New Midlife Mommy

It's Over

My mom died.  That's so very hard to say.  I could never imagine it coming to pass.  But here it is.

They did move her from ICU, because she was doing so much better.  But, on Saturday, I received a call at around 8:00 in the morning.  It was her night nurse.  He told me that my mother was "coding."  I later learned that her respiration slowed down to nothing, and her heart stopped.  My mother always wanted efforts to be made if there was any hope.  So, we did not leave a DNR order for her.

I called my brother and my father.  My brother is about 45 minutes from the hospital.  I live an hour away.  Yet, I got there first.

Her room was empty.  I panicked.  Then I learned that they'd moved her back to ICU.  She was on a ventilator, because they didn't think she could breathe on her own quite yet.  She was a little confused when I saw her, and struggling to get out of the hand restraints that the nurses said were necessary to make sure she didn't pull out the breathing tube or the IVs.

Because it was the weekend, we were all able to stay without having to worry about calling work.  They threw us out before 2:00 to attend to her.  We were allowed to return from 4:00 to 8:00.  And we did.  And we did the same thing on Sunday, though we were limited to two people.  My father wanted to be there the whole time; my brother and I took shifts.

We watched my mom go downhill from Saturday morning until Sunday evening at 8:00 when we had to leave.  In the beginning, she was somewhat responsive.  At the end of the visiting day on Sunday, she seemed to be unresponsive.  The big problem was keeping her blood pressure up over 100.  If they could just do that, then they could start dialysis (her kidneys had stalled again).  I whispered in her ear that she needed to work on that before I left.

Until this point, the doctors had given us some hope, though all had said that she was in trouble.  Even though her liver values were in the normal range, she was having problems with her heart, lung, and kidneys, which they all believed was due to her liver problems.  And, she had developed an infection that was resistant to antibiotics.  They left me with the belief that Monday was the day that we would have to make a decision.

As it turned out, we didn't have to.  At 10:00 on Sunday evening, the nurse called and said that my mother's blood pressure had dropped, and none of the medications they were using to bring it back up were having any effect.  I asked if she was dying, and she said yes, that no one can live very long with a blood pressure as low as my mother had (generally, around 75/30).

We all returned.  After we got there, I asked how long she had, and the nurse told me it could be a couple of hours, or it could be a couple of days.  I immediately felt bad dragging my father back to the hospital.  We were all exhausted, but at 77, I imagine that it was more draining to him.

So, we sat.  And waited.  And watched the monitors.  The nurse brought in two additional recliner chairs so that we could try to get some sleep as we stayed with her.  I positioned my recliner next to her bed, so that I could lie next to her.  I jammed pillows above and below my hand, so that I could always be holding my mom's hand, even if I fell asleep.  It was the least I could do, and I know she would have done it for me.

I've mentioned that my mother and I have sometimes had a difficult relationship.  I was a brat when I was a teenager, and I rejected my parents as hopelessly irrelevant.  I didn't have much to do with then when I was in my 20's and 30's, mostly because I always seemed to be in night school.  But after I got married, things changed.  I realized just how wonderful my parents were, and we became very close.  That was over eight years ago.  But still, no one could push my buttons faster than my mom.  I would often yell at her.  She rarely yelled back.  I felt so badly about this, and I tried to talk with her about it before she went to ICU.  She dismissed it, saying that I had been a good daughter.  But, on Saturday, after my father went down to the cafeteria, I was able to tell my mother how much I really loved her, and how very, very sorry I was for ever treating her badly.  She wasn't perfect, but she was the very best mom I could have asked for.  I know that she heard me, because at that point she was still able to respond to us.

On that awful night, as I lay next to my mother, a wonderful thing happened.  Sleep escaped me, but I was bathed in the warmth of one wonderful memory after another.  Memories of just my mom and me, of our whole lives together.  Memories of childhood.  Memories of my wedding.  Memories of the last day we spent together, when she held me as I cried because I was worried about her slipping health.  She'd asked me then, "Do you believe in God?"  I told her of course I did.  "Well, then there's nothing to worry about then."  I think that on some level, she was trying to give me one final gift on her last night here on earth.  A gift of love.  To let me see that all was forgiven, that in the end, our true heart is all that matters.

At around 3:30, my mother's heart rate started fluctuating.  At 4:00, her heart just stopped.  It was over quickly.  We were told that she was not in any pain.

