into a 12 fluid ounce / 355 ml bottle to make it easier for Tammy to drink. Tammy took a sip of water.

07:00 Tammy asked for two sodium bicarbonate anti acid tablets.  She chewed them and swallowed them successfully.

07:33 E-mailed Reverend Kathy Graves, Shaman Circle of the Sacred Earth and Reiki Master Practitioner is she did / is willing to perform a passing ritual / last rites.  Tammy's breathing is very labored and rapid.  Her eye sockets (not currently awake) are very dark.

07:42 Last night, Tammy asked me to "hug her leg" because it "felt good"  :)

09:25: Spoke to Meridian At Home Hospice. Stated that Tammy and I are pleased with the support we've been receiving and would like to extend our support to seven days per week -- less one individual whom Tammy is not comfortable with.  Meridian stated that they will see what they can do.

10:46  Tammy drank approximately 6 fluid ounces of water on her own. She held and maneuvered the bottle.  Hackensack Meridian at Home just called and a replacement health care aide will be here shortly per Tammy's wishes.  Very pleased.

13:17 PM Rosanna came and saved the day...  bed side bath, teeth brushed, diaper changed with ointment, bed change, improvised because my hot water heater broke, thought on her feet and got the job done -- extremely pleased

17:09: Metrics / measurements / medication nurse made assessment and plan for tonight. Social worker and I chatted about maintaining a vision and plan of action for the way through and beyond this challenge.  Health care aid scheduling nurse called to schedule a visit for tomorrow. Rectal constipation suppository administered.

11:45 PM: Tammy's fluid intake increases to about 16 fl Oz. Some sips of beet juice included.  Both caregiver and Tammy getting some sleep. I'm helping Tammy make adjustments to her sleeping positions to avoid stiffness.

11:51 PM Soy Sauce event.  Caregiver was at bedside adjusting Tammy's position so caught most of the discharge in a pink tub. Opinion: given the volume of these events, it is not possible for the material suspended in the liquid to be entirely comprised of Berberine Berry dietary supplement pills. Berberine has only been added to the diet post "the talk" advisory.

Journal entry by Steven McGee

Tammy said on Monday, "it's Monday at the Masters"

02:00 AM  Tammy asks for and receives two Tylenol (for a headache).  I told Tammy it is OK to pee and that she needed to drink her water.  Tammy drinks about three ounces of water.

03:30 AM Tammy asks for the blankets to be taken off her legs so she can stretch them out completely.  I hand her the water bottle so that she drinks some liquid.  I tell her it's OK to pee.  She asks for her diaper tabs to be loosened.  Her abdomen after the operation was retaining fluid about four months ago but the hospital said there wasn't enough fluid in her abdomen at the time to warrant a draining procedure.  We have been asking for a fluid drain procedure for several months now -- for comfort reasons.  Tammy dislikes being rolled from side to side for this reason -- it is uncomfortable.  Catheter to be installed Monday. Could have, would have, should have had it installed on Friday.

09:22 A.M. Tammy said "I peed" / I said "good" !  Then I said, let's get some Macro Life Miracle Reds energy drink into you before we start the diaper change.  Tammy said OK -- and here's the awesome part..   wait for it....  Tammy took her morning pills with the energy drink!  Hallelujah song playing in the background...

09:26 A.M. I've thought this through.  Rather than disrupting the team in place just because of one individual Tammy does not want around her.  I'm going to add a full week of staff support and overlay them at different times in the day from a different vendor -- unless the team in place replaces the teammate Tammy and I do not think should be providing care at this time. This way, if the person who we feel shouldn't be providing health care at this time shows up, I can just decline the help and wait for the other team's person to assist me. Issue resolved.  (Linda "The Psychic" "spend the money")   ;)

10:19 AM  Incessantly receiving weather warnings on cell about increased chance of fire warnings: 20 - 25 % increase so I moved the emergency medical Oxygen tanks out of the master bedroom to the farthest point in the garage. Increased fire warnings when all it's done is rain and snow this spring?  Seriously? 

11:11 Changed Tammy.  Better methodology this time.  Diaper was soaked so she may have peed several times last night.

12:12 Feeding Tammy hard boiled eggs mashed up with butter.  Tammy crunched an egg shell chunk -- I get "the look"  ;)

17:37 PM System purge day.  Lost the eggs, complete purge of the stomach with lots of mucus. Two shirt changes, bed change, a baby wipe shower followed by a wash cloth Aveno soap portable tub bath to clean up after the system purging and we're back to a clean bed and a sleeping Tammy.  Anxiously awaiting a mouth spray mist as needed product to help clean up the lungs to arrive recommended by the Shaman, Circle of the Sacred Earth who has been beyond invaluable.  Caretaker took a shower. Is finishing washing all the towels and soiled clothes to start back again tomorrow on a clean slate.

