The Hardest Part

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Life has changed dramatically in the last 24 hours. Nate’s pain has increased at phenomenal speed, and we’ve had trouble keeping ahead of it with the drugs Hospice has given us. Yesterday, from around 3:00 pm until 3:30 in the morning, he was extremely agitated, attempting to get out of the hospital bed with energy so forceful we needed the adult boys to “convince” him he could no longer stand on his weakened legs.

As we talked repeatedly on the phone with the Hospice nurses, we decreased the intervals between medicine doses until we were administering one thing or another every hour. During our struggle to determine how best to overwhelm his sky-rocketing abdominal pain, the nurse decided to make a visit.

Her summary statement was, “He’s shutting down, one organ at a time, and is very close to the end. Maybe tonight, maybe tomorrow. Men hang on longer than women and wait to slip away until their wives are not in the room.”

I told her I wanted to be sitting next to him holding his hand if I could, when he died. “If that’s important to you, then do that, but be sure your words give him permission to leave you.”

She assisted and directed us in changing the Depends and washing him, pointing out the bluish toenails and fingernails, as well as pooled blood at his knees, back and palms. She also changed his white t-shirt. Just as we were wondering how she’d get the old one off without upsetting him, she said, “We have a trick for that,” and pulled out a giant scissors. Even after the soiled shirt came off in four pieces, she continued to use her scissors to cut the clean shirt up the back, leaving the neck band in tact to hold the whole thing together.

“Voila,” she said. “As good as any hospital gown.”

Mary offered to stay the night, and we sent everyone else to bed with a promise to wake them up “if anything happened.” Dozing here and there between 3:30 and 7:00 am in chairs pulled up to his bed, we each kept an ear open toward his gravelly breathing.

As the light of dawn came through the window, his throat and mouth were filled with an ugly grey phlegm causing him to choke and panic. We called Hospice again, and the nurse returned, showing us how to place drops under his tongue to decrease bodily fluids including the ones in his throat. She remained calm throughout the process over a 90 minute period, even as Nate struggled, until gradually his body responded to the drug, allowing him to breathe easier.

As I write now, at midnight, oxygen is helping him, and medicine every three hours is holding back his pain. He’s sleeping peacefully, pink-cheeked from a 105 degree fever as his body tries to cool itself down.  We are thankful for his brief visits yesterday with each of our kids and several others while he was still alert and talking. They were able to give love and receive it, to share hugs and kisses and express gratitude. I’ll never forget how he worked to stretch out his thin arms to receive each child, winking here and there at things they said, using this creative way to stay in the conversation without words. Today those scenes could not have taken place.

This afternoon as Nate slept, the younger girls and I had a great conversation about what we’ll be feeling when we stand next to Nate’s non-breathing, cooling body. As the tears poured forth, we talked about his point of view. “We’ll all be crying,” I said, “but he will be happier than ever before. Let’s do our best to think about all that good stuff.” They nodded and cried.

As I hold Nate’s hand and watch him sleep, I search for a way to put this heavenly phenomenon into earthly understanding, so have pictured God putting the finishing touches on his dwelling place. Right about now he’s unfurling the rugs and putting fresh flowers on the tables. Nate’s prepared home (mentioned in John 14) is almost ready.

God knows what he’s doing within Nate’s body and in the lives of the others under our roof. He is perfecting his plans minute by minute, and we are trying to follow his lead rather than usurp it. I am keenly aware that our Lord has a specific moment in mind, planned from before Nate was born, when he will pluck him from this world and escort him into the next. No matter what we do or don’t do, that moment will not change.M and N in hospital bed

As we go into another watchful night of waiting and wondering when and how Nate will separate from his earthly existence, we hover between exhaustion and anticipation. As Nelson said tonight, however it works out, it will all be good.

“As for me, my life has already been poured out as an offering to God. The time of my death is near.” (2 Timothy 4:6)

Faithful Provider

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Nate has always been a good provider. By that I mean every dollar he’s earned, he’s shared. He’s forfeited fancy cars, custom suits and exotic vacations to give to others. I’ve been blessed to be a stay-at-home mom since Nelson was born in 1973, which necessitated receiving money from Nate in the form of a household allowance each week. The amounts have varied over the years with family changes and inflation, but the system has worked well.

I’ve heard of husbands who’ve made their non-working wives plead and beg for each ten dollar bill. “Why do you need it? What are you planning to buy? I don’t think you have to have any of that. You can wait.” Nate has been the opposite, giving and giving again.

When I’ve commented on his shirt pockets being ink stained, encouraging him to buy a few new ones, he’s always turned it back on me saying, “You take the money. I’m sure you need something more than I need new shirts.”

Since he’s been sick, he hasn’t been able to follow our usual routine in money matters, although again and again during these last weeks he’s asked me, “Have you got enough money?”

Little by little Nate has lost track of where we stand on our bills, what the due dates are and how much is in which bank account. Even as he’s been losing interest in the things of this world, something deep inside of him still wants to take care of me.

Since he’s been sick, part of getting him ready for the day has always been handing him a folded wad of bills to slip into his pocket. He’s never been a wallet man. Since several important things have ended up in the trash or even the toilet recently, I’ve “stacked” his wad of bills with singles, except for one twenty wrapped on the outside. While folded, it looks like quite a fortune.

