There's no space for fear...

Sunday night.  Got home from the  nursing home about an hour ago.  The ride home is always rough. I get a good cry.

Ed's ok.  He's not really his "old" self.  At the VA, for a time, he was.  He was clear, lucid, smart. This was in November.  Even he said he felt better, more like himself, than he had in a long, long time. Now, at the end of January, he's just ok.  Weaker for sure.  But I'm trying to figure out him.  Usually I think he's here with me - pretty lucid.  Sometimes, though, I'm not 100% sure.  

It's little things like not remembering I was with him the night before.  Or if it's night or day. He'll wonder when we're going someplace but doesn't know where.  I try to be gentle with the fact we're probably not going anywhere anytime soon.  

We tried last week - when it was warmer.  We were going to see a movie but when I got to the nursing home, he was freaked out.  I can read him so well now.  He had those scared eyes.  I told him it was ok - we didn't have to go.  Maybe a movie was too big for the first outing.  Maybe we just needed to get him in the van and drive a block and come back. We didn't go to the movie.

Mostly, it's all good.  Like in this picture.  We sit next to each other.  I hold his hand - like I'm his anchor and I keep him from floating away.  

Around 6 pm most every night - when it gets dark - he has a panic attack.  I can tell.  We'll be watching the news and suddenly, he's agitated. Making noise, moving his toes. 

Within minutes, he'll be panicked, shouting to get off the blankets, turn down the heat, move his arms around.  

I try to anticipate it without making too big a deal of it.   Rub his legs, his hands.  Brush his hair.   In the end though, we always end up with an extra dose of anxiety medication.  Maybe we should just start with that.

Ed's vitals are good - his blood pressure is a little high.  His breathing is good.  His attitude is actually really positive.  Tonight, he got his catheter pulled out.  It was, at first, pretty painful and gory.  The nurse asked why we had it and honestly, I couldn't remember. Hospice shoved it in him back in September and that led to hallucinations and the trip to the VA.  I honestly think hospice did it out of convenience.  Once he got bedbound, it was too hard to use a urinal.  We never had the conversation, though, about why.  And we never revisited the why.

Tonight, the nurse decided to take it out; it seemed painful and tender.  At first, it was awful to see Ed worry about whether he was going to wet the bed, see him in pain as he peed, it was hard to hear him say he didn't want to pee because it scared him.  

A few hours later, he woke up and was smiling.  He said he felt soooooo good!  It didn't hurt to pee, he didn't feel like he was connected to tubes, he felt pretty free wheeling!  I had to laugh - it made my heart happy to know that's the old Ed... he's still in there.   

I want him to feel loved, secure, comfortable.  I think he does.  I hope he does. We both have a great support system of friends and family.  

Time is weird.  I feel it breathing down my neck, like I don't have much time left with Ed.  

Our time is so limited.  He could be here another year, maybe more.  How lucky I will be if he is.  

But time at the nursing home almost stands still. It's quiet, we're quiet.

I used to be able to share my fears, concerns, dreams with Ed.  But now, that's too much.  It overloads Ed's sensibilities.  Instead, it's all about the moment - being present with him, making sure he's happy, peaceful, content.  I keep my fears, concerns, dreams to myself.  I think I can deal with things later.  When there's more space for those things.  

Waiting...

This feeling, this lonely sad feeling is hard to describe.  It's consuming.  I think it's ok.  I've tried to push it aside, thought about re-engaging with the world.  But I can't.  I want to spend every moment with Ed.  I feel a shift in his demeanor.  Something is lurking around the corner.  I know it.  We've been through this enough in the last 3 years that I see the signs.

But what?  What's left for Ed to lose?  He's totally immobile.  He can't move his head anymore.  He can't eat anymore.  The next thing for him to lose is his voice.  The thing that's kept us connected for the last 3 years.  I get to hear that he loves me.  He can tell me what hurts, what he needs.  I've become obsessed this past week with what happens when he loses his voice.

We met with our speech therapist today to see what kind of technology is available.  We know there are programs out there which will allow Ed to "talk."  My worry is his energy level.  It's gotten harder for him to sit up in his wheelchair.  It's hard to use the computer in bed because his head doesn't move.  It takes a lot of brain power to concentrate on the program and sometimes, Ed just doesn't have it.

So what happens when he can no longer communicate?  I don't have the answer.  We're still working on the computer... we'll see how that goes.

I wonder if I'm being too negative?  Looking for signs that aren't there?  Whatever is going to happen just will happen.  I can't prevent it.  Even when I gear myself up for something, I'm still surprised when it happens.  Heartbroken.  How must Ed feel??

We're at a point where I can't really talk to him about it.  We used to.  Now he seems far away.  If you sat with him, he'd be fine.  Quiet, maybe.  Or he might fall asleep as you talk with him.  Lots of drugs, I think.   No energy.  Plus I don't want to talk to Ed about sad things.  I want him to feel love and happy and comfort.  I spend lots of time touching him, massaging his swollen, heavy arms and legs.  We don't talk much.  We did a crossword puzzle about a week ago and it made him anxious.

This is hard.  It's going to get harder.

I think it's ok to be this sad.  To mourn the loss of our relationship, the loss of having him here at home.  It's amazingly scary how easy the tears just flow.  Sometimes it feels good to let it out.  Other times, the sadness is too much.  I hope if I get it out now, when he dies, I won't have any tears left.

Added:

This is the question I just asked my online ALS group:

I've been thinking about this a lot the last couple of weeks. Our ALS doc discussed end of life with us way back when end of life seemed far off. Back in the day when we were worried about other stuff like losing his job or his legs. Our doctor said my husband has control over when he wants to die. He'd stop tube feedings. It's up to him/us - along with input from the doctor - when this happens. I keep hoping he'll just pass peacefully. And maybe he will. We have an advanced directive but it never included this locked in scenario. We're getting closer to it. He's completely immobile, recently lost use of his head. He's tube fed but he can talk. His voice is going. We're in the process of getting an eye gaze system. That being said, he's so tired. He's rarely in his wheelchair anymore. I worry about his lack of energy in order to use a communication program. I guess my question is - have you thought through this scenario? Once bedbound and locked in, what next? We've discussed some of it -- but not really pinning it down. Can it be pinned down!?? If he's unable to communicate, how will I know? Ugh. Tears. I hate this.


These are the thoughts that keep me up.