17:49 Tammy just brought up a thick green blob of mucus similar to that which one brings up when one has a bad chest cold. Thanks to the Shaman, Circle of the Sacred Earth, who sent this link: http://icnr.com/vanish/purchase-vanish.html Vanish is on the way to provide Tammy with mouth spray ease relief.  Thanks again Rev K!  Help is on it's way!

09:49 Mucinex pill taken.  Blu Emu (like Ben Gay without the smell) placed on neck and shoulders. Lights out so Tammy / Caregiver can get some sleep after a long day.  Mucus is better out than in.  Hopefully, Tammy will have several good days now

11:16 PM The caregiver, that would be me, lay down to get some rest after the Mucinex pill was given.  I heard Tammy moving in the bed which means some event is happening (vomiting, bringing up mucus) and I rushed around the bed to watch Tammy throwing up what seem like at least a pint of brownish, reddish tinted vomit from the stomach.  There was some mucus in the vomit but overall, the vomit was more like material suspended in the liquid.  Tammy managed to aim much of it into a pink tub but a good deal made it down onto the fresh chucks I had positioned underneath her earlier from the afternoon's session of vomiting and bringing up mucus.  Keeping in mind Tammy's air readings were 97 a few blog posts ago, I was completely surprised by what just happened.  I changed her shirt for the third time and used some of the bedside cleaning spray that Mera had brought to clean Tammy up.  I cleaned up what made it onto the chuck as best I could.  The chucks are stained a deep brown / red on either side of Tammy.  I placed wash clothes between Tammy and the stains as she was too exhausted to go through the rolling back and forth on her distended belly necessary to remove and replace the chucks.  So, obviously better out than in -- but, the volume and the color of the discharge was admittedly unsettling.  Tammy did manage to watch the final hour of the Master's Golf Tournament today.  She enjoyed seeing "Captain America" win the Green Jacket.

11:36 PM  Final thoughts on the volume and color of the vomit described above.  I have been making energy drinks from freeze dried fruits and vegetables using a product called Organifi Red Juice.  Tammy dislike this beverages red husk residue.  So, several days ago, I switched to MacroLife's Miracle Reds Superfood product that does not leave behind the residue like MacroLife's product does.  As I blogged this morning, Tammy drank down her morning pills of Tumeric-Curcumen, Berberine Berry from India (a stomach / intestinal cleansing remedy) and N.A.C amino acid N-Acetyl -L Cysteine that is used to mitigate chest mucus according to Web MD (used in lung misting) and by a University of Maryland study.  

Tomorrow morning, I will offer Tammy water and some of the MacroLife's Miracle Red juice as she must have energy and nutrition. We will focus on eliminating mucus and omit use of the Tumeric-Curcumen / Berberine  pills for the next several days.  Tammy is still coughing unfortunately.  As I mentioned earlier, Tammy's lung seal operation to prevent fluid build up by sealing the lungs with a type of "talcum powder" was only successful on one side of her lungs.  The other side had too much scarring by the cancer growth to fully seal.  That operation was approximately four months ago.  What state her lungs are in I cannot say other than pointing out that her Oxygen measurement was at 97 (while on the O2 machine) and fluctuating between 86 and 89 without the machine on Friday.  Palliative care...  nothing prepares you for this.  Caregiver out.

"Soy Sauce"...   my wife's last words ? Another dash around the bed to Tammy's bed side.  She had managed to lift the pink tub to her mouth for another round of vomiting which yes, looks like soy sauce.  Another Baby wipe and disinfectant bedside spray rub down, another clean shirt -- the fourth today... another load of laundry. Tammy looked me in the eyes and squeezed my hand.  She gave me a good long look and smiled.  I told her that when she gets to heaven with her mom and Grandma that she should have a big, grand party and watch the rest of us down here dealing with total economic collapse and drastic climate change due to the Milankovitch Cycle (see my other blog) and enjoy herself because, no one will be able to touch Tammer "The MC Hammer" / The Heart Beacon then. https://www.scribd.com/document/375652904/Tammer-the-Hammer-The-Heart-Beacon / https://en.wikipedia.org/wiki/Milankovitch_cycles   Tammy's care giver / Scribe for the Heart Beacon Cycle Time - Space Meter Eco-Economic Heartbeat out.  See the Vanish bottle down below?  Tammy's energy signature will vanish and depart from it's body and travel to her home star.  Reverend Kathy Graves Shaman Circle of the Sacred Earth "It's in the Stars"

