Tuesday, January 25, 2011
2010: A Year of Loss Part I: Mom
In March 2009, I had a chance to have a quick visit with Mom. I was at a work conference not far from her place, so I called her and she came over for a little while. She wasn't feeling very well. She looked tired and run down and said she had a sinus infection.
I didn't think anything of it at the time. It was right after the big ice storm that hit her county so hard, it actually made CNN. She went without power for a while, and I think we both thought she must have gotten sick then. Mom was always prone to colds and sinus infections, which always seemed to hit her hard and last longer than they did in other people. Seeing Mom sick after a hard winter just did not seem to be that unusual. In retrospect, though, this was something entirely new. I'm now pretty sure that this was the first manifestations of her cancer, but none of us were thinking in that way yet.
In the summer, she called me and told me she was going into the hospital. She still wasn't over her illness, so she was going in for an anti-biotic treatment. They were going to give her some high strength anti-biotics by IV during the day and release her at night to go home. She'd been scheduled for surgery on her sinuses, and the hope was that the treatment would knock the infection out so they could operate.
Right after this, she called again. During some testing that they did during the hospital stay, they discovered a grapefruit sized "mass" in her lung. There wasn't going to be any sinus surgery. Instead she'd be going for scans and biopsies and such.
In September, I went with her to an oncologist here in Louisville. She had all her scan results with her and they were going to give her a diagnosis and discuss treatment options.
It wasn't good. The mass was cancer, but it had grown to the point that surgery wasn't an option. It had also spread, primarily into her liver. She was given a prognosis of 4 to 6 months without treatment and 6 to 8 months with treatment. The initial plan was for her to start a course of radiation and chemotherapy within the next few weeks. She was going to do the radiation at a hospital closer to her and the chemo in Louisville.
My mother was one of those people that seem to be hyper-sensitive to medication. All of her life, if there was a side effect from something she was taking, she'd have it, sometimes pretty severely. The thought of her doing radiation and chemo scared me. It's rough under the best of conditions. I was afraid it would be murder on her.
And it was. In November, my uncle Larry passed away unexpectedly. She had started the radiation at that time, and the day of the funeral, she was too weak to attend. None of us, including her, ever saw that one coming. I remember sitting in the funeral home, surrounded by family, and realizing that we'd be doing this all again.
By Thanksgiving, she'd been hospitalized. Between the radiation and the loss of appetite, she'd developed anemia and an infection. We had planned a family gathering, but that turned into my brother and I bringing her home. My brother, his wife and I did spend some time cleaning her house and stocking her up on things. She had been so weak for so long, she was leaving her trash bags on the porch, because she couldn't get across the yard. My brother and I took 300 pounds of trash to the dump.
She was supposed to be starting the chemo around that time, but the decision was made to finish the radiation and then start the chemo after the holidays to give her a chance to rest. It was a good decision. Radiation had taken a toll on her, but chemo would be even worse.
I never could figure out the effects on her appetite in a way that made sense to me. If she was with me and my brother, she would eat and talk about how good the food was and how much she was eating at one sitting. If she was at home, she wouldn't eat.
By the end of the chemo, she was emaciated and bald. She had one lock of hair in the front that didn't fall out. It was only a few hairs, but she'd always comb them forward so that they would show under whatever hat she was wearing. She'd always been proud of her hair--managing to create a somewhat civilized, stylized version of a femullet that she rocked right into her late 60's. When got to the point that I was signing admitting papers and such for her, I'd show them her id so they'd know what she looked like before she got sick.
Unfortunately, for all the nasty effects on her, the chemo didn't seem to faze the cancer. At the end of the course, the tumors in her lungs were shrinking, but the ones in her liver were not. Some of them were even growing. She was too weak at that point to start a stronger chemo, so they were going to give her an oral chemo for her lungs and send her home in the hope that she might be stronger in several weeks. Privately, the doctor told my brother that she wasn't going to get any stronger and would most likely enter a rapid decline within six weeks.
In May, that decline hit. We were all working toward getting her moved off the farm and into town during the next to last week in May. My brother and his wife were to help with the move that week. Keith and I were going in the weekend before to pack things up. I was taking off the Thursday and Friday before Memorial Day and staying through the holiday to get them settled. At least that was the plan. The reality was a whirlwind of hospital admissions and releases, hospice involvement, and ultimately, her death. It was so fast, none of us knew what was happening until we were in the middle of it.
Keith and I made a surprise visit on Mother's Day, something I am so glad that we did. She was alert and coherent and able to sit up and visit with us for a bit. It would be the last time. Hours after we left, she was rushed to the hospital. Even though we weren't supposed to come back for two weeks, we decided to go down the next weekend, since there was a lot of packing to do. It didn't get done. We had to rush back to the hospital with her. Her pain and weakness were growing so intense that she couldn't bear them. She'd go to the hospital, get rehydrated and get new pain meds, stay a couple of days to stabilize and then be released home until the next time.
At was also at this time that she started to become more and more incoherent. She'd been saying for a while that the morphine was making it hard for her to understand things. When we arrived, she was in a panic about a bill that needed to be paid, but she couldn't remember how to write the check or how to record it in her check register. I helped her through that, but I was so stunned to be doing that for the woman that taught me how to do a check register when I was sixteen. Later, when I was looking back through her stuff, I realized that just three or four days earlier she had written a bunch of checks to pay some bills and had done everything perfectly. Rapid decline, indeed.
My brother spent as much time taking her to the hospital as he did moving her when the time came. At the end of that week, she was released to her new place, and we were to start making arrangements for hospice. That all fell through over the weekend. We weren't able to arrange for any kind of in home care for her, so hospice wouldn't admit her. Her pain was growing worse and worse, so she was admitted back to the hospital.
Sometime around this point, she snapped back to lucidity for a few hours, but it was a paranoid lucidity. One of the side effects of morphine is acute paranoia. The nurses were trying to kill her. The clock was spying on her. The last conversations we ever had with her where she wasn't either semi-conscious or mumbling through her pain, and they didn't make any sense. My brother stayed over night with her and said it never got any better.
During her last hospital stay we got her doctor to approve her release to a nursing home, instead of going back home. Hospice would step back in with her in the nursing home, because they would be assured of her round the clock care. By Thursday of that week, she had started her final decline. The nursing home called me and I started making calls to the family. I stayed over night with her in the nursing home Thursday night and Friday night. At about 3 or 4 in the morning, the nurse who came to check up on her and give her meds woke me up to tell me her feet were getting cold. A few hours later she was gone. I had been sitting with her and she passed so quietly, I hadn't even noticed.
All of a sudden my brother and I were orphans. All I could feel at that moment was relief. She wasn't in pain any more and didn't have to go through that any more. It was over. The time for dealing with loss would come later, but at that moment, Mom wasn't stuck in the middle of all that any more.
One of the things I learned from working with AIDS organizations in the 90's is that the disease strikes at one person, but it usually manages to wound a larger group of people--the family and friends of the infected person. I've never fully experienced that until this roller coaster ride through cancer hell.
I'm not totally sure that this is that I set out to write when I decided to finally say something about Mom's passing. I think I really wanted to talk about memories and things. But this whole experience has been bottled up for so long, that it was starting to all run together in my mind. I really needed to get the story out first. I'm not through with this topic, for sure. I have a feeling that I'll be coming back to it for some time.
But, when I think of 2010, this is what I think of.