This is Part 3, the final installment, of our journey with Cherie back to our heavenly Father. It covers the period of my visit with her from June 30 to July 15, and it is the most difficult and painful to write. I would like to acknowledge my sister Gina, who wrote most of the emails during this period. I edited and excerpted many of her emails in this post, so I give her thanks. I would also like to thank Tish who edited all the three parts of this Final Journey.
After Tish left on June 20, Gina took over from her and also kept us posted with daily emails on Cherie’s condition. I have re-read all her emails during this period. Even then it was a roller coaster ride with Cherie eating well enough, and then the following meal not eating at all; taking morphine on schedule, and then asking for morphine barely an hour after taking it; enjoying a visit from Alex, and then forgetting that they were leaving in the evening, etc. But clearly, she was declining. There would be no more ups in the roller coaster ride.
On June 28, Gina sent us an email where she recounted how Cherie told Jun that she thought she was dying soon. She also asked for her second son Jiffy and told him to take care of his Papa. Later in the evening, she asked for her eldest son Davy to fly in from San Francisco. So I talked with Manny and we both agreed that I should already fly to Pasadena.
June 30, Sunday
I left Baltimore on June 29 and landed in LAX past 10 pm. As in my previous trips, Tito Mon picked me up, together with Tita Inday and Maricar. We arrived in Rose Court past midnight and everyone was already asleep. In the morning, when I heard Jun move around in their room, I peeped in. Cherie woke up, we hugged, and I told her I loved her. After our hug, we looked at each other. Her face brightened and she gave me the sweetest smile. We all went to the 11 am mass, including Davy and Jiffy. After communion, I became emotional and couldn't hold back my tears. The thought came to me that this would probably be the last time we would hear mass together. Fortunately, the three Galvez men were in between Cherie and me. The tears flowed even more when the singer sang Panis Angelicum. During the mass, Cherie was seated the whole time. According to Gina, the previous Sunday, she was still able to stand up and sat only during the kneeling parts.
July 1, Monday
While Gina and I were having breakfast, Jun joined us and asked, “When the day comes, what do we do? Who should we call? Where do we put her body?” I said that, in fact, I was going to call up Cabot Funeral Services to set up an appointment with them that day so we could talk about the process and the funeral arrangements. Jun and I agreed that we would both go to Cabot.
At past 10 am, Cherie woke up and told us that she wanted to go to the bank to make a transfer. We asked if she could do this online. But Cherie had a difficult time answering the question. She said she needed to go to the bank but she couldn't tell us which bank. All she could say was that her state disability payments were being credited to her account in that bank and she needed to withdraw them so she could transfer them to her and Jun’s joint account at Citibank. She also said that those payments had accumulated for one year. Fortunately, Davy was also at the table working. When he heard state disability payments, he said that he was familiar with the process since he had received a payment for Alex. The payment was made to his Bank of America account and this could be transferred online.
So we went to Cherie’s computer but she couldn't remember her login password. Fortunately she had written it down and she was finally able to access her account. But we were surprised to see that the balance was only $288. When I looked at the transactions, there were regular withdrawals from the account with the latest one made on June 15. I asked her if she had gone to the bank. But she couldn’t answer. I could see she was trying so hard to recall those withdrawals. She kept looking at the screen. It was heartbreaking to see her struggle with her mind. It seemed like she was going through a thick fog trying to find her way.Then I saw there was a menu item to "Manage Transfers." So I told her to click it. Then the screen showed that she had not set up a “Transfer To Account.” So I told her to click that. She must have been so tired already because she asked me to do it myself. So I set up their joint Citibank account as a recipient account and transferred the whole balance to their Citibank account. The confirmation of the transfer was immediately emailed to her. While we were doing these transactions online, she asked if there was anyone knocking at the door. I said I didn’t hear any. She asked Davy to check the door but there was no one there. It was so painful to see. Here was this very bright woman who was now functioning in a fog. And doubly heartbreaking was she knew it -- that her mind had been ravaged by the disease.
After lunch, Jun and I went to Cabot and had a good visit with Wendell Cabot, the grandson of the founder. He said that when the time came, we should call them and they would be at the house in one hour. He told us we should call them only when everyone had said their goodbye. He also said that we should have the outfit ready and her picture so that they could properly do her face. We looked at caskets, guest books, holy cards, etc., and discussed singers, the supplier for the flowers, deacon, and costs. He said we had two options for the singers – a married couple (Ralph and Vicki) and a male singer – both from Cherie’s parish.
After Cherie woke up from her afternoon nap, she asked me how the visit with Cabot went. So I told her about the decisions we had to make. I showed her the catalog of the holy cards that Wendell had lent us. She asked me if I had shortlisted any. I said I checked if there was a Lady of the Holy Rosary but there was none. So I suggested we look at the Madonna and Child pictures. I showed her a design which I thought she would like for its subtle colors and she liked it too. I said that we also needed to choose a prayer, and I showed her my ipad with the prayers that I had googled, and the one that I liked. At this time, Gina came and I told her we were looking at prayers. She said that Fr. Gerry had a prayer at the pews which she found beautiful but it was short. I showed her the prayer that we were considering, and she excitedly exclaimed that it was the same one! So here’s the holy card that we gave away; the prayer was composed by the English poet and convert to Catholicism John Henry Cardinal Newman.
