Wednesday, March 2, 2016

A Lot To Process...a final lesson from my mother

A few months ago, I wrote a post about my mother’s diagnosis of late-stage ovarian cancer and how she was battling the beast.  She and I shared this “sixth sense” that her time was short…but I had no clue how little time we truly had left.  I have to admit, when my always stoic and positive mother began to tell me “I really feel bad today”…or “It’s not going well”…I thought, “Her attitude is not helping!”  After all, everyone tells you that “attitude is half the battle” with cancer…right?

But when the oncologist stopped chemotherapy after the 2nd treatment, noting that the blood work indicated that the cancer was spreading, I found myself feeling discouraged…and I knew that Mother felt that, too.  When she visited a surgeon, and he outlined how risky – and ineffective – “debulging” would be in her case, I felt her disappointment and despair, as hopes for beating this were somewhat dashed.

We tried to look on the bright side…cessation of the chemo treatments meant that Mother would hopefully feel well enough to join the rest of our family for a Thanksgiving meal at our house…and for our Christmas Eve celebration.  And indeed, Mother was able to come to both events.  She mostly sat quietly in one of our club chairs in the living room – or at the dining table…but she engaged in conversation, and she delighted in her great-grandchildren, who kept everything lively.

Mother was able to attend the children’s Christmas program at church – and a play that Timothy’s first grade class performed shortly before Christmas break.  The classmates presented “The True Story of Rudolph” – and our Timothy was Rudolph.  Mother and Lee attended, along with other family members – Mother sporting a red and white “Santa” cap…and Lee wearing a felt “elf” cap.  Timothy never questioned their attire.  In fact, none of our children ever asked about Mother’s wig or her caps throughout the entirety of her illness, as far as I know.  Timothy even visited her in the hospital once when she was wearing no cap or wig…and he didn’t say a word.

My mother decided that her only hope might lie at M.D. Anderson in Houston.  So she secured an appointment there for a “work-up” on January 6th.  She and her husband, Lee, planned to get in their motorhome on Monday, January 4th and set out for Houston…taking 2 days to arrive.  This was the earliest available appointment that would not be interrupted by the holidays…meaning Mother waited almost 3 weeks without any treatments whatsoever.  During that time, she developed pneumonia, which was treated with strong antibiotics…and she grew visibly weaker.

Even though I talked to my mother virtually every day – and exchanged e-mail messages several times – she kept us all somewhat “on the fringe” about her illness. She would drop hints that she did not think that she was getting well – or that she would beat her disease.  But for the most part, she talked of the future.  She wrote a blog post about how she was unable to do anything for Thanksgiving…but next year she hoped to pick back up her apron and host again.  And she waffle between talking of getting weaker – and planning her next RV adventure or writing assignment.

So I would think, “Girl, you are being melodramatic.  Your imagination is working overtime.  Mother will beat this!  You’ll see…this time next year, she will be traveling and hosting family dinners and playing in the back yard with the kiddos.”  But when I hugged her as she left our house on Christmas Eve, and she began to quietly cry, I knew something was terribly wrong.

In addition to the concern over my mother, my husband’s brother and sister-in-law were involved in a terrible head-on car crash on December 21st.  My brother-in-law suffered massive internal injuries from the seat belt that resulted in four bowel resection surgeries in three days.  He was transported to a trauma ICU in Little Rock a few hours after the wreck, where a surgical team met the ambulance and whisked him off to begin repairing the damage.  Thankfully, his wife suffered only bruising and a broken pinky finger; however, she was in pain – and shock – and needed medication for quite some time afterward to allow her to take deep breaths and ward off pneumonia.

Just as we entered the week of Christmas, I contracted an upper respiratory virus that knocked me to my knees. So one day while Greg took his mother to Little Rock to see his brother at the hospital, the cat and I stayed on the couch under a blanket and tried to recuperate.  I finally decided that the lovely sit-down ham dinner with all the trimmings I had planned to prepare for our family on Christmas Eve would be a health hazard in more ways than one.  My mother graciously offered to treat us to pizza…and it was such a hit (served on festive paper plates) that I think this will become a new holiday tradition.

