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O/T My Mother

secondplace's picture

I don't blog very much, but I am on here most days.  I need some advice and support and I thought I would start here.

My mother has been feeling somewhat ill the last month or so.  Severe constipation and not wanting to eat.  She went to the walk-in clinic a couple times and went to emergency on Saturday.  They gave her an enema and sent her home.  On Sunday, she called me and said "I'm sick".  DH and I rushed over there.  She was somewhat confused, not even able to get herself dressed.  I called 911 and an ambulance took her to the hospital immediately.  They sent her for emergency surgery.  She had a perforated bowel, which basically exploded because of a large obstruction.  The large obstruction was a tumour.  They also found another very large tumour on her liver.  They removed the whole large bowel and sent her for a second surgery to clean out her insides.  

As of today, she is stable, but they still haven't woken her up. They tried yesterday, but she was flailing about and very agitated, so they upped her sedation again.

My mother is not a positive person.  She is very nice and will do anything for anyone (she's always the person who brings the birthday cake into work etc.), but I know she is not going to take this well when they give her the news.

Does anyone have any ideas?  How to talk to her so she can at least have some hope?  

This has been a rough few days and I know it's just going to get worse.  My mom is 77 years old.  Her mother lived to 93, so I think that's what she had in mind for herself.

Comments

secondplace's picture

The pathologist report hasn't come back yet, but they are already suggesting she is Stage IV.  And yes, they did the permanent ostomy yesterday.

Kes's picture

Sorry to hear about this.  Your mother has got a lot to come to terms with - from being fit and well, to suddenly not - and being told you have several large tumours which as there were several I'm assuming have spread and are cancerous?   Personally, I would suggest that you offer to contact any relevant support organisations on her behalf - if she is OK with this. It's always easier to cope with something if you have support from people who have already been in that situation - we know this very well from StepTalk!  not the same thing - of course - but the same principle of like minded support. 

secondplace's picture

Thanks Kes.  She hasn't woken up since Sunday - they are still keeping her sedated.  I really fear for her state of mind when she finds out.

Ursula's picture

So sorry to hear this.  Can you ask for the hospitals palliative care team?  They can help both you and your mom.  

Polar_Sun's picture

Sorry to hear about this, I can't even imagine how hard it may be. 

Maybe she can work with a counselor or therapist to help her cope with the information she will be given about her overall state. 

somethingwicked's picture

How very sad for your mom,for you and all family.

That her entire large bowel was removed is very telling that this  was more than likely a malignancy.That her liver, too ,shows a growth could also be a metastsis.

Your mother's initial confusion could have stemmed from fluid/electrolyte disruption associated with the large bowel involvment, or a  septic process in evolution from the perforation or/and that the liver,too, has a growth disrupting the liver's ability to properly function.

Why are the doctors keeping her sedated? OR is  she still confused because of a buildup of ammonia in the blood when the liver is unable to remove it so they keep her sedated ?Is she also humanely restrained?

I know this is  an overwhelming time for you,family and your mom as this just seemed to have happened overnight.

No one is prepared to deal at the drop of a hat with this type of family emergency, tragedy~ and while it may be early in the situation you should ,if you have siblings ,round up family involved and have a meeting with the physicians over-seeing your mom's care. Get as much info as you can about current situation, treatment going forward, what is her overall prognosis.

Does she have any chronic health condition  that she deals with daily ,like diabetes ,and the implications.Etc.

Get as much info as possible on a regular basis to help you or whoever is designated as  mom's durable power of attorney to make informed decisions for her care.

Is your mom divorced or is your father deceased? If she is separated not divorced from your father time to get him up to speed and ,too, if he is not the one you want to be involved,calling the care on mom,then you need to get durable  power of attorney . DO this asap.It will help immensely in streamlining your mom's care and all the info will be going through you.

If you do not want  to have this responsibiity or can't  ,and understandable if so,ask  a sibling  OR one of your mother's ..your aunt or uncle if available .The hospital social service dept should be able  to help you with this.

