Thursday, September 4, 2014

2013: The Year of Funerals

I started this blog because I wanted a place to talk about video games. I've never been much for forums, as I have a tendency to get into arguments with other people. So Heavy Attack became the place I could say whatever I wanted to about whatever I wanted, without issue or concern. I had hoped to become better at writing, and maybe even turn Heavy Attack into a full blown website one day. Unfortunately life did what it always does, and threw one giant wrench into the gears.

In 2013, I attended more funerals than I ever imagined I would in five years, let alone in one. Funnily enough, it all actually started on Christmas Eve of 2012. My half-sister's father had been suffering from pancreatic cancer for the last year, and on Christmas Eve his heart gave out. This made Christmas a pretty tragic time for us. Even if he wasn't my father, she was still my sister, and I felt for her. If I'd only known the downhill journey that we were going to take the following year, I'd have bundled up under the blankets, and waited for 2014 to get here.

Things were calm for a few months after my half-sister lost her father. We had a fairly decent early 2013, all the way up until my girlfriend's father started complaining of stomach pains. It turns out that while my half-sister's father was battling pancreatic cancer, my girlfriend's father was suffering from colon cancer, only none of us knew it. By the time he was diagnosed, it was stage 4, having spread to his stomach and liver. They tried to administer heavy doses of chemotherapy, but he continued to wither away at a rapid pace. He put up a good fight, but ultimately lost his battle with colon cancer in early June, passing away after three long hard days in the hospital.

A month before my girlfriend would lose her father, my own father started complaining of difficulties breathing. A lifelong smoker with a thirteen year old emphysema diagnosis, trouble breathing wasn't a new development for my father. So he made his complaints, and carried on as if it was all perfectly normal. If we'd only known how bad it actually was, maybe something could have been done to help him, but my dad was stubborn, and he had my mother to worry about, so he just kept going along as if nothing was wrong.

My father was finally diagnosed with lung cancer the day my girlfriend's father entered the hospital to live out his final days. My father would begin his own final journey in a hospital bed a week and a half later. It happened quick for my father, going from diagnosis to death. By the time they figured out what was going on inside of him, they didn't even have time to administer a single treatment of chemotherapy. He collapsed in the master bathroom, and was rushed to the emergency room where doctors would tell me he was septic, he had pneumonia, his right lung had collapsed, and the cancer spread to his liver. When I went back to visit him, he told me to take my mother home and get some rest. My father passed away at 1 a.m. in mid-June, after three days in the ICU with a CPAP mask on his face, constantly asking for something to drink. Like my sister's father, my own father's heart gave out, unable to continue battling so many serious illnesses at once. I got to give him one final Father's Day card, and an hour into the next day, he was gone. He passed away two weeks to the day after my girlfriend's father died.

The next few months were hard, dealing with my father's estate, but my ride down the rabbit hole hadn't come to an end just yet.

On my 17th birthday, my mother was diagnosed with a brain tumor. She had brain surgery the following September to remove as much of the tumor as they could. I, being young and naive, thought it was over. Two years later, they would begin radiation treatment on my mother, informing us that she had an Astrocytoma brain tumor that could become cancerous. Then for a decade, all was well with my mother. She ran the family business, and we prospered. Then the tumor started to grow again, so the doctors put my mother on chemotherapy, which held the tumor at bay for three more years. Until the summer of 2012, when the damn thing came back again. This time they tried something they claimed was "radical," they would administer both chemotherapy and radiation at the same time. The following six weeks of radiation and chemotherapy destroyed my mother. By the end of it, she couldn't drive, barely ate, and started doing strange things that she never remembered doing. This punishing treatment bought my mother another year of her life. It allowed her to live long enough to bury my half-sister's father, and my own. It was only three months after my father died that she stopped using the left side of her body.

In September, my mother came to me and said that she didn't feel right, that her balance was off. At this moment she was standing there with her left breast exposed, having only put the shirt over her neck, and her right arm through the sleeve. I admonished her for walking around exposed, and helped her get dressed. I didn't realize that this was the beginning of the end. For a week, I stayed home from work with my mother, feeding her, dressing her, and helping her navigate the house. Then stranger things began happening, she would confuse the closet with the bathroom. She would also ask me if we could go home, despite being in her very own bedroom. Family argued that she should go to the hospital, but my mother refused, even going so far as to make a personal recording stating that she did not want to go to the hospital under any circumstances. It's the last recording I have of her voice.

