yesterday morning, mam woke me up saying she didn't think her oxygen was working. i checked the condenser, and the tubing, and couldn't find a plug-up or anything, so i changed her cannula, and she still wasn't getting any oxygen, so i hooked the cannula to a portable tank. that worked. but as i was trying to figure out wtf, i noticed she was laying her head on her crossed arms, on the corner of her computer desk. i asked her what was wrong and she said she was having a hard time breathing, and felt really dizzy. i moved her rollator closer, and told her to lay her head on that, as it was soft and had no hard corners in case she passed out. she did, and i said, do you think you need to go to the hospital? and she said, i don't know. i said, ok well, then you need to go to the hospital. she said she didn't think she could walk to the car, so i called 911.
i've mentioned before that this is a SMALL ASS ISLAND. 20 people showed up when i called 911, the street was blocked, thank GOD the tourists are gone now. i knew everyone that showed up and they were all really kind and loving and supportive, and we made a team effort and got her out and into the ambulance, and i followed it all the way to the hospital, running lights and stop signs right behind them.
they got her into the ER, and hooked her up to the monitors and discovered she was in a-fib - her heart rate was irregular, with no sinus rhythm, and going from 135-216, for several hours. they gave her several IV meds to slow her heart down, and when she was finally stabilized, they did a sonogram on her heart, to see if the fluid that's around it is causing a tamponade. luckily, it was not. however, as everyone at the hospital knows i also work in medicine, they pretty much turn into a teaching hospital whenever i'm around, and let me watch all the procedures, and explain everything. i didn't need it to be explained that it's not good that there is as much fluid around her heart, as there is heart muscle. the biggest concern was that the fluid was not making the heart unable to beat. since this was not the case they said ok, and put her up into ICU.
when i got to the hospital this morning she looked TERRIBLE - grey, slurred speech, an almost thick-seeming tongue. she managed to explain she couldn't breathe, and she couldn't breathe too well all las tnight, and didn't sleep. so i rang the nurse, and also the doctor on her case and i had spoken extensively yesterday, and continued to do so today. they elected to start giving her morphine, orally and via vapor. that did the trick and got her breathing regulated and got her asleep.
i also talked a lot with her doctor, as well as her oncologist and pulmonologist. this morning, the pulmonologist did a quick sonogram of her lungs and saw there was an extensive amount of fluid around her right lung again, and they'd been hearing very limited sounds in that particular lung, so he decided to do a thoracentesis, which i watched, along with my friend john (hi john!). this was her 2nd one. the first one, they pulled a little over a litre of fluid off her lung. this time, they drew 1.75 litres off. the fact that so much has built back up so quickly is a bad sign. so, much discussion occurred between doctors and myself, and we decided no more treatment - comfort only. this means no more chemo. this means we are preparing now for the inevitable.
her oncologist actually came and found me in the parking lot while i was having a cigarette, and reading up about the stages of death in lung cancer, and we talked a bit more, and i told him that from my experience as a caregiver, i honestly would be shocked if she lived to see my birthday (end of october) and truthfully, would also be surprised if she survived until october. he agreed with me.
sometimes, being right fucking sucks.
no one has told her her life expectancy, because in the realm of medicine, people are always wrong. people beat the odds, miracles happen all the time. but i know what her expectancy is, and i knew it before the oncologist confirmed it.
the stages of death with lung cancer aren't much different from stages of death from any other cause. i've seen death. i've watched it be terrible and i've watched it be easy. my solace is that mam's not in any pain whatsoever.
she's been moved out of ICU and into the regular unit in the hospital, where they'll keep her for another day or two while they arrange for hospice care for her at home. i will be her main caregiver, and i'm praying that i'll be provided with another caregiver for respite, so i can just get out of the house for a few hours now and again and not worry about her being alone. but i also know me, and i know, from past experience, that when i know in my heart the time is close, i can't bring myself to leave.
here's an interesting note about people dying that is not very well known: most people, when dying, will wait until everyone has left the room, to actually pass. this is usually only the case in the event of long illnesses, not so much things like car crashes or bullet wounds, etc. but it's the norm. and it's happened to me a lot. and i'm not sure why it happens. no one can explain it, other than, it's the dying person's wish to not inflict that lasting memory on their loved ones.
mummy has already entered a few of the stages of death. she's refusing food and water, though she'll have an occasional sip of water if her mouth is really dry. she's picking at herself and a bit uncomfortable in her own skin. she's hallucinating that people are in the room with her, who are not (me, actually). her breathing is that of the dying. there's not many stages left to pass through before death. however terrible it may be for me, i just hope it's an easy cross-over for her. i can handle anything, i'm not worried about me. i just don't want her last weeks, days, hours, minutes to be fucking awful. i pray that she goes in her sleep.
i hate the guilt i have over leaving the hospital. it's not that i don't trust the staff, i know many of them, and completely trust them and know she's in excellent hands. but i always have the nagging "what if she goes and i'm not there" in the back of my head. i've had it almost since she was diagnosed a month ago, because i can tell, even without having looked at her films, how bad off she is. i've cut my work down to no more than 4 hours per shift, even though going to work is actually a break for me, because i'm terrified something will happen and she'll be all alone. once she's home and on hospice, unless i can get someone in when i'm at work, i won't be working. right now, making some money is at the bottom of the list of my concerns. my mummy is my #1 concern, obviously.
once she passes, i will be officially an orphan. i feel like i'm too young to have both parents dead. there's some family on my dad's side, but i'm not close to them, and haven't seen any of them since my dad died in '06. and i have a cousin on my mom's side, but we've not spoken in over 20 years. oh, there's 2 cousins there. so aside from my step-family, who are all back in virginia and maryland, i'm all alone in the world. i'm also all alone here. everyone, and i do mean EVERYONE on the island has said to call if i need anything at all, no matter how big or small, and my god their kindness is appreciated, but i just don't know what i need or want, you know?
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