A couple of years ago at a moment when my mom was expressing her love to her children and grandchildren, she mentioned that her Patriarchal Blessing stated she would live for as long as "life was sweet for her." She told us that while she missed her sweetheart dearly, life was indeed sweet. I thought that was a blessing for her and for us.
This past year has been quite difficult for her. Last November she began having pain in her upper back, arms, and shoulders. She visited a pain clinic and received a series of injections providing her with some relief. By Spring her hands and feet were swollen and misshapen and she had difficulty getting her body moving each morning. If she had a morning appointment she would wake up at 4:00 a.m. in order to get her hands moving so she could use them. In the spring her primary care physician suggested she see a rheumatologist.
In the past she has had bad experiences either with rheumatology medications or doctors and I began going to her appointments with her. She seemed to like her new doctor and he prescribed a drug that she had not taken before. After a couple of months she received a lot of relief. Her hands and feet were back to their normal shape and size; however her hair was falling out. She stopped taking the medication because of it. Fortunately, she did not have a relapse of symptoms. She continued taking prednisone up until about a week ago.
She functioned fairly well throughout the summer and even took a trip to Alaska with David and Jessica and Erika to visit Renee and her family. She also has compressed discs in her back and she began having terrible pain in her buttocks in August. An orthopedic doctor gave her shots in her hips and back. She had very little relief from that, even though she had had that done several years before and received years of pain free living.
With that background in place I want to focus on the events of the last week of her life.
As I mentioned before she was having a lot of pain from the compressed discs. She even had trouble walking and began using a walker. Stairs became almost impossible. She had some friends she met on her mission in England come to visit her on September 28. She had been looking forward to it and really wanted to show them around. She prepared breakfast for them and they drove to the Payson Temple to look around. Then she returned and as she was trying to pull herself up the two steps onto her porch she pulled a muscle in her groin.
The preceding paragraphs were written on October 9, 2017.
Continued on May 12, 2018 (the day before my first Mother's Day without her).
A few times throughout her last year of life I had the privilege of taking her to doctor's appointments, shopping, and doing a few things around her home that were too difficult for her to do. To say she was an independent person would be understating her character; in spite of her pain, she took care of herself and others. She never missed a Sunday dinner. She did miss a few trips to the family history center and Spencer's high school graduation. But she rarely asked for help, which is why when she called me on October 2, Monday morning (in tears) asking if I could come down and help her shower and get ready for a dentist appointment I quickly got my kids off to school and rushed down.
She was in so much pain in her groin that she cried as she walked to the bathroom. I convinced her the dentist was not a necessity. She didn't want to cancel her appointment because she had cancelled it a few weeks earlier because she wasn't feeling up to it.
I stayed the night with her. She had an appointment scheduled with her primary care physician on Wednesday morning, so she decided to tough it out until then.
She mentioned that she had been having diarrhea off and on for about three weeks and her feet and ankles were swollen more than usual. She would perspire profusely just walking to the bathroom, but we both thought that was because she was in so much pain and it took so much effort and about ten minutes just to get there.
When I got there on Monday, I could not imagine how she managed by herself all weekend. She wanted me to put a mini fridge and a microwave in her bedroom then go home. She would be fine, she said.
Please bear in mind that in spite of her pain and discomfort, my mother was not only pleasant, but funny. She would make jokes about herself and her condition. She was also concerned about my time and comfort.
I did not know she was in such bad shape when I left my house on Monday that I didn't even consider that I wouldn't be back home that night. She was not in any shape to be left alone, so Jessica was able to be there with her Tuesday afternoon and she and David spent the night there so I could go home and shower, brush my teeth, and check in with my family. I was back down on Wednesday morning to take her to her doctor appointment. David was able to help me get her into her car and then into the doctor's office before going to work.
I told my family to plan on getting one of the girl's rooms ready for her to move into and to put all three girls together. My mom was not a fan of that plan. At that point I told her she didn't have much choice. I could not take care of her in Springville and my family in Saratoga Springs and leaving her alone was out of the question. I told her it would be temporary, just a couple of weeks; however, I wasn't sure how long it would be.
I feel like her doctor was overwhelmed by her list of symptoms, many of which did not seem connected. He decided that an x-ray was in order due to the severe pain she was having. He also thought she needed some blood taken for labs. He wanted me to take her to the emergency room for care.
