Posted in Chronic Pain, Death, Death of a child, Family, Family Life, Grief, Terminal Illness, Vicky Bruce

The boys and their grief…


Vic and her beautiful boys
Vic and her beautiful boys

Today, Jared (16) was called in by the school psychiatrist.

The psychiatrist spoke to him at length about the stages of grief.  Jared loves facts.

Thanks to Google I am well versed in the stages of grief and constantly try to monitor where the boys are in the process.  I did not stop to think that knowing the stages, in detail, would give them a sense of comfort.

Ten years ago we were told by the doctors that Vic had maybe 5 years to live.  The boys were then 6 and 4 years old.

At the age of five, a child may have thought of death as a deep sleep from which the person would eventually awaken, (like the princess in Sleeping Beauty).  At seven, the child may believe that only grandmas and grandpa’s and other elderly folks can become ill and die—but not little kids or their parents. Age 12 they know that death can happen at any time…

Jared developed a sugar problem at the age of 6…due to the stress of Vic’s illness.  Over the years he has developed a weight problem as he stress eats.  His school marks have dropped and he has lost interest in sport, his friends and life.  He is a Type 2 Diabetic.

On the surface Jon-Daniel appears to be coping far better than Jared.

He excels in school and has immersed himself in sports or hobbies. I think what may really be at work here is a defence mechanism known as sublimation. I believe that Jon-Daniel has over the years subconsciously channeled his strong feelings of grief into a more “socially acceptable” outlet. He directs his attention solely to areas where he feels comfortable.  It is his way of regaining control over a world that has been jolted out of orbit.

Having the intellectual capacity to grasp the implications of death doesn’t necessarily equip teenagers to cope emotionally with the tragedy. Adolescents typically appear to feel grief more intensely than adults, especially if one of their parents has died. The Adolescent Life Change Event Scale (ALCES), which mental-health specialists use to help quantify the events that are the most stress-inducing in teenagers, ranks a parent’s death as the number one cause of adolescent stress. Second is the death of a brother or sister, followed by the death of a friend.

The stress started years before Vic died.  The boys grew up knowing that their Mommy was ill and in a lot of pain.  The realization actually only hit home with them in 2007 when we told the boys on a couple of occasions that Vic was dying.  In hindsight it would have been better if we never told them but at the time I believed it to be the right thing to do.  I could not lie to the boys and tell them Vic was doing well when she was fighting for her life on a ventilator and the doctors were turning off the ventilator.

It was clear with Jon-Daniel over the years that he harboured resentment towards Vic when she was in hospital.  In his eyes Vic abandoned them…his way of coping was to “harden” his heart.  He would literally ignore her or act up when she was ill…  Over the past year he however “softened” his attitude towards his sick mom.

Because adolescents are so sensitive about their “image”, they may feel self-conscious or outright embarrassed by displays of grief and struggle to suppress their emotions. This can also be a means of protecting themselves.

As a family we experienced “anticipatory grief”.  During the past year especially we resorted to black humour. There is no “right way” or “wrong way” to mourn.   Jared told me today that he asked his Church councillor last year whether you can mourn someone whilst they are still alive….

Grief is often expressed in one of the following ways:

  • Depression
  • Changes in conduct or acting-out behaviours
  • “Perfect” behaviour
  • A decline in academic performance
  • Refusing to attend school
  • Turning to alcohol or illicit drugs to numb the emotional pain
  • Seeking solace through a sexual relationship
  • Overeating or under-eating
  • Sleeping more than usual or not getting enough sleep
  • Physical symptoms

It is said that a teenager who loses a parent is also subconsciously mourning the end of the childhood he’d led up until now.  However in the case of Vic the boys have potentially regained a childhood…I just hope and pray it is not too late for them to have a childhood.

Five Stages of Grieving

Shock / Denial

This is a protective mechanism that helps the person to function for the time being. With denial, the person may refuse to believe what happened. For instance, one teen was waiting for her friend to come to her graduation party and kept texting him to see when he would be there. Finally, she got a call from his sister telling her that he was killed in a motorcycle accident. She refused to believe he was dead, however, and reacted by telling the sister she was lying. Of course, his friend was experiencing shock. During shock, the person can function as though nothing happened, but may feel like she is in a surreal world or place.

