Sam has most certainly deteriorated quickly. So quickly, in fact, it happened over the course of one day. At 1:30 on Monday we were enjoying looking at the animals at the Avila Valley Barn, and by 2:30 Sam was puking. And yes, he slept and puked all day Tuesday. He was restless all last night.
Today Sam slept all day again. He had a seizure this morning at 7, followed by vomiting up his steroids and Keppra. We gave Ativan for seizures since its a tiny dose that's easy to absorb, a suppository for nausea and vomiting, and topical steroids for the swelling in his brain caused by the tumors. He seized again at 2 so we gave more Ativan, but his breathing was so labored (I thought he might die right then) that John decided to call 911 while I called the hospice nurse. By the time paramedics got here the seizure was over and his breathing was better, so we did not go to the ER.
The thought of losing Sam is unbearable. But the thought of losing Sam in a panicked, chaotic, scary situation is well, scary. Awful. Terrible. I don't want his last moments to be full of fear and struggle.
The hospice nurse has pieced together a puzzle for us: restlessness, vomiting, lowered heart rate, sleeping all day...this is end of life stuff. We likely have days with Sam. We'd like to keep him at home if we can control his seizures and the vomiting (which keeps the meds in him). I want him to die in his sleep, surrounded by family, comfortable.
As to visitors-we don't want any. As to updates in the near future-don't expect them. If you want to help-there's a care calendar that we will be asking friends to open up so that you can bring meals (we'll provide a link later). Sorry if that sounds harsh, but...there is no but.