2:51 AM another pint or so of "soy sauce" -- no way blocked Berberin berry pills constitutes this amount of volume...  I took pictures of the liquid..  probably too tacky to post...    I asked Tammy if she wanted me to call 9-1-1..  she shook her head no.  I asked her did she want to pass (assuming that is what is happening) right here.  She nodded her head yes.  Care giver out.

3:15 AM awaiting call back from on Meridian at home on call nurse to ask for advice and an explanation of what is happening.  I took several pictures of the vomit / discharge "soy sauce" as Tammy called it.  I fed Tammy hard boiled eggs and noon mashed up with butter but the chunks that are being expelled with the discharge are multi-color green, blue...red, and don't look like eggs..   no one told me about quarts and quarts of "soy sauce"...  would have been nice to have been given a heads up

03:35 Spoke on the phone to Meridian Health on call nurse and requested a house visit. Per instructions, I gave Tammy the CP Prochlorper 10MG tab for nausea and vomiting.  While on the phone, the on call nurse said I was giving her the best thing I can give her -- love.

03:44 Set out the copy of the Living Will / Do not resuscitate papers in preparation for the on call nurse's visit.

04:53 On call nurse departs.  Oxygen level off oxygen generator 91 - 92.  On Oxygen 96.  Blood Pressure 127/94

Journal entry by Steven McGee

Tammy asked for and received a small bowl of cereal and milk -- Life cereal mixed with Kashi Go Lean wheat flakes and berrys

14:17: Tammy asked "can I watch the Masters Tournament on my tablet" ?  She is watching the Masters on her tablet.

14:44: Gave Tammy a Baby wiping on her upper body. Put Blue EMU on her back, changed her top while she was watching the Masters Golf Tournament on her tablet.

16:00 Used a web site that provides Hospice help in addition to the primary Hospice provider Meridian at Home that works like airline flight, hotel booking sites and received a call from Hiberian Health who is searching for people in the area who might be available to work a hour each weekend day.

16:44 Retrieved tablet given Tammy was sleep watching the Masters Golf Tournament.  Asked her to take a sip of the energy drink which Tammy did.

17:08 Requested a bid from Meridian at Home for weekend hospice support: http://www.meridianathome.com/MAH/

17:52: Care giver / husband completes taking shower - shave, change of clothes, puts load of all unwashed clothes in washer so that all clothing in house to include towels, wash clothes are clean. Sets out change of shirt, sox for Tammy. Watching for an opportunity to encourage Tammy to finish her energy drink prior to eating something solid (e.g., soup, Gerber's baby food) for dinner. Tammy has been sleeping since about 16:00. Have logged medication times and re-medication windows.

18:29: Tammy took a drink of water but declined to sip / finish the energy drink. So I told her that she needed to drink more fluids as to not dehydrate.  So Tammy responded with "tomorrow". I said that she needed to drink fluids now.  She said, "I'll just pee it out and I'm not ready to roll -- referring to my yet to be perfected diaper changing skills or lack thereof. So, I told Tammy that we would ask Meridian to install the catheter on Monday to limit diaper changes to to urination.  We will extend Hospice coverage into the weekend either via Meridian or another vendor who is polling their work force to see if anyone is in the area available to provide weekend coverage / coverage in the event that Meridian at Home has an open day. Decision is made to "spend the money" (Linda the Psychic session)...  don't ask..  long story..  Caregiver Steve out

18:30 Tammy is eating her pear, cinnamon and oatmeal Gerbers

22:30 PM Tammy asks for a dosage of Morphine.  

Journal entry by Steven McGee

This website is for Tammy Sue Lee McGee's lion pride.  Being former military US Army Signal Corps, I thought this "smart push, warrior pull" strategy to provide updates was a smart thing -- her primary care giver / husband Steve

April 7th 2018: the oxygen tank adapter came today and is in use.  Tammy drank half a 1 gram of sugar per container protein shake last night about 3:30 AM and a half of fruit / vegetable energy drink this morning. She took her mucus medications and a few supplement pills as previously described.  She is sleeping and is on O2 -- without the humidify bottle because the nurse pointed out that her lungs are already moist with the mucus.
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