Remembering the 12 hours we spend in the ER at Utah Valley Hospital earlier in the year I opted for the less busy Timpanogos Regional in Orem. It was a bit further, but I thought it would be a better choice as far as time was concerned. I was right about the time, but will have know way of ever knowing if she would have received better care elsewhere. She was given an x-ray and some pain medication and told that her primary care doctor should order the lab work. Her hip was not broken, by the way. We didn't think it was.
While we were waiting in the exam room of the hospital, my mom tearfully told me that she wished my dad could just give her a hug. But then she said that that would likely not be enough. She knew she would want more time with him than just a hug and that she might actually feel worse seeing him for a short time.
Once she was comfortably situated in the car, she made a couple of phone calls and gave me my marching orders. After getting some lunch at a drive through, we stopped at Macey's in Provo to get a couple of sale items and dropped of the prescription at her pharmacy inside Springville's Walmart.
Jessica's sweet dad, James, met me at my mom's house to help me get her up her front steps. Mom tried to dismiss him once she was barely inside the front door, but he refused to go. We had a nice visit. He teased her about dating an old, rich man from the reality TV show, Duck Dynasty.
At 7:40 that evening, I gave Mom a pain pill because she wanted to go to the bathroom and it was so painful getting there she wanted to see if that would help. I looked at the clock so I would know what time she could have another one should she want it. Little did I know what would happen in the coming hours.
By 8:00 she was in agony. She was sick to her stomach and her abdomen was distended. I incorrectly thought she was feeling sick because of the pain medication. She called her home teachers to ask for a blessing. Alan and Courtney Curtis came over. They visited and my mom was chatty and a bit over-sharing in my opinion. She was still good humored. She wanted them to help her get to the bathroom. I thought that was strange, but they obliged. I had been putting her on her walker that has a seat and slowly pulling her backwards to her bathroom. The hallway is narrow and the turns are sharp and I had had more practice, but Alan, who is older than my mom pulled her in. I helped her in the bathroom then the three of us put her into her bed. She had been sleeping in her recliner for a few nights and really wanted to sleep in her bed. They left after we got her settled.
She was not comfortable and began to have dry heaves. I kept a bowl handy and tried to reposition her. Nothing worked. She wanted to get up, but she was very weak and I was afraid that I wouldn't be able to hold her up if she should fall. David was planning on stopping after he got off work. I started texting him to get there as soon as he could. My mom would ask me for something and I would walk a few steps away to get it then she would tell me to stay with her. I broke down momentarily. She unnecessarily apologized and I pulled it together. She was in agony--dying really and there seemed to be nothing I could do.
I sat with her on the edge of her bed for what seemed like an eternity waiting for David to get there and help me move her. She wanted to go to the bathroom again then we got her back into her recliner. She was disoriented when David got there; she told him he was supposed to be at the hospital with Jessica having her baby. As soon as she sat down she said she was having trouble breathing. She looked pale and her lips were turning blue. We quickly decided that a 9-1-1 call was in order. I talked to her and tried to keep her alert because she seemed to be fading. Two police officers got there quickly, but to me they were a nuisance because they could not help her. They were asking me things and wanting to know what medications she was taking, etc. My mom keeps a list in her purse that David got out while we were waiting for the paramedics to get there.
After the paramedics made their assessment, they started her on oxygen, told us her pulse was weak and that they would take her to the hospital. They said that one of us could ride with them in the ambulance. I decided to send David home because Jessica was to be induced the following morning. I said I would meet them there. Mom would need some clean clothes to come home in and a ride home of course, so I packed a bag and drove her car to Utah Valley Regional Medical Center.
I didn't want to have to go through whatever rig-a-ma-roll would be necessary at the ER desk in order to get taken back to my mom, so when I saw the ambulance parked and the EMT loitering outside I went to them and they kindly escorted me back to the room he thought Mom would be in. He told me she "declined" on the way to the hospital. I had no idea what that meant and I was either in denial or sincerely had no idea how sick she was at that point. He took me to a room and said that they had taken her to get an x-ray and that she should be back soon. A few moments later someone else walked by and said they had moved her to a different room. VIP aka trauma. That should have clued me in, but it didn't. There was a doctor and several nurses working on her. She had been hooked up to an IV and they were putting some stitches in her neck/shoulder area with a catheter giving her medicine to keep her blood pressure up. I think the first thing the doctor said to me was, "We're not out of the woods yet."
