Friday: Part I

Mom just said God bless you.  Her eyes are closed and she otherwise looks like she’s dreaming, but still…the ever present politeness that’s grown to define her.  Earlier today she called me “whore-face” (thanks to Diane) while trying to suppress a smile.  Thankfully, she’s perkier today, after being relatively unresponsive the past few days.  We’ve been told that tumor patients often have these highs and lows, and though we’re not sure what to make of it, we’re embracing the highs whenever they come. 

Today’s been an intense day, after an equally intense evening.  After spending an hour or two at dinner last night (Thursday), D and I returned to the hospital to find mom slumped in her hospital bed, and a frenzy of medical personnel surrounding her.  She had aspirated on her smoothie just a few minutes before, and the nurse felt she was less mentally alert than before.  Dad was visibly distraught by the whole thing.  The three of us walked beside her as they wheeled her downstairs for another CT scan and X-ray, which later came back normal.  Diane and I slept over while dad bunked out at Brelles.  During the night, mom made some gurgling sounds like she was making bubbles with her saliva.  The nurse said she was aspirating, and suctioned a good amount of saliva out of her mouth.

The next day, we awoke for rounds.  First, the neurology med student performed his routine tasks, and was surprised to see mom more alert and talking.   Just as he finished his assessment, the oncology resident showed up and also noted mom’s alertness.  Then the neurology resident arrived and expressed how happy she was to see mom feeling better.  About a half hour later, the oncology team popped in, and after two minutes of chit-chat, the head doctor asked Diane and I to step outside to talk prognosis.  After ten minutes of discussion (the details of which I’ll discuss some other time), we thanked the team for their candor and D proceeded inside, while I left with the social worker to continue our discussion. 

I then left to pick Craig and Emily up to take Emily to the airport.  After saying our goodbyes, C and I drove the fifteen minutes to the hospital.  I opened the door to find Diane crouched over mom; they both were crying.  Craig and I entered, and I put my hands on her feet while D and C held her hands.  We stood there while Diane explained what had happened.  While C and I were away, the neurologic team visited with mom, and was excited about her progress.  They suggested that mom try an NG tube for nourishment, and to get a particular medicine down which could help with her mental alacrity.  Mom refused; I don’t blame her, given the pain and suffering C went through just a few months ago.  Overhearing neurology’s discussion with mom and subsequent recommendations, the palliative care team stepped in and suggested that we avoid an NG tube, if at all possible -- cue a big sigh of relief.  Then the palliative team began discussing with mom her diagnosis, picking up where the first doctor left off.  They were candid with her, which I think mom appreciated after being talked down to by the neurologic team, et al.   We listened as Diane recounted the discussion, and told us mom’s wishes regarding her treatment and next steps.   We all started to cry a bit, and I called Erin and put her on speaker phone so that she could be there with us in the moment.  (Dad had not yet arrived.)    

After awhile, D and I went downstairs for some lunch and to finish our discussion with Erin, who, by then, had decided to return to Denver.  Dad joined us and we briefed him on the day’s events.  Where we go from here, we’re not sure.  We’ll have a “team meeting” with her doctor and the palliative care team on Monday.  We’re just taking one day at a time, and trying to make each day beautiful – as we have been -- leaving the big discussion and decisions for another time.  -- J