Small bites of happiness

Against all odds, my mother is still here, among the living.

She struggled through her touch and go night, and then swung more up than down throughout the few days since.

I have stayed at her side or close by, fearing a call saying "Hurry now, she's turned for the worst." But it has not come.

She is ill still; weak, and broken-boned. The heart still gallops, controlled by medicine's drip, drip, drip into her arm. Her blood is still hosting hostile invaders, though fewer, we believe, than in the depth of her illness.

And yet, she had returned from the brink. No longer at the precipice of "multi-organ failure" her liver and kidneys are back in the job; her lungs and heart, though diminished, have not thrown in the towel.

She gains strength slowly, minute by minute. I watch the clock tick by with her heartbeats, the monitor screen my Rosetta Stone, translating her complex body into simple numbers I can witness the rise and fall of.

With these I can infer trajectories; legitimize hope. When her O2 sats at 99, *I* breathe easier.

Everything in such a delicate equilibrium, we are all tiptoeing around her, afraid to do too much and send the scales wildly tilting again.

And yet things must be done: IVs changed, oxygen delivered, blood pressure measured, pain medicine given. Most painful of all: her position shifted, so as not to develop bedsores. With every move her unset bones dig into her flesh from the inside, scream warnings of pain the drugs can only dull, not eliminate.

Also? She must eat. Because if her body is going to repair itself, to heal? It must have fuel and the ingredients to do so with.

Yet finding foods she is inclined to swallow is a daunting task. Sedated, reclining, nauseated from medications, she would rather skip the whole affair.

So I am once again mothering my mother. Offering tiny tasty morsels on the tip of a spoon, coaxing and cajoling her to take "one more bite"of something "yummy" harkens back to the days of my boys' infancy.

We are most successful with the comfortest of foods: soft, sweet, easy to slide down her tired throat: soups, yogurts, puddings.

Yesterday, perusing the hospital's dining menu I noticed an item I had previously overlooked and inspiration struck: baked sweet potato, one of Mom's all-time favorite foods!

It came soft and well done... perfect for my plans. I cut it open, smelling the earthy sweetness rising up from the deep orange flesh, slipped it all out of its papery skin, then went to work.

I emptied the margarine pats deep into the mound and watched them swiftly melt. I took up the fork and mashed and smashed, tamed lumps of potato flesh into a smooth purée. To thin it out to a consistency that would slide right down, I slowly spooned about half the accompanying tomato bisque soup into the potato, blending and rendering it halfway between a thick soup and a mash.

And? It was perfect.

People? She ate THE WHOLE THING. And with gusto.

And in those few moments when I was scooping spoonful after spoonful of nutritious goodness into my mother, and I could see that eating this was something that was actually giving her pleasure, I was happier than I can ever remember being.

A very small, very brief bite of happiness, to be sure. But blinding in its intensity, and staving off the encroaching darkness, if just for a little while.

That train is coming...

I am sitting by my mother's side. again.

Watching her breathe. again.

But not for very much longer.

She is dying.

It's not just a broken hip.

It's a broken heart. literally.

And an infection that has gone septic.

Blood that won't clot, or that may actually be forming tiny clots within itself, and therefore not where it is actually needed.

There are all kinds of official medical terms for these things, and I know them; have heard all sorts of acronyms flying about the ICU that will surely be the last room my mother occupies.

But is comes down to this: her body is worn out, as is her spirit.

There is no more fight left in either, only pain and suffering.

And it's soon time for that to come to an end.

I thought it would be last night, came barreling back to the hospital through rain and fog, having arrived home at dinnertime and stayed through putting the kids to bed; all while fielding phone calls from nurses, doctors and family members.

I walked into her room here in the ICU a shaggy mess, expecting to find her the same. But somehow in the hour since I'd last phoned in, her blood pressure had normalized and her heartbeat reigned in, no longer pulled by stallions, champing riotous at the bit.

"Your mother may not last the night" was still a possibilty, but no longer a softened, near certain prognosis.

And, indeed, she stayed the night.

This morning a nurse woke her up in the wee hours to administer another shot of vitamin K, attempting to stem the blood tide. "Thank you" my mother responded, astonishing the nurse who told me she had never been thanked for an injection before (more frequently cursed, I assume). That's my mother: gracious, grateful, full of love. And sorrow.