The doctors had already told me that my mother was not sick as a result of the cat bite.  Her main doctor told me that he used that as an excuse to get her into the hospital, because she was much sicker than she appeared.  In the end, I believe that she died of sepsis.  All along, the doctors had been talking to us about an infection in her body that she was trying to fend off.  It was just so low on my radar screen that I really didn't hear it.  I was worried about everything else.  But, sepsis probably caused her kidneys to fail and her blood pressure to drop.

Since then, we have just been performing our obligations.  Or, actually, I've been performing most of our obligations.  My father is feeling lost, because my mother always did everything for him.  My brother has expressed no preferences one way or another -- somehow, I find this incredibly annoying.  I have often felt overwhelmed since my mother left us.  I dread the thought of what kind of funeral she would have had if it were up to the two of them, instant indecision makers that they are.  I'm thankful that my mother drilled her history, my history, into my head.  It allowed me to answer the funeral home's questions easily.  We still have some decisions to make, but I guess we will talk about them tonight.  I think we will probably lay her to rest on Saturday, many miles away in a grave that is near her parents.

In a few minutes, I will start to get ready for the funeral home.  It will be the first time that I've seen my mom since early Monday morning.  I am dreading it.  I don't know how any of us will get through the visitation.  I wonder about stupid things, like whether I should even bother with makeup.  Because I've pretty much cried it all off every time I've put it on.

Lord help us all.  But most of all, please take good care of my mother.  We miss her so.  And mom, if you could, please leave me some kind of a sign to let me know that you live on.  Because that is the only thing that is keeping me going.  Hoping against hope that someday, I will see you again, healthy and whole.

My Heart Is On A See Saw

"They're moving me to ICU.  I don't have much longer."

That was the message that I received from my mother yesterday.  She called me at work from the hospital.  See saw down.

As it turned out, things weren't quite so dire, though they were still very bad.  They did move her to intensive care.  Her kidneys were shutting down.  Her heart was failing a bit.  And she could hardly breathe, because her lung was filling with fluid again.  The pulmonologist, who is the point person now, decided to move my mother.  Her general practitioner, a man who is truly sent from heaven, told me that the pulmonologist does his best work in ICU.  They just wanted to be able to watch my mother more closely.  The nurse ratio there is 1:2; in the "step down" ward, it is 1:4.  I was assured that she was not "actively dying."

She looked awful.  She could hardly breathe.  She started to hallucinate.  And I couldn't understand anything that she was trying to say.  The pulmonologist asked me about "end of life measures."  What would she want?  You know, her whole life, she's never been real clear on that.  She wants the doctors to do whatever is necessary, as long as there is hope.  What does no hope mean?  Well, when my grandmother was dying of congestive heart failure, they offered her a pacemaker.  It would have given her 24 more hours of life.  My mother refused it on my grandmother's behalf.  I agree that was the right decision, but it has haunted her ever since.  But the "end of life measures" question was what convinced my mother that the end was near.  I was convinced as well, because the pulmonologist told me my mother was  sicker than she appeared.  I couldn't imagine how that would be possible; she looked so very bad.

My mother argued against dialysis of her kidneys.  The kidney specialist was blunt, as was I.  If she didn't want it, she could expect to live for one more week.  If she tried it, they might be able to jump start her kidneys.  Based on everything she's ever told me, I would have thought that was what she wanted.  But, she was scared.  She didn't want to start dialysis, because she thought she might never stop.  And it would "tie her down," once she got out of the hospital.  She is such an optimist.  The rest of the family was thinking that she would never leave the hospital.  In the end, she agreed to try it.

And, they used the dialysis machine last night and this morning.  And she looked so much better!  So much better, in fact, that they kicked her out of ICU this afternoon.  Praise God.  See saw up.

I haven't been able to stop crying these last few days.  I know that my mother doesn't have much longer to live.  Even if she does get out of the hospital, the chances are she's no longer a transplant candidate, if she ever was (due to age and other medical conditions).  When she was originally diagnosed with liver disease in January 2005, that doctor gave her 2-1/2 to 3 years to live.  I don't know where all the of the time went, but we are into the end of that time frame.  And, earlier this week, my mother understood that she only had 2-3 months more.  I'm not quite sure where that came from, but after yesterday and thinking that the end was near, I thought how much I would have preferred the 2-3 months I had bitterly railed against only days earlier.

Please understand.  I love my mother.  I would trade places with her if I could.  She is a wonderful person.  But, over the years, our relationship has been tumultuous, to say the least.  No one can push my buttons as fast as she can.  We have had some knock down, drag out fights.  My husband often reminds me that I will be sorry someday for fighting with my mother.  I guess someday is here.  I have so many regrets.  I wish I could have bit my tongue more.  I wish that I would have known how much it really meant to her to spend time with me after DD was born -- I was just so overwhelmed.  If I had even an inkling how important it was to her, I would have gladly invited her over.  And those are things I think about.  Not about the times I was able to help her.  I'm in a flagellation mode, I guess.

