Having a tough time right now

Parent Cafe
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<p>Posted this on the “Chaos at Christmas” thread, but feeling pretty wobbly after typing a long e-mail to some family members, and I’ve talked with you all about my mom on several occasions before…</p>

<p>Monday morning I got a call from my brother on my office phone, and the first thing he said was, “What do you know so far?” (Never a good sign.) They’d found our mom unconscious and unresponsive on the floor of her apartment, her blood pressure was 60 systolic over couldn’t-get-a-reading diastolic… No blood circulating, really. Ambulance to the ER, put her on a ventilator and took her to the ICU. Kidney levels were crap, liver levels were crap, acetaminophen levels were astronomically high. She has a history of narcotics abuse, as I’ve mentioned around here, so the current working theory is that she’s likely been pilfering another resident’s Vicodin or Percocet (both contain a good kick of acetaminophen) and just spiked her level high enough that it set off acute liver failure. Now it’s just a waiting game. They’ve stabilized her and we have to see whether or not her liver kicks back in (she’s still comatose and on a ventilator). If her liver does kick back in, she’ll be okay. If it doesn’t, she’ll die in a few days. She’s not a candidate for transplant.</p>

<p>This puts us in a bit of a jam. Her sisters are in the same city as she is, and they’re with her now, but my brother and I aren’t in the same city. My brother’s plans were to fly back today, and he’s sticking to his original plan, but my husband’s and my plans were to spend Christmas with his family this year, since we spent Thanksgiving with my family this year. </p>

<p>My mom has done stuff like this in the past-- creating personal trauma to redirect everyone’s attention-- but this is the first time that there’s a very significant likelihood that she’ll die as a result of her actions. The way we understand acute liver failure from reading up on it and talking to her doctors, she’ll either be just dandy in three weeks, or she’s going to die in a few days. If she regains consciousness and sees that her stunt has worked and my brother and I cancel our Christmas plans to rush to her bedside, then if she doesn’t die this time, she’s GOING to end up killing herself one of these days. Our swooping to her rescue in the past has only fueled this fire we’re in now.</p>

<p>It’s likely that if she regains consciousness at all, she’ll be okay–and then, to go to her would severely endanger her in the future, and it would dampen our leverage to get her into treatment for her addiction this time. If she’s going to die, she’ll likely do so without ever regaining meaningful consciousness-- no possibility for a meaningful goodbye. I’m just scared out of my wits at the slight possibility that she’s going to regain consciousness, see that we’re not there, and then die before we can determine whether or not she’s going to recover. This is a game of chicken that I do NOT want to be playing. Not three days before Christmas. Not ever, really, but… not Christmas.</p>

<p>Just had one of my aunts try to guilt trip me for not coming home, and while it’s getting to me, I know that if I were to give my mom any support while she’s in active addiction, it could be devastating to both of us. If my mom gets another chance after this, she’s going to HAVE to have this be a wake-up call. I wrote a very long e-mail to my aunt explaining my mom’s history of addiction and psychosis, and about how dealing with addicts is counterintuitive… I’m all shaky now.</p>

<p>This is so very, very not-good.</p>

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<p>aibarr - So sorry for your situation. I can assure you that you are not the only one with serious elder health issues. I’m sure whatever you do, and whatever you decide, will be laudable actions/decisions. Try not to second-guess yourself, as it truly serves no constructive purpose. Good luck with your Mom.</p>

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<p>No advice, just big hugs.
Know that lots of people that you don’t even know are pulling for you and for your family to find peace this week.</p>

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<p>So sorry this has happened. I am very confused as I don’t understand why even if she’s in kidney failure, dialysis won’t keep her alive, if that’s what she is willing to endure. My dear MIL had dialysis for many years and it’s done pretty often for folks who have non-functioning or poorly functioning kidneys. If it’s an option, it would allow her to continue to live as long as the procedure continues to work for her.</p>

<p>I really can’t presume to figure out what makes the most sense for you & your brother & hubby given all that you have been through together. If it were me, I think I’d move forward with my plans and ask to be kept posted if your mom does regain consciousness and is in danger of dying any time soon. </p>

<p>Seems like you really don’t have a good understanding of your mom’s medical condition and options. Is she in counseling? Are you? If you are, I’d talk with your therapist about what makes sense and what you can best live with.</p>