Anger

Often there is blaming others for the loss or lashing out at people. Sometimes people act out their anger in other ways. The mother of  a teen realized she was blaming her son for causing his own death after she began telling his friends, “Please, don’t do this to your mothers.” In essence, she was saying to her son, “Look what you’ve done to me.” The anger needs to be processed, though. The mother began to realize that her son was a teenager and that teenagers take risks. Teenagers’ brains aren’t fully developed in the area of judgment, so they don’t gauge risks the same way as an adult. Also, there were other factors that contributed to her son’s death besides his risk-taking behavior. Working through the anger helps a person to move through the other stages of grieving.

 Bargaining / Magic

This often involves either cutting a contract with yourself, asking your higher power to take you out of the situation or fantasizing that this is some sort of dream and tomorrow you’ll wake up and it will never have happened. This stage helps the person to feel some control over the situation. For example, when one mother saw her son in the hospital emergency room lying dead in a body bag after all attempts of resuscitation had failed, she laid over his body begging God to breathe life back into him, praying for a miracle.

Depression / Grief / Sadness

This stage involves a lot of “what ifs.” The person now turns the anger inward and blames herself for the loss. Often this is false guilt, though, and the person really had no control over what happened or no real way to prevent it. This stage provides an opportunity for the person to grow spiritually and perhaps further develop spiritual beliefs as she searches for the meaning or purpose of life, death, pain and suffering. Even if the person is somehow at fault, perhaps the person’s actions or shortcomings are being used as part of a greater plan.

Acceptance / Forgiveness / Resolution

Accepting the loss doesn’t mean you like what happened. It does mean that you are trusting that life can be good again in spite of the hurt and pain the loss has caused you. Sometimes we need to forgive the loss or perhaps someone who has directly caused our pain or grief. Forgiving means letting go of bitterness and revenge, which only harm us and not the offender. To be unforgiving means we are not moving on and letting go, but continuing to allow ourselves to be hurt by the other party or the loss.  We feel more powerless when we keep wanting something from others that they cannot give us. Perhaps this is an apology or maybe a change of heart. Nevertheless, we can always grow and move on without seeing any change in the other person or getting back what was taken from us. We take back our power in the situation when we begin reversing the negative consequences in our lives and perhaps by finding new purposes and meanings for our lives. http://www.cincinnatichildrens.org/service/s/surviving-teens/stressors/grief-loss/

Grief never ends, but it does change in character and intensity.  Grieving is like the constantly shifting tides of the ocean; ranging from calm, low tides to raging high tides that change with the seasons and the years.  I know this from my parents and BFF deaths.

We will meet with the Hospice councillor that the boys saw last year – they connected with him.  Maybe it is time to start Jared on an anti-depressant….

We love the boys so much.  I wish we could wrap them in cotton and protect them from the world.  They are so beautiful and have these AMAZING personalities.  They are not difficult or rebellious teenagers.

I wish I knew what to do.

Posted in Death, Death of a child, Grief, Terminal Illness, Vicky Bruce

There is no limit


I have received many words of encouragement and support from so many people.  Some just say “hugs” and other’s offer advice.  One of my most loyal supporters is a lady called Miss Morgan’s Mom – She lost her 16-year-old daughter in a senseless accident.  She lives her loss and grief pours from her posts.  I remember one of her first posts I ever read on her blog she was counting the days (still does) and her grief was so raw and all-encompassing.  I recall thinking “Oh God, is this what awaits me?”  At the time I could only comment “hugs”….  A couple of posts ago she wrote that 14.5 months after Morgan’s death she is finding it more difficult to blog.  People want her to move on….  get on with life.  
 
Last week, a mere 3 weeks after my most precious child’s death I was told by people “Let her rest….Concentrate on the boys” ; “don’t let the boys see you cry…”
 
On Thursday I cried in front of the boys as I did this morning in the supermarket.   I will not apologise for my tears.  My child deserves my tears.
 
I realize people want me to move on because I scare them when I am sad.  They are used to me being strong, fighting for Vic’s life, always laughing, always in control.
 