Yesterday afternoon Nate motioned for me to come into a corner of his tiny room. He was trying to count out his bills, putting them into denominational categories, but of course there were no fives or tens. “I can’t figure this out,” he whispered, fumbling with the money. “I guess I can’t give you as much as I thought.”

He handed me the twenty and folded the singles to go back into his pocket, shaking his head. Immediately I ran to my purse and took out the four twenties there, bringing them back to him and feeling guilty for my deception scheme.

“These are actually yours,” I said, handing him the bills.

“Ok,” he said, taking them and then handing them right back to me. “Here. This isn’t much, but you’ll have to make do.”

“It’s plenty,” I said. “You’re a wonderful provider for all of us, and you always have been. Thank you.”

“I feel bad that I can’t do more,” he said, patting me on the back.

Today there are new signs that we are coming close to the end. Nate desperately wanted to get out of bed and walk yet could no longer support his own weight and refused the wheelchair. The only answer was for the boys to pair up on either side and support his weight 100%. After he was standing on his noodle-legs, two of the boys holding strong, we all gathered in a semi-circle in front of him.

He pointed to me and said, in an almost unintelligible whisper, “Forty years. Forty years.” Then he puckered up and leaned toward me, hoping I’d lean in for a kiss, which I did. He followed that with, “Forty-one years. Forty-one years.” I’m not sure if it was longing or sadness or just the sting of impossibility, but it ended well with another pucker and another kiss.

When a man feels his greatest responsibility is to provide for his wife and all he can give her is “this isn’t much” and “I can’t be here for forty-one,” his emotional pain must be nearly too great to bear. Never have I been more thankful for his faithful provision for me than I am now.

“As the Scriptures say, ‘A man leaves his father and mother and is joined to his wife, and the two are united into one.’ This is a great mystery, but it is an illustration of the way Christ and the church are one. So again I say, each man must love his wife as he loves himself, and the wife must respect her husband.” (Ephesians 5:31-33)

Sweet Sleep

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Today in our little cottage we had a wild ride. Nate’s pain has been escalating steadily over the last ten days or so, frequently requiring the break-through pain medication to override it. So the head nurse spent an hour sorting through his current meds, rearranging doses, subtracting some items and adding others. After she’d gone, Nate’s pain gradually rose to new heights as his body began the adjustment away from the pills he can no longer swallow easily and toward two pain patches.

He stuck close to me all day and wanted, at one point, to nap on a double bed on the other side of the living room from his hospital bed. It was a tender time to whisper things to each other, but suddenly he said, “Don’t lean on me. Don’t press on me. Don’t cover me. It hurts too much.”

These words were whispered in high, raspy tones, the only voice he’s got left, and I had to ask for three repetitions of some of the words to understand. Assuring him I wouldn’t touch anyplace he was hurting, I asked him to tell me where it hurt the worst. He palmed back and forth on his abdomen, the first time he hadn’t answered that question by reaching around to touch his back.

When the nurse visited before, she’d measured his mid-section, just like a pregnant woman’s belly is measured for baby growth. When I’d asked what she was doing, she said, “His abdomen is beginning to fill with fluid now, as the organs fail to function right, because of the cancer.” All I could think of was the pain that would most likely accompany the pressure of that extra fluid.

“How do we solve that problem?” I’d asked. She said the team would be sure he didn’t have to suffer but that draining the fluid, a surgical procedure, was hurtful, invasive, and something to be avoided if possible.

Today, as his body continues to shrink with his bones becoming more and more visible, his belly has grown to resemble a woman seven or eight months pregnant. It is hard to the touch, with nodules or bulges that must be tumors. As I lay next to him on the bed holding his hand but not touching anything else, he whispered, “I’m afraid. I’m afraid.”

“Of dying?” I asked.

“No. Of the pain. Afraid of the pain,” he said.

It probably hurt so much at that moment, he was afraid he wouldn’t be able to endure it, if it increased.

“I feel trapped,” he said. “And I’m so sick of all this.”

I felt the same way. Nate has been hurting badly since January, without respite. That’s when his life began to be dominated by chronic pain from stenosis of the spine and related back problems . I can’t imagine how wearisome such long-term pain must be. Nate is a champion at endurance.

Today I was determined to find some relief for this new, increased pain, and phoned the nurse. Two phone calls later, we’d settled on morphine drops under the tongue and a sedative/anti-anxiety pill. Within forty five minutes Nate had drifted into a restful sleep. Watching him breathe deeply and sleep soundly was nourishment for my heart and I’m sure also for his.

He’d been agitated and awake most of the last 24 hours. Because of the pain, he’d eaten nothing. It was serious relief to know that as I watched him sleep, he was not in pain. I’d always insisted to every medical person along our journey that we wanted to keep him alert and communicating with the minimum of medicine. Today, with his overpowering pain and the fear that came with it, I pulled away from that thinking. As a matter of fact, it sounded selfish.

Nate may be sleepy from here on out. If that’s what it takes to curb the awful pain he felt this afternoon, then that’s what it will be.

“It is vain for you to rise up early, to retire late, to eat the bread of painful labors, for He gives to His beloved, even in his sleep.” (Psalm 127:2)