Finally things went too far, I awoke one morning to find my mother on the floor, her room destroyed. During the night, she became convinced that I was out buying drugs, and got out of her bed in an attempt to stop me. For the record, I have not and do not use drugs, I didn't even drink alcohol until after she passed. After she managed to get herself out of the bed, she started to climb underneath it, but in her mind, she wasn't simply under the bed, she was trapped under the house. Her thrashing panic left her with cuts and scrapes along her arms and legs, and the room was a mess.

I called my sister to come to my aid, and we agreed that my mother had to go to the hospital, despite her wishes to the contrary. We helped her to the very same bathroom where my father collapsed so she could use the restroom, and then I carried her to her car, and drove her to the emergency room. It didn't take long for them to tell us what we already knew, the tumor had grown substantially. This growth caused swelling in my mother's brain, and lead to a condition called left side neglect. My mother wasn't being careless or lazy when she left her breast exposed that morning, she didn't even know it was there.

They began steroid treatment to help my mother, who at this time was still eating on her own, and was able to recite to me the entire story of I Am Sam, a film we watched together in her hospital room several times. My girlfriend and I stayed with her in the hospital every day, believing that she was going to bounce back from this latest battle with her brain tumor. That wouldn't be the case.

Eventually the hospital determined that my mother was well enough to leave her care, I wanted to take her home with me, to continue caring for her as I had since I was a kid. Unfortunately, the general belief was that I was not equipped or skilled enough to take care of her in her current state, she needed to go to a home where professionals could take care of her. Our insurance wouldn't pay for the hospital that was considered the best of the best, so we had no choice but to take our mother to a nursing home/rehabilitation center. I hated it from the start, and my mother was always terrified of being put in a home, but we had no alternatives. I drove my mother to a home, which I won't name.

On my first visit the very next day, they already had my mother sitting in a chair in front of the nurses station. They explained that she had tried to get out of her bed the previous night. They had also put a diaper on her, despite my mother's ability to use the restroom with assistance in the hospital, and my sister's express orders not to put her in a diaper. I called my sister, and took my mother back to her room. My mother's second day in the home was uneventful, my girlfriend spent the day with her while I went to work. Then the very next night, it happened. My mother fell while under the care of the people who supposedly could take better care of her than I could.

My girlfriend and I had both gotten sick in the hospital while staying with my mother, so I didn't spend much time with her that day. I got off of work, drove to the home to pick up my girlfriend, and only spent around thirty minutes talking to my mother before driving with my girlfriend to an Acute Car Center. I wish to God I had known what would happen that night, I never would have left my mother's side.

At 1 a.m., I got a phone call from the home. They informed me that my mother had fallen, was at the emergency room, but that it was just a precaution, and she would be back soon. I drove to the home immediately to check on my mother, when I got there, I called the front desk to gain entrance. The lady who answered calmly informed me that my mother was still at the hospital, I asked which one, and she hung up on me.

I used my phone to find the nearest hospital, and drove there to find my mother. Luckily, I knew from my experience with my father that an ambulance driver will take a patient to the nearest hospital unless told otherwise. I raced into the emergency room, talked to the front desk and confirmed that my mother was a patient. I went to her room, and it was empty. Panic immediately set in, but one of the nurses informed me that she had been taken for a cat scan. A few moments later, I saw them pushing her bed down the hall. Her left eye was swollen like a baseball, she was vomiting on herself, her collar bone was broken, and she wouldn't open or eyes or speak to me. Then the doctor came and informed me that my mother had a bleed on her brain. I immediately started trying to reach family, believing this would be the night my mother died. It wasn't, she was tough, she lived for three more weeks.

After the fall, my mother was no longer able to see, eat on her own, or control her bodily functions, now she really did have to wear a diaper. Although my mother began the week completely unresponsive, we were very happy when she finally opened her eyes and smiled at my request. Once she started speaking again, my mother would frequently say things that made no sense to us. She also couldn't remember my name, although she did recognize my voice as belonging to her son. During this time I got my first glimpse into the reality that my mother wouldn't be by my side much longer when she informed me that she was walking in the woods with my father, who had passed some months beforehand.