On Saturday Esther, Vic’s sis, asked me “So what does Google say?  When do sisters start feeling better?”  I replied “Never.  you just get used to the pain”
 
I read this amazing post and had to share it.  Reposted  http://missmorgansmom.wordpress.com/2013/02/04/there-is-no-limit-to-ones-time-for-grief/
 

THERE IS NO LIMIT TO ONES TIME FOR GRIEF

broken heart When someone is grieving i believe in my heart that many if not all outsiders have the best intentions to help I truly do, but understandably  they have no real concept  on how long and how often the mourning need support or just understanding. People that lose loved ones, I have come to find that there is no limit to the time it takes for each individual to find their new normal. I think that sometimes when people view the lives of the sorrowful, they think that the person or people grieving should have come to terms with their loss after a certain amount of time. I have found  this not to be true, I have sadly gained the knowledge that every moment to everyday is different. It is so hard to help people understand that we need to grieve as long as it may take. We all seem to have our own way to do this, whether it is to submerse our time into our work so that our mind has little time to feel the pain, or that we become some what of a recluse trying to understand our torture. There is no right or wrong way to grieve, there are no rules.  I personally try to battle the pain by writing my feelings at that moment. I think some may not understand and my God am I thankful for that because I would not wish this on anyone. It is so important to me to put out there that when you see someone struggling and they may seem as if their path is destructive, it might not always be as it seems, sometimes we must  look outside the box! This is  because anyone who is grieving that keeps having emotions whether negative or positive has not given up the fight. I cannot identify my grief with anyones else, I have learned to accept the death of my father and step mother and although it still hurts, I have learned to move forward. I have found that burying a child is a completely different kind of grief for me anyway. I am moving forward, I am fighting to become a new normal.   I have found that  not just me but all other parents who are trying to win the fight are on this similar  path and they may feel like there is no end, keep fighting. I want to post this link for those that may be fighting this fight to maybe offer support that you are not alone. I also want to post this for people who may just want to understand some of the process grieving parents may be going through. I am also posting some writings from this site that have heart felt meaning to me. https://www.facebook.com/pages/Grieving-Mothers/162680380444494 no limitDear Clueless I would like to share with you my pain but that isn’t possible unless you have lost a child yourself and that I wouldn’t want you to have to experience. So with that being said, I would like to say this. I will try to my best to understand you if you try to understand me. I lost my child. My life will never be the same. I will never be the same again. I will be different from now on. I no longer have the same feelings about anything. Everything in my life has changed from the moment my child left to go to heaven. I will, on some days be very sad and nothing you say will changes that so don’t feel like it is your job to make me feel better on those days, just allow me to be where I am. When you lose a child you not only lose your reason for living, you lose the motivation to go on. You also lose your sense of self. It takes a long time to come to some kind of understanding for why this has happened, if ever. Of course we who have lost children know we have to go on but we don’t want to hear someone else tell us too. Especially from someone who has not lost a child. It makes me and anyone who has lost a child want to say who are you to tell me that? Did you bury your child? I don’t want this to sound like I don’t appreciate everything you say because I know you mean well, but I just want you to appreciate where I am coming from too. I want you to understand that some of the things you say hurt me and others like me without you really knowing it. I know it must be pretty hard to talk to people like myself, not knowing what to say. That is why I am writing this letter. If you don’t know what to say, say nothing or just say I’m sorry. That always works for me. If you want to talk and say my child’s name feel free I would love to hear her name anytime. You not saying her name didn’t make me forget it, or what happened to her. So by all means say her name. When special dates come or holidays come please forgive me if I’m not myself. I just can’t keep it up on those days. I may wish to be by myself so I can think about my child without putting on a front. Most of all I want you to know I’m having a hard time with the death of my child and I am trying my very best to get back into life again. Some days it may look like I have accomplished that, and other days like I am at square one. This will happen the rest of my life periodically. There are just no words to explain the living hell this feels like. There are no words that could ever do it justice. So please bear with me and give me time and don’t put your own timetable on my grief and let me be the person I am now and not have to live up to the person you think I should be. Allow me my space and time and accept me for me. I will try my best to understand you. Love, Your Friend in Grief forward

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Posted in Chronic Pain, Daily Post 2012, Family, Family Life, Grief, Terminal Illness, Vicky Bruce

“Sisters by Heart”


Vic lost the Christmas gift she bought Esther. It is not the first time this has happened – Vic previously bought Esther a “Sister” fridge magnet and mislaid it somewhere…

Vic has spent a lot of time sorting out some last things – double checking her insurance policies, photo albums, writing cards for the boys to be read on the first Christmas, first anniversary, final school exam…  She has been going tick, tick, tick…Oops Outstanding item: Esther’s gift!

