abri! abri!

[jawnbc]

It’s been an eventful day. It’s not all been fun.

Today was impromptu family barbecue day. My brother Mike (whose new family nickname is apparently Cubby!) picked up some marinated steaks and staffed the grill. I picked up salad fixings, but my sister-in-law (though she’s really a sister) Theresa enlisted her daughters Casey, Caitlyn and Christina to make the salad. Theresa organized steaming a whack of broccoli in the microwave. The rest of us took turns visiting Ma, teasing and taunting one another, and generally being Egans. It was fun. And nearly everyone was there:

Ma [Patricia] & Da [Pádraic]
Kathleen & (Marty)	Mike	Tommy & Theresa	John & (Max)
Jen		Caitlyn
(Jackie)		Casey
(Jessie)		Christina
Marty
Katie
Richie
Grace

Only the family members in parentheses--my brother-in-law Marty, my nieces stoplabelingme and Jessie, and my husband querrelle couldn’t make it.

As things wound down, the matter of Ma’s living will and health proxy had to be attended to. Da had run it by each of us again, and there was a consensus of what Ma’s wishes had been before this episode. Theresa (who’s a nurse) pointed out some of the vagueries in its current form. If Ma wanted more specifics added, that’s fine, but I couldn’t sign it unless she did.

And all of a sudden all the grief I’ve been carrying around just poured out of me. I couldn’t stop crying, and then sobbing, for the better part of an hour. In fact, I was so upset I couldn’t go with Tom and Da to ask Ma about Theresa’s suggestions. Ma rejected them, but signed the proxy. It.Is.Done. There will be no more vents, and probably no hospital. I was bereft....and still am.

But the next thing to sort out is palliative care. If Ma had cancer or heart disease we could ensure that she gets adequate pain meds. With COPD/emphysema, it’s more complicated: pain meds suppress respiration, and what she’ll experience in the end (if conscious) won’t be pain so much as distress--she won’t be able to catch her breath. I cannot bear the thought of her going through that anxious and panicked: we’ll need to get some benzos or sleep tablets or something here, so her last hours are a nightmare. For her, and for Da.

I’m here for another few days, until Thursday. I’m hopeful we can sort out these issues to some extent before I go. Well, I’ll do my damndest

Comments

[mondragon.livejournal.com]

I have some experience with what you're going through and there's no easy way to get through it. Cling to the knowledge that you're doing the right thing and cry as often as you need to. ::Big Hug::

You mention wanting benzos - in people who are old/weak/sick, they can have very disturbing effects. Here's a link that describes some of the reasons for it:

http://www.uspharmacist.com/oldformat.asp?url=newlook/files/Feat/Senior_Care.htm&pub_id=8&article_id=868

I've seen it happen twice - first in my lover, who was about two weeks away from death after being very sick for a year, and then in my grandmother, in about the same condition (but different reasons.) It was horrible, worse agitation and paranoid thoughts requiring a constant talking-down until they wore off (which it seemed they never would.)

"Horror" is the term that I think fits the experience best, for all concerned.

You or someone in your family should bring this possibility up with the prescribing doctor and see what they say and whether or not they think it might be a problem for her. You may have to make the difficult choice of treating her distress with drugs that may hasten her death. Personally, after my experiences, the choice between suffering and a few extra hours or a day or two of life would be straight-forward to make.

[qbear.livejournal.com]

When my father entered the hospital for the last time, it was by ambulance--he was in respiratory failure. Everybody knew that this was it, so his pulmonary doc simply admitted him, cranked up his O₂, and flooded his system with morphine. He definitely was not in distress when he passed--it was very peaceful.

If you can arrange home hospice care, they can set up a morphine pump or a standby IV so that when the time comes, your mom can be made as comfortable as possible.