As durable power of attorney you or whoever is legally designated  will be acting on behalf of your mother,making health care decisions based upon all the information that the doctors and nurses in her care will provide until she is able to do so herself  .Currently she  is unable to do  so on her own as she is mentally and physically incapacitated. 

Does your mother have a living will or Advanced Directives ? What do you think she would want to do ?

Time to get all the facts laid out .What is the growth on her liver? Are they planning a biopsy or do they know it is the same  type of tissue,benign or malignant? Can mom survive chemotherpay,radiation or is  more surgery is required ?  What are her chances of survival her prognosis.

I know how difficult this is.My mother had liver cancer .I understand your fear and how your whole world has been upended..and the anger and the fear.

Please take a deep breath. And hold hope in your heart. I know that medicine and surgery have progressed light years from when my mother was sick ..that was 30 years ago. 

And remember to take care of you throughout this entire ordeal. You need to eat and rest .You need to let your employer know that there is a family crisis and that going forward  you may require time off. Try to cover  the bases.BUT above all please take care of you.LEAN on those around you if they are willing. If you are wrung out and unable to deal emotionally or physically because of exhaustion then you are no good to you, your mom your family.

I am hoping for you and all.

 

secondplace's picture

Thanks for your kind words and advice.  They tried to take her off sedation yesterday, but she got very agitated and her heart rate went way up, so they put her back on it.  

They do have her in humane restraints, which was very helpful in her agitated state yesterday.  She hasn't been conscious since Sunday when she had her first surgery.

My Mom and Dad are divorced and she lost her second husband eight years ago.  My youngest brother is deceased and my other brother is still isolating for Covid-19, so he can't visit.  All her brothers and sisters are out west.  Currently, they are only allowing one visitor on premises for each patient.

She does not have a living will.  

How do I get durable Power of Attorney?  

somethingwicked's picture

Did the docs have a serum ammonia level drawn?And is she getting adequate pain medicine while being sedated ?

Ammonia in the blood will cause confusion even with the large bowel removed bacteria in the small bowel will /could create  ammonia that the sick liver cannot remove. .  

Severe pain will cause and lack of true resting (rem)sleep and will cause confusion. IF they are only sedating her (like with propofol) to keep her calm but not treating the surgical pain with the proper analgesia  she will be experiencing pain while sedated  .

How is she breathing? Is she on a ventialtor.She should be with the sedation.Is she getting enough oxygen..that can support confusion.

Just thinking out loud here ..

I am sorry ~I wish I can be there for you.

somethingwicked's picture

I meant healthcare power of attorney.Or medical power of attorney Sorry.

First tell her doctor you want to be your mother's health care decison maker while she is mentally  incapacitated by her illness and the tcurrent treatment . Who knows if and when your mother will regain her clarity,lucidity? 

Find out if the social service worker or the office in that hospital  has the required forms and ask for their assstance .Call or visit the social service dept at that hospital and explain that you want to be the designated decision maker, the medical POA  for your mother's health care decisons while she is heavily sedated and unable to speak and decide for herself.  

This will not give you any legal jurisdiction over her tangible assests .It is meant only for you to act on her behalf as her health care proxy helping guide decision making even for the health care team. Usually once the document is completed you will need to get it notarized.Some hospitals have notary ability or you will have to get it to a notary.That may cost $50.

You may need to see a lawyer that  is familiar with this to get the documents finalized. Depending upon your state. 

 Does she have a living will or advanced directives  on her chart?  And if so is it because  the doctors asked you  what is mom's wishes or did she already have a living will on record?

IMO the doctors  should have already asked you who is going to be designated as your mother's respresentative while she is mentally incapacitated. 

Thumper's picture

((((HUGS)))))

I am so sorry to read about your Mother.

There is a social work task force at most hospitals who are trained to guide you.

I am soooooooooooo sorry.