I have searched the house and not found the sentimental nick-nacks Vic bought Esther for Christmas.  I have driven around and looked for replacement gifts, but to no avail.  So yesterday Vic said to Esther “Sis, I have to replace your Christmas gift…  I cannot move on before I do that…Mommy is taking me to Eastgate tomorrow.  I know I will find it there.”

Esther, who has a superb sense of humour, said “I won’t let you die before I get my present…What time are we leaving tomorrow?”

Early this morning Vic was dressed and ready for the excursion.  At about 11am we set off shopping (after a hefty pain and nausea injection…) At the second shop we struck gold!  (I actually found the gift she was looking for.)  Vic had the salesperson wrap it with Christmas gift wrap.   She is a stickler for “attention to detail”

Mission accomplished we went to a restaurant for lunch.  As usual Vic agonised over the menu.  She wanted a salmon dish with cream cheese – No salmon…. Arghhh!  She settled for a sandwich and coffee.

The gift Vic bought was a Willow Tree figurine set of two girls holding hands.  “Just like we lay and chatted last night Sis…”

Sisters by Heart

Celebrating a treasured friendship of sharing and understanding

 “I’m very close to my sisters, and the friendship and support of other women has always enriched my life. I also realize that there are friends or other relatives that may not be blood sisters, but share this same type of closeness.”

 

Vic and Esther are step sisters.  There is no blood bond, but they are bound by their deep love for one another.  Esther has been an absolute pillar of strength to Vic and the rest of the family.  Daily Esther sends Vic beautiful text messages.  She brings Vic flowers from her garden.  She lies next to Vic and listens to her babbling.   Esther is the sister Vic never had.

Needless to say, Vic did not handle her lunch well and after a visit to the toilet we left.  I could see her heart beating like crazy in her neck.  People looked at us as far as we walked.  I realized with a shock that it is because Vic obviously looks ill and shuffles like an old person.  I look at her and I only see a beautiful young woman; my baby girl and the mother of my grandsons.

Vic is having a strange day… Her blood pressure is all over; her heart races and then slows down.

“Something is wrong mommy.”

This evening Vic double checked with me whether I remembered which hymns had to be sung at her memorial service.  She cried when she (again) named her pallbearers.  “Please don’t let me lie in a refrigerator for a long time Mommy…Let them cremate me as quickly as possible”

Vic asked that I get her minister to come and administer Holy Communion to her this week.

The whole situation is so surreal.  I find it impossible to believe that Vic may actually be dying.    She is so beautiful and her mind is crystal clear!  I think Vic is just caught up in the Hospice talk.  Maybe I am in denial.  She has not vomited blood for two days.  That is a good sign.  Google says her heart rate can go up to 250 and Vic’s HR is only at 120 and occasionally at 155.

Oh dear God please grant my child peace.  Please grant us all peace.

Sisters holding hands
Sisters holding hands

Celebrating a treasured friendship of sharing and understanding

"Sisters by Heart"
“Sisters by Heart”

 

Posted in Chronic Pain, Daily Post 2012, Family, Family Life, Grief, Palliative Care, Terminal Illness, Uncategorized, Vicky Bruce

Morphine extends life!


Vic and I in healthier days

The downward pain spiral has already begun.  Vic is quite swollen and had a bad day.  This afternoon late she perked up and has only had one vomiting spell tonight.

As Sr Siza was examining her this afternoon and taking her vitals I remarked on the swelling.  “It’s the organs shutting down” she whispered….

“I am scared Siza.  I administer such massive dosages of medication to Vic… What if I kill her?” I asked over a cup of tea.

“Don’t worry my love.  You won’t.  There is no upper limit to the amount of morphine that Vicky can go on… As long as we titrate the dosages she will be fine.”

