Saturday, February 25, 2012

Say What You Need To Say

One of my cousins recently asked if we girls were like our mom. I replied that I was too close to the situation to know. But as I think on her question and as we ride the roller coaster of daily life here, some similarities do come to mind. I know from talking with my sisters that we all have a hard time making our thoughts, feelings, and desires known. Whether to the world, those closest to us, or even to ourselves, it seems we have to wade through a swamp of reticence, self-doubt, and denial, sometimes even for the simplest communications. I also know from talking with my sisters that we are all three working on it in our own ways. I try to remind myself: What do I think? What do I feel? What do I want? Say it!

Unfortunately in this, the apples have not fallen far from the tree. Yesterday, a hospice nurse came by to check on Mom. Not our regular nurse, but I was glad for the check-up. Mom blithely assured her that everything was fine, freely admitted to weakness and sleeping almost all the time, said her swelling was gone, and she was so glad she could pee again. We asked for a refresher course in morphine and oxygen, just in case. The nurse noticed Mom's comfort kit meds were mostly expired (!), and ordered replacements. But I had to request for her to take Mom's blood pressure and heart rate. I said it would make me feel better. Everything did indeed seem as fine as possible.

Until about 7:15 last night, when Mom transferred to the red chair for a power nap before Hannity and said, "Gwen, my legs are swollen and leaking again." And then she told me she hadn't peed all day. Why? Why didn't she tell the nurse when she was here? Something like, "You know, I haven't passed any urine today," would have been appropriate. I realized that since she had been using the potty chair and been changed by a hospice aide, I was really only aware of one diaper, which had had no pee. I assumed (and you know what happens when we assume) she had peed other times. I had given her 3 cups of water throughout the day, plus coffee! I assumed, and Mom did not say what was really happening, and we ended up with a repeat of last Friday night. Same on-call nurse and everything.

As I moved Mom back to her bed, she declared that she would make no decisions without talking to her regular hospice doctor and nurse. I told her that would mean waiting until Monday. She remained resolute. The sweet on-call nurse called to say she was on her way, and I recommended she turn the car around and save the trip, because Mom would not do anything until Monday. Nurse said she was afraid of that, but insisted on coming anyway. I am so thankful.

Mom's edema actually extended from her torso down to her toes. The nurse was able to correctly insert a foley catheter and immediatley drained a bunch from Mom's bladder. Then because the cath was working well, she was able to convince Mom to take a lasix to start draining fluid from her tissues. Mom slept incredibly well last night and had a full bag this morning. Her edema is noticeably better. Mom is extremely weak, with only enough energy for transfers from wheelchair to bed or red chair, and eating. She used the oxygen this morning while napping in bed and said it helped to ease her breathing.

Where we go from here is anyone's guess. The nurse did warn me that eventually we will not be able to drain the edema. She will be back to check on Mom tomorrow. I guess I know we are going downhill, I just don't know how we will get there. And Mom's not saying, that's for sure.

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