Oh boy, this just keeps getting more and more absurd.
A little backround: She has Stage 4 uterine cancer, it's actually a type of sarcoma. It has spread to her liver and was inoperable. She went thru a series of approved chemo treatment, but it did not provide sufficient success, so there was nothing left to do. However, her oncologist told her she'd be a candidate for a clinical trial, so she agreed to do that.
MIL is not educated and is not of high intellect. She did not fully understand the magnitude of her diagnosis, and her medical team never really explained it to her in simplistic terms. If they'd said 'you have less than a year to live' she (and her children) would have been better off. Instead, she was offered the opportunity for the clinical trial and her words "well, any day above ground is better than being below' and she agreed to it. I'd learned that it was really for research purposes only, she'd basically be a guinea pig, but since there were few side effects, and she was willing, maybe it would be ok. At least it'd give her more hope. I read over the side effects and in the zero to Guess what category my MIL fell in to? She might as well have played the lottery.
We just learned today that this was the cause of her liver failure. Now the oncologist has requested that we hold off on pallative care and continue pushing fluids to help her liver enzymes to stabilize. I don't know the exact numbers, but a normal liver enzyme count is generally a single digit. Last night her count was over 15,000. With the push of fluids it has now 'improved' to 12,000. IMPROVED. This is the key word...IMPROVED. This is the word that her sons (and new DIL) are hanging their hats on. But the reality is that the oncologist/trial supervisor NEEDS the numbers to come down so as to not have a serious impact on the clinical trial numbers.
There is no way her liver is going to function normally. Her kidneys are in failure, her blood is essentially plateletless-and there is a very good chance she has brain damage. If by some grace of God her liver enzymes come to be normalized, she will never leave the hospital-at a minimum will require nursing care for the rest of her life.
So, the small group of us who are more pragmatic and fact driven know that the 'improvement' is just a clinical term. She is never coming back to us. However, it has been agreed to wait 24-48 hrs and if there is no recovery of consciousness and liver enzymes are still not within a normal range, she is to go on comfort care-essentially hospice related care.
She is no longer coded as an ICU patient, as she has essentially been written off as a coded patient by the hospital (this is good in an economic sense-no sense billing at in excess of $5k/day for the room alone).
So this is where we are at-those who feel what is going on is inhumane and know barring a miracle, she is dying, and those who believe that there is a good chance she's going to wake up and ask for a cheese burger.
Ok.now that is not all. I was late in getting to the hospital today-apparently the oncologist called and spoke to the family (her sons) and explained the situation. They heard 'improvement' and 'could wake up hungry' and they believe that she's going to rally. (note that she has not had any food or drink in 3 days, her veins are collapsed and she has no urine output.)
At one point new SIL (H) got in a p*ssing match with MIL's step-daughter (Sue) who is her father's (B) spokesperson. B is the only one with the legal authority to determine MIL's treatment. B, via Sue, has agreed to the 48 hour time frame.
So H started being really snippy and got into it with Sue, Sue came out of the room shaking, and I decided we needed to put an end to this. H has been dictating everything since she got here yesterday afternoon-Sue and I have remained quiet because we don't want to fight in front of mom. I went into the room and politely asked H if she would step outside with me for a moment so we could talk. She refused and got all up in my face-now, realize, that I am NOT the type to take that-and I used all my professional skills and remained polite and asked her again to please come outside with me to talk. Long story short-she started yelling and causing a scene and was removed from the room. She then called BIL and, of course, said I'd kicked her out. I finally had a few minutes with mom and next thing I know BIL and H come storming into the room and he's screaming curses at me and H is glaring at me and I just kept calm and quiet-asked to please, lets not fight in front of mom. Finally THEY were pulled from the room, and I walked out so we could all go to a private place to hash this out. Sue, my DH, BIL, H and I all went to talk and I was so upset, I was having daggers shot my way-naturally *I* was the bad guy. I let Sue do the talking as I was so upset and I didn't want to cause a bigger scene. We finally came to an uneasy truce but it got ugly there a few times. Sue and I were accused to trying to 'pull the plug' and going behind their backs to do so. H had screamed at me that since I hadn't spoken to the oncologist, I didn't know what was going on. Heavy sigh...I got all the facts before I even entered the room with mom, but that is beside the point.
So we finally all got on the same page that Sue and I and the others are not sitting outside the door with the hearse, that we will not discuss final arrangements with them (but we did give the hospital direction). We'll respect their wishes that we won't be 'morbid' and they'll respect our being pragmatic.
But H got a little lesson on her place within the family-she said she thought they ought to buy mom a dress for the funeral. BIL told her his mom had never worn a dress-and I mentioned she hadn't worn a dress in over 50 years-when she had married their dad was the only time she'd ever worn one. Pardon my humor, but mom would not be caught dead in a dress. And besides...she is to be cremated-no funeral, no casket. Other comments came up to remind H that I had been part of this family for 24 years and I have been thru their father's death, mom's original fight with cancer-I've been to all the oncologist meetings-I know her medical history intimately-she and I have a lot of history. Once BIL acknowledged that, he and I were a little better-but H had her nose out of joint.
Ahhh-the drama of families.
In any event, there is no hospice-she's not going to leave the hospital this week. If she does, we'll look into that, but she'll need full time nursing care. We're planning to have her DH move to his son's house, so their apartment is to be packed up soon. The boys will have opportunity to go get some of mom's personal things before then, and we made it clear that no one is trying to take over. LEgally her DH gets it all-it's even in her will-so that should stop some of the fighting. My DH is the executor (BIL was pretty shocked that we had a copy of her will-we've had it for 20 years!). So the drama will likely continue, and moms' suffering will continue a few more days. But honestly, I don't think she's going to make it that long. She is incredibly jaundiced, has no cognitive ability, even involuntary movements and sounds have diminished considerably. When her eyes open involuntarily, they're yellow and there is no recognition in them. I am mourning her now-the little pest who I had an incredible love/hate relationship with is gone-now there is just a poor, wretched body hooked up to an IV and a heart monitor. There is a DNR, and we agreed no central line (her body can't take it any way). So no food, nourishment other than glucose, and just some IV pain meds. I pray that she goes peacefully soon.
Annie Deighnaugh
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