Greg's mother and his brother, Bruce
July 2015
Greg and his mother and I traveled to Little Rock on Christmas Day to visit his brother in the hospital.  He was sedated and never knew we were there. He had suffered a stroke the day before, and doctors were monitoring him closely for long-term effects.  The day after we visited, my niece telephoned and let Greg speak to his brother via speakerphone.  It was music to Greg’s ears.  Maybe his brother had turned a corner!

We visited again the following week, after my brother-in-law was transferred out of ICU to a regular room.  He passed a swallow test and cognitive exams, and though he was weak and very sore from all of the surgeries, plans were made to transport him the following day (Day 10) to a rehab in a city closer to home.  There he would work on regaining his strength and energy to care for himself and his personal needs at home.

However, things took an ugly turn after we left that day.  My brother-in-law became nauseous, then he suffered three bouts of cardiac arrest…and before 7:00 the next morning, he had passed away.  We knew blood clots, stroke and cardiac arrest were all possible side effects following surgery – this is the very thing that claimed my dad’s life following a surgery 16 years ago.  But we were still shaken.  My brother-in-law was less than one month shy of his 67th birthday.

So as we dealt with the sudden death of Greg’s brother, GREG succumbed to the respiratory virus…and my mother’s general health decline continued.  I had insisted on accompanying Mother and her husband earlier in the week to her clinic, where her doctor (who happens to be a close friend of mine) did a follow-up exam for Mother’s pneumonia.  He determined that she seemed to be clear of infection; however, he surmised that tumor growth was pressing on Mother’s lungs, preventing her from getting adequate breaths.  I could see that Mother felt very weak and tired…and she was struggling to breathe.  She also seemed unsteady on her feet.

I point-blank asked my friend if he thought that Mother was okay to travel to Houston the following Monday (this was Tuesday).  He told me, “I am not comfortable with her making that trip…BUT…her only hope is if they can do something for her at M.D. Anderson.”  He went on to say that he suspected that the doctors there would recommend “debulging” – surgery to remove the tumors that had grown and were pressing on Mother’s lungs and other organs.  My friend left the room, and I looked from Mother to her husband and asked, “If the doctors in Houston recommend surgery, are you going to do it?”  They both shook their heads in the negative and firmly said, “We’re not doing that.”  I silently wondered why they were still planning this trip.  And I told God, “I cannot fix this.  If Mother is not able to make this trip, YOU will have to step in and do something.”

New Year’s Day…the day after my brother-in-law died…I stopped at my mother’s house to check on her.  It was 10:30 a.m., and her husband said she was still asleep.  However, as I made my way to her bedroom, she stumbled toward me.  I watched as she staggered into the kitchen…fell into the refrigerator…then staggered to a cabinet, where she began to prepare a large bowl of cereal – sugary frosted mini-wheats.   This was not really a good breakfast for a diabetic, but Mother HAD said that at this point, the doctors said to eat whatever tastes good.  I asked if she could carry this bowl of cereal and milk to the table, and her husband stepped in and carried it for her.  Mother staggered once again…fell into the wall, and made her way to the dining table.  She trembled as she ate her cereal, and she was visibly disoriented and distracted.

I was concerned about what I observed, and I phoned my sister to let her know how I had found our mother.  My sister stopped in to see Mother on her way to work that evening, and she found her even more disoriented, in pain, wheezing, and running a high fever.  Mother’s husband was in their motorhome out in the yard, and Mother had been so confused that she could not dial his cell phone.  She was walking through the house carrying the mouse to her computer…she thought it was her cordless phone.

My sister and I got in touch with the doctor, and he told us to take Mother to the Emergency Room at the hospital.  It took me a while to get her there…she wanted to take time to shower!…but I finally got her in my car and drove her across town to our local hospital.  We put her in a wheelchair and rolled her into the Emergency Department, where a nurse triaged her and took all of her vital information.  Mother was able to answer questions about her medications, treatments, and more.

