However, at the October appointment, her mind was set at ease when she learned her blood work numbers were still within the normal range as it related to her pre-diabetic condition.
It was a cool, rainy fall-like morning, and after the follow-up appointment had been scheduled and Mom was settled in a chair in the waiting room, I hurried to the parking lot to bring the car up to the door. I thought I had all the required items checked off my mental list for getting mom in the car...seat position all the way back and just at the right tilt, window down, fan on high, car pulled up to the building close enough so she didn't have to walk far but not too close that the handicap door wouldn't clear my car...check, check, check and check. I threw the car in park, clicked on the hazard flashers, and rushed around the car to be ready to take her walker out of her way and fold it up to put in the back seat.
Unfortunately, I had neglected to notice one critical prep point. The car had a sheen of water droplets from the rain. As Mom steadied herself using the top of the car to maneuver into the seat, her hand slipped. While she managed to get seated, she cried out. "I heard a pop." she said..."Behind my knee." I told her it was probably just her shoe scuffing against the pavement that she had heard...hoping it was all in her head. But as the day went on, it was clear it was not in her head. (Hindsight: Eleven years ago, Mom had a period of inactivity after breaking her wrist followed by a pulmonary embolism that would've taken her life had Dad not called an ambulance immediately--the embolism was caused by a blood clot in her leg that broke loose and traveled up through her heart and lungs).
Knowing her anxiety over going to the doctor, we tried one home remedy after another...anti-inflammatory medication, hot packs, cold packs, Aspercreme, and extra time in her lift chair with her feet up. But it just wasn't getting any better.
Her daily complaints of pain and anguish grew in intensity. She was still managing to walk back and forth from her kitchen table to her lift chair, however, and I thought at least she's still moving and the more she moves, the sooner she will feel better. As I grew more frustrated with not knowing how to best help her, she grew more anxious over the constant struggle to move and breathe.
I called my sister to enlist her thoughts on the situation, and we began to discuss assisted living options as I just felt I could no longer give Mom the necessary physical help in her own home. I didn't tell Mom what we were thinking as I wanted to have everything in place before presenting her with a new care plan. Feeling guilty about my thought processes, though, I began bringing Mom more and more comfort-type foods as well as pretty flowers for her counter and patio in an attempt to brighten her day and give her mind something else to focus on.
Her anxiety became so severe, that she was causing herself further stress and making herself physically sick. She began cancelling services I had in place to help her--like her home health aides and Meals-on-Wheels--saying she wasn't feeling up to it. She would call me instead at 7:30 in the morning panicking about not being able to get comfortable or breathe normally. I finally obtained a prescription for an anti-anxiety med to help her relax. That same day, she requested some cough medicine to break up what she thought was some congestion in her chest. Unfortunately, all that the medicines did was knock her out to where she was doing more sleeping and less moving. (Hindsight: The beginning of congestive heart failure could have been causing the chest tightness and breathing trouble).
On Thursday, October 30, I called the County Health Nurse to come over and check mom's vitals since she seemed to be having so much trouble breathing. The nurse took her blood pressure and temperature and checked her pulse-ox and listened to her lungs and heart. I watched her write down all the numbers and conclude that all was normal. This seemed to help mom relax a little, and I was glad we weren't needing to make a trip to the hospital.
On November 1st when I came over to bring Mom one of her favorite BK salads, I opened the refrigerator to find she hadn't eaten the two meals from the day before...she was sleeping in her chair at the time. I left her a note saying that we needed to cut back on the anti-anxiety med and that we would be back to have supper with her around 6:00 p.m. (Hindsight: A sign of the body shutting down is not eating as much. This should have been a big red flag, as Mom LOVED to eat).
At supper, Mom was uncharacteristically reserved and quiet, while my hubby and daughter and I chatted about the day. I attributed her reserved nature to the combination of meds in her system and all the sleeping she was doing. After supper, my family went home while I stayed to talk to mom about when she should take her medicine the next day. She was over-the-top concerned about how the daylight savings time change was going to affect her sleeping schedule. She seemed confused about the times she was supposed to take the medications, which was so unlike her. I made a schedule on paper of when she would take what meds for the next week and left for home. (Hindsight: I think she knew something was terribly wrong and didn't want to alarm me or dwell on it herself, and that's why she was so quiet).
Two hours later, she called me at 10:15 p.m. to come back over as she was not able to make her lift chair work and had had trouble getting her TV to come on with the remote. I rushed over, and stood next to her as she pressed the lever on the chair remote to make it rise. All seemed fine, and I made sure she could get the chair to go back down as well. (Hindsight: I think she was losing feeling in her fingers as a result of whatever was happening internally and that's why she couldn't press the remote buttons or the chair button hard enough to activate it...on a subconscious level, I think she just wanted to see and talk to me one last time).
"I feel like such an idiot [for calling you over]," she said, as the chair seemed to now be working. I told her she was not an idiot, gave her a hug, told her I loved her, and left for home.
That would be the last conversation we would ever have.
As I look back on the sequence of events for the month of October, I've played and replayed the "what if" game and done a fair share of beating myself up over what I could have or should have done differently. I know my frustrations got in the way of my compassion and logic, and that's probably what I feel the worst about. But, I do think on some level, mom either knew her time was drawing near or she sensed the direction of the next step I was about to be taking her without me even saying it. And truth be told, I could not see her living out her life in either of the assisted living facilities that my sister and I had toured just 48 hours before Mom died.
Rereading some of the last Facebook messages she sent me, I know she wanted to make sure I understood how much I was appreciated and loved. (Hindsight: She was saying goodbye).
10/17 10:31pm
Thanks for all you do and all you are. I LOVE you. Mom
10/24 10:07pm
Love you to the moon and back......thanks for the extra care when I am feeling so hopeless.....
10/25 11:09pm
YOU ARE THE BEST! I could not ask for better than you. I just want my mind to be in a better place.....
10/29 11:07pm
G'night my precious girl.......LOVE YOU
10/31 10:03pm
I am so TIRED..... just want to sleep. I am ready for it to be GONE!
11/1 8:54pm
THANKS TO YOU ALL: Just needed your sweet presence
Mom's Bible was a daily morning ritual. She would read a devotional and usually post some scripture or inspirational message on her Facebook page as her first post of the day. As I was going through her things a few days after her passing, I noticed a piece of paper sticking out of her Bible. The words on the paper, in Mom's handwriting, are lyrics from a song...a song I think she was using as a prayer.
(Hindsight: An autopsy might have given us a clear cause of death so we didn't have to wonder if it indeed was another pulmonary embolism, or congestive heart failure, or something else entirely--but it would not give her back to us).