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Then we talked about what she would wear and she said the outfit she wore at Davy's wedding; we talked about the pallbearers and the singers. She chose Ralph and Vicki. She then asked about the reception after the interment. She wanted a place that would be exclusive for her guests. So we assigned the selection of the venue to Davy and Jiffy, who are more familiar with LA. I said we still needed to choose the flowers, the songs, and the readings. But she was clearly very tired at this time, so we stopped. Of course, this was a very painful discussion and I had to call on my inner resources not to cry; Cherie however remained calm and focused the whole time. But it must have been very difficult for her too because we didn’t have any further discussions on the final arrangements anymore. She didn’t raise the matter again. In the evening, Davy flew back to San Francisco to drive Michelle and Alex to Pasadena in time for the July 4 holiday.
July 2, Tuesday
Early in the morning, I thought, “What would this day bring?” And I remembered what Tish used to say before we went to Arrowhead, “What would May bring?” So then I realized that we were down to taking each day as it came.
Cherie woke up past 9 am, took her morning meds and then went back to sleep. Around 12:40 pm she woke up again and asked for morphine. We then asked her if she wanted to eat. She said she wanted the macaroni salad which Jun’s sister Evelyn had prepared. So she went down, had about 2 tbsps of the salad, a small steak strip which Gina had cooked, and a small piece of biscotti. For dessert, she had pistachio ice cream in a cone. As she was having the ice cream, Davy called to say we could Skype. So Gina placed her iMac on the dining table, and immediately Cherie's mood lightened up and she was smiling at Alex. Thank God!
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| Cherie skyping with Alex |
In the afternoon, the hospice nurse Patricia came. After checking out Cherie and prescribing a timed release morphine patch for her to supplement the morphine tablets, Patricia left Cherie and started doing her paperwork in the dining room. Jun, Jiffy, Gina and I then talked with her. Jun asked what we should do when Cherie dies. So Patricia explained the process of calling them up, and telling them which funeral services company we were dealing with. At that point, we told her it was Cabot, and that Cherie had already told us her wishes -- what she wanted to wear, the singers she wanted for the funeral mass, etc. Then I asked her how much longer Cherie had. I said that our eldest sister Tish was flying in from Manila on July 4, and our Mom and eldest brother Pet would come for the final services. Gina added that we wouldn't hold her to her answer. Of course she said that only God knows. But based on her experience and what she had seen in Cherie, she said from three to seven days. Gina and I almost bolted from our seats and we held hands right away. Three days away was first Friday and our Dad passed on first Friday! Patricia added, “I'm saying this because I can see that the family is ready and I know the whole family is making plans. Your mom is coming, your brother, your sister. So this time is just for family. Not for visitors, nobody but family. Everyone outside the family who wants to visit, tell them it's too late. This time is just for family.” Patricia also said that most patients knew when the end was coming. She said they would usually say that they were dying (Cherie said that to Jun last Friday) or that they were seeing their deceased loved ones (Cherie never did) or that they were hearing voices (Cherie did twice), things like that. We thanked Patricia for her candor. Then she said that we could call her up anytime and she would come.
Cherie joined us for dinner and she had a little rice and dinuguan. After dinner, we started praying the rosary, and it was heartbreaking. Cherie was barely moving her lips and her fingers through the beads. This was so painful to see because when we prayed last Sunday, she was still audibly saying the Our Fathers and Hail Marys, etc.; and on Monday, she was still silently mouthing the prayers and correctly following with her beads. That night, there was neither sound nor lip movement, and very little and purposeless movement of her fingers. It took all our strength not to cry.
When Gina and I went to our room, we broke down. We just cried and cried in each other's arms. But we said we were so happy and grateful to be with Cherie, for Cherie, and with each other. We kept asking Cherie silently to please hang on and wait for Alex and Tish.
July 3, Wednesday
As we were walking to church for our daily morning mass, Gina and I agreed that we would see Fr. Gerry after mass to ask him to give Cherie the anointing of the sick. Fortunately it was Fr. Gerry who celebrated mass. As usual, he said a special prayer intention for Cherie during the Prayers of the Faithful. He also included her name during the Eucharistic Prayer. After he gave the concluding prayer, Fr. Gerry walked up to Gina and me and asked about Cherie. We told him that she was getting weaker, and we asked him if he could give her the last sacrament. He said only if Cherie wanted the sacrament, and we assured him that she did because she had asked for it last Friday.