"Tough old bird" I whisper under my breath as I kiss her forehead once again.

How thing-like a body becomes when it is old and broken and clinging to life with tendrils weak and brittle as snow-scorched vine.

And yet my mother's hands are strong still, fingers wrapped, embracing mine, one of the few points of physical contact not obstructed by tubes and wires, her whole body a minefield of pain.

She looks like a fighter pilot: mask covering nose and mouth, offering air ever more oxygenized as her lungs are capable of absorbing less and less.

And fighter she is (tough old bird) clinging still to life, diminished now to this room, my hand, my voice, a cup offering ginger ale through a bendy straw.

She is still here.

I am here with her.

She knows I'm here.

And, for now, that's enough.

A matched set of broken hips

I got the phone call at 4 AM, either late Friday night or early Saturday morning, depending on how you count time.

The BEST news a 4 AM phone call can deliver is a drunken wrong number. NO Candice is NOT here and (to my knowledge) she did NOT steal your man.

But this wasn't that.

This was the other thing. 

The "your mom fell and is in a world of pain so we've called an ambulance and are sending her to the ER" thing.

And so it goes... again.

I did not see my children on Saturday, leaving long before they were up for the day and retuning home long after they were asleep; Ethan in my own bed, missing me.

By the time I arrived at the ER my mother had been to x-ray and returned with the tech's unofficial "broken hip" reading, that soon became official. Her right side, this time. So now she has a matched pair.

There will be days ahead of back and forth on trains and in cars. There will be packed bags and sleepovers on Long Island friends' and relatives' sofas.

There may be an operation, or there may not.

This will be swift or long and drawn out.

There is no way my mother is getting away clean, without pain and suffering.

And that sound you hear?

Like crystal, cracked; musical and violent all at once?

It's the sound of my heart breaking.

Again.

The Rollercoaster

The view from where I sit

My life since last Friday morning has been a jumble.

I am riding the rollercoaster, strapped to my mother's flagging health.

I am up, down, and all over.

I couldn't even begin to put things into a coherent sequence, present a normal timeline to you. The days whiz by, but the minutes telescope to feel like hours. Waiting is excruciating. But so are the events that puncture the boredom.

The biggest single up/down moment:

On Sunday morning, Mom's orthopedic surgeon came out to find me in the waiting room, to tell me that the operation had gone well: rod and pins in, bones fit together like tidy puzzle pieces, quickly done. He told me she was about to be extubated; that in about an hour she would be waking up, and they would send someone to bring me to her side.

The hour came and went. I didn't want to be a nudge; figured she probably was waking up slow from the anesthesia. (I know I do.)

I was being happily distracted by my friend Barbara, who had surprised me by a visit with rations (black and white cookie!) and delightful conversation.

But when she left it was nearly two hours without a word.

I walked up to the desk to ask "When can I go to my mother?" and did not like what I was overhearing as the reception clerk attempted to track her down.

"She's in recovery on another floor." was all she told me, and the unit and bed number. But when I got out of the elevator I saw that the unit had a name too: Surgical Intensive Care Unit. This did not bode well.

And when I arrived at her bedside I was shocked to see her surrounded by medical folks frantically doing... THINGS to her. Not what "successful operation" had lead me to expect.

I was shooed away to wait outside with nary an explanation. I tried hard not to flip out. Eventually I was made to understand the situation.

No one ever properly apologized for leaving me in the dark for so long. But I understood, people had been kept busy trying to save my mother's life. I couldn't be too pissed.

And so it has gone for the last 48 hours.

I am up, down, and all around.

My mother, due to her critical aortic stenosis, is such a delicately balanced machine, and they have not yet found the perfect sweet spot for her blood volume. Push too many fluids and they back up into her lungs, send her into heart failure. Remove too much of that excess fluid and she can't maintain her blood pressure.

So a ventilating machine is helping her to breathe, so she can get enough oxygen in spite of the (hopefully lessening) fluid in her lungs, and medicines are keeping her blood pressure in a normalish range. There are various other forces pulling and pushing at her including her levels of pain and sedation.

All in all, an incredibly complicated dance.

