Monday, August 31, 2009

The Abyss

Here we are, at the last day of August.

In early May, brother-in-law was diagnosed with cancer and declined rapidly. In June, he died. July is a blur, as my mother was declining. She died in early August. Today I got word that a family friend had died, two weeks shy of his fiftieth anniversary, after he had announced that he intended to stay around long enough to dance with his wife to celebrate that milestone.

I have a hole in my life now that I don't go to the nursing home every day and worry worry worry about my mother's care. I don't have the constant preoccupation to distract me. I grieved so much during her illness that I find I feel more of a sense of relief than anything else, but sadness that we all got gypped when it came to quality time.

Now that I haven't got the preoccupations, I spend more time with my kids, maybe just give them more of my attention, more time on the house, more time on homework, more time on reading. I find my mind is clearer when I do my schoolwork. Maybe "a hole" isn't the best way to describe it. Maybe it is not a void in a negative sense, but a big, open space: my life is no longer so compressed. I have parts that I can fill up however I wish.

And I want to choose things which give me joy.

After six years, I'm not used to that.

Wednesday, August 12, 2009

Drama mama

I love back to school weather. I love hearing the night bugs and frogs in the still air. I love the morning light, so perfectly time with my drive to work. I love the temperature in the mornings.

And I love having my kids back in school. However, Kiki is at that age where girls appear to make everything into a drama. For example, the school put the names of the students and their groups on the front door of the school today. Of course, her name wasn't there when we went there after I got off work. Kiki became hysterical, inferring from this apparent oversight that she had been retained in the seventh grade and didn't get the memo. Nita, of course, was far from sympathetic--let's say annoying--and the two girls escalated into a huge squabble in front of the yams in the produce department at the grocery store.

I finally got her calmed down enough to listen to me, but she went to bed early so tomorrow morning and its attendant doom will come faster.

Saturday, August 8, 2009

Boo-WAH

I am sitting here in the quiet, again starting the day with the peace of the early morning. I have never been one to sleep in, and the dogs now ensure that I get up and have the part of the day I need the most before the kids and responsibilities start lining up.

Penny, our female lab is with me. We have described her as a toddler with fur, or rather, since she has four legs, it would be more appropriate to describe her as two toddlers with fur. And hyperactivity. Because she is so large, she can cruise the counters without jumping up, she sticks her long nose in my purse or any bags in the room, and she can open cupboards and closets and refrigerators.

Penny, aka Penelope Pitstop, is a large, reddish dog with a tremendous amount of drive. She feels no pain that we've been able to discern, or perhaps she just bulldogs through it. When we got her, she had been surrendured to the dog pound--her owners said, "We didn't think she'd get this big, and boy, is she hyper."

Major understatement. We thought Marley and Me was rather dull compared to some of our adventures.

The sound most commonly associated with Penny, boo-WAH, is included in a narrative of her escapades and is always accompanied by a demonstration of how she jumped, front feet up in the air, like two high fives, before pummeling someone or something she is overjoyed to see. "How did this happen," I will ask, looking at a combination of cat food, oregano, Legos, pencil shavings, and shredded cabbage on the kitchen floor. "Well," one of the kids will tell me, "we were going outside to play with the Legos on the porch when Nita was feeding the cats, and Penny saw the kitty, and boo-WAH (hands up), she went after the kitty, who went on the counter and Penny knocked down the cole slaw and spices and the newspapers and the phone and answering machine and the kitty ran into the closet, climbing the coats and knocking the pencil sharpener off the wall. Penny grabbed the pencil sharpener and took it, and we chased her."

Why do I even ask.

Or, "Some guy came to read the meter, and Penny was outside and saw him, and boo-WAH, she went to say Hi and he said for you to fill in this card and mail it back."

Or my favorites was the lady who pulled in to pick up something I had for her. She said, "I forgot you said to park behind the basketball hoop, and boo-WAH, that dog was in my car."

So, in the quiet of the mornings, I put Penny on a leash and tie her to my chair while I read the paper and drink my coffee. Now that she is four or five, she has moments, albeit very brief, of stillness, and she will lie next to me while I rub her with one bare foot. She honestly does not have one mean bone in her body and loves all humans and cats (dogs are okay if they don't sniff her tail, and I see her point here). Like Will Rogers, she never met anyone she didn't like. Boo-WAH.

Friday, August 7, 2009

The Hole

My sister said recently that her grief is like a hole.

Sometimes she can't help but fall into it. However, she is learning when she is getting close to it, and now, sometimes, she can choose to fall into the hole or not. Plus, the edges are no longer a sharp dropoff but are getting rather boggy, so she can tell when she is getting close to that edge.

Yesterday, I took the rabbit to the nursing home for his picture session for his article, then met up with my sister to make the funeral arrangements, then to the florist to choose the flowers, then to the nursing home to pack my mother's things, then to lunch, then to meet with the minister to plan the funeral, then to the grocery store, then home to make supper. I realized at seven, when Nita was needy of attention from Mama while EG had the other two at music lessons, that I was so exhausted I was shaking. I did some homework and then went to bed with EG, where we talked for the first time that day. All that activity kept me away from the hole.

This morning, just before dawn, I woke and realized I was right on the edge of that hole. Two cardinals, my mother's favorite birds, were calling, competing if you will, with how loudly and beautifully they could sing. Pretty, pretty, pretty, pretty, pretty, they said, sounding as if they were throwing back their heads and just letting loose with all they had in pure joy at the sun coming up one more day.

