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Reply by NatR
19 Nov 2012, 3:23 PM

Dear Trueheart,

I have just read your long note this morning...and my heart goes out to you as only a caregiver can understand.  I care for a family member who has ups and downs...and not nearly as ill as your mother..but the same feelings go through my mind at times...as they have gone through yours....the feelings of wanting to give meds to help, but wanting no suffering to go on...wanting to keep your loved one as long as possible...but wanting them to have a peaceful and quick end before suffering any longer.

You are an amazing writer, and an amazing daughter.
Thank you so much for sharing so much of your daily experience with your mom.  Your words will be so helpful to others...who will be dealing in similar circumstances and wonder if anyone else knows how they feel.

I cannot imagine the incident at the grocery store...your Mom collapsing...and the stress on your sister and niece as they managed to get her back home.

It is definitely a change in her condition and I am sure her doctor will do what is necessary to make life the best it can be.  You are right...give her quality days and peaceful nights and spend all the time you can.

I think in your mind you have now made the mental transition...(listen to me talk like I know what I am saying..I am no expert, and not a professional except for being a PSW and a person who cares about others :)

But I hope you understand what I am trying to say...that I sense that you know now and realize that there is no way around the coming days and weeks and it sounds to me like you are ready to brace yourself, rest when you can and be there for your mom

Definitely dont leave her alone.  She doesnt sound safe to be alone.  Anything could happen and you wouldnt forgive yourself if she was alone and injured etc.

I applaud you for giving of yourself, for sharing your story with us, and because of you many more readers going through similar situations will gather information, strength and learn how to handle the challenges...

Your story touched me.  So many of the stories on the Forum reach out and grab your heart...I dont know them all, and havent replied to them all..but I know that the Forum is a learning and healing place...before during and after an illness and/or loss.

Thank you for journalling here.  Thank you for showing us all how to do things.  How to support and love someone as they are going through their final journey, the final days.  We all need insight into that journey.
Also your interest in medication, the effects of those meds and wanting the best days and nights for your mom...its all great content.

Keep writing when you have time and energy...and in the meantime...you are doing an amazing thing for your mom.  Amazing!!

In appreciation,
Sending you a virtual hug today...which I am sure you will pass on to your Mom.

NatR 
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Reply by Brayden
19 Nov 2012, 4:54 PM

Dear Trueheart,
I am just amazed at how you demonstrate what one is capable of when backed against the wall. You have such internal strength. Please ensure though that you do get adequate rest in order to sustain yourself. There is so much strength in genuine love. We can only pray for you and your Mom for daily strength. Deeply moved,
Brayden
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Reply by TrueHeart
20 Nov 2012, 9:24 PM

Today, I don't know where to start except to say that I am frustrated. We did visit the doctor today, and we have increased her steroid medication. Going from 4mg to 6mg since Friday and upping it to 8mg as of tomorrow.
I haven't noticed any significant improvement yet, but will wait until Friday to measure that in order to give the meds time to get in her system.
She seems more childlike these days and her anxiety levels are high. It bothers me that I can't call the family doctor for support on weekends or after hours. Calling the palliative nurse is semi-helpful, but I feel a bit at odds with her too. For the last several visits, she tells me she will come at a certain time and then shows up an hour earlier - I think, hoping to avoid me. Why? I don't really know. I think it is because I do my own research and ask very specific questions.
I inquired about a palliative doctor, but it seems I am asking for too much. When a patient opts out of treatment, or has been told that further treatment is no longer an option, the oncologist, cancer clinic and specialists refer the patient to their family doctor. All well and good, I guess, but something is lacking. The palliative nurse, while professional, has limited knowledge of mom's condition and often surprises me with her lack of knowledge. The problem is, I guess, that mom continues to "look good" despite her decline. Assessing her in half an hour doesn't equate an accurate assessment of her true condition. Just because she isn't bedridden and vomiting, doesn't mean she is doing "well".
Both the family doc and the palliative nurse have decided that the 2nd MRI doesn't indicate any significant interval change, because that is the conclusion of the report. However, I have read both reports and there are marked differences that neither of them seem to appreciate. I wish I could sit with a neurologist and have them bring up the images on their computer and give me their opinion.

I woke up this morning feeling discouraged and distraught. I don't even know why. I really had to pull myself together to face this day.
Hoping that I wake up feeling more together tomorrow.

Thanks Brayden for your constant kindness and NatR for your heartfelt virtual hugs.
Holding strong, TrueHeart xoxo
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Reply by Cath1
20 Nov 2012, 9:56 PM

Dear TrueHeart:

I understand your frustration and your sense of discouragement as your Mom's primary caregiver. It's a hard thing to stay positive all the time - no - it's impossible!

You must give yourself so much credit for being so proactive and taking it upon yourself to do all the research about your Mom's illness! It shouldn't be necessary as your should be able to count on the professionals with experience for this kind of guidance. It's a real flaw, one of many, in our healthcare system.

I know what you are doing on all fronts - including your hands on care of your Mom, your knack for taking care of all the little details while seeing the big picture - it all makes such a big difference for your Mom and to her!

In my experience, when we can speak to doctors and nurses armed with good information we are treated either with respect or disdain. It's hard to know how one's efforts to be an active and integral part of the care team will be perceived. Your Mom's nurse may in fact feel out of her depth when you seem so well versed about your Mom's health. I think that the visiting palliative nurses that get assigned to care for someone at end of life are not all of the same high calibre. It's too bad that your Mom and you don't have the benefit of the advice of a good palliative doctor. The one that cared for my Mom, and by association, me, was amazingly helpful! My Mom spent her last week in hospital though and I suspect that is why she  and I had access to that particular doctor.