When Cherie woke up, we told her that Fr. Gerry was coming to give her the anointing of the sick. So she said that she better go down and stay in the hospital bed. Jun and Gina then went to Citibank, and I stayed behind. Fr. Gerry came and administered the anointing of the sick. When Jun and Gina came back, I was starting to have my lunch. Then Cherie woke up and said she wanted to have lunch too. She had a small portion of the salmon belly sinigang and two spoonfuls of rice. Alleluia!
After lunch, Jun’s brother-in-law Monet and Evelyn came to fetch me so we could go to ABC Caskets to select and order the casket. It was going to be cheaper by about $1,000 if we ordered it directly from the factory. ABC Caskets was in the east side of LA. Monet had warned me that this was a dangerous, gang-infested area. He was right. There was a lot of graffiti and not much traffic. It felt eerie. But the factory was owned and run by a very nice family. I took pictures of the caskets that we liked (exterior and interior), emailed them to Jun, and got his approval. We paid and left. Then Monet drove us to Bernie’s BBQ to buy dinner.
Before we reached Rose Court, I received an email from Gina asking for prayers from the whole family. She said that when Cherie woke up from her nap, she asked for morphine and told Jun not to leave her side. She then asked what time Alex was arriving. When Jun replied around midnight, she said, with tears rolling down her eyes, that she might not make it anymore. When we reached home, we found them praying the rosary so we joined them. After the rosary, we took turns kissing her. When it was my turn, I looked at her intently and reminded her of what the nurse in the plane said to me which became our mantra: “No negative vibes.” And I added, “No one is going today. No one.” She nodded. (As a result of this scare, Pet decided to fly with Tish immediately. My Mom decided not to come because she had been sick with the flu and saw this as a sign from our Lord not to come. Our remaining sister Gigi, who had not been planning to come anymore, decided to fly too but had to take a later flight.)
After dinner, Cherie went upstairs and we went in to say goodnight. She told Gina, “Good night, sister.” So Gina said, “Good night, Ate Puput. I love you.” Then I approached her, and she said, “Good night, sister.” And I said good night and told her I loved her too. That struck us as both odd and sweet. She had never called us “sister” before. We took it to mean that she valued our relationship a lot. Then she said, “Wake me up when Alex comes.” We said yes. Then she added, “But if he’s awake, don’t wake me up anymore.” Then she immediately corrected herself, “If Alex is asleep, don’t wake me up anymore. Tomorrow will do.” Then I heard her say, “Just one more day.”
Throughout the night, she was restless and kept moaning. Around 1 am, Davy and his family arrived. Gina and I woke up, greeted them, stayed a little, and then left them playing and bonding. They probably stayed together until about 2:30 am. Davy said that his Mom was sometimes engaged and sometimes agitated. But she was definitely happy that Alex was there and that her whole family was complete.
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| Jun, Cherie with Alex, Davy and Michelle, and Jiffy |
July 4, Thursday
As usual, Gina and I went to the 8:15 am mass. It was a special mass for Independence Day and we knew that Ralph and Vicki would be singing too. So after the mass, we talked to them about singing at the funeral mass, and said that Cherie had specifically requested for them to sing at the mass. They asked when it would be and we said we didn’t know but she was fading. They readily agreed and gave us their business card. They asked us to choose the songs that we liked and to just send them an email.
Since it was the 4th of July, we decided to have all-American cuisine the whole day. Lunch was Pizza Hut pizza and buffalo wings. So when lunch was ready, Jun asked Cherie if she wanted to eat lunch. He said that he had asked Jiffy to buy pizza and wings and he had just arrived from Pizza Hut. She didn't answer but shook her head and creased her forehead. Then we asked her if she wanted to receive communion. She didn't answer but we got the feeling that she didn't want it either. We asked her if she wanted to go to the bathroom and she didn't reply again. It seemed like she just wanted to sleep.
Then around 2 pm, she stirred and I asked her what she wanted. She said she wanted to dress up. I said I could give her a sponge bath (her last bath was on Monday). She said she would just wash her face. I asked her if she wanted me to call Jun, and she said yes. She went to the toilet and while she was there, Jun told me she didn’t like the shirt he had chosen for her. So I showed her a striped shirt and she nodded. So I left them alone and went to our room.
About 15 minutes later, Jun rushed into our bedroom all dressed up. He asked me if I knew about a pictorial. I said what pictorial. And he said that Cherie had told him to dress up because we were going to have a pictorial. So I went to their room and asked Cherie if we were going to have a picture-taking. She said yes and I asked her where. She said either in front of the house or at the back. I asked if we could just do it in their room. She repeated at the front or at the back. Note that it was already mid-afternoon and she had not gone down. And here she was wanting to go to the deck! (The hospice material talked about a surge of energy in the last days. I was thinking this was probably it.)
So I told Jun to tell everyone to get ready for the picture-taking. We helped Cherie down the stairs, and guided her to the deck where we had group pictures taken -- all the Galvezes, three sisters, original four, Alex with Lolo and Lola, everyone. Then we guided her back to the house and brought her to the hospital bed where she promptly went to sleep.