So I Googled Morphine+dosage+death and one of the first articles that came up (and I could understand) is “When Morphine Fails to Kill”  By GINA KOLATA

 Proponents of assisted suicide often argue that when a doctor helps a patient who wants to die, it is no more ethically troubling than when a doctor kills a patient slowly with morphine, often without the patient’s knowledge or consent, a medical practice these proponents say is increasingly common.

So why forbid doctors to prescribe lethal pills that could allow patients to control how and when they die? There is no question that doctors use morphine this way. “It happens all the time,” said Dr. John M. Luce, a professor of medicine and anesthesiology at the University of California in San Francisco. And there is no question that most doctors think that morphine can hasten a patient’s death by depressing respiration. But Luce and others are asking whether morphine and similar drugs really speed death.

Experts in palliative care say the only available evidence indicates that morphine is not having this effect. Dr. Balfour Mount, a cancer specialist who directs the division of palliative care at McGill University in Montreal, firmly states that it is “a common misunderstanding that patients die because of high doses of morphine needed to control pain.”

 No one denies that an overdose of morphine can be lethal. It kills by stopping breathing. But, said Dr. Joanne Lynn, director of the Center to Improve Care of the Dying at George Washington University School of Medicine, something peculiar happens when doctors gradually increase a patient’s dose of morphine. The patients, she said, become more tolerant of the drug’s effect on respiration than they do of its effect on pain. The result, Dr. Lynn said, is that as patients’ pain gets worse, they require more and more morphine to control it. But even though they end up taking doses of the drug that would quickly kill a person who has not been taking morphine, the drug has little effect on these patients’ breathing.

Dr. Kathleen Foley, who is co-chief of the pain and palliative care service at Memorial SloanKettering Cancer Center in New York, said that she routinely saw patients taking breathtakingly high doses of morphine yet breathing well. “They’re taking 1,000 milligrams of morphine a day, or 2,000 milligrams a day, and walking around,” she said.

The standard daily dose used to quell the pain of cancer patients, she added, is 200 to 400 milligrams. Dr. Lynn said she sometimes gave such high doses of morphine or similar drugs that she frightened herself. She remembers one man who had a tumor on his neck as big as his head. To relieve his pain, she ended up giving him 200 milligrams of a morphinelike drug, hydromorphone, each hour, 200 times the dose that would put a person with no tolerance to the drug into a deep sleep. “Even I was scared,” Dr. Lynn said, but she found that if she lowered the dose to even 170 milligrams of the drug per hour, the man was in excruciating pain. So to protect herself in case she was ever questioned by a district attorney, she said, she videotaped the man playing with his grandson while he was on the drug.

On rare occasions, Dr. Lynn said, she became worried when she escalated a morphine dose and noticed that the patient had started to struggle to breathe. Since she did not intend to kill the patient, she said, she administered an antidote. But invariably, she said, she found that the drug was not causing the patient’s sudden respiratory problem.

One man, for example, was having trouble breathing because he had bled from a tumor in his brain, and an elderly woman had just had a stroke. “In every single case, there was another etiology,” Dr. Lynn said. “Joanne’s experience is emblematic,” said Dr. Russell K. Portenoy, the other cochief of the pain and palliative care service at Memorial SloanKettering Cancer Center.

 He said he was virtually certain that if doctors ever gave antidotes to morphine on a routine basis when dying patients started laboring to breathe, they would find that Dr. Lynn’s experience was the rule. Patients generally die from their diseases, not from morphine, Dr. Portenoy said.

The actual data on how often morphine and other opiates that are used for pain relief cause death are elusive. But Dr. Foley and others cite three studies that indirectly support the notion that if morphine causes death, it does so very infrequently. One study, by Dr. Frank K. Brescia of Calvary Hospital in the Bronx and his colleagues, examined pain, opiate use and survival among 1,103 cancer patients at that hospital, which is for the terminally ill. The patients had cancer that was “very far advanced,” said Dr. Portenoy, an author of the paper. But to his surprise, he said, the investigators found no relationship between the dose of opiates a patient received and the time it took to die. Those receiving stunningly high doses died no sooner than those taking much lower doses.