I thought, "When did we get in the woods? She's having some trouble breathing, she's in pain, I packed a bag, and her car is parked right outside. Just fix her and I'll be more than happy to take her home." I'm answering questions and listening to what they are telling me, but I could not wrap my brain around it.
"It's either her heart or a blood infection," they said,"we're treating her for both until we get all the labs back."
"Okay, keep up the good work."
They tell me they need to intubate her.
"Okay, I don't want to watch, I"ll just step outside."
I did and texted my mom's people to let them know what was going on.
"Do you want us to come and sit with you?" ask the people.
"No, just come in the morning. I'm already here. I'm fine. Just come in the morning."
E.R. doctor says that they will be moving her to ICU and that the ICU doctor will come down and talk to me.
"Okay." I sit on a chair and hold her hand. She's cold. But the nurses tell me they don't want to put too many blankets on her because she actually has a fever. When they intubated her they also put a tube into her stomach that was pumping out blood.
Pharmacist comes in to ask what medications she takes on a regular basis. I happen to have them all in the bag I packed for her. I showed her and she took a few notes and left.
Enter ICU doctor.
"Do you know what her end of life wishes are?"
My thoughts were, "What do you mean end of life wishes. Just fix her up. I packed a bag and her car is waiting for her just outside."
The nurse caught my stunned look and asked more specifically if I wanted them to do CPR, etc. I didn't really need the clarification. I knew what the question meant and I knew the answer. I just wasn't ready to accept the fact that I needed to provide those answers right then. We agreed to talk after Mom was moved into ICU.
I urgently told my siblings what was happening and Erika said she was coming right then. Kent would also be driving down from Idaho then. Renee was going to see about getting a flight. Kevin needed a babysitter and Jessica was supposed to be having a baby in a few hours.
It was midnight.
Erika got there while I was waiting for an MRI of my mom's abdomen to happen. We both went to ICU waiting room while Mom was getting situated. the ICU doctor and a surgeon both came to talk to us. We were told they could do surgery, but there was likely nothing they could do to help her. Her bowels were dying, not just in one section, but everywhere. I think I understood her fragility by this point and I wasn't even sure she would survive a surgery. In addition, her kidneys were not happy and her breathing was being done entirely by the machine. Her heart was beating, but her blood pressure was plummeting.
I asked them to do all they could to keep her alive until her children could get there to say goodbye. They agreed.
Mom was conscious when we went in to see her. David and Jessica, I think, got there next. Mom heard us talking about Kent and what time we thought he might get there. We were discussing Renee's flight. She missed the red-eye and had to wait until morning to leave. Mom couldn't really talk because of the breathing tube down her throat, but was coherent enough to know that we hadn't talked about Kevin. She asked about him. We knew that Christine's parents would be getting there to watch their kids then they would make the drive to Provo from Stansbury Park so we didn't need to talk about that.
Erika asked her if she wanted surgery. She didn't.
"Did she want to go see Dad?" She did.
"Should Jessica wait to be induced?" She got big eyes, tried to sit up and give us the most emphatic no she could muster.
She had been waiting a long time, just like everyone else, for "Baby Girl" as she called her, to join the family. She couldn't wait to see her. I hope their spirits crossed paths as Mom passed away a few hours before baby Quinn Renee Smith made her entrance.
I had decided that my children were old enough to handle seeing Grandma in the ICU and would want to say their goodbyes to her. I thought I would call Destry at 6:00 a.m. and have him bring the kids over then, but Mom's heart started to misbehave around 4:00 a.m. so I called then. Kevin and Christine had gotten there at some point. Destry and the kids were there sometime after 5 and I think Kent made it around 6. The nurses kept Mom sedated most of the time, but when someone new showed up they cut back the drugs and she woke up. She acknowledged everyone and everyone got to express their love and say goodbye. All her kids made it, except Renee.
At some point I stepped out into the hall to catch my breath and find some water when I ran into my sister-in-law, Calie Macdonald, who is a respiratory therapist at the hospital. I hugged her and told her my mom was dying. She told me she knew and that she had seen my mom's abdominal scan and thought to herself that that person was in a lot of pain. At first the name on the chart sounded familiar to her, but she didn't know immediately who it was. She figured it out though. She brought me and everyone else some water.
It was getting crowded and technically we were only allowed two people in the room with her. The night nurse let it slide, but told us it would be busier when the daytime shift got there and we needed to take turns being in there.
