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2022 Frozen Tundra Farm Report

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Hopalong:
Happy dance!

Yay,
Hops

lighter:
 Finally....
Yes.

sKePTiKal:
So, last week the skilled nursing facility took Mom's lab results again and her kidney function has dropped significantly. Mom nixed dialysis, went it was first suggested. But the care team was suggesting she be moved into hospice. That's prompted quite a few conversation with Bro. He's the health POA.

[So, like many geriatric patients - she has multiple issues. Type 2 diabetes, HBP, a 90% blockage in the carotid and has had 2 minor-ish strokes. She's sleeping a LOT and is unresponsive, except to Bro.]

Fortunately, even on a sensitive topic like this our communication has improved a lot in the past couple years. We decided it would be good to ask mom again - if she wanted to take a chance that dialysis could help her (she's been TRYING to do the therapy to recover strength/dexterity from the strokes). She hasn't given up the will to live yet, per the Bro. He's had to fight multiple doc's "expert opinion" that it would be too risky to try it. And I took the position that ANY chance was better to try, than just resigning yourself to the indignities of a kidney failure death. But that ultimately it was his call.

I've been in daily talks with him, providing support and lending my way of thinking through situations. Letting him vent, and just ramble out his thoughts & feelings on the matter. There isn't any point in me trying to talk to my mom - and I don't really WANT to. When I initially let you guys know about this decline in her health, I explained that I had anticipated the whole smorgasbord of complex emotions to bubble up for me. And this has been the case, but fortunately it's mostly been just one feeling at a time. Nothing overwhelming, but it has definitely been stressful, emotionally, for me.

I'm getting "time off" from it, too. B's been lovely to be with now that his pain levels are managed better. And we're happy just being in the same room or off doing things on our own for hours at a time. My role is less about monitoring his pain and trying to find him some relief or comfort no matter how temporary or effective. Which is opening new doors. He's definitely a keeper.

Hopalong:
People are so different, and there's no perfect choice in end of life situations.

For me, a kidney failure process would be just fine, especially if I'd already become mostly unresponsive. But I don't care about dignity, just comfort and pain relief. I'd rather be on my way out than try heroic things to extend my time, particularly if doctors are advising against it living on may doom me to new strokes or more decline. Your mom may be an instinctive fighter or maybe not pursing dialysis would be a relief. You and your Bro know her best.

Sounds like she hasn't left a clear Advanced Medical Directive to ease him! Dang.

Comes a time when treatment can be torture and personally, I'd pass. But that may not be true for your mother at all or suited to her personality.

Hope you and Bro weather it all well and that when the next step comes, she'll get through it peacefully, whatever it is.

Must be hard hearing these updates and feeling some confrontation with the past, (((((Amber)))))). I hope Bro can decide and trust himself with whichever way he goes. Maybe it will be good for him to embrace the trust he's been given and feel  confident in his own reasoning. It's just not possible to make everyone in a family have the same opinions, and impending death is such a stress.

On the happy note,  it's just a joy to hear about you and B living life at last, together. After all the time and struggle and all B's pain and your deep patience, it seem almost unbelievable that it's finally come to pass. SO glad for you both.

hugs
Hops

sKePTiKal:
Obviously - I don't know how my mom REALLY feels about this part of life, given the LC I created & maintained and her increasing mental fog. Only what she's said to me over the years and what I've observed, separately. And I have my own preferences.

I understand many medical procedures are suffering-inducing and no guarantee of a resultant "quality of life" worth (IMO) living. Others may have different ideas about those qualities. That was why I suggested he ask her what she was willing to go through to not die (it's inevitable anyway) within a month. Bro has been doing fine with the responsibility of decision. He sees both sides in the matter and hasn't been trying to delegate the decision. Just keeping me in the loop and asking me to help fill in blanks in what he thinks he knows. So, I've been supporting him, as best I can. It's a rare opportunity for us to revisit old parts of us (individually and as sibs) as openly and vulnerable as people are in this situation. That's going pretty well.

My mom - as far as I know - has been a complex mess of self-sabotaging bad habits (minus the "vices"), emotional conflicts/issues than she's tried to assuage with those habits, distrust of traditional western medicine -- and demanding of the same docs that they "fix" her. The idea that perhaps she could fix herself simply didn't exist in her understanding of life & the world. It's been her innate strength that's helped her endure so long, as her habits combined with genetic predisposition to the chronic physical ailments. Whether any acceptance, letting go or fight exists in her... is outside my experience of her.

I have always had some hope, that she would be able to breakthrough her life-long gamesmanship/covert manipulation tactics and just be real (not even my "imaginary" mom). She made some baby-steps toward that before she started forgetting how to use her phone and what my name was. I've said what I needed to say to her over the years. I am comfortable letting her go and have no agenda surrounding her death. I have some sadness that it wasn't important to her to create a real relationship with me. But that is, what it is and I'm used to that nugget of reality. Other people don't quite understand this bit about me - and it doesn't bother me. It wouldn't give her any comfort or permissions or anything for me to try to "help" now.

Bro is processing his emotions within the experience of his decisions and responsibility. Doing pretty well at both too. So, he's not "needy" about my support; he's pretty clear about expressing himself and whatever connection still exists between us seems to be making up for the things one or the other of us aren't all that good at. So except for the frequency of communication between us, this is going about as peacefully as anyone could hope for.

Dialysis started yesterday; doc sez it'll be a week or even a month before any significant changes will occur. But given how the toxins will amplify all her other issues, I think the brain fog will be the first noticeable difference - IF it's not too late for this to help. It very well could be; Bro and I talked about that potential for this to be an exercise in futility and unnecessary intervention. So we're in wait & see mode now.

On the stroke side of things, I have some suggestions that helped Jean out a lot, that could be just the thing for my mom to re-engage with her own "agency". IF she can stay awake for longer periods of time.

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