Archive for March, 2014|Monthly archive page

Thinking about death

My dog died on March 20. Our sweet Spencer was diagnosed with probable bone cancer in July. Eight months later, he was obviously in some pain, but his disposition had not really changed. We visited our vet for advice – we weren’t sure we could trust Spencer to let us know when the pain was unbearable. The cancer appeared to be less aggressive – not bone cancer – and confined to the leg. Spencer had lost weight and was used to hopping around. He was better equipped now to handle life as a three-legged dog. So we opted for amputation.

The surgery took place on a Monday. Spencer’s vitals were fine, but his exit from anesthesia was like nothing our vet had ever seen. We took him to Ohio State’s Veterinary Hospital for close monitoring and access to a better supply of pain drugs. He appeared to be overly sensitive to the sedative effect of IV pain meds, but it became clear by Thursday that he was not going to fully wake up. Ever. The theory is that he had a stroke during surgery. So we opted for euthanasia, to free him from that existence.

Spencer in his favorite spot on the couch.

Spencer in his favorite spot on the couch.

It was stunning to learn that the outcome was going to be this bad because all week, we thought we just needed to wait for the IV meds to leave his system. We had been preparing for his demise for months and were then elated by the possibility of more time with him, cancer-free. As soon as I learned he was cognitively impaired, though, that was it. There was no reason to prolong a life like that in a dog that had been so connected to his humans. While I was talking it through with the critical care vet, I said, “I’m influenced by my mom. She has Alzheimer’s, and has had it for a long time. I don’t know if her life is worth living anymore.” I was sitting on the floor of the ICU with Spencer, my hand on his furry neck, and tears rolled down my cheeks and dripped onto the floor. Euthanasia seemed, to me, to be the clear choice for Spencer. Patrick and I were in complete agreement about that.

We had been on a death watch over those eight months, wondering when Spencer’s pain would be too much and worrying that his bad leg might break. There were some lows when he seemed very tired. And highs every morning when he bounded to the kitchen for breakfast. It might not seem to be appropriate to compare my dog to my mom, but I began this Alzheimer’s journey thinking a lot about when Mom would die and how she would die. That outcome is inevitable with Alzheimer’s, and I strongly opposed prolonging her life – by controlling her cholesterol or vaccinating her against pneumonia, to name a few examples. But the time frame of the illness is another thing altogether, and I’ve stopped thinking in those terms about Mom. I think about her mood, and her overall health. When she will show any signs of decline after years of stability. Whether she is clean and comfortable. How she will respond to me during any given visit.

Lately, she has been asleep or uninterested in me when I have dropped in at the Alz center. I have felt discouraged – not taking it personally, but not all that interested in subjecting myself to rejection. For the past several months, I’ve let a fair amount of time pass between visits. But after Spencer died, I felt compelled to see her. Mom had been a good grandma to him and our other dog, Bambino. She had taken the death of our previous dog, Cookie, extremely hard. Losing Spencer but still having a mom, despite her terminal illness – it just had an odd effect on me. I was fretful about staying away from her; she is, after all, on borrowed time.

Mom and our dogs on Christmas morning in 2008. They loved her.

Mom and our dogs on Christmas morning in 2008. They loved her.

And just when I needed it, Mom was back to her cheerful self last Friday. I left work a little early to drop in before dinner. I loaded her closet with a stash of new clothes and then joined her on the couch, where she was lying down but easy to wake up. She sat up and I sat next to her, and within a few minutes she reclined again, with her head rested against me. I loved that physical connection. I coaxed her to a table – it was close to dinner time. We sat together, waiting for her tray, having a conversation even though I didn’t understand anything she said. A woman at the table, a resident I didn’t recognize, asked me who I was. “I’m Bonnie’s daughter,” I replied. Later, still waiting for the tray, Mom mumbled, “My daughter.” “That’s me!” I exclaimed. And we both laughed. She even said she loves me.

I texted Patrick that Mom was in a good mood and that I wanted to stick around to see how she did with eating and to enjoy the pleasant visit. Mom’s aide said she was still good at feeding herself solid foods, but that she tended to spill her liquids so he helped her with those. I assumed his role for this meal, encouraging Mom as she ate with her fingers. I fed her bites of cottage cheese and peaches and helped her with sips of water and milk. She slurped up her high-calorie cereal. When she was done, I cleared her tray and wiped her hands clean. An activities staffer and I walked her over to a chair with others to watch a Rock Hudson movie. I kissed Mom goodbye. And I didn’t think about death – hers or Spencer’s – for the rest of the night.

Advertisements

No visitors allowed

I tried to visit Mom last week after a doctor’s appointment (more aches and pains-tendinitis in my foot), which was in the same general neighborhood. But I was stopped at the front desk. The receptionist was turning away another visitor right before me – she said staff members were trying to contain a rampant flu in the program area, so visitation was put on hold. I had a flu shot in the fall and Mom did, too, so I wondered about the overall risk but didn’t want to put up a fuss. I asked if Mom was sick, but she didn’t know for sure. I guessed not since I had not received a call. I returned yesterday, Sunday, to try again. The weekend receptionist said visitors were allowed but that a lot of residents were still sick. And it wasn’t influenza, it turns out, but an intestinal virus. Lots of vomiting and diarrhea. She hadn’t heard that Mom was one of the sick ones. I dosed up on antibacterial hand gel and headed toward the program area.

Mom was sound asleep on a couch just outside her room. I actually had another task – I checked her closet to see how her wardrobe was faring. She has too much money again, by Medicaid standards, so I have to go shopping for her. I’m going to focus on lots of pants. Her pants always seem to disappear. And her clothes in general take a beating because she is such a messy eater – her clothes are laundered very frequently. I’m always looking for a bargain when I shop for myself, but for Mom I’ll strive to pay full price so I can quickly get her checking account below the maximum allowed. Seems odd to me that I need to spend her money, again, but I don’t think I would have predicted in August 2009, when she went on Medicaid, that she’d still need it in 2014. That’s also odd to think or say… But even as little as the $40 per month she’s allowed to keep from her retirement earnings eventually adds up over 4 1/2 years.

After checking the closet, I stood over Mom and looked at her. She was wearing a Buckeye sweatshirt and a pair of old gray fleece pants that she has had for many years. Her color was good and her hair looked clean. And she snored, and flailed her arms a little bit as if she were having a dream. So I didn’t think I should wake her from such a deep sleep. I know now that she’s OK. And I hope she avoids the virus. I hope I do, too – I lathered up twice with antibacterial gel, once in the lobby and again in my car.