My family was there for about an hour when Destry took everyone except Emma home. Emma wanted to stay.
I had been with her the whole time, so I went to the waiting room. I had been out of the room for a half hour or so when Erika sent me a text telling me to get in there. I stood up and then she called and told me to run.
I did.
I passed a slow moving hospital worker of some sort carrying a box. It felt like he was blocking my path, but I made it past him. I found out later that he was heading to my mom's room. Some of the family were out in the hallway and the room was filled with medical people and the rest of the family. A couple of people asked me if I was the one to make the medical decisions for her. I told them that I was. They wanted to know if they should keep doing chest compressions or to stop.
I felt like I was in some sort of alternate reality. The people were there, but somehow frozen in time. Some people are looking at me, others are beating up my mom--or so it looked. They wanted me to tell them what to do. Someone, a nurse, I think, put her hand on my shoulder. That human touch connected me a bit. Thankfully, I heard Erika ask them if they could keep her alive until 5:00 that evening. I knew that even that would not be long enough for Renee to get there, but they said, "No."
I said, "Stop."
"Do you want us to stop?"
"Yes, stop."
Nearly everyone left. Mom's breathing machine was disconnected, other stuff turned off. We could hear the inconsistent bleeps of the heart monitor and watch her occasional breath. The nurse put a couple of drugs into her IV to help her breathing be more comfortable and for pain or something.
We all held our breath as we waited for her to take her last one. Erika and I held her hand and everyone else watched closely. It didn't take long. It was 8:00 a.m., just 12 hours after she became ill. We hugged whomever was closest to us at the moment. We cried and talked and were asked if we wanted to leave while a nurse took out the breathing tube and everything else and cleaned her up a bit. We declined. Once we left that room, we weren't going back.
I called Destry. He and the kids had gone to One Man Band for breakfast. They cried together in the restaurant.
David and Jessica left first. The Payson hospital where Jessica was to give birth told her to come whenever she wanted. None of us knew at the time, but she had been having contractions while we were with my mom. Christine and I told her to go home and rest. She had been up all night and labor requires a lot of energy. She wanted to make sure everything was okay with the baby so she went to the hospital before going home and they kept her. She was dialating and having regular contractions.
I don't think Jessica wanted her baby to share a birthday with her mother-in-law's death day, but by then she didn't have a choice. Quinn was born before the day was over. It took a few years and three miscarriages to get her here, but she is pure joy. We all love her so much. Now we get to celebrate October 5 and not mourn over it. David and Jessica handled everything with so much strength and grace which brought me peace and comfort.
When we walked out of the room I was told someone wanted to talk to me on the phone. I answered several questions and listened to several prepared statements and gave permission for my mom's eyes to be used for research.
Mom probably died right when Renee boarded the plane in Alaska. She had told Erika she would call when she landed for a layover in Seattle. She wanted to know the truth. Erika called her, but Renee ignored the call. Adam called her shortly after. She answered. She heard the news from her husband and she took it well. She eventually made it Utah.
I thought I should call her home teachers to let them know since they had just seen her the night before.
No need. We hadn't even left the ICU hallway when my mom's phone rang. It was Alan Curtis calling to check on her. I had to tell him the unfortunate news. I knew he didn't want to believe it.
Kent, Kevin, Christine, Erika, and Emma and I went to Kneader's for breakfast.
Then we planned a funeral.
Two things kept coming to my mind. The first was the voice of my mom saying "Thank you," as she had so many times the past several months. The other was the words of her blessing. I knew her life was not sweet any more. I knew that it wouldn't likely get better. I'm glad she didn't have to live through more months or years of suffering, but I sure do miss her.
The official cause of death as written on her death certificate states, "Cardiopulmonary arrest due to (or as a consequence of): septic shock, respiratory failure, acute kidney injury, lactic acidosis due to (or as a consequence of : intra-abdominal infection." She had rheumatoid arthritis and had been taking steroids for months. Both of those, the ER doctor told me, compromised her immune system and put her at a greater risk for sepsis.
While I doubt the outcome would have been different (at least that is what I tell myself) if the first ER doctor had done blood work, or her primary care physician would have been more aggressive in ordering the tests himself, I still feel like the medical system failed her that day. There was no one taking responsibility for getting to the bottom of all her symptoms. Maybe I should have demanded more, but I put my trust in people with letters behind their name to know more than I and hoped they would do what was necessary.