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| The "surge of energy" pictorial |
When she woke up after the pictorial, she briefly played with Alex and sang “I Have Two Hands.”
Cherie didn’t join us for our All American dinner of burgers and stayed in her hospital bed. I noticed she was becoming restless and couldn't find a comfortable position. So Jun and Jiffy tried to comfort her. Gina and I went to her and repeatedly said the prayer that our Dad’s aunt taught us when our Dad was on his death bed:
Jesus, Mary, Joseph, I give you my heart and my soul.
Jesus, Mary, Joseph, assist me in my last agony.
Jesus, Mary, Joseph, may I breathe forth my soul in peace with you.
Then we prayed the Divine Mercy Chaplet and she finally calmed down. After those prayers, Gina asked Jun to join us in praying the rosary. He asked the children to join us too. So we started to pray and, after the first mystery, Cherie wanted to sit up and did. Then after the third mystery, she lay down. After we finished the rosary, she turned to her left to reach for Jun and kissed him. Jun kissed her back. Then she turned to her right to kiss Davy, then Jiffy, Michelle and Gina who was already in tears because we both realized what was going on. Gina told her that she loved her, thanked her, and asked her not to worry and be at peace. Then I kissed her, told her how much I loved her, and asked her to wait for Tish and Pet. I said the plane had already landed. I told her to sleep first. She said yes and asked us to wake her up when they arrived. All the time that she was kissing us, she was smiling and looked so peaceful and beautiful. After the kisses, Davy took out the monitor to show her Alex sleeping upstairs. He also showed his iphone with the Alex videos. Then she slept.
Tish and Pet arrived in Rose Court after 10 pm. As we promised Cherie, we woke her up. Tish went straight to Cherie, kissed her, hugged her, and asked, “Kamusta si Alex? [How’s Alex?]” Cherie replied, “Pika-pogi pa rin [Still the pika-pogi [most handsome].]” Then Pet kissed and hugged Cherie, and said, “Puput!” She gave the new arrivals both a sweet smile.
Conversation then turned light as Tish talked about their flight, how she enjoyed business class immensely, how she was so envious of Pet being able to sleep for a total of about seven hours, and she was hardly able to sleep, and of course she talked about the food. She even kept the menu! :-) At one point, we were talking about Pet gaining weight. Gina repeated it to Cherie because she might not have heard it. It so happened that Pet was approaching the hospital bed. So Cherie put her left forefinger on her mouth and said, “Shhh...he might hear you.” We all laughed!
After a while, she wanted to go up the stairs to her room. It looked like she was so tired because Davy had to support her back as Jun helped her up the stairs. With the picture-taking in the afternoon and the waiting for Tish and Pet, she really seemed spent. She changed to her pajamas, and then we all said good night to her. We all kissed her and told her we loved her. She smiled at each of us. She looked so beautiful.
Pet and Gina then left to check in at Quality Inn. Tish and I spent the night in Rose Court.
July 5, Friday
Tish, Pet, Gina and I heard the 8:15am mass. After mass, Monet picked up Gina and they proceeded to LAX to fetch Gigi. When they got to Rose Court, Gigi went straight to Cherie and said, “I'm baaackkkkkk!” Cherie smiled, and they hugged and kissed. There were now six siblings in Rose Court -- half of the 12! Gigi gave Cherie the Lake Arrowhead photobook that she had prepared. Cherie spent some time looking at the pictures, sitting up. After a while, she wanted to lie down and we had our pictures taken.
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| Five sisters - Aggie, Gina, Cherie, Gigi and Tish |
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| With our eldest brother Pet |
Gigi and Gina (the two Marthas) then went to Chipotle to buy burritos for our lunch. Meanwhile, Tish, Pet and I said the rosary with Cherie upstairs.
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| Praying the rosary |
Cherie joined us at the table for lunch and she had only one spoonful of the burrito. But she was able to finish one Belgian chocolate covered dried mango strip (from
Cebu) and then she took her medicines. (This turned out to be her last meal.) After lunch, we started working on the readings and program for the funeral mass. Cherie went to her hospital bed and slept.
Cherie didn’t have dinner and before 9 pm, she slowly and painfully went up the stairs to her room. She had such a difficult time that it almost drove us to tears just watching her struggle up the stairs. (The siblings agreed then that she should no longer go down to the hospital bed.) She smiled when Pet, Gigi and Gina wished her good night before driving back to Quality Inn. Tish and I slept the night in Rose Court though we had to wake up several times to give Cherie morphine for her pain and Ativan for her anxiety. She was so restless and agitated.
July 6, Saturday
The five of us heard the 8:15 am mass. Fr. Gerry, as always, included Cherie in the Prayers of the Faithful and also in the Eucharistic Prayer. He then told us that he wanted to speak with us after mass. He asked about Cherie and Mommy, and he agreed with Mommy's decision not to fly to LA. He said he would see Cherie later in the day.