Another study, by Dr. Luce and his colleagues in San Francisco, looked at 44 patients in intensive care units at two hospitals who were so ill that their doctors and families decided to withdraw life support. Three quarters of the patients were taking narcotics, and after the decision was made to let them die, the doctors increased their narcotics dose. Those who were not receiving opiates were in comas or so severely brain damaged that they did not feel pain. The researchers asked the patients’ doctors to tell them, anonymously, why they had given narcotics to the patients and why they had increased the doses. Thirty nine (39%) percent of the doctors confided that, in addition to relieving pain, they were hoping to hasten the patients’ deaths. But that did not seem to happen.

 The patients who received narcotics survived an average of 3 1/2 hours after the decision had been made to let them die. Those who did not receive narcotics lived an average of 1 1/2 hours. Of course, Dr. Luce said, the study was not definitive because the patients who did not receive drugs may have been sicker and more likely to die very quickly. Nonetheless, he said, the investigators certainly failed to show that narcotics speeded death.

Dr. Declan Walsh, the director of the Center for Palliative Medicine at the Cleveland Clinic, said it had been 15 years since he first questioned the assumption that morphine used for pain control killed patients by depressing their respiration. He was working in England at the time, and many doctors there were afraid to prescribe morphine or similar drugs for cancer patients, Walsh said, because “they were afraid they would kill the patients.”

So Walsh looked at carbon dioxide levels in the blood of cancer patients on high doses of morphine to control their pain. If their breathing was suppressed, their carbon dioxide levels should have been high. But they were not. Nonetheless, Walsh said, the idea that morphine used for pain relief depresses respiration is widely believed by doctors and nurses because it is “drummed into them in medical school.” So, said Dr. Susan Block, a psychiatrist in the hematology and oncology division at Brigham and Women’s Hospital in Boston, it is not surprising that many doctors try to use morphine to speed dying. “There is more and more evidence most of it unpublished, but it’s coming, I’ve seen it that physicians, in addition to wanting to ease patients’ discomfort, also want to hasten death,” Dr. Block said. “Everyone is feeling guilty.”

Source: NY TIMES July 23, 1997  http://www.chninternational.com/Opiods%20for%20pain%20do%20not%20kill.htm

No more pain angel.

Posted in Chronic Pain, Daily Post 2012, Family, Family Life, Grief, Palliative Care, Terminal Illness, Uncategorized, Vicky Bruce

A night out of hell


Vic had a night out of hell!  The nausea was vicious and unrelenting.  Pain reduced Vic to a whimpering bundle of human flesh.

Vic’s palliative Care physician, Dr Sue, visited Vic this morning.  I think she was a little taken aback by Vic’s condition.

Sue is an amazing person.  She was so gentle with Vic.  Vic’s heart rate is fast and her blood pressure is 101/58.  Vic has a bronchial infection, her liver is taking severe strain and the sepsis has flared up – badly.  Her oxygen saturation levels are low – 90%.

Sue gently explained that although Vic is running a fever her body’s “warning systems” have started shutting down….. Vic is very warm to the touch yet the thermometer only reflects a temperature of 36.8⁰.

I asked her what I was doing wrong because sometimes, when I inject Vic and withdraw the needle, blood and/or the injection fluid spews out!  Sue explained that it because Vic’s collagen is so poor…. In layman’s terms; the flesh does not “seal” when I extract the needle….  That is why the subcutaneous syringe driver did not work and blood and whatever else spews out.

Vic is such as gentle, beautiful, caring human being.  Last night when I gave her an additional morphine injection, in desperation, she said “Mommy, what do poor people do who have no access to pain medication?

As a layman with access to Google I Googled “low oxygen saturation” and nearly had a heart attack of my own.

Basically, a saturation of 97% of the total amount of hemoglobin in the body is filled with oxygen molecules. A range of 96% to 100% is generally considered normal. Anything below 90% could quickly lead to life-threatening complications. The margin between “healthy” saturation levels (95-98%) and respiratory failure (usually 85-90%) is narrow. If oxyhemoglobin is low (below 90%) inadequate amounts of oxygen will reach body cells!