That's it. I find it a bit ironic that my last post was of my dad's death day. At least it didn't take me 13 years to write it down this time, so that is progress.
This past year has been quite difficult for her. Last November she began having pain in her upper back, arms, and shoulders. She visited a pain clinic and received a series of injections providing her with some relief. By Spring her hands and feet were swollen and misshapen and she had difficulty getting her body moving each morning. If she had a morning appointment she would wake up at 4:00 a.m. in order to get her hands moving so she could use them. In the spring her primary care physician suggested she see a rheumatologist.
In the past she has had bad experiences either with rheumatology medications or doctors and I began going to her appointments with her. She seemed to like her new doctor and he prescribed a drug that she had not taken before. After a couple of months she received a lot of relief. Her hands and feet were back to their normal shape and size; however her hair was falling out. She stopped taking the medication because of it. Fortunately, she did not have a relapse of symptoms. She continued taking prednisone up until about a week ago.
She functioned fairly well throughout the summer and even took a trip to Alaska with David and Jessica and Erika to visit Renee and her family. She also has compressed discs in her back and she began having terrible pain in her buttocks in August. An orthopedic doctor gave her shots in her hips and back. She had very little relief from that, even though she had had that done several years before and received years of pain free living.
With that background in place I want to focus on the events of the last week of her life.
As I mentioned before she was having a lot of pain from the compressed discs. She even had trouble walking and began using a walker. Stairs became almost impossible. She had some friends she met on her mission in England come to visit her on September 28. She had been looking forward to it and really wanted to show them around. She prepared breakfast for them and they drove to the Payson Temple to look around. Then she returned and as she was trying to pull herself up the two steps onto her porch she pulled a muscle in her groin.
The preceding paragraphs were written on October 9, 2017.
Continued on May 12, 2018 (the day before my first Mother's Day without her).
A few times throughout her last year of life I had the privilege of taking her to doctor's appointments, shopping, and doing a few things around her home that were too difficult for her to do. To say she was an independent person would be understating her character; in spite of her pain, she took care of herself and others. She never missed a Sunday dinner. She did miss a few trips to the family history center and Spencer's high school graduation. But she rarely asked for help, which is why when she called me on October 2, Monday morning (in tears) asking if I could come down and help her shower and get ready for a dentist appointment I quickly got my kids off to school and rushed down.
She was in so much pain in her groin that she cried as she walked to the bathroom. I convinced her the dentist was not a necessity. She didn't want to cancel her appointment because she had cancelled it a few weeks earlier because she wasn't feeling up to it.
I stayed the night with her. She had an appointment scheduled with her primary care physician on Wednesday morning, so she decided to tough it out until then.
She mentioned that she had been having diarrhea off and on for about three weeks and her feet and ankles were swollen more than usual. She would perspire profusely just walking to the bathroom, but we both thought that was because she was in so much pain and it took so much effort and about ten minutes just to get there.
When I got there on Monday, I could not imagine how she managed by herself all weekend. She wanted me to put a mini fridge and a microwave in her bedroom then go home. She would be fine, she said.
Please bear in mind that in spite of her pain and discomfort, my mother was not only pleasant, but funny. She would make jokes about herself and her condition. She was also concerned about my time and comfort.
I did not know she was in such bad shape when I left my house on Monday that I didn't even consider that I wouldn't be back home that night. She was not in any shape to be left alone, so Jessica was able to be there with her Tuesday afternoon and she and David spent the night there so I could go home and shower, brush my teeth, and check in with my family. I was back down on Wednesday morning to take her to her doctor appointment. David was able to help me get her into her car and then into the doctor's office before going to work.
I told my family to plan on getting one of the girl's rooms ready for her to move into and to put all three girls together. My mom was not a fan of that plan. At that point I told her she didn't have much choice. I could not take care of her in Springville and my family in Saratoga Springs and leaving her alone was out of the question. I told her it would be temporary, just a couple of weeks; however, I wasn't sure how long it would be.
I feel like her doctor was overwhelmed by her list of symptoms, many of which did not seem connected. He decided that an x-ray was in order due to the severe pain she was having. He also thought she needed some blood taken for labs. He wanted me to take her to the emergency room for care.