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<p>@newhope-- I’m glad for several things: her sisters are with her, my brother’s now up there in the same city, and she’s got a lot of good people looking out for her. I just wish she were a little more “elder”… She’s sixty-one, and by far the youngest person at the elder care community (she’s there primarily because of physical ailments and an inability to care for herself without some pretty significant supervision-- we’re very blessed that there are available resources to fund that option, otherwise we’d be up a pretty major creek). I’m twenty-eight; my brother is twenty-five. My husband and I just bought our first house, and are eyeing our guest room as a future nursery… Mom’s been sending us stuffed animals for a couple of years now, and has pointedly informed us that they’re “suggestions”. I know I’ll be heartbroken if she never gets to meet her grandchildren.</p>

<p>@HImom-- her kidneys had been in bad shape, but they’re starting to rebound and she’s producing urine. If she’d been in kidney failure, dialysis would’ve been an option, as it was with your MIL. Unfortunately, she’s in liver failure, not kidney failure… With liver failure, it’s basically that you either get better without too much invasive treatment once your system gets going again, or your liver doesn’t get better. If your liver doesn’t get better, you’ve basically got one option: liver transplant, and she’s not a candidate for that because of her history. My mom’s in counseling, I’m in counseling, my brother’s in counseling, my husband’s in counseling. No shortage of counsel around here! I’ve discussed this with several trusted advisors. I know I’m doing the right thing, and I’m doing exactly as you suggest, actually… staying the course and getting frequent updates… but it doesn’t keep me from noticing a couple of times a day that my hands are literally shaking since I got the initial call. It’s a decision that requires a lot of intestinal fortitude.</p>

<p>Thanks for the hugs, dragonmom.</p>

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<p>I am so sorry. Your family and you shall be in my thoughts.</p>

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<p>I’m so sorry you have to go through this. My brother (who died 3 weeks ago) put the family through similar things many, many times. I know exactly how you feel, but it’s worse since it’s your mother. My prayers are with you and your family (and my D is here with me and offers you her thoughts and prayers, too).</p>

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<p>No advice. Just more {{{hugs}}}. </p>

<p>I know how hard it is to decide what to do when illness hits family members who live some distance away, as my family are in England. I have been through this with both my parents. With my Dad, who I was not close to, I did not go the first time he was very seriously ill. he recovered that time though was very disabled afterward. I did go 2 years later when he suffered a massive stroke. I saw him once after I got there, then he died the morning I was about to leave my Mum’s house to go and see him again (they were divorced). While I have always been glad I did see my dad before he died, sadly I’m not sure I would have been devastated if I had not. He had some major mental issues that had led me to not enjoy being around him and to not want him round my kids, so I had had very little to do with him for many years. My brother was somewhat in denial about the severity of the situation after the stroke so I dithered a bit about whether to go. I think it also helped my brother out for me to be there as we had to make the decision about whether they should put him on life support.</p>

<p>My Mum has had 2 major health scares and I went immediately both times. I am very close to my Mum, so very different emotions and decision making process. There was never a moments hesitation, but we just have a completely different relationship. I would be devastated to not get the chance to say goodbye to her (though that is fairly likely in the long run given her age and the distances involved).</p>

<p>In the end I think you have to make the decision based on how you feel. If she were to not recover, would you have regrets? Or would you still feel that this is the right decision for you? Only you can decide that. Really tough to deal with, I know.</p>

<p>Do what you think is right for you. {{{hugs}}}</p>

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<p>I think your aunt is making you nuts right now, and that’s not helping one little bit.</p>

<p>How are you getting the info on your mom’s probabilities here? IF your brother hasn’t called you since Monday, you need to have a closer report. Perhaps it’d be better if you asked the doc directly than hear it from the aunts? You are a young adult married woman, entitled to a direct report on your mom.</p>

<p>I wonder if it’s possible to contact your mom’s doctor by tomorrow morning, for a more direct understanding of her immediate condition. Maybe leave word tonight with the nursing staff. Ask them if he might pick up your urgent message on his morning rounds to phone you during the day. Make it clear you’re the daughter, callijng in from out-of-town and need to make decisions concerning travel based on her current condition.</p>

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<p>Aibarr,</p>

<p>Sorry to hear about your troubles. Do what you can for your Mom now. If she passes on, you’ll be glad you did.</p>

<p>Ignore her mental illnesses, her troubles, your aunt, and everything else that is superflorous. If your mom comes through, you can deal with these later. But for today, do waht you can for your mom.</p>

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<p>Aibarr – hugs at a very tough time. I’m so sorry you’re having to deal with this. </p>

