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I hope all goes well with the surgery!
My suggestion is that you take the "errand" slot for Saturday during the visitation time with Cupcake (maybe do the errand before or after the visit). That way you are able to do both.
As for your guilt...we all have that. I will say though that one thing I needed during times like this with my parents was a distraction. I can only focus on the fear, unknown, length of time etc. for so long before I need something to distract me. I can't be there for others if I am immersed in it 24-7, kwim?
So maybe look at your visit with Cupcake as a great way to have your distraction, reminder of life and love, and that afterwards, you'll be in a better frame of mind and energy to be there for your mom and grandma.
((HUGS))
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Mom to 4 fun loving kids (adopted from foster care)
7 years into our forever family! 
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