Remembering the 12 hours we spend in the ER at Utah Valley Hospital earlier in the year I opted for the less busy Timpanogos Regional in Orem. It was a bit further, but I thought it would be a better choice as far as time was concerned. I was right about the time, but will have know way of ever knowing if she would have received better care elsewhere. She was given an x-ray and some pain medication and told that her primary care doctor should order the lab work. Her hip was not broken, by the way. We didn't think it was.
While we were waiting in the exam room of the hospital, my mom tearfully told me that she wished my dad could just give her a hug. But then she said that that would likely not be enough. She knew she would want more time with him than just a hug and that she might actually feel worse seeing him for a short time.
Once she was comfortably situated in the car, she made a couple of phone calls and gave me my marching orders. After getting some lunch at a drive through, we stopped at Macey's in Provo to get a couple of sale items and dropped of the prescription at her pharmacy inside Springville's Walmart.
Jessica's sweet dad, James, met me at my mom's house to help me get her up her front steps. Mom tried to dismiss him once she was barely inside the front door, but he refused to go. We had a nice visit. He teased her about dating an old, rich man from the reality TV show, Duck Dynasty.
At 7:40 that evening, I gave Mom a pain pill because she wanted to go to the bathroom and it was so painful getting there she wanted to see if that would help. I looked at the clock so I would know what time she could have another one should she want it. Little did I know what would happen in the coming hours.
By 8:00 she was in agony. She was sick to her stomach and her abdomen was distended. I incorrectly thought she was feeling sick because of the pain medication. She called her home teachers to ask for a blessing. Alan and Courtney Curtis came over. They visited and my mom was chatty and a bit over-sharing in my opinion. She was still good humored. She wanted them to help her get to the bathroom. I thought that was strange, but they obliged. I had been putting her on her walker that has a seat and slowly pulling her backwards to her bathroom. The hallway is narrow and the turns are sharp and I had had more practice, but Alan, who is older than my mom pulled her in. I helped her in the bathroom then the three of us put her into her bed. She had been sleeping in her recliner for a few nights and really wanted to sleep in her bed. They left after we got her settled.
She was not comfortable and began to have dry heaves. I kept a bowl handy and tried to reposition her. Nothing worked. She wanted to get up, but she was very weak and I was afraid that I wouldn't be able to hold her up if she should fall. David was planning on stopping after he got off work. I started texting him to get there as soon as he could. My mom would ask me for something and I would walk a few steps away to get it then she would tell me to stay with her. I broke down momentarily. She unnecessarily apologized and I pulled it together. She was in agony--dying really and there seemed to be nothing I could do.
I sat with her on the edge of her bed for what seemed like an eternity waiting for David to get there and help me move her. She wanted to go to the bathroom again then we got her back into her recliner. She was disoriented when David got there; she told him he was supposed to be at the hospital with Jessica having her baby. As soon as she sat down she said she was having trouble breathing. She looked pale and her lips were turning blue. We quickly decided that a 9-1-1 call was in order. I talked to her and tried to keep her alert because she seemed to be fading. Two police officers got there quickly, but to me they were a nuisance because they could not help her. They were asking me things and wanting to know what medications she was taking, etc. My mom keeps a list in her purse that David got out while we were waiting for the paramedics to get there.
After the paramedics made their assessment, they started her on oxygen, told us her pulse was weak and that they would take her to the hospital. They said that one of us could ride with them in the ambulance. I decided to send David home because Jessica was to be induced the following morning. I said I would meet them there. Mom would need some clean clothes to come home in and a ride home of course, so I packed a bag and drove her car to Utah Valley Regional Medical Center.
I didn't want to have to go through whatever rig-a-ma-roll would be necessary at the ER desk in order to get taken back to my mom, so when I saw the ambulance parked and the EMT loitering outside I went to them and they kindly escorted me back to the room he thought Mom would be in. He told me she "declined" on the way to the hospital. I had no idea what that meant and I was either in denial or sincerely had no idea how sick she was at that point. He took me to a room and said that they had taken her to get an x-ray and that she should be back soon. A few moments later someone else walked by and said they had moved her to a different room. VIP aka trauma. That should have clued me in, but it didn't. There was a doctor and several nurses working on her. She had been hooked up to an IV and they were putting some stitches in her neck/shoulder area with a catheter giving her medicine to keep her blood pressure up. I think the first thing the doctor said to me was, "We're not out of the woods yet."
I thought, "When did we get in the woods? She's having some trouble breathing, she's in pain, I packed a bag, and her car is parked right outside. Just fix her and I'll be more than happy to take her home." I'm answering questions and listening to what they are telling me, but I could not wrap my brain around it.