As a rule of thumb, respiratory failure usually occurs when saturation (SpO2) falls to 90%, although some patients with chronic respiratory disease may tolerate lower saturations. http://www.favoriteplus.com/oxygen-saturation.php

Every time your blood oxygen level falls below 92% saturation your body suffers drastic consequences Insufficient oxygen level is an immediately life threatening issue. http://www.heartfailuresolutions.com/34/oxygen/low-oxygen-levels-how-low-is-too-low-and-should-you-worry

By tomorrow afternoon we should start getting the results in from the blood tests and blood gases.  In the interim Sue has increased the amount of intravenous anti-nausea medication as well as the pain medication.  Dr Sue will make a call tomorrow whether Vic should go onto oxygen or not.

We have cancelled all our vacation plans.  We desperately wanted to take the boys away for a couple of days to give them a break, but it is not possible.  We will have the best Christmas ever.  A Christmas filled with love and togetherness….  Maybe our last.

 

 

 

 

Posted in Chronic Pain, Daily Post 2012, Family, Family Life, Grief, Palliative Care, Religion in my world, Terminal Illness, Uncategorized, Vicky Bruce

Signposts for Dying


Yesterday I posted on “time”.  Today after the visit from the Hospice sister I actually realized that just maybe Vic has entered the first stages of dying 

Some of the stages of dying start to be discernible a few months before death occurs.  

 Vic has become less active; she rests more, sleeps more and has withdrawn into her own inner realm. 

 Vic is reliving memories and spends a lot of her awake time talking to the boys about her childhood, her “illustrious” school career and their childhoods.  This year she relived every minute of her father’s final journey… Vic has started living in the past.  

 I read that it is the terminally ill’s way of taking stock of their lives and making their peace with it.

 Vic no longer eats big meals and I seldom hear her say “I am ravenous”.  Due to the 81 abdominal surgeries and multiple bouts of septicemia  Vic’s absorption is very poor.  (Poor absorption = BIG appetite!)  Vic used to have the appetite of a horse – always nibbling and scrounging for food.  Now it is sheer discipline that keeps her eating.  She knows she cannot have medication without eating first.  Strange thing is that she is not really losing weight.  Hospice says it is due to the high levels of cortisone she takes…  I have been told by Hospice not to worry about her loss of appetite.  Her body does not need a lot of fuel (food) anymore because it is not burning a lot of energy anymore….

 The effect of the reduced food and liquid intake is that the body starts producing chemicals that create a feeling of mild euphoria.  Our bodies actually start relaxing into this stage of dying. 

 Vic still drinks a fair amount of coffee.  She used to drink it warm but now she dozes off before she has finished her cup of coffee.  She will wake up and take a sip of cold coffee… A cup of coffee now lasts a long time.

Vic spends the majority of the day in bed, gently dozing…. It is not a deep sleep.  It is as if her little body is preparing to hibernate….preparing for what lies beyond death whether it is Heaven, Nirvana or the Other Side…. 

 Reduced appetite and increased sleep is called “Signposts for dying”.

 A couple of weeks ago Vic was very emotional.  She would tear up without any reason.  This stage has passed.  It is as if her tears cleansed her soul. 

 Vic is battling with loneliness.  She hates being alone.  If she could she would have one of us around her all the time.  She often complains that we do not spend time with her.  We do spend a lot of time with her.  She just dozes off and then we leave to carry on with our lives…  The boys are writing exams – they have to study; I have to work…. Dying is a lonely journey

 Vic is not in good shape at all.  She is suffering severe cramping and nausea that is not responding to any of the medication.  The Hospice Sister called the doctor this afternoon and asked her to see Vic in the morning.  She also suggested that Vic be admitted to Hospice In-Patient’s.  Vic and I firmly declined…

 It is obvious that Vic has one or other infection.  I think it is the abdominal sepsis.  She seems flushed and feels hot and cold.  The thermometer does not reflect her running a fever.  This is obviously something as Ceza mentioned it to the doctor.  She explained that this happens when the auto-immune system is compromised.  I have tried to Google it but without too much success.  I will ask the doctor tomorrow morning.

 Vic is in terrible pain tonight.  I have already given her double her normal evening morphine injections; double the quantity of morphine syrup; I have changed her Durogesic patches…. I lay behind her back and gently held her until her breathing became deep and even.  She whimpered in her drug-induced sleep….

 I know the shutting down process has started.  Not because Hospice told me but because Vic told me. 

 Will my poor baby’s hell ever end?  If there is a lesson to be learnt PLEASE God show me what it is so I can learn it!!  This has come to an end!