Stop and listen…

23 Jan

Sunday December 22, 2013

I’m a very habitual person, much to my dismay at times. After I got back to Mom’s place on Saturday night, bathed her dogs, drank a glass of wine, I called Mom one last time before hitting the hay to check in on her and assure her that her beloved puppies were well cared for and all was good.

As per habit, I turned off the volume on my iPhone. I’m a firm believer that there should be no technology interruptions that would impede my sleep.

So I missed my mother’s frantic call just before 7am. There were only two words on that message and I can hear them still.

“Emergency… Emergency…”

Then the line goes dead. My sister had been texting me since about 6am – she had tried to call Mom and couldn’t get through. She finally got to the nurse’s desk and found out Mom was being rushed to surgery. Her call to me meant she was scared and needed me.

I started to panic. It took just a couple minutes to reach her doctor who told me she woke around 4am with pain in her left hand and then no feeling. They determined she had developed a blood clot and it traveled to her left arm where it lodged in one of the smaller veins. They’d have to perform emergency surgery to remove the clot. They had her prepped and ready for the operating room.

I didn’t bother showering – just brushed my teeth and took off for the hospital. Inside, my inner self was pacing and confused. Outside, I appeared calm. Once again, I wasn’t there when she needed me. Had my phone been on, I would have been able to tell her it was going to be okay, that I was on my way, that we were in this together and I would take care of her. But instead, her call was met with my voicemail. She was alone.

This is now Sunday, December 22. My sister, who lives in Southern California, and I kept in constant contact during surgery. When the vascular surgeon was done, he came out and talked to me. He filled in the details behind what happened over night, and what they needed to do to remove the clot. Bottom line, the surgery went very well, Mom was doing well. They would be moving her shortly out of recovery and into the Intensive Care Unit.

I’m not a religious person but I believe in a higher being and purpose to life. I posted a message on my Facebook page asking all my friends to pray for my mother, many of whom knew her personally. The outpouring of love and support for us was a huge comfort.

Just before they settled Mom into her ICU room, the surgeon came back to talk to me. He felt it best to keep Mom intubated and sedated, given the congestive heart failure. She was on a ventilator. He explained the aggressive therapies that were needed. Careful balance of Lasix to remove the fluids, and Heparin to keep the blood flowing. The catch 22 is that the more the blood flows, the more fluids can be retained. And in places like her lungs. So the ventilator was a good idea – until I saw her.

Mom was sedated but not asleep. She kept trying to remove the vent, which is a huge foreign tube inserted into her mouth and down her throat. It’s held on her face with clamps. Her wrists are restrained. She writhes in bed and cannot make any sounds whatsoever. I’m beyond myself at this point. I call her nurse to up the sedation – I refuse to see her uncomfortable. The doctor comes in and advises me that in elderly patients, after general anesthesia, to be sedated more fully will make it harder for her to recover from the dementia.

Wait… What?

He was trying to explain that she could have serious complications with her brain. Coming out of a traumatic event, and being in the ICU, where there is sensory and light/dark deprivation, constant interruptions to sleeping patterns, and stress, puts a strain on the brain and causes delirium. It might take her longer to recover.

“I think the risk/benefit here is worth it. I want her as comfortable as possible.” I also may have mentioned that I was her healthcare agent and that since she couldn’t state her wishes, I would. She would NOT want to be lightly sedated with a tube down her throat.

The vent would have to remain in for 24 hours, enough time for her body to begin the surgery recovery. I called Sandy and Greg (my siblings) and delivered the news. Up to this point, we all had expected a couple days inpatient to stabilize her – now with the surgery, and intubation, this was even more serious and the sibs should come. My sister would drive up first thing Monday morning and my brother would fly in Tuesday morning.

I hated seeing my mother like that. The image of her discomfort and lying helplessly in the ICU on a ventilator will forever be etched into my brain. I left that night at the urging of the ICU nurses who reminded me that I had to take care of myself as well. The doctors would remove the vent around 8a Monday. I wanted to be there as she was coming out of the sedation to keep her calm. Everything the nurses explained about the process had me worried she’d be out of her mind with fear.

I didn’t sleep much again that night, but being in her house, with her dogs, her things, made me feel like she was there with me. I woke early, showered, and was back in the ICU by 7:30am. Mom was coming out of the sedation state and aware for the first time of her surroundings. She struggled against her restraints. I calmly and gently explained what was going on, to keep her relaxed, and that we needed her calm and once she was fully awake, we’d be able to remove that pesky ventilator. Mom’s agitation grew.

The nurses gently asked me to leave the room, that I might be making it more scary for her. I agreed – I just wanted Mom to be okay. I went back in to tell Mom they needed me to sign some papers, and she tried to tell me something. Her eyes were frantic and she mouthed words around the tube. I couldn’t understand them. The nurses couldn’t either. I told her that in just a few minutes, she’d be able to tell me anything and everything – that I’d be right back.

After a short time, they let me back in the room. I greeted Mom with a kiss, hug and an “I love you so much”. I asked her what she was trying to tell me.

She said “I told you I didn’t want you to leave me.” I teared up, but knew I had to in order for the staff to do their jobs. I simply apologized and told her I will always be here for her. That’s when she told me what she knew. She said “I’m dying. You have to listen to me. I’m dying.”

I scoffed at that. “Of course you aren’t my love. The surgery was a huge success! You are going to be just fine!!”

But she knew better. If only I had listened. Paid attention more.

96 hours later, she’d be dead.

Halloween 2009 - being silly

Halloween 2009 – being silly

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