I haven't blogged in ages, I haven't really spoken in ages, in real life or online. The old 'weird' became the new 'norm', life carries on, we simply adjust and adapt and that becomes the way of life.
Questions of mum's health or well-being have been met with an almost unbroken six month continual answer of...'Ok, not brilliant but, Ok.' This has been the genuine and only stock answer up until yesterday.
Yesterday my honest answer would have been, 'She needs to go to Hospital'.
The carer called, the paramedics were called, well - that was when I got pretty much nowhere with GP out-of-hours and had no choice. It just got to the point where someone, anyone had to be called.
She had spent the day...and the previous night, feeling nauseous and was retching a lot, burping constantly and couldn't get down fluids easily, couldn't take medication at all and last night...was producing frank blood from her mouth and nose all mixed in with saliva and juices from an empty tummy. Breathlessness was coming and going and it was frightening.
Her carer called and I told her to call 999, after a fruitless call to out-of-hours that is. I then called my sister and we all - somewhat slowly in the snow - descended upon my mum from our various locations. She was extremely unimpressed. Once we had all converged we spent an hour trying to convince her to go with the Paramedics to hospital. We tried everything, every trick in the book - from logical common sense to emotional blackmail - she was having none of it. She wasn't going, end of story, don't tell me what to do, don't tell me what I can or can't remember (she has Alzheimer's). I am not going, you can not compel me. I'm staying here, it's my choice.
Can't argue with that, eh? She could have so done with IV fluids and an anti-emetic jab but, No - she was going nowhere.
The carer left. After doing observations that (it almost annoys me to say) were A* exemplary, and writing a huge report and giving us some top notch advice, the paramedics left (they were brilliant).
After settling her in bed and feeling confused, worried, helpless we, the family, left.
I slept fitfully. Quietly and unspoken to anyone, I was expecting the morning carer to ring and say she had passed in her sleep.
She didn't pass this morning, I hasten to add, and after staying on the line listening to, 'We are busy but, your call is important' for a considerable time (I managed to do a wee and then have a cigarette out the back while the dog did his business, clear up the dogs business and then have a conversation with my teenager about how, once an adult, snow does not mean you get an automatic day off) I finally got through to the GP surgery to ask for a home visit.
I showered and off I went. The morning carer was waiting for me to arrive, bless her, before she left. She had made mum a coffee but, mum couldn't drink it. Mum managed half a cigarette and that was it. I managed to get her to take her morphine tab and then get her cozy on the sofa. Her house was tropical but, she was freezing, shaking. She wiped her mouth at one point and more frank blood was evident, not a lot but, it was there. She was extremely thirsty. For a woman who had not drunk anything, anything but, coffee for the last X amount of years she was drinking cold milk (wanted it as cold as pos) water - and squash after I had gone to town to get some.
I checked upstairs and there was evidence of more saliva mixed blood on her pillow. Her fatigue was immense, the slightest movement causing breathlessness and groans. Drink, rest, drink, rest, drink.... We would talk to her and mid conversation her eyes would roll and she would be asleep, unresponsive, for a second before coming back round. She struggled to wee, she was burping and clearing her throat constantly - and she looked like she was dying.
At one point the carer and I were spying on her and it looked to me like she wasn't breathing. Well, she must have looked like she wasn't breathing to the carer as well as we both leaned forward together, shoulder to shoulder. At that point mum took a deep breath and we then noticed that the other had done the same and withdrew, quietly giggling at each other.
The absurdity and tension of the situation coming out in little giggles.
My sister and I manged to do housework, clothes washing, drive/path clearing - anything to keep us busy really until the Doctor came. Obviously in between many, many requests from mum for more fluids.
He knows my mum and he knows us. He told us what we did, and didn't, want to hear.
Basically, Mop her up and make her feel comfortable
That was it. He told us off in the kindest possible way. 'Yes, I know you are both hurting and frustrated and angry and helpless and worried but, your mum wants nothing. No investigations, no intrusive interventions, no mucking about with, no fuss. She wants to go nowhere, she wants to see no one but those who care for her. She is clear in what she wants, she has capacity. It is what she wants.'
*Speechless*
*Again*
He gave her an anti-emetic and did a script for Fentanyl patches which I picked up 'Just in case'. He is back on Wednesday.
So, mop her up and keep her comfortable. Oh my gosh.
Looking around the house after, I felt that I should have seen this coming. I had gotten used to chucking all the food I bought but, I also knew she was yumming the odd trifle - all the trifles were still there. I buy her a pack of 200 fags a week (after I had told her that she must cut down from 300 a week as it was bankrupting her) and 300 still remained today of which stark reduction speaks volumes for the committed nicotine addict that she is. I hadn't noticed over the week that, not only had her food consumption stopped but, her coffee and nicotine consumption had reduced significantly too.
The GP nearly feinted when I told him she had smoked half a cigarette all day.
I cancelled the night carer as she wanted to go to bed early, she had most of her tablets and I spent time moving the hot water bottle strategically around her bed before she got in. The intermittent breathlessness apparent.
I settled her in and made sure she had a sick bowl, the care alarm and some squash and tissues to hand...and I left.
Back again tomorrow.
How long? How much? How will it go? How bad will it be? What is going to happen..? With no treatment, no intervention, no mechanical or surgical relief, just pain management.
I can't help but be certain that this is the beginning of the end.