Cherie remained restless, agitated and in pain. We asked her what she wanted and she said no to everything: water, Boost, communion, bathroom. So we all started to pray the rosary, stopping only when it seemed like she wanted to turn. She couldn't find the position that was most comfortable for her. At one point, we called Jun, Davy, Michelle, Alex and Jiffy so they could be with her. They all surrounded her while we kept on praying. They kept reassuring Cherie that they would all be fine and that they would take care of one another. Davy even said, “Alex has the best Lola!” At one point, Michelle brought Alex close to Cherie and she was unresponsive even to Alex. We all felt so sad; she must have been in such terrible, terrible pain to not have the energy to acknowledge Alex. Then we left them alone with Cherie. It was a very difficult morning.
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| Galvez men comforting Cherie |
Beginning that lunch, we started to eat in shifts – the Galvezes and then the siblings, or vice versa to ensure that Cherie would not be left alone upstairs. At 1 pm, Cherie stirred and opened her eyes. We told her that we wanted to change her morphine patch as 72 hours had passed and it was time to change it. Then after a while, she coughed a little bit so we gave her water. We asked her if she wanted to receive communion and she said yes. We told her that she could take it lying down but she decided to sit up. After receiving communion, she went back to sleep. (This would be the last time she would receive the sacrament.)
The afternoon was more of the same. Cherie remained restless, agitated and in pain. We gave her morphine and Ativan several times. Every time she would feel agitated, we would start the rosary and the Chaplet. Her agitation was not just putting the blanket over her then removing it, but she was also trying to find a position that was comfortable for her. She usually would lie on her right side (because her left side had the lesions) and then she'd want to lie on her back or turn to her right side; but then she'd be in pain, so then she'd turn again. She had also become so heavy that it required several of us to actually turn her or sit her up to take her medicine and make her drink water. She also kept scratching her pelvis, and stretching her feet and toes like she was cramping.
Late in the afternoon, she turned to her left and reached out her hand. Gina was sitting on that side of the bed so she took Cherie’s hand and lay beside her. She started saying that she loved her, that Tish, Pet, Gigi and I were there and that we loved her and we were all there for her; that Daddy, Mommy, and all the brothers in Manila loved her; Jun, Davy and Michelle and Alex, and Jiffy loved her; that Davy and Michelle were excellent parents and would take very good care of Alex; that everything would be fine and they would all take care of one another. She also said that everyone in Caltech loved her. She opened her eyes and asked, “Who?” So Gina answered, “All of them. All of them are praying for you.” Then she asked again, “Who?” So Gina said, “Fritz, Kathy, Barry, all of them. All of them love you. They all wrote letters saying that you're the best, that you made their lives better, that you always had a smile on your face. And Barry wrote too! He said that you are always in his thoughts and prayers.” It gave us the impression that she was really very happy at Caltech. After that, we all talked about our childhood and all the happy times with Cherie.
We all just kept praying and praying. And then at one point, she was agitated again, and then it looked like she was forcing herself to sit up. So we helped her sit up, and then she was trying to put her legs down so it meant that she wanted to stand up. So we asked her if she wanted to go to the bathroom. She said she wanted to sit down on a chair. So we got the swivel chair because it had a soft bottom and back. She sat down but she was sliding because the material was soft. She said, “I’m sliding down.” So she put her left knee against the bed so she could stop herself from sliding. Then she turned to Jun on her left and, with some urgency, clearly said, “Let’s go!” Jun asked where. She said, “I don’t know. Wherever you want to go.” So Gigi said, “Just go, Ate Puput.” Then she calmed down and said she wanted to lie down again.
Fr. Gerry came before 7 pm and blessed our bottled water and blessed all of us. He then prayed with Cherie before blessing her. Fr. Gerry then told us that it was important to always hold Cherie’s hand and that anybody could bless her now that we had holy water. Before going down for dinner, Pet sprinkled holy water around her bed and also on Cherie’s forehead.
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| Fr. Gerry praying with Cherie |
After dinner, we went up to continue to pray for Cherie. It was at this time that she said her last words to me. She told me, “Go to sleep now Adj.” I said that we were still waiting for Mike (Gina’s husband, who was flying in from Nova Scotia) and Manny (flying in from Baltimore), both of whom were arriving around 10pm. We had arranged their flights so they would be landing around the same time. Mike and Manny arrived in Rose Court past 11 pm. When Mike kissed Cherie, she said, “You’ve come from so far away.” And then to Manny, who had just washed his hands, she said, “Your hands are so cold.” She was quite lucid that night.
Pet, Mike and Gina, and Manny and I left and slept at Quality Inn. Tish and Gigi slept at Rose Court.
July 7, Sunday
Cherie was less agitated and restless. Upon the advice of Jun’s sister Caroline (a nurse) and with the approval of hospice, we doubled her morphine. We continued to watch her in shifts while praying the rosary, the Divine Chaplet, the Holy Cross prayer, the novena to Our Lady of Penafrancia, and other prayers.
