Wednesday, May 11, 2011

Mother's Day

It all began on a little forty-acres-and-a-mule farm in Eastern Oregon on May 9, 1917.

That's when my mother, "Gramma Geek" was born. She was the fifth of six children (3 brothers, 2 sisters) borne by my maternal grandmother. All of them born at home, with no more help than neighbors and relatives as midwives.

One brother was killed in the war, at the Massacre at Malmedy. One brother died on his own farm, the other in a hospital. One sister was a schoolteacher, the other the wife of an abusive bastard (she was the youngest, who died 3 years ago).

They have all died; my mother is the last of her family, and often wonders why she was doomed to be the Last Living member of her family.

Last weekend my sister planned to take my mother to the Oregon Coast for an annual pilgrimage. Since Mom's birthday was so often close to Mother's Day, Mom missed out on a celebration every year; Mother's Day and Mom's Birthday were celebrated together.

This year, their plans were cancelled due to illness. Mom had severe digestive problems for the past 10 month, and this year she was overwhelmed by nausea, vomiting, diarrhea and severe cramps.

Instead of the coast, my sister took Mom to a doctor. He referred her to a new specialist, who immediately checked her into the hospital.

Mom's chronic Diverticulitis had caused a stoppage in her large intestine. The Diverticulitis had caused scarring in a section of her colon, and shrinkage in the diameter. He saw no alternative to operating.

The usual solution is to resection the bowel; cut out the obstructed part and sew the two major parts back together. The problem was that the affected section was so large (long), the remaining sections were dramatically different in diameter. In his discussion, the doctor described it as "trying to attach a garden hose to a drinking straw". After reviewing the images from the MRI, he was not certain that it would be possible to do a simple resection.

The best alternative might turn out to be a Colectomy ... that is, a resection as described above.

But if that proved during the surgery to be impossible, the alternative would be a Colostomy. That is the solution where the severed colon is connected to an artificial portal outside the body, and the product of the colon is collected in a bag which must be emptied manually, every day.

Mom has been experiencing depression since the death of her last sibling, and the thought of a Colostomy bag was, in her mind, worse than her own death.

And in fact, that third alternative result of the operation was a very great risk. Because of her age (94 years), her poor general health as a consequence of her extended debilitation, and what seems to be a random toss of the dice ... she may not survive the operation.

The surgeon claimed to have a great deal of experience in this procedure, but he was unable to be more reassuring than to say he would know what needed to be done when the surgery allowed him to actually view the state of her organs, first hand.

The operation was scheduled for 8am this morning. The doctor decided to delay the operation so that all of the normal day-shift medical professionals would be on duty, alerted to the possibility of extravagant medical reactions to what he found, and be able to respond immediately. He warned that there was a very good chance that the surgery may only be partially successful, or fatal.

My sister and I agreed to meet at the hospital at 6am, so we would have an hour with Mom before they begin at 7am to prep her for surgery.

Mom was already awake when we got there. She had not slept well the night before ... the pain and discomfort were only partially alleviated by a wide range of pain-killers, including Morphine and its derivatives.

We tried to be as positive as possible, but in all of our minds we were aware that this was the last time we might be able to talk. The kiss I gave her on greeting her might be the last kiss.

The hour we had together passed quickly, and we were all, I think, pleasantly surprised by the calm (or fatalistic) attitude we shared. Whatever happened, we were together as a family.

They took her to Surgery pre-op at 7am, and my sister and I went to breakfast. Neither of us were able to finish the excellent meal we had been served. Still, it helped.

Then we went to the Surgery Patient Family Waiting Room at Sacred Heart ("Riverbend") hospital in Springfield, and settled down for a long wait. The doctor told us that nothing would happen for at least two hours, so at 8am we went to look at the new Cabela's store which had just opened last week. My sister and I shopped ... I bought a holster and a box of .45acp bullets ... and tried to keep our minds off what was going on. That didn't last for more than an hour, though, so we went back to the waiting room.

Ten o'clock came and went, with no word. Eleven o'clock ... still no word. By 11:30 we decided that the operation had went past the expected duration because they had to do more than the simple resection; they must be performing the Colostomy.

At 11:45 the doctor came out to talk to us in the waiting room. He was surprised, he said, that he was able to join the two ends of the colon to bridge the gap left by removing the damaged portion. He said he had double-stitched it, so that it would remain strong while the body began to heal itself. There was no danger of sepsis; it was a clean operation with no actual complications. He rated her chances of complete recovery very high, although he emphasized the she would have to stay in the hospital for five to seven more days, until they were sure she could accommodate solid foods and process them correctly.

We were stunned. Both of us had been reluctant to expect this most perfect of all possible results. We were not sure, we said, whether the Colostomy or death would be the preferred solution for our mother ... but we were actually both convinced that Mom would rather be dead than to spend the rest of her live with a Colostomy bag taped to her side.

It was as if we had both received the best Christmas Gift ever. Mom was going to be in Recovery for another two hours, so we (my sister and I) retired to the local Steak House for lunch. We both had drinks before and with our meal ... neither of us quite finished our meal, but we didn't leave unfinished drinks behind and I gave our waitress a 40% tip: no reason why we should be the only ones celebrating an unexpected gift today.

We got a call from the Hospital as we were leaving; Mom was on her way back to her room. And we got there just after they had got her settled in.

Mom was in a lot of pain, so the nurse gave her a shot of something more powerful to bolster the on-demand Morphine derivitive they had flowing through her IV. After she fell into a deep sleep, I said goodbye to my sister and told her I would let her know what time I would be back tomorrow. She was going to stay for a while, "just in case Mom wakes up".

But we also called our friends and family, and gave them the good new.

My sister's short discussion to Mom, while we were waiting for the nurse to bring the seditive:

"Mom, you're a tough old bird, and you can get through this and it will better than it has been for a long time. I'm a tough old bird, too, and together we can get through this. I know it hurts now, but that's just the incision from the operation. It will heal. And you won't have the pain you've had to live with for the past year."

What she didn't say, but she could have, was: "Next year, we'll all go to the coast together".

I'm planning on that. Our family has more than one generation. Today I realized just how much I would miss Mom, if she wasn't here for us.

I grow tired of losing the important women in my life.

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