Kroger, Library, and Morphine, 2014

On 25 January 2014, I posted on Facebook, "Oh, just a typical Saturday morning, picking up a morphine emergency kit." My friends in turn thought that statement was both funny and horrific, because many of my friends had already experienced what I was going through. The morphine kit was part of hospice's directive to have medical supplies at the patient's home to use in case of an emergency. In reality, that kit is usually used to help the patient transition from life to death.

A hospice morphine emergency kit (aka hospice comfort kit, emergency kit, or E-kit), is a collection of medications and supplies that can help relieve end-of-life symptoms. The contents of most comfort kits typically include at least the basic medications for pain, anxiety, nausea, insomnia, and breathing problems.

The kit also can include prescribed medications, and meds for reducing mucus production and the "death rattle" of wet breathing sounds that mucus buildup causes. Our kit also included sponges on straw-like stems that were intended for the patient to suck on for dry mouth. Morphine is the main druge to use for mucus buildup, respiratory distress, and pain.

I also visited the library that morning, but I didn't say whether I was picking up books or returning them. I had to stop at Kroger on the way home as well, as mom wanted a few things from the store. When I returned home, dad wanted to know what was in the kit, but it was sealed. I told him we could look at it later, and reminded him that hospice told us that the kit was to be kept in a safe and convenient place and not to use anything in it unless instructed.

I didn't know what was in the kit at the time, but I sure remember not wanting to examine it. The photo included here is not a hospice comfort kit, but it's similar. I don't remember all the meds that mom was taking, but I have a list somewhere and I'll find it. 

The most important medication other than morphine was the medicine for anxiety. Mom both needed that medication and wanted it, as it didn't make her groggy like her prescribed pain medication. I came to rely on the anxiety medication over the next couple of months more than any other med while dealing with mom's failing body.

Interventional Radiology Tests My Patience, 2014

I took a few days off from writing this history about mom and her cancer, because sometimes the memories can be overwhelming. Additionally, little happened on the 21st. On the 22nd of January in 2014, I wrote, "I've only been pissed off twice with mom's treatment over the past year and both times my ire has been directed with the sub-par IR (Interventional Radiology) at this hospital."

I hope, sincerely, that much has changed at my mother's hospital's IR since 2014. I know the man in charge either quit or was let go before June of 2014, because mom told me he was no longer there. IR as a practice was first introduced in the 1960s, but became a medical specialty in 2012, just two years before mom experienced their treatments. The departments conducts angiography, angioplasty, embolization, stent placement, needle biopsy, foreign body removal, and more. While IR became a medical specialty in this century, they introducted biliary and genitourinary system interventions, and should have been very skilled with those process by 2014.

That said, my mother had to return to the IR just two weeks after her hospital stay to replace her biliary catheter because someone in IR did not suture her correctly. As a result, mom developed a fever and was in "pain". When she returned from the hospital, she was exhausted. The next day, 23 January 2014, I wrote, "Mom sleeps. Mom's been sleeping for hours. Mom's twitching in ther sleep. She's been sleeping in the easy-boy chair, and I can't get her to wake up enough to get her to bed. I keep watching her chest to see if she's breathing. I may have to sleep on the couch, because I can't bring myself to go to bed, either."

She woke at 1 a.m. and said, "I've got to go to bed." She took herself back to the bedroom, where she fell asleep again immediately. She had been awake for a total of four hours that day. 

The comments from friends regarding my anger were in empathy, and many responses focused on the anger they felt when their loved ones were shortchanged by any given department within hospital systems. When I expand these entries for my published journal, I'll include some quotes that hit home for me. I had worried at times that I shouldn't be making our private lives public, but my parents didn't mind as long as I directed my writing at friends, and not to the world in general at the time.

Now that time is over. They're both gone. I have learned, through this process, that sharing is what cements us as a society. We need to know that we're not alone.

Note for illustration: This is a graphic image of the digestive system showing the bile duct, which is in the public domain. It is one of the graphics used in the article on Cholangiocarcinoma at Wikipedia. If the cancer cannot be removed and is pressing on or within the bile duct, the patient requires a bile duct stent (aka biliary stent) made of either plastic or metal. That stent holds the bile duct open so bile can continue to flow into the bowels. See more at Cancer Council, NSW, "Inserting a Stent".