My mother spent a week at the hospital where the ambulance driver had delivered her, not eating, but improving in small amounts. Eventually, my family and I made the decision that we needed to get her back to the hospital that I first took her to, so her original Neuro-Oncologist could treat her. So we signed transfer papers, and they loaded my mother into an ambulance for the second time, and drove her to our preferred hospital. Once there, we were informed that my mother required a feeding tube. Like my father, my mother was opposed to life support, and feeding tubes. They just wanted to pass when their time came. This put me in a tough spot, as I was still struggling to keep up the fight for my mother's life. Finally I made the decision, I wouldn't consent to an NG-tube (through the nose), but I would consent to a G-tube (directly into the stomach).

My family argued that she needed sustenance now, and that I should consent to the NG-tube that could be administered that night while awaiting the surgery for the G-tube on Monday. I had read a lot about the feeding tubes since the subject was first brought up, and had read several things about the dangers of NG-tubes in patients with dementia. The most worrisome being that patients with dementia could pull the tube out of their stomachs and into their lungs, drowning them with their own liquid food. Still, under family pressure, I relented, and they gave my mother the NG-tube. That night, she pulled it out just as I feared she would, but luckily, it didn't go into her lungs. I immediately refuse the nurse when she tried to reinsert the NG-tube. The nurse called the doctor for instructions, and the doctor accepted my wishes. That Monday they performed the surgery to insert the G-tube into my mother. She would live for two more weeks.

After the G-tube was inserted, the hospital informed us that there was a treatment option called Avastin, but that it was a harsh treatment. My mother didn't have enough physical strength to survive Avastin, but we had options. We could take her home to die, or send her to a rehabilitation hospital to hopefully build up enough strength to survive the treatment. My sister and I figured some chance was better than none, so we opted for the rehabilitation center. To my great joy, the insurance company determined that since this new brain injury was related to a fall, they would finally pay for her to go to the rehabilitation hospital I wanted her to go to the first time. So the nurses helped me load my mother into her truck for the third and final time, and I drove her to rehab thinking we still had a chance.

Nothing really went well at the rehabilitation center, my mother wasn't cooperative with the therapists, and spent most days lying in her net-bed. (It's a bed with a net over it to prevent patients from climbing or falling out, which is what the other home should have had her in.) Due to her lack of motion, they had to perform a small surgery on my mother to insert a net that would catch blood clots in her legs before they reached her brain. They couldn't use blood thinners because of the bleed she had. After informing me that the surgery was a success, the surgeon who performed the procedure tried to tell me that the tumor that my mother had would just keep coming back stronger and stronger until it won. I know it may sound like a cruel thing to say, but I really believe he was trying to prepare me for what was to come. Unfortunately, nothing and no one could prepare me for what came next.

A few nights later, while I was trying to maneuver my mother in her net bed, she began shaking violently. I remember thinking to myself that even the skin on her cheeks was vibrating. My girlfriend ran for the nurse's station while I tried to speak calmly to my mother. Seizures were nothing new, she'd had them off and on throughout her battle with the tumor. I'd been burned with hot coffee trying to catch her as she fell many years before. The problem was that I was used to her going limp, falling down, not shaking violently like this. I was terrified, and so was she.

After the seizure, the rehabilitation hospital sent us to another hospital to check my mother's brain waves, then to get another CT scan. My mother's brain waves were good, they saw no signs of another seizure, but the CT scan confirmed my worst fears. The tumor had progressed further. The rehabilitation hospital sent my mother on her third ambulance ride, back to her original hospital. In the emergency room of that hospital, the neurologist informed me that my mother had developed a second bleed, and that Avastin would no longer be an option for treatment. This was it, my mother had no options left. They could only keep her for 24 hours under observation while my sister and I raced to set up hospice care. She would live for one more week.

My mother always liked to talk a lot, and she told me a great many things. She was always afraid of going blind, being paralyzed, and dying in a hospital. She wanted to die at home, peacefully in her sleep. So once I knew that there was no fight left to be had, I started setting up to care for her at home. Hospice brought food, diapers, and medication. They gave my best friend, my girlfriend, and I a quick course on how to administer food and medication through the feeding tube. That was that, and for the next week, I changed the diapers of the woman who changed mine, watched her on a baby monitor just as she listened for me on one, and fed her through a tube like she fed me from a bottle.