<p>The hospital quite likely has a chaplain, as would hospice if they’ve been called in. One of my siblings wasn’t able to get here in time when my dad’s condition suddenly worsened, and the chaplain’s talks over the phone with her really helped. Our lives are pulled in many directions, and it isn’t always possible or practical to be everywhere we need to be. I’d agree with babyontheway that now is not the time to focus on her addiction. Set that one aside for the moment. </p>

<p>Sending thoughts of peace…</p>

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<p>Aibarr, many cyberhugs to you. I’m so sorry that you have to go through this.</p>

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<p>@p3t – Thankfully, her attending physician is a family friend of ours, and I’ve got the direct line to the nurses’ station on the ICU floor. I’ve been able to talk with the resident or the nurse in charge of her care every time that I’ve talked to them, and they’re more than happy to pull the charts and give me actual statistics. I’m actually feeling pretty comfortable with the amount of information they’re giving me, and with how willing and ready they are to give the information to me.</p>

<p>@botw & arabrab – I wish it were that simple… There’s not really much of my mom to be there for anymore. Her personality has been consumed and replaced by a desire to sink into addiction, to not feel pain or emotion. To survive, the family members of an addict have to detach with compassion. Every time that I’ve gone to her side to run interference for her during her crises, I’ve only served to cripple her ability to rebound and face her problems, just like every other codependent loved one of a narcotics addict ever has done. This could very well be her final shot at facing her addiction and recovering some quality of life. No matter how counterintuitive it may be to my nature, I have to give her the room to do that. If I hadn’t struggled this long with an addict as a mother, I am absolutely certain that I’d say the same thing as you’re saying, but this is not the same. Anything aside from addiction-- psychosis, bipolar disorder, schizophrenia, stroke, heart attack, traumatic injury-- and I’d be there now. Since addiction and overdose is the driver here, though, that changes things. Dealing with an addict, I’ve learned, is completely antithetical to dealing with any other illness. I’m not doing this because it’s the easy thing, believe me.</p>

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<p>aibarr, I’m so sorry and I join in the cyber group hug! </p>

<p>We ended up moving my parents into assisted living, largely due to drug abuse issues, and man oh man, it is rough! You mention other residents in your first post – is your mom is some kind of residential care setting? If so, how in the world is she getting her hands on other peoples’ meds?</p>

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<p>Aibarr,
Sorry for the mix-up on liver vs. kidneys. My bad. Glad that you’re getting accurate info & counseling and doing what you know to be best for the situation. Do NOT second-guess yourself and I hope your mom is able to move forward and start salvaging what she can in the near future. It really sounds like a very challenging situation for everyone involved, which is probably why the sister/aunt is trying to guilt you. That is just HER way of dealing with the situation but not the solution that is appropriate for YOU.</p>

<p>Hang in there–as you know, sometimes the best solutions are not those that appear easiest. Keep in touch with those who love and support you at this difficult time. Cyberhugs to you, your hubby & your extended family!</p>

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<p>I am also so incredibly sorry for your pain, and all that your mother has put you through.</p>

<p>My sister’s sister-in-law just died in the hospital, in a very similar situation. Though her addiction was alcoholism, they don’t know for sure if that is what destroyed her liver. Seems likely, though. And apparently when they put someone on a ventilator, there is a significant chance (about 30%) that they will get ventilator induced pnemonia, which often kills people. So certainly, they don’t put people on that unless there is no other choice.</p>

<p>Are the options, according to what the doctors are telling them…is that she will either never wake up, and if you go down to see her, you will basically be going down there to watch her die? Or if she wakes up in a few days, then she will probably recover and will have seen you respond to the drama (as a negative)? Because if those are the two options, it doesn’t seem like you should go to visit. Unless you feel like you couldn’t live with not having been there. I second the motion to talk to the doctor directly.</p>

<p>In my sister’s situation, neither she nor her husband wanted to go watch his sister die. At all. She hung on, comatose, for weeks, and never woke up. I convinced my sister to talk her husband into visiting, not for those last moments of watching his sister, but to be there for his parents and by him being there, his mother felt she could leave the hospital room. This doesn’t sound like it is applicable to your situation. I personally think I’d wait a couple of days, and see what happens either way. It would be hard to not be enraged at my mother. You must be unbelieveably strong.</p>

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<p>I disagree with this on a certain level. I don’t think any of us can tell the OP what to do regarding her ability or willingness to set her feelings aside. As hard as it may be for some people to understand and accept, different people have different levels and ways of coping with mental illness/addiction in their families</p>