"It's either her heart or a blood infection," they said,"we're treating her for both until we get all the labs back."
"Okay, keep up the good work."
They tell me they need to intubate her.
"Okay, I don't want to watch, I"ll just step outside."
I did and texted my mom's people to let them know what was going on.
"Do you want us to come and sit with you?" ask the people.
"No, just come in the morning. I'm already here. I'm fine. Just come in the morning."
E.R. doctor says that they will be moving her to ICU and that the ICU doctor will come down and talk to me.
"Okay." I sit on a chair and hold her hand. She's cold. But the nurses tell me they don't want to put too many blankets on her because she actually has a fever. When they intubated her they also put a tube into her stomach that was pumping out blood.
Pharmacist comes in to ask what medications she takes on a regular basis. I happen to have them all in the bag I packed for her. I showed her and she took a few notes and left.
Enter ICU doctor.
"Do you know what her end of life wishes are?"
My thoughts were, "What do you mean end of life wishes. Just fix her up. I packed a bag and her car is waiting for her just outside."
The nurse caught my stunned look and asked more specifically if I wanted them to do CPR, etc. I didn't really need the clarification. I knew what the question meant and I knew the answer. I just wasn't ready to accept the fact that I needed to provide those answers right then. We agreed to talk after Mom was moved into ICU.
I urgently told my siblings what was happening and Erika said she was coming right then. Kent would also be driving down from Idaho then. Renee was going to see about getting a flight. Kevin needed a babysitter and Jessica was supposed to be having a baby in a few hours.
It was midnight.
Erika got there while I was waiting for an MRI of my mom's abdomen to happen. We both went to ICU waiting room while Mom was getting situated. the ICU doctor and a surgeon both came to talk to us. We were told they could do surgery, but there was likely nothing they could do to help her. Her bowels were dying, not just in one section, but everywhere. I think I understood her fragility by this point and I wasn't even sure she would survive a surgery. In addition, her kidneys were not happy and her breathing was being done entirely by the machine. Her heart was beating, but her blood pressure was plummeting.
I asked them to do all they could to keep her alive until her children could get there to say goodbye. They agreed.
Mom was conscious when we went in to see her. David and Jessica, I think, got there next. Mom heard us talking about Kent and what time we thought he might get there. We were discussing Renee's flight. She missed the red-eye and had to wait until morning to leave. Mom couldn't really talk because of the breathing tube down her throat, but was coherent enough to know that we hadn't talked about Kevin. She asked about him. We knew that Christine's parents would be getting there to watch their kids then they would make the drive to Provo from Stansbury Park so we didn't need to talk about that.
Erika asked her if she wanted surgery. She didn't.
"Did she want to go see Dad?" She did.
"Should Jessica wait to be induced?" She got big eyes, tried to sit up and give us the most emphatic no she could muster.
She had been waiting a long time, just like everyone else, for "Baby Girl" as she called her, to join the family. She couldn't wait to see her. I hope their spirits crossed paths as Mom passed away a few hours before baby Quinn Renee Smith made her entrance.
I had decided that my children were old enough to handle seeing Grandma in the ICU and would want to say their goodbyes to her. I thought I would call Destry at 6:00 a.m. and have him bring the kids over then, but Mom's heart started to misbehave around 4:00 a.m. so I called then. Kevin and Christine had gotten there at some point. Destry and the kids were there sometime after 5 and I think Kent made it around 6. The nurses kept Mom sedated most of the time, but when someone new showed up they cut back the drugs and she woke up. She acknowledged everyone and everyone got to express their love and say goodbye. All her kids made it, except Renee.
At some point I stepped out into the hall to catch my breath and find some water when I ran into my sister-in-law, Calie Macdonald, who is a respiratory therapist at the hospital. I hugged her and told her my mom was dying. She told me she knew and that she had seen my mom's abdominal scan and thought to herself that that person was in a lot of pain. At first the name on the chart sounded familiar to her, but she didn't know immediately who it was. She figured it out though. She brought me and everyone else some water.
It was getting crowded and technically we were only allowed two people in the room with her. The night nurse let it slide, but told us it would be busier when the daytime shift got there and we needed to take turns being in there.
My family was there for about an hour when Destry took everyone except Emma home. Emma wanted to stay.