Then Mother was admitted to an exam room, where our favorite ER doctor (a high school classmate) was on duty.  He ordered blood work and a chest x-ray.  After the blood work had been processed, a nurse came flying into the room with orange juice, crackers and peanut butter, and she began to feed Mother. “Your blood sugar is 30!” she declared.  The doctor explained that with a blood sugar level of 30, most people cannot walk or talk…much less make any sense!  A subsequent blood test indicated that Mother’s glucose level was dipping even lower – the reading was 17.

The doctor said he could not let Mother leave the hospital with such a seriously low blood sugar level.  By all rights, she should have been comatose at this point.  He looked at Mother and said, “You are exceptional.”  Well, we all knew that!  He also said that the fever indicated infection somewhere in her body.  So six hours after we entered the Emergency Room, my mother was admitted to a hospital room, where IV glucose and antibiotics were begun.  It was determined that Mother had virtually stopped eating when she got pneumonia…but she was still taking medication for diabetes…and that bottomed out her blood sugar.  The medication was immediately ceased.

Knowing that I was exhausted from the virus I was just getting over AND the death of Greg’s brother, my sister left work and declared that she would sit with Mother overnight.  And she did…and for several more nights to follow.  I returned the following morning and met with the hospitalist, who ordered a complete round of tests for my mother…head-to-toe CT-scan…more blood work and x-rays. He told me, “She will not be going anywhere until at least Monday morning, and only IF she is 100% stable will I allow her to travel to Houston.” Mother continued to run fever and was not responding to the constant administration of glucose.  Her blood sugar level continued to be far too low.

By evening, the report on the CT-scan was in, and it was not good.  The tumors had almost doubled in size since late September.  One that was 10 cm in September was now 17 cm…and pressing on her lungs.  Another was pressing on the adrenal gland to her kidneys and causing her serious back pain.  And the fever was keeping Mother in a stupor.  She was hallucinating and “talking out of her head.”  A nurse suggested to my sister that perhaps it was time for Hospice care.

Sunday morning – January 3rd…the day of my brother-in-law’s funeral, I awoke EARLY.  I was back at the hospital by 5:30 a.m., sitting with my mother. When the hospitalist examined her mid-morning, we stepped outside to talk, and I asked her about Hospice care.  She said, “I think that is a wise choice at this point.”  Mother was clear enough for us to discuss this with her, and she said, “Yes, that is what I want.  I want this to be over.”  She said these words to me twice…“I want this to be over.”  She also said, “I want to go home.”

I asked the doctor if she felt I had time to attend my brother-in-law’s funeral.  She told me that she felt sure that I had time for that…but that Mother probably didn’t have many days left.  She encourage me to go and be with Greg and his family.  So a dear friend of Mother’s sat with her – and Mother’s husband – and I spent most of that day saying “Good-bye” to Greg’s brother.  It was an extremely hard day for all of us.  The Hospice team agreed to wait until I returned to the hospital late that afternoon to come out and start their paper work.

Monday morning, we made the final preparations to move Mother home.  It was January 4th. Christmas and New Year’s had come and gone, and it was all a blur for Greg and me.  He would still plug in all of the Christmas lights on our trees and decorations, so I came home at night to a warm and cozy house.  But the joy and excitement of the holidays had certainly come and gone for us now.

We got Mother settled in a hospital bed in her living room at home.  Her doctor told me, “I don’t think she will be on Hospice long.”  The nurses at the hospital whispered that it would probably be “only a few days,” and Mother’s doctor concurred.  Tuesday, two of Mother’s step-daughters arrived from Tennessee, along with other family members.  Both women are nurses…one a Registered Nurse, and the other a Nurse Practitioner.  They were life-savers.  They helped my sister and me with Mother’s care…and they helped their dad to come to grips with the fact that Mother was dying and would not recover.