Good for you for not giving up! Good for you for bearing the brunt of it all while doing so much to fulfill your Mom's wish to stay home through this trying ordeal.

Today, honour your feelings and know that no matter how little support comes your way on this day, you are not alone! We are here with you!

Tomorrow I am hoping with you that it will be a better day for your Mom and for you!

Your are strong! Holding strong! Holding your Mom in your sweet and soft heart with your love. You are giving her everything her heart desires. Hold on to that truth until a brighter sunrise meets your gaze!:)

With affection -hugs- -xo-
Cath1 
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Reply by Tian
20 Nov 2012, 10:37 PM

Dear TrueHeart

You have every right to feel frustrated and more. Certainly it is hard for you to accept people telling you that your mother's not all that bad when you have seen how much she is suffering. It is understandable for you to be skeptical of the nurse and family doctor and it seems to me they should be willing to arrange an appointment with a specialist (perhaps a neurologist) who can better assess your mother and address your concerns. You've been racking your brain over how to achieve that and I'm very sorry not to have more promising suggestions for you. Is it possible for a social worker on the case to arrange that appointment? Could something come out of taking your mother (and the MRI's) to emergency after a bad episode? Finally, the "Ask a Professional" section of this website cannot give you medical advice but perhaps you can be guided to how to get it. All I can add TrueHeart is keep at it. What you are doing is right and you deserve information you have confidence in. At some point a palliative care doctor will be required (whether your mother has received treatment or not seems irrelevant to me.) I hope that happens as soon as necessary. I'm behind you 100%.

Tian 
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21 Nov 2012, 1:30 AM

Dear TrueHeart, 

I'm so sorry to hear about your trials today. It doesn't seem right. I completely agree with Tian and encourage you to write to our clinical team for guidance on 

Ask a Professional

Our team includes palliative physicians, nurses, a social worker, ethicists and a spirtual care advisor. You can submit a confidential question to them and you will receive an answer in 3 business days or less. It's free. They can help navigate the medical system in your area you get the medical expertise you are seeking.

Let me know if I can help in any way.
Colleen 

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21 Nov 2012, 3:47 PM

TrueHeart,
I'm thinking of you and hoping it is a better day today.
Colleen 
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Reply by Cath1
23 Nov 2012, 3:22 AM

Dear TrueHeart:

I write this note to you tonight to remind you that we are all thinking of you as you face the uncertainty that has defined your Mom's life and yours with increasing intensity lately.

As you continue to take care of your Mom and to seek answers and assistance to improve the quality of your Mom's life at this fragile time of change, know we recognize in you, strength, compassion and love and we send you ours to help you get through this exhausting and discouraging time! You are not alone, TrueHeart! We are virtually by your side!

I know you will update us when you feel able - no pressure - just know we are wrapping you warmly in friendship and in care.

With affection -hugs- -xo-
Cath1
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Reply by TrueHeart
28 Nov 2012, 12:55 PM

Good morning Dear Bright Ones,

Events have been keeping me very busy and more family drama found a way into the mix recently. I did make a post last week, but the computer ate it and it never appeared in the thread. :-(


I don't have much time this morning, but I would like to say that I have missed being able to come here and talk to you. Mom is very frustrated these days. Yesterday, at the doctor's appointment, we were given a resource in the community which I am exploring today. It is a non for profit alternative space for relaxation and comfort for cancer patients. I haven't had any time to explore their website, or phone them yet, but it gave both of us hope that there might be something that we can do to offer mom more support emotionally and mentally. 

One tidbit of wisdom I would like to share with you this morning is that the issue with family during these times is that there is a tendency to revert back to old and out-worn childhood patterns, responses and insecurities that invariably surface under these conditions.  Old sibling rivalries, jealousy, resentments and silly competitions. Instead of allowing things to explode into a dramatic and hurtful display, I am trying my best to approach this dynamic with kindness and loving firmness. Saying only that which is relevant and true, refraining from accusations and diffusing potential explosions that could have long term damaging effects on the whole family.
The entire family has been under extreme stress since we learned that mom is not going to get better and that her time to leave us is coming - whether we want it to or not. The ups and downs of her condition have seen us all preparing for the inevitable several times. Each time we thought her time was near, we found a medical way to delay - the blood clots, the seizures, the swelling around the tumors etc....while grateful - it is still a road paved with high anxiety, sadness and frustration. 

I've run out of time to write this morning. I'd still like to take a moment to express my infinite gratitude for all your advice and support.
With love, TrueHeart  
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Reply by Cath1
28 Nov 2012, 1:10 PM

Dear Trueheart:

It's wonderful to hear news from you this morning. I've been worried about your Mom and you and wondered how things were going. I have been too busy this past week to post as well, but like you I miss the contact with everyone here when I cannot take the time to read and respond. Virtual Hospice for me has been such a lifline of hope and when I read the posts from you and others and witness your courage and kindness, it is sweet inspiration for me! Thank you for making the time to update us all, Trueheart!:)

Your outlook about family dynamics in the situation is extremely wise! I hope others will, as I do, reflect on the wisdom in your words and apply it to their own lives as I will. The restraint you speak of I believe makes all the difference in hard times between loved ones. My Mom used to say it is better to bite one's tongue and take a step back from any highly emotional situation. It can save the day and can lead to healing rather than hurting hearts of those we love. You are simply incredible, Trueheart!

Stay brave and loving as you are so naturally, and know I am with you, as are we all, as you keep working through all of your feelings and striving to uplift and protect the feelings of those you love. They are all so fortunate to have you watching out for them and for your Mom! I hope this new resource for respite for your Mom will work out!

We will be thinking of you with love and admiration until the next time we hear from you!

With affection -hugs- -xo-
Cath1 
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