She rides it up and down throughout the day, as do I. I am sharp one moment, lost the next. I have been deeply distracted and also in need of distraction (many thanks go out to friends playing iPhone word games with me, you are keeping me sane).

This morning my brain was in another sphere while brushing my teeth. I had accidentally picked up my son's Sponge Bob toothpaste and squeezed it upon my toothbrush, didn't notice until I got a mouth full of bubble gum flavor where I was expecting mint. That grabbed my attention, in a not particularly pleasant manner. And the rest of the day followed suit.

Just as I was thinking that I'd had enough of watching her seeming sleep, that it was time to go home and leap into the waiting arms of my beloved children (who were likely gnashing their teeth and fighting over Wii games) she floated up to consciousness for a moment.

I hastened to stand by her, on the side of the good ear. She was clearly bewildered and very uncomfortable, finding the giant tube down her throat most distressing, her eyes beseeching, full of questions.

I explained as best I could, simply, succinctly since I knew I had likely only moments before I lost her again.  I like to think he heard me, understood.

And then it was time to go, to flee Westward, back into the arms of my husband and progeny.  I missed putting Jake to bed, but caught a very-happy-to-see-me Ethan awake.

And unbathed, of course.

And slightly sunburnt.

And with a big hug and kiss for me, his one and only, irreplaceable Mom.

Up.

Perspective

Whatever I was whining to myself about came to a screeching halt on Friday morning, when I got the call that my mother had taken a bad fall and was on her way to the ER. That sweeps everything stark.

What is important... what is stupid piddly shit... made instantly clear.

Children don't have this perspective yet. Jacob has been clingy, Ethan morose, petulant; they want their mom.

So do I.

Here's the update I don't want to give: 

It's touch and go right now. She is in the ICU. A machine is breathing for her. Her blood pressure is being supported by drugs. She is surrounded by machines, tubes, equipment. A thousand IVs hang around her. Lines snake themselves all over her body. Monitors beep and hum. The thrum and hiss of the ventilator sets the bass beat.

The unquiet quiet of an ICU.

I made a difficult decision on Friday to take the risk and do something (surgery) that may just be the road to killing her quickly, versus doing nothing and walking the path of certainly killing her slowly.

To not have had the surgery, to choose the "do nothing" approach would have meant a month - or two or three - on complete bed rest.  And bed rest plus an elderly person such as my mother - with cognitive/memory issues and a bum heart - usually equals an excruciating, permanent slide into the abyss.

And yet, whatever the immediate outcome, the long term is still not good. I have been losing her bit by bit for quite a number of years now, hastened much by my father's death. (Can it really have been two years and counting?)

The incline of her decline has steepened in the past few months. I really have felt like I'm watching the color fade from her spirit, before my very eyes.

And yet now that feels glacial slow compared to what has transpired in the last three days.

In one word:

Freefall

The hip repair surgery went well, but...

BUT

BUT

(Like that old joke, "The operation was a success, but unfortunately the patient...")

She was not a good candidate for surgery.

Her old, huge, much used heart is tired and worn out.

The valves don't work like they should, like they used to (though one has been tricky since the beginning: she, a little girl with a heart murmur).

So even though they took a zillion extra precautions.  Were oh so careful to try to not unduly stress her heart during the surgery. It's still surgery. Things had to happen. Things her heart did not like.

The surgery went well. She could stand on that leg (if she could wake up and stand).

But her heart needs the help now.

The machines. The slow drip of the IVs.

And so she slumbers deep below the level of consciousness; sedated, kept under to avoid the unbearable discomforts her body is enduring in its struggle to remain alive.

And yet still, she is there, some small part of her. The spark of her life flickering but not guttered.

I sit by her side (until they toss me out for the night).

I cannot touch her skin; she winces, grimaces at even the gentlest caress.

So I stroke her hair, smooth it down; fan it out on the pillow, fingertips following the ripples of her silver curls out to the ends.

I whisper in her ear. Words of love. Of encouragement.

Is it cruel that I ask her to hang in there for yet one more day, that I am not willing to let go?

I will accept what comes.

She may fight and rise.

She may release, and fall.

But not yet. Please, not yet.

I want my mommy.