Birthday Wishes on a Rough Day

First of all, I'd like to acknowledge all the birthday messages, flowers, food, and cakes that Susan received today. She has been asleep all day and could not acknowledge them herself.  

Last night was extremely rough as she could not get to sleep because she was coughing so much. Under the direction of her palliative care doctor Dr. Rabow, I increased the dosage of morphine, but it was not until early this morning that her cough subsided. Dr. Rabow thought perhaps the coughing might be a result of another clot in her lungs. The blood thinner Eliquis that Susan is on does not dissolve clots--rather, it holds them at bay hopefully enough for the body to get rid of clots on their own. The abruptness in which Susan's cough subsided might be an indication that the new clot resolved itself with the coughing if indeed that's what caused the coughing in the first place.

The sleep and grogginess were equally as alarming, but even in her half-conscious state, she was hungry and thirsty enough to eat and drink indicating that she has not yet passed to that next level where the body naturally refuses nourishment. Dr. Rabow and the hospice nurse surmise that the extreme grogginess is due to the increase in morphine, so I will cut back the morphine dosage as long as she is not feeling short of breath (or, in today's case, if she is sleeping through the morphine schedule). My immediate concern is her lack of urination, and even though it doesn't look like she is retaining fluids, it is still a pressing concern.

All these new developments conflict with the plan to start ozone treatments this week. I guess we will take it day by day to see if she is in any state to start the treatments. If not, so be it.