We were in the hospital. Mom was in the hospital. I was merely her loyal sidekick, accompanying her for the sake of bad jokes, fussing, and ordering the staff around.
“Your mom swallowed or took a bite out of some soap,” the night nurse from Mom’s memory care home had said over the phone at eight o’clock that night. “Her face is swelling from some sort of reaction. I called the ambulance.”
I heard reaction while lounging in my pajamas waiting for the NBA Finals game to be broadcast, and casually thought mosquito bite.
“OK. Tell me where they’re taking her and I’ll meet her there.”
A few device chargers later, I arrived at the hospital to find Mom in an altered state. Her lips had swollen like a Disney fish.
“Oh Mom,” I said in shock, cringing at the fear I found pooling in her eyes. And some hatred too. For Mom, my presence in a strange environment was cause for even greater confusion and an anxiety she could not articulate.
I tried to respond with a pair of kind eyes, but a mom was a mom was a mom. She knew when I was lying.
Mom struggled mightily to breath for the next minutes while I engaged in several consults with ER doctors and respiratory therapists, nurses and registration. Admission stuff was hard work. For everyone.
“Well, we’re between a rock and hard place,” the ER doc confessed quietly as he explained the order of events that would take place. First, sedation. Then a nose probe, then a breathing tube if they could get that down her throat. If that didn’t work and Mom’s throat was too swollen, an emergency tracheotomy was typically advised next. “Do you understand how severe this is?”
I was still thinking mosquito bite. Not angioendema swelling. After earning my expertise in caregiving for leukemia, cancer, Parkinson’s and Alzheimer’s, I was on my way towards developing an unwanted, but warranted, interest in respiratory care.
After the acute event of the nose probe and successful intubation of a breathing tube, I took stock in the What if. What if the nose probe/intubation hadn’t worked? Any procedure with the word emergency in front of it constituted a life-saving measure. Mom had a DNR on file. Where was the line? Had I already crossed it?
Approaching 48 hours in the ICU, Mom’s breathing tube stayed in place. Her body had not responded to the typical treatment of steroids and Benadryl (I asked for her share instead).
I sat at Mom’s beside and wept. Nurses stood behind me to enter data or hang IV’s. Chaplains came and went. The palliative care team visited frequently. I practiced more chair yoga in a day than a senior citizen could practice in a year.
The gravity of the situation was not without consideration. Leave the tube in too long, there was a greater risk of infection. Remove the tube too soon and leave it up to Mom’s devices and the Universe, and then what? Then what?
I had run through the DNR instructions multiple times with multiple doctors, palliative care teams and men and women in collars. I had run through that obstacle course a dozen times in my head. But never in my heart. Never as the instructions had appeared right in front of me.
She and I, mostly Mom, were on a collision course with the future. And the future might not like what it saw. Or maybe that was just me.
I had traveled the road of bodily decline with a first husband who died of cancer. I was keenly aware of the potholes and turnoffs and rest stops and blue signs for attractions along the way. But, my past experience didn’t make the situation easier. In fact, decisions became more complex. As the POA for my husband, we had discussed his wants. As the POA for a parent, family members were involved. My mother had dementia. At no time in the past four to five years would my mother have confirmed what she first articulated in her will.
And now, what was her destination other than death or the relentless routine of recovery. Meds. Doctors. PT’s. Eating on her own again. Walking. Walking. Walking. Sleeping. Sitting Outside. Wheelchair? Yes, no, maybe. Soft mechanical? Yes, no, maybe. Return to her home at Arden Courts? Yes, no, maybe. Recognizing me? Yes, no, maybe.
Those were the dilemmas not written into the DNR. They were the small ones that ate away at my signature and hers. The big ones were easy to make, even obvious when the time came. But how many little dilemmas were insignificant if taken separately, and when added together, constituted a violation of Mom’s wishes?
A new medication was ordered and administered. IF it worked, we would see immediate, detectable results. And if the medication produced even more measurable results, the doctors would remove the tube and allow Mom to breathe on her own.
After five hours, the doctor appeared. He entered quietly while I typed, but he didn’t fool anyone. I sent him good vibes via my laptop, wrote good vibes, good vibes, good vibes, like a child punished to the chalkboard. Then I stopped typing, because if the doctor could hear anything, I wanted him to hear the slightest sigh.
A slight man, he looked up at me, a hint of sunlight captured in his dark brown eyes. “I heard a gurgle.”
“We’ve got a gurgle?” I asked once more, as if the doctor had just delivered a healthy baby girl.
There was much joy. There was more waiting. Overnight. Early morning.
It’s still the same old story / a fight for love and glory / a case of do or die.
I had played so much damn Sinatra already, the walls had started to cave and the ceiling begun to drop.
But, we got a gurgle.
After the doctor’s pronouncement, I had sighed so long my laptop screened turned foggy. Despite my Cincinnallergies, I exhaled more fully too.
After all, I had been only one breath away from saying, “Yes, those are her wishes.”
Next Week: More about the soap!