Food and Snow, 2014

I skipped a few days posting because nothing much happened during this period in 2014. On January 21st I wrote that mom had a great two days without oxygen, with receding edemna and a good appetite. She had returned to the oxygen and was sleeping on this day, and I noted I hated to wake her up, but she needed to eat lunch.

I don't know what she had for lunch, but I made tortellini with porcini sauce for dinner, along with a healthy salad filled with lettuce, English cucumber, tomatoes, celery, and yellow pepper plus one roll, that dinner came to 1 gram of sodium. That 1 gram represented 1/3 of my mother's mandated daily intake, and it was the most she'd had in one meal since she left the hospital about a week prior.

That said, the portions were small. "10 Tortellini, 1/4 cup of sauce, one roll with one pat of olive oil butter, and a tablespoon of dressing on the salad." I had purchased much of the food the day before at a Fresh Market, not far from where my parents lived. I was at that market mainly because they carried probiotics and elderberry--two items I needed for myself. That store had been open for only six months, and I swore I would shop there more because of their organic options, but as time went on, my time was limited. I think I only shopped there twice, as Food Lion was much closer, and--according to my friends--a much less expensive option. I didn't see that. Fresh Market was competitive with Kroger, at least.

Other than shopping for food, we concentrated on a winter storm that was sweeping east from Kentucky. My husband sent a photo of his car outside the local coffee shop in Kentucky at the time (shown here), and that photo showed much more snow than we had at the time. A few hours later, though, we caught up. The conversation about snow was a long, ongoing reminiscence about snowfalls in the past. One guy mentioned 16" of snow in the late '70s or early '80s in Virginia Beach and the best I could find was 12" in 1980. The largest snowfall ever recorded in Virginia was the Jefferson-Washington snowfall where both Thomas Jefferson and George Washington recorded snowfall of around 3 feet in their diaries, occurring on January 28, 1772, making it one of the most significant snowstorms in Virginia history. Essentially, the storm dropped approximately 3 feet of snow in the areas where Jefferson and Washington resided. 

Anyone from Virginia might know where Thomas Jefferson resided in 1772. He had just married Martha Wayles on January 1, and they were residing in a one-room brick house on his Virginia plantation as enslaved laborers were building his Monticello plantation home. That location is about halfway between Richmond and today's Interstate 81 along I-64. Washington? He was residing with Martha and his two children at Ferry Farm, located near Fredericksburg, Virginia. That must have been some storm!

In the meantime, in 2014, my mother wasn't that interested in the snow. While she said she enjoyed my dinner, she had much to do about the mess I left on her stove. I honestly did not believe I left a mess, and I distinctly remember clearning up after myself, washing all dishes and wiping down everything. My father just shrugged. 

That was life with my mother, sick or not. I guess she was feeling fine that evening.

Time for Myself

I read a lot while caregiving my mother in Virginia. Mom lent me her library card to use at the only public library I knew about in Lynchburg. Campbell County actually has three public libraries as well as some private collections, and I just learned the library snagged the former visitor's center to create a downtown library. In 2014, however, the library on Memorial Avenue was the only one I knew.

I thought mom weathered the hectic and short-lived visit with friends the previous two days, because I felt comfortable enough to leave the house for the afternoon. I stopped at Starbucks on Boonesboro, then traveled down Rivermont to the library. I was familiar with their collections by this time, as I already had gone through the eight books in Stephen King's Dark Tower series, as well as the five books contained in The Hunger Games series by Suzanne Collins. I read the former as a dare to myself, and the latter so I could understand my daughter's fascination with the movies based on those books.

This time I listed The Invention of Murder by Judith Flanders, Indiscretion by Charles Dubow, Deeply Odd by Dean Koontz, and House of Earth by Woody Guthrie as my borrowed reads. I don't remember reading any one of these four books, and I don't know why. I do remember the premise of Deeply Odd, because my late husband and I discovered "Odd Thomas" during one trip to Virginia as we listened to a book on CD. I became slightly addicted to poor Odd.

I won't know why I don't remember those four books in particular until I go through the upcoming memories that Facebook holds. I do know that, after my husband died in 2015, I couldn't read for years. I couldn't concentrate enough, and my retention of what I did read was at zero. Only recently, almost ten years after his death, have I been able to read and retain information. Fiction bores me now, even Stephen King. What I crave is non-fiction works that prove I am now capable of learning and retaining.

Who am I trying to prove anything to? Myself. I think that's important.

Photo by Vincenzo Malagoli at Pexels.