I never broke while I was caring for my mother, I never yelled or cried, until the night before she died. My mother wouldn't sleep, she stayed up for 48 hours straight. I wouldn't sleep either, lying in a cot next to her as she mumbled things that made no sense. I was exhausted, and after the sleeping medicine that hospice delivered to us failed, I lost it. I began yelling at my mother to go to sleep, begging her to rest, telling her that she was hurting all of us. She yelled for me to please stop yelling at her. I did stop, but she would die the next day, and nothing tears my soul apart more than the vivid memory of her yelling, "Please stop yelling at me!"

The hospice nurse told me she would go on for a few months, that we had a long road ahead of us. I had refused to go back to work while she was in the hospital ever since the fall. I didn't trust anyone to look out for her well being but myself. So the morning of the day my mother died, I decided to finally return to work. I took my shower, got dressed, administered my mothers food and medicine, then leaned down next to her right ear and said, "I'm going to work, I'll see you when I get home." To which she softly responded, "OK." That is the last conversation I ever had with my mother.

While I was at work, hospice sent someone to give my mother a bath. They lifted her into her wheelchair, and she threw up all of the food that I gave her that morning. My best friend immediately called me, and I raced home to care for her. The person hospice sent to bath her simply left, not even changing my mother out of her vomit covered nightgown. I cleaned her up and sat with her the rest of the day. That night she started breathing rapidly, and I noticed that her hands and feet were like ice.

When hospice comes to your house, they give you a pamphlet with the stages of death, so I went to check the pamphlet. Rapid breathing, check. Cold hands and feet as blood rushes to the heart and lungs, check. My mother was dying, and I knew it. I called hospice and they sent a nurse with morphine, he instructed me on how to administer it orally, and told me that she probably wouldn't make it through the night. He also informed me that the rapid breathing was my mother struggling to survive, putting up the final fight of her life, and that she might perish after the morphine slowed her rapid breathing. He told me that it wasn't the morphine killing her, it was the disease. I asked him to administer the first dose, kissed my mother on the forehead, and told her that she was the best mother I could have ever asked for. She didn't perish with that first dose, and the nurse left, the burden was to be mine to bear.

I called my sister, and texted my uncle to inform them that my mother would not last the night. My sister began racing to be at my mother's side. My uncle never came. I just sat there on my mother's bed, with my mother's friend, my girlfriend, and my best friend sitting around us. I spoke to her of great memories we shared when I was a child. During this time, my mother's friend became too upset and left, unable to watch her friend die. When the time came, I administered my mother's second and final dose of morphine. It happened very quickly. Her breathing became short, and I climbed into her bed and grabbed her into my arms. I told her that it would be OK, that my father was waiting for her. I told her that no matter where she went, I would find her. Then she was quiet, her breathing stopped, and as I lied her back down on her bed, one final breath of air was pushed from her lungs. I looked down at her lifeless face, and her unmoving eyes stared back at mine. She wouldn't go to sleep, it wouldn't be that easy, she would fight til the last breath.

I walked out of the room to call hospice, they said they were sorry, and that they would send a nurse to determine the time of death. I called my sister who was still trying to get to my mother's side, and told her that it was already over. Then I called the funeral home that buried my father, and they told me they would send the hearse for pick up. My mother died of Astrocytoma brain cancer at 9:44 in the middle of November, the credits of her favorite show scrolling on her TV's screen.

I wanted them to take the feeding tube out, and take the diaper off immediately, but the nurse said the diaper should stay on, as bodies will continue to void their bowels during transportation. They did take out the feeding tube at least. The hearse pulled up two hours after my mother died, the gentlemen were dressed in fine suits, and they wrapped my mother's body up and put her on a gurney. Before they left, they asked me if I wanted to see my mother one final time, I did. I walked to my mother's side, kissed her cold forehead, and said the first thing that popped into my head, "You're going to be OK."

A month later, in the middle of December, my grandmother died. One more funeral, squeezed in just under the wire. That was 2013, the year of funerals.

I'm not sure what the point of the story is, if there even is one. All I know is that death will come for us all, there's no changing that, we can only choose how we face it. Whether it be like my father, who ignored his own declining health to care for my mother, or my mother who refused to close her eyes and fade away. I like to tell myself that I'll be like my parents, and face it without fear, but I can't know that for sure. I just know that my time will come, and I'll have a choice to make.