I hope that she can come home.  I hope that we have another Christmas.  While I'm at it, I hope that she's a candidate for a transplant and is lucky enough to get the opportunity.  I pray that the surgery would be successful.  But if it can't be, then I hope that we can make peace.  I hope that she knows how much she means to me, and how I can't even imagine life without her.  It is so hard to tell her without crying, and she is so tired of everyone around her crying.  She said that it is very depressing, and she just wishes that we would all save our mourning for after she's gone.  I can't say as I blame her.

I'm so fortunate that my employer, the one that I complain about from time to time, has been understanding.  I understand that I can use the FMLA, and that they have generous leave policies, but they have just been really nice about it.  I expected my supervisor to be nice, but someone that I thought was hostile through and through is being supportive as well.  The hospital is fairly close to work, so I have been able to come in earlier and tack that time onto my lunch hour.  It's nice to be able to spend time with my mom like that.  And, if I need to stay longer (like today, when she needed help to eat), they don't care.  In fact, I gave my supervisor a leave slip (we are supposed to document all leave time usage), he simply tore it up.

I really believe that my mother is still alive by the grace of God.  I've asked everyone I know who prays to please pray for her.  Whenever I get too overwhelmed, I tell God that I am choosing to trust Him.  And I am.  I am going to trust Him.  And we will all get through this.

It is just so unbelievably hard.

Rejected Again (And Again)

Recently overhead at our house:

DD:  I have a new mommy.

Me:  A new mommy?

DD:  Yes.

Me:  Why do you have a new mommy?

DD:  Because you're too old.  (Does she know right where my weak spot is or what?)

Me:  Really.  And how old is your new mommy?

DD:  21.

DH:  Well, maybe you should ask your new mommy for milk.

Me:  Yeah.  That's a good idea.

DD:  Noooooo!  You can be my mommy.  I want milllkkkk!

* * * * * * * * * * *

DD:  I want to go on vacation again.

Me:  I know what you mean.  Me too.

DD:  No, you can't go. 

Me:  Really.  So, who is going on vacation?

DD:  Just me and daddy.  You can stay home with the cats.

* * * * * * * * * * *

I feel so rejected.

Drifting Without A Rudder

That's really how I feel.  Drifting, just drifting.  I'm so very, very worried about my mom.

She has an appointment at a university hospital on Wednesday with a very good specialist, but she may not make that appointment.  Why, you might ask?  Because she's in the hospital trying to get over an infection.  From a cat bite.  From my cat.

A long time ago, I rescued a litter of kittens who were abandoned and nursed them back to health.  It was hard to find homes for them.  My parents took one, my brother took one, someone from work took one, and I kept two -- a boy and a girl.  For whatever reason, these cats are one family cats.  They don't like outsiders.  Period.  They all growl and hiss and just generally avoid other people.

My male cat will "turn" if he feels that his sister is being attacked.  And once, he turned on me when he thought my daughter was being attacked -- by me (she'd fallen and was crying; I think he thought I was hurting her).  On these occasions, even though I know why it's happening, it's very upsetting.  And it hurts!  He doesn't have claws, but if his teeth connect with an ankle or a foot, yikes.  I've had him for twelve years.  This has happened about six times.  On each occasion, there was a precipitating event.

My father, who loves cats, just can't seem to accept that my cats don't like him.  He is always trying to approach them.  And they don't like it.  The Monday before last, he was trying to pet the female.  And she started growling.  So, the male cat came out of nowhere and started attacking my mother's foot.  No big deal.  He didn't get past her shoe.  And then he left the room, and I assumed it was all over.  Then, I guess I did something stupid.  I went over to the female cat and stroked her fur, hoping to calm her down.  She growled a little, not really at me, but just because she was still upset.  Then, out of nowhere, the male cat came over and bit my mother in the ankle.  Hard.  I guess she was the first human in his line of sight.

She wouldn't go to a clinic.  She was in a hurry to go away for a couple of days, and we were on our way out to begin our vacation.  Because she has fluid buildup in her legs from her liver disease, she couldn't get the wound to stop draining.  Two days later, she brought it to her doctor's attention at a regular appointment.  He gave her antibiotics.

Apparently, they didn't work.  Her leg turned red from the ankle to the knee, and her doctor instructed her to go to the hospital, where she was admitted.  They've been pumping her full of antibiotics ever since. 

