Pale and Purple

This morning Dad is breathing very rapidly and his breaths are shallow. He is very warm and clammy and  had some blood in his mouth when i came downstairs; I think he must have had another seizure in the night and bitten his tongue. I've also noticed that although warm, his hands are a ghostly white and his knees look purple, while his shins and feet are a bit pale. The nurse who came this morning washed him and remarked that he did look different from yesterday. Early on the nurses declared what a 'lovely bottom' Dad had, but this morning the nurse found a pressure sore on his bum. So we have put some cream on it, in the hopes it doesn't burst and become even more painful for Dad. He is lying quietly now with the radio on and i am going to light a fire as it is freezing.

A day of visitors but few words

Mum's cantankerous old cat excelled herself this morning by vomiting all over the lounge moments ahead of visitors arriving. She has been in disgrace all day since. Dad has been almost mute today. These visitors were a work friend of Dad's and his wife and although Dad communicated with hand-grabs, looks and eyebrows he didn't actually say a word. As soon as they left i said to Dad "It was nice to see them again wasn't it Dad?" Of course, it was at that point that Dad spoke and said "Yes". The Macmillan nurse came during the afternoon and couldn't really evaluate the effectiveness of the patch we put on Dad yesterday. She said it was better to reconsider the dose when we replace the patch (which will be Thursday) so we have seen it at its most effective. We are continuing with the oramorph too. I asked her if Dad is in the sort of condition that she would expect at this stage from her experience of melanoma (and other cancer) patients and she said he is. Dad's head is still fixed looking to the left. He doesn't seem in pain when he is still but when the nurses move him to wash him and change his pyjamas he makes such a face it looks like he is in agony. I find it really hard to see him like that, but the Macmillan nurse said not to worry that he is in a lot of pain as it is quite likely also an expression of displeasure at being moved around and messed with. He has never been a very touchy-feely person, so although that makes sense, it still worries us. He only does it when his head and neck are moved and the only other thing he said today was "Ouch!" when moved by the nurses in the evening, so i hope the full strength of the patch comes into effect soon. Partly because of the position of Dad's head and partly because he cannot understand verbal directions anymore we are now feeding Dad liquids only and through a plastic syringe. We have been told we can continue like this as long as he can reliably swallow, which he still can. Once he can no longer swallow a line can be hooked up to give him medicine and fluids.

Looking awkward

Today has been a day of activity. My brother and my boyfriend were here so we put them to work fixing the fridge this morning. The panel-cover was coming away from the door and there was an almighty midnight-snack-exposing creak which needed fixing too. After the fridge came the firewood which needed chopping smaller. Dad has been quiet all day again. He fell asleep yesterday evening with his head facing sharply to the left and looked uncomfortable. Today he stayed in that position all day and seemed in pain when we tried to help him move to face anything other than the wall. We called the NHS out of hours service again and a doctor came to see Dad. She told us there could be several reasons for the neck pain and concluded there is no danger in moving Dad but that it is simply a question of comfort. We now have a prescription for a morphine patch which we can get from the pharmacy tomorrow. It will release 12mg an hour into his system, through his skin, for 72 hours so is a much more constant dose than we are currently able to give him. The doctor said that if it is only pain-related this may enable Dad to sit holding his head straight again. It is also possible however that it is caused somehow by the metastases in his brain and will not be remedied. At least we can relieve his pain, even if he sits a bit wonky.

Grumpy Grumps

Dad was quiet today. He was awake most of the day but got a bit grumpy towards the evening. After a lot of fussing from the nurses, Mum asked if he was comfortable and he shot her a look so i asked if he needed anything or would rather we all piss off. I got told in a weak-voice "Piss off." Fair enough. He ended up dozing-off watching the television while we were eating dinner, rather noisily, across the room. My brother came today after work, so is here for the weekend. This helps us tell one day from another. We will have a full house tomorrow as my boyfriend will be here too. He has been away completing a course, so perhaps tomorrow we ought to celebrate the end of his exams with that party Dad mentioned. My brother will be in charge of drinks!

Absent without leave - passive seizures

Dad has been very quiet for a few days. He thumbs a few pages of the newspaper but doesn't really read it, despite having read one every day of the 29 years that i have known him. He often stares at the television for long periods but we can't say how much he is actually interested and how much he is drawn to look in its direction simply because of the sound and motion. He is not interested in food, but mostly puts up with us spoon-feeding him and seems annoyed almost at our insitence that he tries to drink more too. He told me the other day "Stop trying to pump me full of water"
After Dad's recent seizures i realised that he has, i think, been having seizures for a while, but seizures of absence rather than active physical seizures. There are periods where he stares at nothing and it is impossible to get his attention through talking and waving at him. They tend to only last 10 - 20 seconds each time, but it has happened several times most days. He often says a few words of a sentence and then suddenly stops without finishing it. We had noticed that he 'zoned-out' every so often, but it was only after seeing him have an active seizure that i really thought about it. I'm sure he was only confused last night though, when he hiccupped loudly while the nurses were here and i said "Been on the sauce again Dad?" and he replied "No you've been on it for me!" Serves me right for being cheeky.