Just like on Saturday, Cherie had no intake that day except for the little water that she took with her morphine and Ativan. She had also stopped taking her other medicines (anti-constipation, folic acid, hypertension, etc.) since Friday afternoon. We were down to pain management and anxiety alleviation.
Cherie was now exhibiting the same symptoms that Daddy had before he passed -- tugging at her blanket and then removing it; the smell; the far-away, sometimes glassy look; and, for the first time, wanting to remove her shirt. When she did this, Tish and I took the opportunity to change her souvenir shirt from Macau which she had been wearing since Thursday night. Tish cut the shirt vertically so we didn't have to pull it over her head. I removed the left sleeve of the shirt and put on the left sleeve of a blouse. While Jun lifted her, I pulled both shirt and blouse under her, and put on the right sleeve. Cherie was protesting the whole time, so Tish and I hurriedly buttoned the blouse.
It was also difficult to moisten her lips. The day before, we were partially successful. But that day, she showed such displeasure when we used a lip balm and a wet cotton ball on her lips. So her lips were very dry.
After dinner, Cherie was a little restless so we gave her her meds. Then she wanted to sit up, and then it looked like she wanted to stand up. So we asked her if she wanted to pee. She didn't reply but we brought the commode close to her. But she didn't want to pee. Instead she leaned towards Jun (who was supporting her) and rested her head on his chest. So we said that maybe Cherie wanted a hug from Jun. But he said he couldn’t because he was supporting her. So Cherie motioned that she wanted to go back to the bed. While this was going on, we kept asking her where she wanted to go but she didn't reply. As I looked back on the events of that day, I realized that she didn’t utter a single word that day.
July 8, Monday
Tish and Gigi stayed with Cherie Sunday night. The hospice nurse Patricia came at 1:10 am because we were worried that Cherie had not passed urine since Saturday. She stayed two hours. In her email to us, Gigi gave us an account of the visit. In brief, Patricia put in a catheter and urine immediately started to flow. But Cherie protested and wanted to remove the catheter. Then Patricia tried to put a diaper on her and Cherie started crying and was trying to remove it too. Tish was holding her hand and Cherie was saying “Ate Tish, Ate Tish,” imploring her to have the diaper removed. So Patricia removed the diaper and replaced it with regular panties. Cherie agreed but she was still trying to pull out the catheter. Then Cherie asked to go to the toilet and they told her there was no need because she already had a catheter. But she still wanted to go so they sat her down on the commode hoping she would move her bowels. She sat there for a while, straining hard while first leaning on Gigi then on
Tish and finally on Jun. After a while Cherie gave up and asked to stand up. Patricia did an exam and said there really was nothing to pass, but inserted a suppository. One more indignity for her! And again she protested and was crying with no tears. They brought her back to bed, but she really didn't want the catheter and was trying to pull it out herself. So Patricia agreed to remove it.
Cherie was crying and said that she was going home. So they told her, “Puput, uwi ka na, uwi ka na. [Go home, go home.]” They told her sons to stay beside their Mom, and tell her that they would be fine and she could go home. She eventually calmed down and fell asleep.
Before 8 am, we picked up Tish and Gigi from Rose Court and proceeded to mass. After mass, we returned to Rose Court. For Tish and me, this was the most difficult day. Cherie was so restless and agitated. It was a real challenge giving her the morphine and Ativan as well as removing the “crust” from her very dry lips. In hospice terms, she was combative, shaking her head left and right, and closing her mouth tightly so the syringe with morphine couldn't get in. We prayed the rosary, the Divine Chaplet, the litany of the saints, and so many other prayers. Just when we thought she would calm down, she would stir and start to get agitated again. I don’t think there was a five minute period when she was still.
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| Gigi and Gina singing to Cherie |
In the evening, the hospice nurse Jim, who had admitted Cherie to hospice, arrived to check in on her. He saw how agitated she was and obtained authorization to increase her morphine dosage even further. In my frustration over Cherie’s continued anguish, I asked Jim what would have happened if we were in a hospital setting. Was there anything the hospital could do that we were not doing. Jim said the only thing they would do was put restraints on her and we certainly didn’t want that. And he said that the hospital is the last place you would want to be in when you’re in a condition like Cherie’s. He said that she had terminal delirium. Her mind was so confused. Sometimes she did not know where she was, who she was with. Everything was scary. But he also said that she was not in pain though she was very agitated. [As I mentioned in Part 1, Gigi turned to google and found out that there are two roads to death – the easy road and the difficult road. The easy road is increasing weakness, sleepiness, semi-consciousness, coma and then death. The more difficult road is agitation, restlessness, discomfort, coma and then death. Perhaps because Cherie had metastasis to the brain, she took the more difficult road.]
