Hospice nurse visit last Friday and 3-week doctor visit was today.
Gary's in and out of sleep about 18-20 hours most days. Sometimes he can communicate with us pretty well, but then he goes back into the silent shell. He goes through long periods of unresponsiveness and blank stares at the ceiling or past you when you stand in front of him. His arm circumference has dropped from 29cm Feb. 7, down to 27cm. We got a top weight of 135 yesterday on the scale compared to December's 163. You can now see the blades of his hips on his back, and nearly where his spine joins them. His ribs are defined on his back when we turn him. I told the nurse Friday it seems like Gary might break when we turn him over. She said my instincts are good and that we have to be extremely careful. The doctor says he's down to skin against bone on his entire back (which is not surprising considering what I've described) and very high risk for pressure ulcers.
His left arm and hand are contracted and stiff. Most days he can't straighten that arm to more than about 70 degrees. His pinky and ring ringer on that hand are often painful to straighten from a permanent fist. His left leg (hip fracture leg) and arm are both noticeably smaller than his right side and his toes are starting to point. So, his limbs are close to skeleton on his left side, and 1/2 way to skeleton on the right. Dr. says some sort of blockage is likely causing that, but he was quite surprised at the decline in condition referring to the stark contrast between right and left side in just 3 weeks.
Even more concerning now is the low urine output in contrast to the fluid he's taking in. Overnight Saturday/Sunday he was 14 hours between urination and it was dark like medium coffee. Then he only needed 1 additional change yesterday. Today only 3 changes, and not very much output each time. After a long conversation with the doctor (he asked Gary for his permission, too), we put in a catheter tonight for a clean sample for testing and to reduce the need to roll him and risk fractures with too much movement. The doctor fears renal failure but we'll know more tomorrow after testing and we'll play continuation of the catheter by ear pending the results and how he tolerates it.
One day at a time. I updated his sister tonight.
