Mom and Mac

Seems I haven’t had the time or inclination to write anything. My mom died on September 27th. Thankfully. She took the low road to death. At one point she looked at my sister and me and said “I don’t want to do this anymore. Do you understand what I mean?” My sister nodded yes, she understood. But she didn’t really. I knew mom was asking us to kill her. She was too far gone to take her own life and gratefully, Hospice had provided the tools I needed. We had at our disposal liquid morphine, liquid Ativan and dilaudid tablets which we would crush and mix with fruit punch or applesauce. So every hour we medicated her until she fell comatose. Blissful non-awareness. I know I hastened her death and i am glad I could do it for her. She was cremated and had asked that we spread her ashes into the creek that the house is on. A task still to be done.

Her husband, Mac, has dementia but I do believe he understands she is gone. He continues to deteriorate mentally and plays no role in his own care now. My mom asked that the family continue to care for him at home, her fear being that we would put him in a nursing home once she was gone. So far, my brother and sister-in-law have shouldered the responsibility of caring for him. They left their home in the mountains of WV to come to VA to provide for his care. But, I feel from talking to my sister-in-law that this arrangement is going to cause some friction in the not too distant future. My brother is adamant about never moving him, but my sister-in-law is feeling the loss of her life and home and believes, like I do, that taking him home with them to WV is the better option. She knows from caring for her mom who had dementia that changes can and often do accelerate their decline. But Mac knows them very well, trusts them, and has visited their home before. While it may not be ideal to move him, I’m much more worried about the strain on their relationship. Unfortunately my sister and brother-in-law run their business out of their home and simply can’t be away for too long. I am simply too befuddled and selfish to take on the job. I just don’t want to do it.

Doc

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It’s all too much

Currently my Mom is scheduled for a bone biopsy to diagnose the lytic lesions found recently in her left pelvis, left 7th rib, and right parietal skull. Likely metastatic disease from her previously diagnosed and treated (with a right lower lobectomy) adenocarcinoma. She’s been in nearly constant, soul-crushing pain in her hip for months. She’s lost so much weight in the past year. She looks like a walking skeleton. The various pain killers she’s tried have only been minimally effective, so if nothing else, this HAS to change soon. We’re waiting now for her I.N.R. to drop low enough (1.5 or less) for the surgeon to agree to do the bone biopsy. So, no more Coumadin (a. fib.) and lots of green, leafy vegs. She already can’t take care of herself or environment nor can she help her 86 year old husband who has advancing Alzheimer’s disease. At least one (preferably two) of us kids have to be here all the time. We all live in different states from them.

Her husband doesn’t fully grasp what’s going on, but knows something is UP. So, we try to keep him comfortable and content while knowing(me) that the shit is going to hit the fan soon.

As far as I go, my depression is worse. I have to hide any symptoms from them as much as is possible and try to be helpful and optimistic for their sakes. But my veterinary license is due for renewal by 6/30/14 and I’m 6 CEU’s short for the year. I spent yesterday trying to look up and complete an online course for the missing 6 units but I got mired in the registration and payment procedures so didn’t finish that yet. I MUST do this today and get the license renewal overnighted to the state board to avoid a late fee or cancellation.

My hospital bills from 2013 are still not paid because of an insurance company fuck up and I just don’t have the energy to try and sort this all out. I’ve been getting weekly calls from a debt collection agency about it and I’m to the point where I just don’t answer his calls anymore. God knows what will happen with this year’s hospital bills.

Since I was in the hospital at tax time, I had to fill for an extension. I really need to work on this, but luckily, I think I have until October 2014 to get this done.

You know, sometimes it really does feel like too much for me to handle. Sometimes i think it would be easier to just let it all go to hell in a hand basket and let the chips fall where they may. Just get on the crazy train and say fuck it all. Let the powers that be deal with it. But I’ve always been seen as the responsible, practical, reliable one, so I guess I have to keep trying (pretending) to be that person.

Doc.

Crying

I feel like crying.

My therapist D rescheduled our usual Friday appt. to Thursday evening (he had a surgery appt. himself on Friday). He asked me how my week had been and I croaked out “BAD”. (More on why later.) He told me that he had been in communication with the director of the mood disorder unit I had been on last year in February. He had been honest and told him I was interested in another course of ECT and that I was not on any psychotrophic meds(and I don’t want to be) and I was using cannabis daily. Well, Dr A. wrote back and told D he would not accept me as a patient because: 1. I’m not on any meds., 2. I use pot daily, and 3. it’s only been 12 months since my last ECT treatments. I really couldn’t believe it, I sat and tried to think about it, but my mind scattered and I felt myself floating away. A few minutes passed in mutual silence and D asked me “What are you thinking?”

“I’m done.”
D- “You’re done?”
*Nods* “I wanted my family to believe that I’ve tried everything to get better.” And I do. Granted, I was hoping I could feel better, even a tiny bit. I also wanted to experience how just ECT alone would make me feel as I desperately need to feel better and I think it is my decision whether or not to take medication. When I could think linearly again, I started to analyze Dr A.’s statement. As I recall, last Feb. when they admitted me to Dr.A.’s service/unit it had been 7 months since my last ECT(at another hospital), I was smoking pot daily, which they knew, and I was not on any meds. So, WTF? Was I a bad patient last time? Was I a difficult patient, did I do something wrong? I don’t know, I don’t remember most of Feb. 2013.

Ah… meds. Last time, I dutifully took any pill they thrust in my direction, without argument. That’s it, isn’t it? As long as we “agree” to be medicated into senseless twats they feel safer and in control.

Now. I usually try to see different opinions and perspectives. I tried to imagine what I would say to a client who came to me and asked me to treat their pet in a manner that I – 1. didn’t approve of or 2. didn’t think would be successful. Honestly, I do believe that clinicians should be able to refuse to be involved in someones’ care if that clinician believed it was going to be a clusterfuck.

That said, where does patient choice and self determination come into this?

Also, ****Hospital is a university-based, teaching hospital. I had hoped they would be more willing to go off the grid and try something different. Could I not serve, in some way, as an example of patients these newly minted psychiatrists are likely to encounter in their futures? Surely, not everyone will want to use medication. Does the practice of psychiatry fail at it’s core without medicated sufferers? Do they have nothing else to offer?

D asked me if I would agree to see a new shrink (last saw mine in May 2013 and D has made little attempt to hide the fact that he doesn’t like my old shrink.)

*Shakes head slowly no* Shrinks mean meds. Then he asked me why I don’t want to be medicated, had I done any research on psych. meds. (really, D?) I explained all this again.

So, for now, he has asked for my permission to contact Dr.A. and see if I can get into any research project currently ongoing. I suspect that I may have to reconsider my no meds. stance in order to access a higher level of care +/- ECT. Frankly, I’m becoming more ambivalent about further care by the day.

I, too, heard the sad news of the death of My Crazy Bipolar Life this week. Also Amy of iamfightingawarminejusthappenstobewithlife – has lost her life. Suicide, I presume but I don’t know. I didn’t know Amy as well as MCBL but I’ve been reading both of their blogs. I lost a close friend to suicide when I was in my twenties, but this is the first time someone I have never met but knew only through the internet has died. I am very sad. I know many people are too.

I am crying.

Doc.