<p>Aibarr - as you may remember, I am a hospice chaplain. I have seen and heard my share of stories from families who judge another family member for not coming. And yes, I’ve heard siblings wonder why their ‘uncaring’ niece or nephew won’t come, won’t call, won’t seem to care. I become very impatient with people who cannot understand that everyone has their own relationship with the ill/dying person, based on a history that only those two people can have. And to project their wishes onto another family member, who has had a very different relationship with the ill/dying person is just wrong. I often get tired of hearing Aunt Mary or Uncle Joe saying, “I just don’t get Susy or John. Why aren’t they here?” What Aunt Mary or Uncle Joe doesn’t appreciate is the unique relationship Susy and/or John had with Aunt Mary or Uncle Joe’s sibling. I can’t tell you how many times I’ve told family members that everyone handles crises in their life differently and we need to respect the choices other family members make.</p>

<p>Swimcatsmom hits the nail on the head when she honestly reflects on whether or not she would have been devastated had she not seen her dad before he died. I find this honesty refreshing because it often does not happen that a family member’s last moments unfold like the oft-portrayed death scenes of TV shows and movies where all conflict is put aside as someone dies and those left behind feel at peace. Yes, I’ve seen the ‘ideal’ situations where all family members are present, no one has any conflict with any other family member about choices that have been made to decline any further aggressive treatment/intervention, but it’s more the rarity than the situations where not everyone is on the same page.</p>

<p>I’m not by any means suggesting that this is what the OP should do (not go), but I’m also not telling her to ignore a sordid history with her mom just to appease her aunt. She needs to make the decision that she can live with and none of us can tell her what that is. We can offer suggestions, like get more information then re-evaluate, etc., but only she has walked in her shoes and will have to face the consequences.</p>

<p>Aibarr - as an aside, I’ve also worked with families whose loved one was dying as a result of addiction and it usually is attributed to liver failure. As has been my observation, unless your mom subsequently has some sort of catastrophic event (heart attack, stroke, etc. as a result of the liver failure), you will most likely have at the least a couple of days notice that the end is imminent. If the decision is made to remove the ventilator, that can be scheduled in order to accommodate your travel time. I also have seen a number of patients who have had ventilators removed, live for several days. I think you will probably have more head’s up of her condition than you are thinking. Right now there is a possibility that she may recover from this last episode, meaning they are not yet seeing signs of a decline that will ultimately lead to her death from this event. I would also caution you not to ask any medical staff what they would do if they were in your situation (regarding what to do about your plans for Christmas), because no one else has been in your situation. Yes, social workers and chaplains are available for you to confide in, and can help you clarify things, but no one should be telling you what to do.</p>

<p>As much as it may seem I am advocating for you to honor your already-scheduled Christmas plans and not travel immediately, I would also encourage you to ask yourself if you think you’d have deep regrets if something does happen and you weren’t there. And you can only make that decision based on facts you have now, not facts you might have ten hours or ten days from now. As the situation evolves, re-evaluate and don’t feel stuck to any one decision. That alone might provide some peace, knowing you aren’t stuck with one option.</p>

<p>I’d also like to add that one of my favorite lines that I often hear one of our social workers tell families is, “Our defense mechanisms are not always best challenged when we’re in crisis. There’s a reason we have defense mechanisms and they get a bad rap sometimes. So do what you need to do.”</p>

<p>Please feel free to PM me if you wish to talk off-forum.</p>

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<p>aibarr, just so you know, you and your family are not alone – elder substance abuse is a large and growing problem, a “hidden epidemic” as I read someplace when I was researching my dad’s addictions. Here is just one article on the subject:</p>

<p>[Prescription</a> Drug Abuse in the Elderly - Associated Content from Yahoo! - associatedcontent.com](<a href=“http://www.associatedcontent.com/article/5731/prescription_drug_abuse_in_the_elderly.html]Prescription”>http://www.associatedcontent.com/article/5731/prescription_drug_abuse_in_the_elderly.html)</p>

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<p>Teriwtt,
What a heartfelt posting! You show a great deal of insight from all your experiences & I hope that Aibarr finds your knowledge helpful in making choices SHE will be comfortable with, since that is what matters.</p>

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<p>Aibarr
I am thinking of you and your family. (((hugs)))</p>

<p>Take to heart teriwitt’s compassionate post, do what you need to do. Whatever that is…at that moment in time. Know that there are people thinking of you at this challenging time in your life.</p>