It was a long week.  We were busy every day with helping Mother turn in bed, sit up, get to the bathroom and to the table for a few bites at mealtime.  She was so swollen and distended that she breathed better sitting upright.  So often, we would help her to a couch and sit with her.  Mother knew from the outset that she had very little time, and she was quite practical about it all.  One evening as I sat with her on the couch, she asked about Greg’s mother.  Having lost a son herself, my mother knew that indescribable heartache that she said was like no other.  I told her that Greg’s mother was doing okay.  Mother said, “She’s a strong woman.”  “So are you!” I reminded her.  “Well! There’s no other way to be!” she retorted.  She then asked about Greg.  I told her we were doing okay, and she said, “You and Greg both have a lot to process.”  I couldn’t hide my tears, and I didn’t even try.

Several times in the hospital – and in the days at home – I kissed my mother, held her close, and cried.  I couldn’t stop the tears…and we shared several tender, precious moments.  I told her at least once, “It is so hard to leave you.”  And by late in the week, I was staying virtually around the clock.  My sister still came in and out through the day, and she stayed at night, but I slept in my old bedroom…or I would doze on a couch near Mother.

My mother last spoke to me in the night of January 10th.  One of the last things she told me was, “I love you so much.”  Over the course of that ten days, we had more than said everything we needed.  We understood one another, what was happening, and what Mother’s wishes were.  At times, she would say funny things…other times she made little to no sense.  Once, when I excused myself to go to the bathroom, she sarcastically said, “GREAT!  Good for you!”  She hated her catheter!  And then a couple of days later when she was too weak to walk to the bathroom, she said, “I’ve decided this catheter is my friend!”

Timothy and my mother, August 2015
When my sister and I tried to walk Mother across the room to a couch, my sister became tangled in the dozens of feet of tubing, and Mother quipped, “I’m okay!  You just choked me with the oxygen…but I’m okay!”  My niece brought her three children to visit, and Mother loved hearing them play on the sun porch…the “ring-ring” of their tricycle bell, and the “quack quack” of some duck-billed noisemakers she had for them.  One by one, they would inch up to her bed and talk to her.  Four-year-old Zola even insisted on giving her kisses.

The Friday before Mother passed, my niece brought 3-year-old Nathan and stayed much of the afternoon.  Nathan played and “did his thing,” just like it was an ordinary “Friday at Granny’s” from back in August/September.  I commented to Mother that it was just like a regular “Friday with Granny” for him…and she added…”except this time I don’t have to watch him by myself!”  She also whispered to me one day as I lifted her from the bed, “I have probably done permanent damage to your body with this lifting.”  I assured her that I would be just fine…and I am.

Monday morning, I woke early and slipped out of the house and drove across town to my own home.  I took a shower and gathered clean clothes, repacked my bags, and returned.  Mother smiled at me when she saw me…but by noon, she was virtually comatose and did not respond to anything or anyone except to grumble in pain when we turned her.  After everyone went to bed that night, I sat with her as she tossed and turned and “talked”.  Her fever soared to 103.3 degrees, and she was terribly swollen and clammy.

I woke my step-sister, Suzanne (the R.N.), and she helped us ice Mother down with zip-loc bags filled with crushed ice and wrapped in towels.  We placed them under her arms and along her legs, and her temperature dropped by a good two degrees.  But we had to keep cooling her down for hours.  The next morning, a Hospice aide came to bathe Mother and dress her in a clean gown.  About 11:00, a dear cousin who was very close to Mother came for a visit.  She leaned in and talked to her, and then we stood beside Mother’s bed and caught up on the family and recalled memories of fun times we had shared.  I looked down at Mother, and her breathing had changed markedly.  Step-sister Suzanne noticed it, too, and ran to get her dad.

In a few brief minutes, my mother had stopped breathing and drifted away from us.  We kissed her and released her to go with the angels…to greet my dad and brother and others…and to meet Jesus face-to-face.  And she did exactly that.