I got up and went into the bathroom, and Harry thought that was a good idea, so he announced he had to go outside RIGHT THIS MINUTE. I went out with him, and stood and looked at the early sunrise, pink and orange and purple with a big thundercloud in the middle of it, and remembered a verse I had found tucked into one of my mother's dresser drawers, written in her handwriting. It said,

I took an hour
To look at a flower,
A day to look at a shell.
A week went by
As I looked at the sky.
Oh, time has treated me well.

So I stopped to fully appreciate the sight. The cardinals flew off to begin their day, leaving me to carry on their appreciation for them.

Wednesday, August 5, 2009

Seven weeks

My mother passed away quietly and peacefully this afternoon. After a long, and at the end, agonizing battle with Alzheimer's, post-polio syndrome, congestive heart failure, and a myriad of other age-related illnesses, her last 45 minutes here with us were so amazing to me in that her body relaxed and she eased gently into another place. I was blessed to be there, holding her hand, in that most intimate of moments.

It was seven weeks from the time my brother-in-law received his diagnosis until his death, and another seven weeks until my mother's death. I hate to see what the next seven weeks brings.

Tuesday, August 4, 2009

Day Three

It has been three days since my mother has had anything to eat or drink. When I try to feed her, she clamps her mouth shut. Not only is that her choice, but from what I understand, people who are dying feel better not taking input.

The changes are gradual and yet apparent. I went in before seven this morning and met her MD, who said, "It won't be long." We discussed turning off the pacemaker, and the doctor delegated that duty to the hospice nurse, who showed up an hour or two later. She spent a good part of two hours chasing around to figure out how to get the pacemaker turned off/discontinued.

First, we started with the pacemaker company. They said they needed the serial number of the transmitter we used to check the pacemaker over the phone lines. Since we had discontinued the checks months ago, no one knew where the transmitter was. We finally found it in a closet near the nurse's station.

Then we didn't need that number, but Mom's patient number. When we gave them that number (keep in mind that she has three binders stuffed full with her patient records), they said we had to call the cardiologist. The nurse called the cardiologist, whose assistant said, "We don't keep any records before 2006, so I don't have her here." Okay, so what has been happening to the pacemaker checks we had sent from 2006 to 2008? The office had to send to Iron Mountain (imagine my mental image), which I guess is a document storage facility, for her records.

Oh, and when was that pacemaker inserted? Like we'd remember?

So we wait. Meanwhile, Mom declines a little more hour by hour. If the pacemaker is what is keeping her alive, then we'll have to wait until the records are retrieved and sent to the MD and then he reads them and gives us permission to turn off the pacemaker, which most likely just needs a magnet to discontinue its use.

However, Mom seems peaceful and is resting, so we can be patient.

But I do have magnets on my fridge...

Sunday, August 2, 2009

Peace

My sister finally got in contact with my mother's doctor, who listened (what a wonderful skill in a physician) and thanked my sister for calling and telling her about my mother's distress. My sister told her, "We realize that by keeping mom calm through the medication, she will most likely not eat or drink, and she will become dehydrated and die. We are okay with that. There is no quality of life, and she should be comfortable. She would be so distressed to know that she is upsetting the children who are visiting their family members."

The doctor wrote the orders. The hospice case manager talked to the nurses at the facility. The nurses at the facility figured out how to get the medication into my mother when she is groggy. And she rests.

I told the kids they were permitted to make the choice to see Grandma or not. Yesterday, when I went to the nursing home with Kiki, who asked to go, Mom was in the dining room. She was moaning gently on each exhale, and she was cold to the touch. Kiki and I rubbed her arms, rearranging them (it was lovely to see them relaxed), and tried to feed Mom. Her swallow reflex was very, very slow, but we managed to get two ounces or so of thickened milk into her. That was the most she had all day, and she was exhausted by the time that was done. She went to sleep, and Kiki and I took her to the nurse's station and asked to have mouth care and have her put in bed.

I called my sister and told her that we didn't have much time left. or, rather, Mom didn't have much time left.

Last night, I crawled into bed and fully expected to be tortured by this ghastly decision we had to make. Did we do the right thing? Intellectually, I know we did. And I don't care what the staff thinks, as they tend to roll their eyes warily at me anyway, much like someone would a stray dog, and this is my mother, not theirs. And I was pretty sure Mom would approve of not prolonging this. However, I wasn't bothered at all--in fact, I had lovely gentle dreams of my mother the way she used to be. When I woke up, I was flooded with warm memories and funny scenes of when I was a child. It was almost like Mom had visited me in the night, on some different realm, to reassure me that this is what she wanted, and she wished for us to be at peace like she would soon be.

Saturday, August 1, 2009

The lower half of the face

I recently attended an in-service for hospice. I was due to get my in-service hours in, and it was a good time, being held on a Thursday evening when the kids' dad takes them to music lessons.

The topic was Pediatric Palliative Care. Hospice for kids. Okay, I thought, this will be so uplifting.

Not.

So I signed up anyway, and I am so glad I did. What a wonderful presentation--the speaker was a retired nurse and retired teacher who was doing chaplain work with the dying on a volunteer basis. Someone mentioned how draining the work must be, but she replied that it was something which energized her. Aha, I thought. She gets it--hospice is about empowering people to live.

I came away with a quote which it took me until the second half of my life to learn--Rabbi Kushner, in his book When Bad Things Happen to Good People, said, and I am paraphrasing here, "When you don't know what to say, say I'm sorry and shut up." I am going to try to adopt that as my mantra. We live in a society of too much noise--television, radio, cell phones, constant verbal attack. I want to listen aggressively to the silence.