Sunday, August 30, 2009

The Watch Continues...

Since Mamo is extremely lethargic and isn't in the correct frame of mind to declare whether or not she wants to revoke or amend that document stating she did NOT want dialysis, the doctor asked the family if she had ever generated a "Living Will", which lo-and-behold she had--- and in it she stated that in the case such as the present one she did not wish to be kept alive by "aggressive measures such as defibrillation, a ventilator, or a feeding tube."

Unfortunately, it was just vague enough to make deciphering whether "aggressive measures" included dialysis or not. Dialysis wasn't mentioned.

So.....the doctor stated he "would do whatever all three siblings agreed upon". My mother and her sister again deferred to my uncle, who demanded that the dialysis proceed.

And so, they put in a temporary AV-shunt and proceeded with dialysis. My grandmother couldn't tolerate the whole 4 hours of dialysis the first day, and so they performed it again on the second day..... and again on the third day.....

Each time she emerges from dialysis she appears utterly and completely exhausted, barely able to open her mouth to accept food (eating less and less each day) and she does not appear to recognize people at times. And she sleeps almost totally round the clock.

Due to the fact that nobody can predict how long the dialysis will keep her alive, much of the family has gone home to wait it out. My mother and I were the last hold-outs, but we finally left today. I have got to catch a train soon and have got to get back to Kansas for some doctors' appointments which I must attend before my trip to Dallas in the third week of September.

So my mother and I left Lousiana today and are back at her house in Texas. But we stopped by the hospital before we left. My uncle is sitting vigil by Mamo's bedside. We were able to see Mamo for a few minutes before the nurse took her away to receive an IV infusion of 4 units of Packed Red Blood Cells, which shocked the hell out of me.

FOUR UNITS???? She must be so anemic that you can practically see through her. But I am wondering why they are infusing the PRBC's before the platelets that she needs, since her platelet level is desperately low. So low, in fact, that she's been bleeding steadily from skin tears and that area around her jugular where they placed the temporary AV shunt.

And she looked.....deathlike. I am amazed that she has lasted this long. And I have come to the conclusion that she is struggling mightily to live. I don't think she wants to leave my uncle, who has lived with her for his entire 64 years of life (except for 6 months in the military and a few other odd, short periods.) He has always been "her baby boy". The bond between them is so strong that I think she doesn't want to go---due to her worrying about who will take care of him when she's gone.

Anyway, I am exhausted, as is my mother. In fact, I am so exhausted that I did not even yell back when one of my cousins yelled at me for my opinion that the dialysis should not have been instituted. (Remember, my mother and I were of the opinion that the dialysis should not have been instituted on a 90-year old in kidney failure, heart failure, and other health problems.)

The... uh.... person (I'm going to refrain from calling her a bad name here) had apparently been building up her resentment towards my mother and myself over the last few days--- since she worships her dad (my uncle) and doesn't believe that he could ever be "wrong" about anything. And then yesterday morning at the breakfast table I had innocently remarked: "Mother says that Mamo is eating less and less each day". To which my cousin SCREAMED HIDEOUSLY into my shocked face: "When she was fed this morning, she ate almost a WHOLE BOWL of oatmeal!!!"

You know, I must have matured in my life. Because if this had been 5 (or even 2) years ago, I would have totally gone off on her and informed her at the top of my own lungs, accompanied by some choice cuss words, that EATING OATMEAL DOES NOT CONSITUTE A CURE FOR TERMINAL RENAL FAILURE. (And I might have called her a couple choice names....if you get my drift.)

But I didn't say anything. I simply let it go and wandered into the living room. I did not want to make a bad situation worse.

And I feel good that I did that. Because if I had gone off on her, I would have totally regretted it and it would have hurt family relations.

Sigh....and so we wait....

And I ain't sending that particular cousin a Christmas card this year...




danielle said...

I think your grandma is allowing your uncle time to come to grips with this. When I worked onco - many times people hung on until they knew that their family was ready to say goodbye. And if he is her 'baby boy' she is waiting for him to be ready.
And Bo - congrats on your maturity!!!!

Cat said...

It's sad when a stressful time leads to blow ups like that. You did good, Bo, we are all praying and thinking good thoughts for you, take care of yourself. We are thinking of you.

(But, yeah, you can skip the Christmas card...)


Charlotte said...

Mamo may be choosing her own way of leaving you when she eats less and less. Eventually, she'll die from starvation BUT she will have had the dialysis her baby boy wanted her to have. I had an aunt who ended up starving herself in order to die because, I think, she was broken-hearted by the treatment her only daughter gave her and the fact that she had leukemia. When encouraged to eat, she'd say it hurt her stomach.