I had been with her the whole time, so I went to the waiting room. I had been out of the room for a half hour or so when Erika sent me a text telling me to get in there. I stood up and then she called and told me to run.
I did.
I passed a slow moving hospital worker of some sort carrying a box. It felt like he was blocking my path, but I made it past him. I found out later that he was heading to my mom's room. Some of the family were out in the hallway and the room was filled with medical people and the rest of the family. A couple of people asked me if I was the one to make the medical decisions for her. I told them that I was. They wanted to know if they should keep doing chest compressions or to stop.
I felt like I was in some sort of alternate reality. The people were there, but somehow frozen in time. Some people are looking at me, others are beating up my mom--or so it looked. They wanted me to tell them what to do. Someone, a nurse, I think, put her hand on my shoulder. That human touch connected me a bit. Thankfully, I heard Erika ask them if they could keep her alive until 5:00 that evening. I knew that even that would not be long enough for Renee to get there, but they said, "No."
I said, "Stop."
"Do you want us to stop?"
"Yes, stop."
Nearly everyone left. Mom's breathing machine was disconnected, other stuff turned off. We could hear the inconsistent bleeps of the heart monitor and watch her occasional breath. The nurse put a couple of drugs into her IV to help her breathing be more comfortable and for pain or something.
We all held our breath as we waited for her to take her last one. Erika and I held her hand and everyone else watched closely. It didn't take long. It was 8:00 a.m., just 12 hours after she became ill. We hugged whomever was closest to us at the moment. We cried and talked and were asked if we wanted to leave while a nurse took out the breathing tube and everything else and cleaned her up a bit. We declined. Once we left that room, we weren't going back.
I called Destry. He and the kids had gone to One Man Band for breakfast. They cried together in the restaurant.
David and Jessica left first. The Payson hospital where Jessica was to give birth told her to come whenever she wanted. None of us knew at the time, but she had been having contractions while we were with my mom. Christine and I told her to go home and rest. She had been up all night and labor requires a lot of energy. She wanted to make sure everything was okay with the baby so she went to the hospital before going home and they kept her. She was dialating and having regular contractions.
I don't think Jessica wanted her baby to share a birthday with her mother-in-law's death day, but by then she didn't have a choice. Quinn was born before the day was over. It took a few years and three miscarriages to get her here, but she is pure joy. We all love her so much. Now we get to celebrate October 5 and not mourn over it. David and Jessica handled everything with so much strength and grace which brought me peace and comfort.
When we walked out of the room I was told someone wanted to talk to me on the phone. I answered several questions and listened to several prepared statements and gave permission for my mom's eyes to be used for research.
Mom probably died right when Renee boarded the plane in Alaska. She had told Erika she would call when she landed for a layover in Seattle. She wanted to know the truth. Erika called her, but Renee ignored the call. Adam called her shortly after. She answered. She heard the news from her husband and she took it well. She eventually made it Utah.
I thought I should call her home teachers to let them know since they had just seen her the night before.
No need. We hadn't even left the ICU hallway when my mom's phone rang. It was Alan Curtis calling to check on her. I had to tell him the unfortunate news. I knew he didn't want to believe it.
Kent, Kevin, Christine, Erika, and Emma and I went to Kneader's for breakfast.
Then we planned a funeral.
Two things kept coming to my mind. The first was the voice of my mom saying "Thank you," as she had so many times the past several months. The other was the words of her blessing. I knew her life was not sweet any more. I knew that it wouldn't likely get better. I'm glad she didn't have to live through more months or years of suffering, but I sure do miss her.
The official cause of death as written on her death certificate states, "Cardiopulmonary arrest due to (or as a consequence of): septic shock, respiratory failure, acute kidney injury, lactic acidosis due to (or as a consequence of : intra-abdominal infection." She had rheumatoid arthritis and had been taking steroids for months. Both of those, the ER doctor told me, compromised her immune system and put her at a greater risk for sepsis.
While I doubt the outcome would have been different (at least that is what I tell myself) if the first ER doctor had done blood work, or her primary care physician would have been more aggressive in ordering the tests himself, I still feel like the medical system failed her that day. There was no one taking responsibility for getting to the bottom of all her symptoms. Maybe I should have demanded more, but I put my trust in people with letters behind their name to know more than I and hoped they would do what was necessary.
That's it. I find it a bit ironic that my last post was of my dad's death day. At least it didn't take me 13 years to write it down this time, so that is progress.
Comments
Post a Comment