I went to the vet this weekend, because while this is an infrequent problem, and it is always explainable, it is still unacceptable.  Even though this cat is protective of my daughter, I wonder what might happen if he thought she was hurting his sister.  I find it hard to believe that he would ever hurt her, but you don't know.

The vet didn't have much to offer.  We have some pheromones that are supposed to be calming; it works kind of like a Glade plug in.  We could administer psychotropic drugs.  I could make an appointment with a behaviorist, and I will probably do that as soon as possible.  I could have his canine teeth pulled, which are the teeth that do all the damage in a bite.  Or, I could put him to sleep.  Oddly, the vet thought that euthanasia was more humane than removing his canine teeth.  I guess they are hard to remove, but still.  Worse than killing him?  I don't know about that.

My mother is very disappointed that she can't make it to her university appointment.  She is having such a hard time breathing with all the fluid buildup around her lungs (they've had to drain it three times now, about every other week), I think that she was hoping to hear some treatment options.  And my stupid cat screwed that up.  He is a very gentle soul otherwise.  And she doesn't want me to put him down for her sake.

Tonight, they told her that she may be developing kidney problems too.  That is a common problem for people with liver disease.  The kidneys try to take over for the failing liver, and then the kidneys begin to fail as well.  I'm hoping that is not happening.  I'm praying that is not happening.  They did just tell her that two very common liver values were within normal limits (PGOT and PGPT).

I can't even talk about this with anyone without tearing up.  I just don't know how we are going to get through this.  I do know that I am not ready to let my mother go. 

But, you know, I am never going to be ready to do that.  Not today.  Not two months from now.  Not ever.

Starting Over

I visited my clinic today for blood and an ultrasound.  I was surprised to see that even with all the drugs and what I thought was total control over my body by my doctor, I still had five small follicles that managed to develop last month.  Not that there would be a good egg in any of those follicles, mind you.  But I guess our bodies just continue on trying, even when it's hopeless.

You know, before my recent visits back to the RE (reproductive endocrinologist), I'd really forgotten what it was like.  The office looks like a normal office, but the women do not talk to each other.  We all just sit there, lost in our thoughts.  We don't even make eye contact.  There's kind of a quiet desperation that fills the air.  You would never guess that this is a place where miracles begin.

And so we start again.  I will begin birth control pills today, and start my Lupron (and hot flashes) on September 26.  September 26 -- my grandmother's birthday.  I hope that she will be looking down as we start again and puts in a good word for us with the man upstairs.

It's Official

The doctor's office called with the not-too-surprising news (she writes, feeling a little tipsy from the wine).  My BFN was confirmed.

On the bright side, I don't have to suffer through a waiting month.  I can start on my birth control pills as soon as my period begins.  Which should be soon, I think.  Another plus is that this is not very expensive (given that my insurance has always paid for the drugs -- we just pay the co-pays).  I think, all told, the cost is around $1,300, including co-pays.  This is such a far cry from the $20,000 plus out-of-pocket for the DE cycle (or the $6,000 plus out-of-pocket for the IVF with my own eggs). 

Thank God that my insurance covers the drugs.  Many people are not so fortunate.

BFN

For those of you unfamiliar with the lingo, BFN = BIG FAT NEGATIVE.  My two beautiful embryos.  All gone.

Sorry for not posting for awhile.  We went on vacation beginning on Monday, and I didn't have access to a computer.  I took three tests -- on Tuesday, Thursday, and Saturday (which was the original test date scheduled by my clinic).  All were negative.  I have to go for an "official" test tomorrow, but I don't think the results are going to be any different, since the home tests are 99% accurate when taken on the equivalent of the first day of a missed period -- which would have been Saturday.  Though Aunt Flo hasn't graced me with her presence yet, I'm expecting one helluva homecoming when she does arrive.

I did bring some wine with me on vacation.  Kind of "in case of emergency, pop cork."  And I did.  Repeatedly.  But not until Saturday, of course.

I'm going to ask if I really have to have a waiting month, or if I can just start on my pills when Aunt Flo arrives.  That way, I can try again in about 6-7 weeks, rather than 9-10 weeks.  The only downside to that is that I have a limited amount of time to try to drop all the weight that I gained from the Estrace -- about 7-10 pounds (I am so not kidding).

Sigh.  This whole thing is bringing back some not so good memories.  What do I have to show for the injections, the ultrasounds, the blood draws, the hot flashes, the weight gain, the stress, and a yeast infection that I wasn't allowed to treat last week in case I was pregnant?  Just a BFN.

L