July 9, Tuesday
Gigi reported that Cherie had an uneventful night. The new dosage seemed to be working well though she still moaned and whined, tugged at the sheets, etc. But they all got some sleep. The two times she went to their room to give Cherie the meds, Gigi had to wake up a dead-to-the-world Jun. I thanked Gigi for coming to help us. If she had not come, it would just have been Tish with Cherie in Rose Court, since Gina and I had to be with our hubbies. So Gigi came not just to cook for us but to give Cherie’s meds too.
But it was another difficult day. Each time we would think that Cherie would be sleeping or resting well, she'd start to moan and groan and whine and wince in pain, looking for the most comfortable position for her. We spent the whole time taking shifts in watching her and praying for her, and giving her meds. It was so painful to see her in such distress.
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| Tish and Aggie comforting Cherie |
Just before 3 pm, Dr. Chang from hospice arrived. We gave her a summary of what had happened and she went up to see Cherie. Highlights:
1. She agreed with Jim that Cherie was experiencing terminal delirium.
2. She said that Cherie seemed to be exhibiting not agitation but discomfort. So she said that we still needed to give her morphine every four hours (together with the Haloperidol, the med that replaced Ativan), despite the two morphine patches that she already had. She also said that we could give the morphine every hour if needed.
3. When she was checking Cherie, she felt that Cherie needed morphine already. So Jun prepared the syringe and Dr. Chang said, “Mrs. Galvez, I am going to give you medicine. It will make you feel better. Please open your mouth.” And to our shock and surprise, Cherie opened her mouth! Soon after the morphine was squirted in, Cherie started to complain. This, after all, was the liquid morphine which had a bitter taste that she had complained about many weeks ago. She also shook her head each time Dr. Chang asked her a question. So we thought Cherie was responding; but when Dr. Chang asked her another question which was a little contradictory to the previous question and Cherie still shook her head, Dr. Chang said that she was really experiencing confusion. But one thing was sure, Cherie could definitely hear well!
4. We told her that Cherie had not produced urine in more than 36 hours and she said that it meant her kidney had started to shut down. She reassured us that kidney failure would not be painful. She did say that after the kidneys failed, the liver would be next. Cherie's heart was fine, though her heartbeat was fast. So while the end was near, it would not happen that night or the next day.
5. She asked us when Cherie last ate and drank, and we said she last ate Friday lunch and last drank on Sunday. And she said that a person could last for a week and a half after stopping to eat, but of course, others may not last as long.
6. Dr. Chang was very pleased that so many family members were with Cherie. She said that that was the critical difference between hospice and hospitals. At the hospital, so many strangers (nurses) looked in on the patient and the environment was very unfamiliar. So she encouraged us to surround Cherie with our love.
After dinner, we had an unexpected surprise. Ralph and Vicki came to sing for Cherie. Vicki had called me up on Monday to confirm that they had received the song selections and also the Filipino song that we wanted them to sing. This song was “Pauwi Na [Going Home Now]” which our brother Ton had emailed to us after his wife Nina found the song and liked it. Vicki said that they were studying the song and would sing it at the funeral mass. She asked about Cherie and I told her that she was fading. She asked if they could come to sing for her and I said I was sure Cherie would love that because she was so fond of music and used to play the guitar too. Ralph and Vicki sang six songs, and this was one of them. And all the time that they were singing, Cherie remained still! It was like magic.
After Ralph and Vicki left, we followed and went back to our hotel. Tish and Gigi stayed behind. Jim came at 10 pm and observed that Cherie was still restless and fidgety even after the hourly doses of liquid morphine. (Cherie became agitated again after the serenade!) He obtained authorization to advance the giving of Haloperidol and increased the dosage to 1 ml, as well as add two more morphine patches.
Jim also answered Davy's questions on what would happen next, in terms of the progression towards death. So Jim told Davy what to expect and what the body would be going through. Before he left, he gave Gigi the instructions for Cherie’s medicines.
July 10, Wednesday
Gigi gave the meds at 1 am, 2:30 am, 3:30 am, and 6 am. Cherie didn’t seem to notice the meds and Gigi was able to give them without any protest from Cherie. She and Jun both tried talking to Cherie but she didn't seem to hear them. Her eyes were half-open and her mouth was always open. She seemed to be breathing through her mouth and was breathing loudly.
When we came back from mass, Cherie was very quiet and still. She was like that for most of the day, coughing a few times and having some involuntary arm movements and opening her eyes halfway. Her blood pressure in the morning had dropped to 90/70 and her pulse was around 134. So we all prayed the rosary, together with the Galvez family. Each of the siblings and in-laws then said our goodbyes to her. Pet blessed her.
After lunch, we asked Tish and Gigi to sleep since they had a late night; and of course, Gigi was waking up almost every hour to give Cherie her meds.
