Mom, 11th post

 And so it continues….

Arrived about 12:30 after a freezer emergency at home made me late. Walked in to find Mom breathing 32/min, her fingers & toes warm but cyanotic, her body very hot. These are, typically, signs of impending death: rapid shallow breaths, bluish extremities from poor circulation, and elevated body temperature which sometimes hits 104. I sent out text messages saying that the end was near, silenced my phone, read Baha’i prayers to her, recounted memories, made sure her favorite music was on, read parts of other favorite books. I put the eye gel in, sprayed a mouth moisturizer, put Vaseline on her lips, and waited.

 Just to make things a little more interesting, Mom has developed PUBS: Purple Urine Bag Syndrome. Yeah, I’d never heard of it, either. Her friend Kathy, who comes in the morning, had asked me yesterday, I’d said it was probably the plastic reaction to the change in her urine and increased bacteria. Turns out essentially that is true, the Cureus on-line abstract says it is very rare phenomenon associated with long-term indwelling catheters, that the color change results from altered metabolism of tryptophan into color pigments by certain bacteria, I had no idea it was a ‘thing’. My mother has generally only developed ‘usual’ medical issues, unlike me, but it appears as she nears death she wanted to be known for at least something weird. Sigh.

 Hospice nurse came about 2:00, agreed with all the above being signs of pending death, except her thermometer only read 98.9, which didn’t make any sense feeling her skin. All Mom’s vital signs were either up or down as one moves towards death: BP down, heart rate & respirations up. She said she didn’t expect Mom to make it through the night, that she would be ‘extremely surprised’ if she didn’t die very soon, but she then threw in the obligatory ‘But, of course, you never know for sure.’ She said morphine regularly, it’s ordered as every hour if needed, that the high rate qualified as respiratory distress. It's a compensatory response as the body slowly goes into shut down, and the lungs gallantly try to correct changes in the body’s chemistry, until they can't anymore.

It's now after 9:00 pm and the only thing that’s changed is Mom is breathing 40 times a minute, the axillary temperature the staff here got was 101.5. Initially I resisted the rectal Tylenol as treatment, because, again, the temperature is a sign, but then figured that since nothing happened in 7hrs without the Tylenol what the heck, might as well. There will be another temperature check soon, but her respirations haven’t changed and she’s still warm.

 So, again, I face the dilemma: should I stay or should I go?

 When believing death was about to happen I was, naturally, crying, and sobbing just exhausts me. It might release chemicals that make you feel better, but I just feel rung out. Despite almost 8.5 hrs of good sleep I’m beat. Stupidly in circumstances which are changing, my pill caddies are empty, the plan was to fill them tonight. And, understandably, it is more than a little tiring to be on edge all day as you watch your frail mother move ever closer to death. Gotta say: this watching your parent die in front of you is not for the fainthearted. (Just because of my health issues I’d already determined that, as a doula, doing vigils was not going to be one of my offerings.)

 As before, I’m going to feel like an ass if I leave and then a couple hours later she dies, but there’s the well-known phenomenon of a parent not dying with a child present, so is she waiting for me to leave? I’ve done a couple trips to the recycling closet with papers, and, being me, have gone to the bathroom repeatedly, but what if those weren’t long enough? And historically she has always wanted me near when she was sick. But what if this not only continues through the night but well into tomorrow? Or longer? I won’t be functioning by then without at least a few hours of decent sleep. And, again, it helps no one if I get sick.

 Just had the temp check, an hour after the Tylenol, and it’s only down half a degree. This makes sense, because the temperature spike isn’t due to an inflammatory issue or bacterial or viral response. But at least it was tried, which made one of the techs happy.

 She’s due for another dose of morphine & Ativan in about 15 minutes, so I’m waiting until about 10:30 and if no change then I head for home, and plan on returning earlier than usual. It’s entirely probable that she will die before I get back, but either she was waiting for me to leave or it falls under the ‘what will be, will be’ category. She wouldn’t want me to get sick. And I've been here for 10 hours, so not a brief time waiting. 

Going to bed.