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A few weeks back, someone told me that no mater your age when your last parent dies,you are orphaned. Damn skippy, they were right. The sense of abandonment, the “what did I do to make this happen?” thoughts, and the sadness of being left with a simple box of belongings that represented a life. A life that gave you life, and (hopefully), nurtured and cared for you. All of that is in that box.

The US gives use 2 or 3 days off of work to grieve and get over it, then pack all of your feelings in that box and continue your 9-5 life. Two years later when you have that nervous breakdown, everyone will wonder why.

There is something to bs said for ritual, and our ancestors worldwide seemed to grasp that need for recognition of a loss before life continued as usual. (if I wasn’t so caught up in my grief, I would have done the proper thing and provided a list of scholarly references we detailing such rituals here.) I thought I was done grieving – having pre-grieved 3 times prior with the close calls she had. I grieved after her stroke – it stole her psyche – the part of Mom that made her “Mom.”

I had said what I needed to say, and it was all OK. Then I got that phone call at 835a on February 21, and every bad thing I was angry or resentful about just melted away, leaving the memories of laughs, and how we clung to each other in our struggles to stay sane while being held captive by my father.

What I would give for a chance to hold the good memories close, and to make her last years here much better.

Suicide, a DNR and a Dilemma

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Hey, wanna solve a mystery?
Say, for example, you know someone that is sick and dying (could be 6 weeks, could be 6 years).

This person is old enough to die without raising suspicion, so to do so would not be unusual (dying that is). But there is no active disease process present to cause death – just the disintegration of the mind, the necessity to wear diapers and the inability to swallow appropriately to eat.

This person has been in a rehab/nursing facility for about 8 yes.

A DNR is in place and this was the disabled person’s choice since 1999, when the stroke occurred. (whaszza DNR? look it up!!!!)

About a week ago, this individual decided to stop eating (nigh a tiny piece of dark chocolate with raspberry), stop drinking fluids. Two days later, medicines are refused; held in the mouth and then spit out, or forcibly knocked out of the nurses’ hand (how ruuudddde!)

OK. Here is the hard part. Do we (me and the medical team) honor the DNR verbatim  (no “heroic intervention: comfort measures only) and allow the patient to basically off themselves via starvation?

Do we force nutrition by installing a central or PIC and an NG tube (there’s another abbreviation for you to Google)?

Or do we start an IV for a route through which we can safely administer meds?

Does an IV violate the terms of the DNR??? Does the feeding tube? The DNR states no heroic measures – is a feeding tube a heroic measure – as it would ease  discomfort from malnutrition.

See, I can be positive!

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My husband wakes me up with a kiss on my forehead to say ‘goodbye’ before he leaves for work. He is smiling and asks me how I am feeling.  This is the hardest question for me to answer.
My lower back is stiff and painful.  My legs refuse to respond to my subconscious directions to move. My big toe joint are on fire and my lower legs are swollen just enough to make them too achy to ignore. The back of my neck and upper thoracic area is on fire. I smile anyway.  My mind goes back to something my husband said in the car a few weekends ago.  “You know what would make me happy?” he said.  “To hear you say that you feel great – not to hear you list off all of your problems and pain – not to hear you dwell on your problems all the time.” But, I can’t lie, and darn it all, I don’t dwell on my medical problems. The cells in my body do that for me. Thus, I am forced to be consciously aware of my pain all of the time, even with diversion.  I briefly think about a worst-case scenario: What if something happens to me later on – he would not be able to advocate for me – “Well, she said she felt fine earlier,” he would tell the doctor/ambulance crew.  So, do I lie to make my husband happy before he goes off to work, so he can have a good start to his day, or do I honor my body, and tell the truth?
I decide to change the subject – I roll over as carefully as possible, peel myself out of the bed and go to the bathroom, telling him that I’ll be right back. By the time I return, he forgot that he asked that question, and the conversation moves on to dinner, and what we need at the grocery store. So he leaves, thinking I am fine since I didn’t complain, and proceeds through his day with now idea how I struggle.
My husband comes through the door, always grumbling about the stupid drivers he must dodge in order to safely navigate the twenty-six miles from his workplace. I empathize.  I used to commute by car too, before I became a medical train wreck. The question is asked again, “how do you feel?” This time subterfuge is easy. I tell him all the things I did; factoids form the silly TV shows I watched, gossip about friends and neighbors. No mention is made about the searing back and leg pain, the stabbing pain still in my neck, alerting me a migraine is just around the corner, or a series of uncontrollable muscle spasms that rendered me unable to drive. I did enough things around the house to make it look like I was busy and actually accomplished something housewife-y – more than watching TV while laying on heating pads, doing stretches to try and loosen my tight muscles that squeeze the nerves that most likely cause my back and leg pain. Or, that I napped for three hours. Of course, the medications that I took to try and maintain some quality-of-life are not mentioned either. Hubby curls up on the couch with his laptop and cruises the net, completely immersed in reading his techno-geek websites. My condition is no longer a concern, or so I think. Then around 8:00p.m. he announces that he has made me a nice warm bath, to help relax my back and legs. Perhaps I will sleep better, he says. Without my verbalizing about the magnitude of my issues, he knows, at least to some degree, how I really feel. I underestimate his ability to perceive my aches and pains. After my bath, I tell him what he wants to hear. “I feel great! Thanks for thinking of me.” It is still a bit of a white lie, but I do feel great – and loved.  For a few moments I am pain free, and I smile, for real this time.