Hi everyone, I hope at some point to write on here all that's happened in the last seven months, but for now I would just like to share some stuff with you who may have concerns about the inevitable. My Mam was diagnosed with non small cell lung cancer in Sept 2009 and the prognosis was 9-12 months, she was 81 years old and up until about a year previous to the diagnosis was quite a healthy and very independant lady, but because she was quite weak at the time of diognosis, palliative care was decided as chemo would have had a massive detremental effect on her already not so good physical health. To cut a long story short, Mam started deteriorating mid March and spent a week in hospital, she was confused, her oxygen levels were low and had had a chest infection for weeks despite 3 lots of antibiotics. In hospital she was given iv fluids and taken off the antibiotics, her MST (slow release morphine was upped to 40mgs from 30mgs) over the week she improved slightly and I decided to bring her home as her care in hospital had unfortunately not been the best. My husband and I moved in with Mam so she had 24hr care as she couldn't manage to prepare meals or drinks any longer and needed some help dressing etc. We spent the time together chatting, doing her favourite - crossword puzzles, completing several jigsaw puzzles and in general having some real quality time together. Last Saturday night her pain was quite bad and she had her usual Oromorph, Nurofen, Paracetamol and MST for bed, she had a quiet night (two nights previous to this she had spent coughing which kept her awake). The next day she slept all day, I kept checking on her and her breathing was fine and she was comfortable, approx 5pm she woke up and was having slight difficulty breathing, I put her oxygen on to no avail so we called the Palliative care team who recomended hospital as her oxygen levels were very low and her chest and legs were filling up with fluid (I might just add at this point she was very confused but no distressed at all), we all went into hospital where they gave her flucsomide for the fluid and got her oxygen levels back up to normal. With the help of what Mam had referred to earlier in the week as '' an Angel'' Sue, a Macmillan Lung Cancer specialist nurse, we moved to a side ward on the chest ward, Mam was pretty out of it by now on constant 10litres of oxygen and iv pain control. I discussed with the medical staff what the best course of action would be and we all decided that giving fluids would just prolong the inevitable and we chose just to keep Mam comfortable until the end. I can honestly say that was the best decision I have ever made, I stayed with her for the duration and only left her side to use the loo and have a wash. From then on she slept and on the Tuesday afternoon she became slightly agitated and was put on a driver of Diamorphine for the pain and a sedative to relax her so she wouldn't become anxious when she woke up. I knew as soon as they started the driver she probably and hopefully wouldn't wake up again as it is very disturbing seeing a loved one scared. We were told she would more than likely not last until the morning though she could still hear us she couldn't respond as was mostly semi concious. Mam baffled doctors by staying with us until Friday morning, approx 10.30am although still in a semi concious state, started having involutary muscle spasms in her arms, legs and mouth, this I must warn you is quite startling though normal and similar to what we do when we are asleep but at an increased level, so I called for her consultant who agreed to give her a top up of the drugs that were in the driver. We had been told previously that if she was given the 'extra' drugs it was speed things up a bit as it can slow the respitory system down to a stand still (Mams breathing had been very shallow for a couple of days and her strong pulse had already started to weaken). We were prepared for the outcome after the injection and sure enough after about 20 mins her breathing became even more shallow and her pulse weakened even more, her finger tips turned cold and had a blue tint to them and we knew this was the end. I held my Mam in my arms for a cuddle, told her how much I loved her and that's where she took her last breath - in my arms. All the time she was sedated I talked to her and sung her songs, brushed her hair, washed her face and moisturised her skin. I am eternally grateful to the Angels for taking her the way they did, she was so peaceful and comfortable and I wouldn't have wanted it any other way for her. I know she is in a much better place now with no more pain or need for oxygen or drips. I miss her terribly but wouldn't for one minute want her back the way she was. For all of you out there who have loved ones and are facing a similar situation to me, I pray that you are as blessed as I was and that your loved ones find peace the way my Mam did. The lady my Mam called ''an angel'' told me although I was prepared for the end it will still hit you hard when it happens, it did, but with that blow also came a sence of relief knowing that Mam had been set free. I really hope this has helped some of you out there tonight, I didn't know Mam could have sedation and drugs to keep her comfortable near the end, it was ''the Angel'' who told me about them, and now I'm telling you. Night night for now and God Bless, Viv x x x
