Where I Choose To Be

Yesterday was my late mum’s birthday. But that was not why it was such a difficult day. In the morning I rang my dad in the aged care home. He has dementia, stroke damage and stage four Prostate Cancer and he was very worked up and totally out of it with agitation. He told me he had manhandled and literally thrown a lady out of his room and that her friends had come to help her. Dad had swung at a man who used to be a fighter, who said he ducked. And dad told me he was going to get a man, later on. He has never been fond of people he finds stupid and these people are demented, bless them.

My son and I then set out after lunch for my appointment with Dr Russo of The Hunter Pain Clinic in Broadmeadow. It’s a level one pain service where medications and injections and ablations into and of nerves occur, unlike at John Hunter Pain Management. I went six months ago, found great success with my SFN and other neuropathic pain due to past surgeries and mesh. It is a lovely bus trip by the lake to Cardiff and then a train to Broadmeadow. Unfortunately it’s a long walk for me from the station, I know now to get a taxi from there. Silly of me not to, I was overconfident.

At some stage of the day the AINs told dad his blood pressure was up, probably to try to get him to stop fixating on the men he particularly hates. So he started phoning and when he could not get me he left messages. Three before I wised up and stopped taking the voicemails. Each was worse with him crying, wanting to go to hospital and beside himself thinking he was going to die.

Meantime my son and I waited over an hour for Dr Russo, who was brilliant as always. He said I needed to increase the Lyrica in my Neuropathy cocktail by 75mg. After that nerve ablation of the Femorogenital Nerve and the Illinguinal Nerve on the left side is all that is left to do. He also wrote that I could have a sustained release painkiller, Palexia. All I use at the moment is Panadol Osteo.

The trip home was a long one. To avoid the walk to the station we caught two buses, one to Glendale which was forty minutes and then a bus home which was around twenty. I stopped being a nasty snarly bitch to my poor ever suffering son once off my feet and on the bus and dropped into a ten minute retrospection ending in quite the insight. I have had moments of clarity before but never quite like this.

I was wondering if it was worth it. Really. To have Small Fibre Neuropathy pain so badly that I had needed a walking aid to get around. The pain so unspeakable I found it hard to describe it. And to lose that pain totally for four months only to have it start to return? With no real hope of it ever going or being controlled. More so with the unbelievable mesh pain beside my stoma. Would I have done it if I had known? Would I not have been better to not have that wonderful break, only to have to learn to deal with the agony again?

And yet, if I had not tried the cocktail, I would never have got off the walker, might even have been encouraged into a wheelchair by now. I would not have had the courage to meet up with my man of many voices, not in an intimate way. Would not have started any relationship at all. Talking to Dr Russo I realised how much had changed since I saw him in November. For the good. Life is full of joy for me, despite the pain. Or in part because of it I truly appreciate life and the beauty in the world.

So yes I would have tried the drugs, I would have knowingly tried them even if they had told me they would not continue to work much beyond the six months. Because where hope is is where I want to be. Where possibility is is also where I am meant to be. Where determination is is where I choose to be.

But for dad, my quandary is very different, to hear him at 4.59 this morning. Crying. Because he “does not know what is happening.” The catch cry, especially of the Vascularly demented. What is the point in prolonging his misery? His fear? His degradation? Should I have ever let the specialist put him on the Zoladex which is stopping the Testosterone which is fuelling the cancer? It will wear off by the end of this year anyway but it’s month upon month of agonising fear for my dad, a once proud, strong man. Can I in good conscience ask for it to be stopped? And let the disease take its course?

In other countries he might have been able to choose his death. But dad thought he was immortal and never prepared for old age. Now I am trying to look after us both. Making tough decisions for both of us. Mine is just pain, it will not kill me though the increase in Lyrica will likely affect my memory. But only while I take it. Whereas dad is going to die. A long, drawn out protracted death whereby he slowly withers away. Even now he is dehydrated. He could choose to stop eating at any time. It happens. And I will be here witnessing it, but thankful my mum did not have to. That she was taken before that. She always looked after dad, he was her first thought in the morning. Her duty was to care for him. Her duty born of love. Mine is a different love, but mum knew I would look after him. It is who I am. And who I am is very much someone who questions suffering. Suffering, the kind that does not enrich life, only demeans and terrifies our elderly. Our loved ones with dementia.

 

 

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It’s Also About Life

During the last week of March in 2017 dad’s pain was shocking. He had phoned me repeatedly daily, crying. Friends who had demented parents on Facebook were telling me that his reality is different. Others like the lovely Janice knew my dad through my posts and just knew he was in agony. I had told the staff many many times I felt he was in pain from his metastatic cancer. So had the Hammond Care Team (DBMAS) and Morag the team leader who came out to see him after I spoke to them in despair about his behaviours the previous year.

So fortunately did the new NUM. He phoned to apologise after we were told by an RN that dad had not got out of bed after crying the day before. He was crying and crying in pain. My son and I were feeling angry, upset, horrified and powerless. So we got in a taxi and went straight to dad. When we got there he was approaching the dining room from his bedroom. It was a hot day and he had on cord pants, two woollen sweaters and one of his lovely Irish tweed jackets. On his head he had a thick woollen beanie I had knitted him. He was totally out of it, as white as a sheet and was unaware of his surroundings.

The ladies were very worried, especially Betty the non verbal lady, who always sat closest to his room, as he always stopped and asked her if she was okay, did she need anything? The other lady who was really upset was the food prep lady. They all loved dad and knew he never ever stayed in bed unless he was in pain. It is totally against his Irish work ethos to laze around anywhere in the daytime. Indeed when I was younger my mum would save a lot of her housework for the weekends so as not to feel lazy around him!

It took about forty minutes to get dad zoned back into why we were there. My son went down to Kmart to get him some computer stuff and I stayed and soothed dad until he was back to a semblance of normality. He said he had not wanted to worry us.

We were so exhausted after settling dad and from the emotional impact of seeing him so weak that we also got a taxi home. Over $120 in taxis that day but it could not be helped. When safely home with a cup of tea I emailed the NUM and we chatted the next day. He apologised that dad’s pain had not been correctly charted over the weekend and he said it’s not good enough. He contacted the GP who was against Mater Palliative Care being called but the NUM insisted and said I had been after that, as his Person Responsible, for some time.

A week or so later the Team from Mater had been out, dad had a Morphine Patch on for pain and Respiradone for the anxiety and fear that was keeping him up at night. Dad is not silly, he knows. And was frightened of the pain meaning he was going to die soon. Whereas the Palliative Care Team is also about life, and living it well until the end. It has been a year this week since dad started the patches and he is a different man. He now needs it boosting with Panadol, which I had to suggest and insist upon, but his endurance is incredible and a testament to his strength of character.

I have always been proud of so very many aspects of dad’s life, and maybe the way he is approaching his death may yet be the thing I will be most proud of.

 

 

 

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