At 1:55 pm, the bathing nurse came. Gina and I helped her give a “bath” to Cherie. When the wet washcloth touched her face, Cherie started reacting and shook her head from side to side. We decided to give Cherie morphine at that point; after all, her last dose was given more than 10 hours earlier. After that, she was not reacting as much anymore, protesting only when we had to turn her on her side. The nurse was also able to clean Cherie’s mouth, the inside of her mouth and her tongue. We chose a happy, pink pajama set to put on her. She smelled so good and she looked so pretty!
Later we saw that she was clutching the holding cross which was given to her by Mommy last May. Gina and I couldn’t remember who put it in her hand after she had her bath. Neither one of us did. She held on to the cross until she breathed her last.
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| Clutching the holy cross |
July 11, Thursday
Cherie was now in a semi-comatose state. In the morning, she was still able to raise her left arm with her left hand touching her mouth, though it looked involuntary. In the afternoon, she was no longer able to do that.
She no longer protested when we gave her her meds, nor when we cleaned her mouth with a swab. She no longer reacted when a wet cotton ball touched her face when we cleaned it. She didn't react when we blessed her forehead with holy water. Her eyes remained open most of the time and were glassy, sometimes looking upwards. She had become much heavier and her limbs had become stiff.
Late in the afternoon when the Galvezes were watching over her, Jun smelled something and he thought it was Alex so they checked him. He was dry. So that's when they realized it was Cherie. Monet, who works in a hospital, had told us that a sign that the end was very near was when patients would pass urine or move their bowels. So when this happened, the Galvezes called all of us. We went upstairs and we prayed and sang. After that, Cherie’s sisters cleaned her up, freshened her up, put a diaper on her, and new pajamas.
July 12, Friday
After mass, we could no longer take her BP. We used three different sphygmos and we couldn't get any readings. All we got was an error message. Doc Manny said we shouldn't be worried about that because Cherie was now “actively dying.”
Meanwhile, we continued to pray and sing, and make preparations. Cherie’s eyes were now always open and looking diagonally upward. Her mouth was also open wide. But she continued to hold on to her cross.
Around 1 pm, Fr. Gerry texted me to ask if he could visit Cherie. Of course I said yes, and he arrived almost immediately. He sat close to her and prayed over her. When he left, he told me that Cherie was now at peace and that the end was very near. Around 3 pm, he texted again to ask how she was and I said she was still holding on.
As Pet and I were praying over Cherie, Gigi came to give Cherie’s meds. As she put in the syringe, Cherie suddenly clenched her mouth and clacked her teeth. We thought she was protesting. But she continued to do that even after Gigi had pulled away the syringe. We realized that her breathing had now changed and was accompanied by a clacking sound. We called the others and asked Jun, who was about to leave to pick up Cherie’s meds, not to leave anymore. So Jun sat on Cherie’s right, Davy on the bed on her left, Jiffy beside his Dad, the rest of us at the foot of the bed. We prayed the rosary and watched her with tears in our eyes as the intervals between her breathing became longer and longer. Then around 5 pm, she stopped breathing and Davy said that she was gone. We took turns kissing her goodbye.
Pet called our brother Ton so he could relay the news to Mommy. Each of us called and texted our respective families. We agreed that we would ask Cabot to pick her up at 7pm. Pet and I stayed with Cherie. He was trying to close her mouth. I was trying to clean her face and completely remove the crust on her lips.
At 7 pm, Jun brought in two gentlemen in suits from Cabot. I gave them Cherie’s garment bag with her pants suit and her picture inside the bag. They asked Jun if he wanted her clothes back and he said yes. Then they told us what they would do – wrap her in a white sheet which would completely cover her including her face, put her on the stretcher, bring her downstairs, lay her down on the gurney, and then remove the sheet from her face so we could say our goodbye.
As they were preparing her, Jim came and confirmed that she was really gone. He then assisted Jun in properly disposing of all of Cherie's highly restricted meds like the morphine, Ativan, etc. Before he left, we thanked Jim profusely and told him that he had done exactly what he said he would do when he first admitted Cherie to hospice. He became a little emotional too and he said how sorry he was for our loss and what a fine lady Cherie was. I told him that we had arranged the vigil to be held on Sunday and the funeral on Monday. He assured us that the death certificate would be ready by Monday morning. And it was. (Hospice really delivered for Cherie. We were able to reach them anytime of the day. The nurses came when they said they would. They were not only competent but caring too. Jim had advised us early on not to hesitate to give morphine to Cherie. He also warned us that some families would experience guilt after the patient's death thinking that they probably overdosed their loved one. But that could never happen and we shouldn't think that way. He also said that patients with terminal delirium looked more distressed than they actually were.)
The Cabot men proceeded to wrap Cherie in the white sheet. They were so gentle and respectful. When they laid her on the gurney, they removed the covering from her face, and we quietly took turns kissing Cherie goodbye.
At last, she was finally delivered to our Lord’s peace in our heavenly Father’s kingdom.
Gigi prepared a memorial website for Cherie at cheriegalvez.muchloved.com. Accounts of the vigil, the funeral, the 9th day novena, and many more, are posted in this website.
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