Dirty 30’s are an OD craps shoot.

Glad you are alive for sure

Noice. A clamp is a clamp.

Normal for you.

When they c/s you they manually extract all the areas inside the uterus. Often there’s nothing left to pass.

And if you are going to seek legal action I encourage you to stay in the hospital. When they try to discharge you…say no.

They can’t throw you out the doors.

I will encourage you to talk to the medical team.

I’m not sure that the normal signs of dying are hard to see but not causing suffering.

Dying people aren’t hungry and not usually thirsty. They want to sleep a lot. There’s something called a terminal fever that will be managed by Tylenol oral/liquid.

Many of the things you describe are an organic part of the natural death.

I hope you seek a hospice that can make this a comfortable journey for you and your loved one.

Empathy isn’t the limit I have. I’m trying to help you navigate the healthcare system as you have described it.

I’m asking the questions that Medicare will be/has already asked.

If morphine is causing irritation ask them to change it to dilaudid or methadose. Those won’t make him as itchy.

Let me back track. I’m a (sometimes falling flat) direct communication person. I don’t think anything about you except that you want to help your dad.

You can mix ORAL Ativan and morphine. Both are very short acting. The oral Ativan mixed with oral morphine lets us use lower doses of both.

If your dad slept 24 hours then woke up- he was likely exhausted.

It’s when we have to use “recovery” doses of meds that we get the opioid nap. The body can finally rest.

When I say hospice MD- ask if the MD is certified in hospice and palliative care. Board certified. If not then move onto another team. That’s a story for another time.

Do you have a LARGE hospice provider near you. Someone national? Not a local mom & pop?

Your dad need hospice nurse and teams that know their business. Folks certified.

Your are looking for

Board certification MD in hospice, pain management, or oncology (employed by the hospice)

Hospice nurse that is CHPN (certified in hospice and palliative care).

Unfortunately in the home setting, if you don’t know to ask for these, they won’t offer the information.

Fire them and find someone who can. PM me your area or nearest town and I can help.

If it’s shitty hospice then send them packing!

And morphine 100% helps with “air hunger”. That’s what I’m trying to say.

I am certified in hospice, palliative care, and thanatology. This is my areas of expertise. I’m not a hospice case manager. I am the one who educates and managed the hospice teams.

The hospice should be able to accommodate a BIPAP. This is part of the hospice care and support.

And if he settles into a breathing pattern then CPAP

Either way the opioid and anti-anxiety allow him to exchange air better and have more meaningful breath. His oxygen needs and comfort care aren’t “either/or”. It’s both.

I hear you. But these aren’t symptoms that need continuing bedside nursing to manage.

Infections that don’t resolve, despite antibiotics, are part of the organic dying process. It seems the infection is t responding to treatments.

When I say “symptoms”

1. Pain that isn’t managed with medication given every 4-6 hours.

2. Breathing problems that don’t resolve with a breathing treatment and comfort meds.

3. Agitation that continues DESPITE several doses of medication to treat the agitation.

These kinds of things.

1. Morphine and Ativan isn’t for sedation. It treats respiratory symptoms.

2. I want to clarify that you want him comfortable but are requesting that they not use meds that keep him comfortable. The morphine is not strong. Oral morphine has the same strength as a Norco/Hydrocodone. 1 full ML of morphine orally is the SAME as 2 Norco. The morphine relaxes the stressed out chest muscles and lets him take better & deeper breaths. Nurses don’t just “push Ativan and morphine”. They are trying to mitigate symptoms and get his air / breath moving better.

3. The Ativan is not likely a high enough dose to sedate almost anyone. Unless they are in excess of 5-6 MG every 4 hours…it’s not sedating him.

You seem like someone that talks/types directly. And I risk making you upset which I don’t mean to do.

But you are asking for his support and then deflecting. He absolutely can be managed at home if you will let the hospice team do their jobs.

If in doubt ask for the hospice MD to call you directly.

I’m sorry this is happening. At this time he’s still able to say yes/no. What are his wishes?

Call hospices until you can get at least 8 hours of some continuous care. Is he Medicare?

So. Dying with symptoms managed isn’t a reason to admit him in the hospital on hospice.

What symptoms is he having that needs medical attention? I ask because that will be the map that hospital uses.

No. Nothing to worry about. This will take a WHILE to completely go away.

You can do GENTLE massage but nothing rough.

Hospice nurse here.

100% this comment before anything.

I have told this story a hundred times.

TLDR is this

I am a nurse. I was night shift when my last (now 18yo) was nursing.

Repetition and absolute sleep deprivation later…

I was near work with her still in her rear facing car seat when she sighed. Not cry. Sigh.

If that sigh came 5 minutes later….im in horror to think.

Put your shoe. Your phone. Your underwear. Your fucking pants. I don’t care. Put ANYTHING in the back seat with your baby.

These keyless entry days out your keys back there.

I almost made is 15 minutes the OPPOSITE direction to work with my 5mo in the car asleep.

I was my “sisters” daughter. 100% this.

Also use some strides wipes a couple times a day. That will help.

Your vageen doesn’t like the shave. You may need to consider laser or IPL.

L&D here. Nah.

Yall all busting out the HPV warts.

Op I work L&D. These are ingrown.

Stop shaving for a bit. Exfoliate GENTLY these areas. If they persist you can

1. See a derm to extract

2. See a qualified esthetician for extractions.

Another option is to start waxing and see if that helps.

Otherwise. Groom, don’t shave.

How much do I need to tip for OP for you to remove the watermark? Thank you

Cough. Goal waddle. Bidet. Cough again. And then have the biology making an exit for the rest of the “deposit”.

I agree with all except bandage.

Also it’s looking like cellulitis around the area?

OP as often as you can soak it in epsom salts…do that. 4+ times a day is ideal.

Hospice (cradle to Geri/grave). 100% deadlift and do my cleans. Good mornings too. Squats. Shuffles. And tri’s.

Spinal protection.

I’m at the gym lifting frequently. I only have one body.