My mum was a little under the weather the previous Sunday evening. Phlegm and cough. Ever-present symptoms of Chronic Obstructive Pulmonary Disease (COPD). By Tuesday night, she was running a slight temperature. Her cough was nagging and disruptive. Sleep deprived, she was tired and slept most of Wednesday morning. And, again after lunch while waiting for the palliative care team to arrive.
Instead of waking my still asleep mum, sister number 3 and I decided to use the time to ask some hard questions we had about her health. The palliative doctor explained it in two parts. Now and after.
With regards to the now. She said my mum’s health will decline. It was inevitable. Gradually, she will have more difficulty breathing despite being hooked on to an oxygenator, almost 24×7. Heart failure with a scarily low Ejection Fraction and COPD combined – will lead to complications like fluid accumulation in her lungs and abdomen. There is already a build-up of fluids in the area. The fluids can be removed. But that would require an invasive procedure known as tapping. A few months ago, after the last CT-abdomen, we ruled out invasive procedures for my mum. We didn’t see the point in putting her through more pain, trauma and/or danger for an unknown/uncertain outcome. When breathing becomes difficult, there will be pain and discomfort. As part of palliative care, morphine was mentioned. And, other pain reducing measures, which admittedly was difficult to hear.
I pulled myself together to listen to the steps that needed to be taken in the after-stage. First, a call must be made to the nearest government hospital. The paramedic service will provide a certification letter. Furnish the paramedics with the palliative doctor’s letter that will contain details of my mum’s ailments – heart failure and COPD. This is critical to eliminate and avoid any possible confusion related to Covid-19. Then, to head to the closest police station with the hospital certified letter, my mum’s identity card and letter from the palliative care team. Once the legal necessities are completed, the after-stage arrangements can be carried out. We didn’t and weren’t ready for that discussion just yet.
It was at that moment that sister number 3 walked over to wake my mum up. We joined her. My mum was fast asleep. We called out her name. Usually, sister number 3 and I gently stroke my mum’s arm and call out the various pet names we have for her to gently wake her up. All that went out the window when we couldn’t arouse her. I was literally shouting into her ear to wake up. Granted it was her deaf ear that I had access to but still I was very loud. I called out again and again. I just wanted my mum to wake up. I didn’t shift my gaze from her. Hence, I cannot remember what was happening around me.
My head was in a panic. Thoughts all over the place. Fear overtook me when I tried to sit my mum up and her head flopped like a rag doll, and her lower lip diverted to the left. It was then that I looked to sister number 3 and the doctor for help and solace. The doctor was doing sternum rubs that provoked fleeting reactions from my mum but her eyes refused to open. She kept them tightly shut. The doctor instructed me to get a damp cloth that she used to dab my mum’s eyes with. This also elicited temporary reactions. Her eyes were still shut. My mum must have reacted at least half a dozen times but all the while her eyes were closed. She remained in a sleeping pose. While all these was happening, her vitals were normal. What I remember is I kept shouting at her to wake up. As was sister number 3.
Finally, after what seemed like eternity, my mum opened her eyes. She looked a little cross, and her first words were, “Why did you three wake me up. I was fast asleep? When the doctor asked my mum how she was feeling, my mum’s retort was, “You’re the doctor. You tell me? How am I?” She made us laugh. Her wit and cheekiness, very much intact. Amazingly, my mum has no recollection of what had happened. And, thankfully, no after-effects. Except for physical exhaustion. Sister number 3 and I, on the other hand, were totally stressed and in a state of disbelief.
For now, we are just relieved and happy our mum is alright and with us.
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