The days have been a whirlwind and a blur since then.  People think that everything is over when you leave the cemetery.  In many ways, it’s just beginning.  There are business matters to attend to…thank-you notes to write…bills to pay…people to greet and entertain…and lots and lots of things to “process.” I finally took down our Christmas decorations on January 18th. My mother was a very wise woman in many ways…but probably the most profound statement she has made to me in years was that, “You and Greg have a lot to process.”  And we are still trying to do that.

In Mother’s last days, I continued to write my devotionals – when I could.  I missed a few days, but not all of them.  It was cathartic for me to spend time in reflection and Bible study…to pray about what to say…and to share my heart.  I posted an update each day on Facebook – the easiest way to answer everyone’s questions.  My mother had a LOT of friends and people who loved her, and they all wanted to know what was happening.  So I would write a “report.”  People would comment…and until Mother could no longer respond to us, we read her each and every word.  It was like hearing your funeral before you die.  Mother would tell me who certain people were when I didn’t recognize a name.  She would laugh and smile at the comments of her former kindergarten students.  One of her piano students said, “Tell her I wish I had practiced more.”  Mother said, “Write back and tell her there is still time!”

I am grateful for the gift of writing to be able to sort out my thoughts – to “process” what has happened.  I thought I understood grief.  The nineties were a great time of loss for my family, beginning with my father-in-law in 1992…my favorite great-aunt in 1993, then my maternal grandmother in 1994…a beloved cousin in 1997, another cousin and my baby brother in 1998…and my dad’s passing 13 months later in 1999.  Surely I had a handle on this!  Well, that’s baloney!  Each loss is different and leaves its own mark…and these two recent deaths have been a swift kick in the gut!

A friend told me that there are losses in life…but there is nothing that compares to losing your mother.  She was right!  In the last eleven days, I’ve thought of dozens of things that “I must remember to tell Mother.”  I’ve opened my e-mail account and anticipated her message…the report on her Sunday morning at church…what she and Lee watched on “Netflick” the night before.  I saw a friend’s Facebook post of pictures he took this past week in Yellowstone National Park – a place my mother adored, and where she and Lee spent last summer as Workampers…and I thought, “Mother would love that!”  Then I realized…she can visit there anytime she likes now.

In a devotional I wrote shortly after Mother died, I spoke of grief.  Greg and I took his mother to the cemeteries today to visit the graves of our brother…and my mother. January 23rd would have been my brother-in-law’s 67th birthday.  His birthday was our first time back at the cemeteries since the funerals.  I am not hiding from grief this time…or running away from it.  As I said in my devotional, to do so seems to say to God, “I don’t need you – I’ve got this!”  And nothing could be further from the truth.  God wants to console us.  He wants us to lean on Him and let Him do the hard work.  He wants us to cry out to Him when it all seems to be too much.  God wants us to let Him help us process all of this.

I don’t know how long it will take…or if I will ever be the same.  And that’s okay.  I know that I had an extraordinary mother who loved me as best she could.  Like any human being, she made mistakes…and she told me often that she had many regrets about her efforts to rear three children.  I assured her that it was all over and done…that everything was “good” between us. And I know that today, everything is better than good for her.  She is with Jesus…and my dad and brother and her best dogs, Spot, Otis and Carmen…and she is healthy and whole and tumor free…and “life” is very, very good.

And life will be good for us again at some point…until it is our turn to join the heavenly party, when it will rise to a whole other level!  Meanwhile, we will keep on processing all that has happened…all that will happen in the days/weeks/years to come.  And we will remember the lessons of our mothers…and fathers…brothers and others.  And with God’s help and grace, we will work through it all.

1 comment:

Kaye Swain said...

I just popped over to visit and discovered what had happened. I'm so sorry you've had such a difficult and dark season of life. But so grateful that your faith is strong and know you are clinging to our Good Shepherd. Praying for continued comfort and encouragement for you and your family in and through our precious Savior.