Alex squeezed a lot in to the last 24 hours.  As I thought how to best discuss it, grouping by type of activity made the most sense.  Everything was intertwined throughout the day.

Living in Dreams

Alex spent most of the day in that familiar space between awake and dreaming.  His day was a lot like the YouTube shorts or TikTok threads people spend so much time scrolling through, only his were all in his head.  A few that stood out to us:

• He was screaming quite loudly.  This was fairly common throughout the day, but this particular time slice was more pronounced.  It continues for a few moments and he opens his eyes to see us staring at him.  "Sorry", he says realizing he must have been vocalizing what was happening.  "I was riding a roller coaster."
• He was giggling for a few minutes.  He woke up and says:  "That was funny.  I was arguing with a group of grizzly bears in white jackets about how the world absolutely did not need another rendition of Bohemian Rhapsody."
• Our dog was sleeping in his room and, as dogs tend to do, started barking in her sleep.  Alex heard this and immediately reacted by calling out the name of our dog that passed away a few months back.  He was playing with Hunter in his dream.
• Late last night, as we were repositioning him to help with his breathing issues, we were telling him how much we loved him.  He woke up and asked what we just said.  We repeated that we loved him.  Without missing a beat he says:  "It isn't hard."

Connecting with friends and family

Alex's closest friends stopped by throughout the afternoon.  We provided a 45-minute window of time they could come see him, and they took it upon themselves to arrange visiting him individually instead of as a group.

He had a really good group of friends.  A story I haven't yet shared about them is they made a book of photos from their trip to Magic Mountain and, much like students do with a yearbook, they all signed the book with their memories of Alex and gave it to him as a gift.  Some really nice, thoughtful kids.

Alex wasn't always lucid for these visits.  With one of his friends, he woke up as the time was ending, saw his friend was in his room, and started crying and apologizing.  He felt bad he was sleeping when his friend was there to visit him.

An even more poignant moment happened with his girlfriend's visit.  We scheduled 45 minutes for her.  He spent the preceding hour preparing.  He wanted his hair combed, and he asked us to position him so there was enough space on the bed for her to lie next to him.

He had already lost the ability to use his hands when she arrived, but he opened his arms to embrace her the moment she walked in.  We left them alone.  When time was up, and his next visitor had arrived, we returned to the room to let him know his next visitor was here.

He was asleep and woke up surprised to see his girlfriend.  He immediately began crying, not knowing she had been there.  We discussed how he had greeted her, given her a hug, and then rested with her.  He had thought that all happened in a dream.

Alex enjoyed when his visitors would pray for him, and several did.

I was able to read to him about half of the comments people made on our earlier post.  My daughter read him several more.  An unexpected benefit of the more than 100 comments we received on that post is how much that helped the rest of us.  Alex enjoyed them, and we were filled with vicarious pride.

Olivia (Livvy) Dunne sent him a video.  Travis Barker reached out to check-in on him.  Jennifer Lawrence asked how he was doing.  His teacher the year he was diagnosed stopped by with a letter answering the questions we posted in the journal.

Alex made the most of the few lucid moments he had.

The Medical

Alex's symptoms worsened throughout the day.  We mostly had the pain under control, but the breathing was noticeably harder, and by early afternoon, he had lost the use of his hands.

Each inhale was a full-body struggle.  I have video of it, but the easiest way to think of it is like a fish on land trying to get oxygen.  Each exhale was a body collapsing in exhaustion from the inhale.  When air is forced from the lungs that quickly, it makes a sound.  Alex spent most of the day struggling to inhale, then barking like a seal on the exhale.

Around 1 AM, Alex was no longer able to take pills.  His body was too exhausted from trying to breathe to have the energy to swallow.  We called hospice and they changed him to a subcutaneous delivery of his medication.  Not much different than how his insulin was administered.  

Because he couldn't swallow, that also meant he was not able to eat or drink to respond to his diabetic challenges.  His blood sugar cratered while the nurse was here, and for the first time since his diabetes diagnosis, we had to raise his sugar with the glucagon shot instead of with food.

Around 2:30 AM, we switched him to pure oxygen from tanks, instead of from the machine that pulls it from the air.

All these changes relaxed the exertion he experienced breathing, and, while he still struggled, he was at least silent and comfortable.

At 6:08 this morning, Alex drew his last breath, ending one journey, and starting his next one.