“I need help.”
When your mom calls you at 9 at night, and you hear those words in a choked voice, you do not ask questions. You grab your keys and drive three blocks as fast as you possibly can.
We got to Mama J’s to find her standing up, bent over the back of the loveseat and holding on so tightly that her hands were cramped. “I can’t breathe,” she said. She was leaned over with deep, wracking coughs, her face and arms blazing hot, her nose completely stopped up.
For several weeks now, we have been in a holding pattern. Maybe a little complacent, even. We (all of us) felt secure enough that B and I were able to get away for a couple of days to spend some time with his family. Mom sat outside by herself on the steps outside of her apartment to get some fresh air, a first since her move. We planned to bring a little table and chair so that she could sit outside more comfortably and more often. I had started but not finished a couple of blog posts — one called “Holding Pattern,” in fact — about our new normal, a steady routine, albeit one with hospice nurses, a wheelchair and the constant presence of oxygen.
“I have this DNR, this do not resuscitate. Just let me die. But then I can’t breathe, and it’s terrifying.”
And then, this. “I need help.”
B and I started quickly gathering information from Mama J, as much as she was able to give in between coughing fits. She had taken a lorazepam about 30 minutes prior. She had had a similar spell in the night. She was concerned about her color, which she thought was gray (and so did we). We took her temperature: slightly elevated. We took her pulse/ox: within good limits. I checked her canula (all good) while B checked her concentrator (also good). I called hospice, who connected me to the on-call nurse, who said she was about 45 minutes away and would get there right away. FORTY-FIVE MINUTES??? Meanwhile, I was to give Mama J some morphine (why, oh, why didn’t I think of that first thing???).
Done. I got her settled in to the recliner while B curled up on the loveseat, and I paced, and we waited.
The hospice nurse finally arrived, and took blood pressure and temperature and all those nurse things, and asked a bunch of questions. The whole time I was thinking, you’re the nurse! Don’t you have any answers? Can’t you fix this? B was dispatched to the scary 24-hour Walgreens for a nasal steroid. At the nurse’s direction, I gave Mama J an oxycodone and more morphine. They can be taken together, in case you’re wondering, because the morphine acts immediately through the mucus membranes in the mouth, and lasts during the wait for the oxycodone to kick in. And she should be taking them at night, to help with the sleep that seems to elude her.
As I watched her sit on the floor talking to Mama J and watched my mom steadily grow calmer, both from the morphine and the presence of the sweet nurse, I realized that the hospice nurses aren’t there to “fix” her. She can’t be fixed. All that they can and are supposed to do is to make her comfortable, to help with symptoms as they arise. And in the knowing, I became calmer, too.
This morning when I called to check on Mama J, she said, “You know, I have this DNR, this do not resuscitate. Just let me die. But then I can’t breathe, and it’s terrifying.” And I was able to remind her: Now we know; we use the morphine first and foremost. And we have some ways now to help make you more comfortable, no matter the circumstance. We won’t let you be afraid.
I’ve been thinking a lot about hospice in yesterday’s aftermath and in light of what I saw and learned last evening, and on a whim decided to look it up in the dictionary. One of the definitions of “hospice,” albeit an archaic use, is a “place for travelers.”
A place for travelers. I know that’s not the sense of how we use the word today, but the sensibility certainly applies to Mama J as she travels from this earthly world to her end and beyond. I realized, too, that “hospice” is not just the nurse or the doctor or the medical equipment people or the agency, but all of us traveling on this journey with her: B and me and all of you who love and bring comfort to her or us.
Next post: “Thagnhgg” and other crises
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