Falling

I guess it all began with another fall; this one seemed innocent enough--Mom simply sliding to the floor I'd thought, banging her elbow.  When nurse Liz called me that Saturday evening, I'd been asleep for only ten or fifteen minutes, but I'd been so exhausted that awakening to the phone's ring startled me.

"Hi, Jane," she said.  "I just wanted you to know your mom must've been trying to get out of bed and she fell.  She's complaining about her elbow.  Do you think we should take her in tonight [she meant to the ER] to be checked out?"

My mom's falling wasn't new, and we knew repeated falls were inevitable, as she invariably tried to stand, forgetting she needed assistance.  Hitting her elbow didn't seem like an emergency, and given my total exhaustion, I didn't relish another night visit with her to the ER.

"Would you monitor her and keep in touch?  I'll take her in tomorrow morning," I said.  

But what I didn't realize was that in my stupor I'd not hit the off button on the house phone, and my cell phone was set to "do not disturb" from 10 pm. to 7 am.  So I was shocked and worried when I noticed missed calls and messages from mom's care center and from my brother the next morning.  Mom had indeed really banged herself up.

We did make it to urgent care the next morning--maneuvering with wheelchair and oxygen tank into and out of the Honda.  My arms hugging her, I lifted Mom and transferred her from the chair to the seat, helped her belt in, and drove through the countryside into town.

"Where are we now?" mom asked.  And I told her, describing our location as I would have years ago--"We're going past where the Stables Supper Club was...Now we're going down Lakeview Boulevard along the country club's third fairway."  

Over the years with so many hospital and clinic visits under my belt, I've become more bold, and decided that even though I wasn't taking Mom to the ER, I'd drive straight into the ER bay and ask for assistance there in transferring mom to one of the hospital's wheelchairs to transport her to the urgent care floor.  The ER garage door opened automatically as I approached it, and as I got out of the car, three or four staff magically appeared to help.  They were kind and gentle with my frail, hurting mama.

The Sunday PA on duty ordered an x-ray of Mom's elbow and forearm, for that's what was bothering her.  It showed the ulna had broken off and was displaced--"No wonder it hurts," the PA said.  She splinted the arm as she explained to Mom she'd broken her elbow.  "I did?" Mom asked. "How did that happen?" Yes indeed--how did that happen. With a prescription for pain pills in hand and a promise that orthopedics would see Mom in a day or two, we made the journey back to the care center.  

What transpired following was this:  The visit to the orthopedist two days later focused on Mom's new complaint of leg pain, and new x-rays showed fractures of the pelvis and sacrum.  Her severe leg pain (merely touching the backs of her calves) concerned the doctor and Mom was whisked via ambulance to Rochester Mayo's St. Mary's ER for review--was Mom's spinal column (nerve center) in jeopardy?

Mom ended up overnighting in Rochester for two nights--the nerves, they felt, were fine, but a bit of pneumonia concerned them, so she was kept for observation, given antibiotics, and sent home on Thursday.  

Back in her room, things seemed unfamiliar to her--she wasn't quite sure of things and admitted, "What I need to do is figure out where I am."  She seemed to view her old room with a new perspective: "Has that picture always been there?"

And for a time Mom seemed comfortable, we knew the pelvis and sacrum just needed to heal on their own, and the elbow?  We'd deal with that later...

But Saturday Mom was visibly distressed, in pain.  By Monday while in bed on her back, she was sliding her hands underneath her lower back--indicating more pain. Finally on Tuesday morning I asked to see Mom's medication list.  What was she being given for pain?  It hadn't been this bad before.

How shocked (and frustrated and disappointed) I was to discover she was being given only Tylenol for pain (1000mg, three times/day).  Apparently she'd come back from Rochester with no pain medication orders, and the care center was following those orders.  

"But didn't you wonder about this?" I asked, indicating her meager pain relief medication.  Apparently Mom hadn't complained about pain, but then I thought, well how could she?  She could barely talk.  I was adamant about her being given something more for pain, and the staff agreed, though they needed to go through the channels of getting an order before administering.  I stayed with Mom until she was finally given a crushed pill of Tramadol.  

When I checked in again in the afternoon, Mom's eyelids where mere slits and though she knew I was there and occasionally responded with gibberish I couldn't really understand, I could see she was failing.  I thought of her as a frail twig, something once strong that now was brittle and weak. But somehow she was able to nod when I asked, "Should I trim your nails?" And so I did.  And she responded likewise when I asked about plucking the errant chin and dark facial hairs from her face.  I left knowing mom was groomed.

And later that evening as I was sitting down in a movie theater and silencing my phone, I noticed the care center was calling--they reported Mom's oxygen level was in distress, down to 73%. I left the theater and within 5 minutes was at her side. On my way there I wondered to myself, Wow, is this it? Is this Mom's final struggle? I texted my two kids in Minneapolis and my brother in St. Paul that things were, I thought, dire.  And once at the bedside and hearing Mom's labored breathing, this was confirmed.

What happened over the next few hours wasn't awful or ugly or even strange.  It was somehow natural and peaceful--calm.  

I held Mom's hand as she breathed deeply, her chest filling, her throat filled.  If only we could get rid of that junk.

Then suddenly I resigned myself to the fact I was with Mom in her last minutes.  Yes, this was a passing, an exit and an entrance into the next realm.  I wasn't scared or teary or depressed.  I only wanted to support Mom on her journey, during her labor.  I was with her as she left the world, just as she was with me as I'd entered it.  So fitting--the circle, symmetry, fulfillment. 

And I fell in love with her even more as she left me, just as I'm sure she fell in love with me as I arrived in her arms.