No knowing now how long mum has to go

A nurse at the nursing home called me this morning to tell me that mum was not responsive and had not been able to get out of bed. They wanted to know if it was OK to call the ambulance and get mum taken to the hospital again. I said it was fine. They told me later in another call that mum would be taken to the Royal North Shore Hospital but this plan was changed, when I spoke with my cousin, who had phoned the nursing home herself for information. They were actually taking her to Ryde Hospital. This is the seventh time for mum to be admitted to Ryde Hospital since we moved her to Sydney 18 months ago.

My cousin had called the nursing home to find out more about the onset of the infection this time. Mum had been due to start taking a new type of oral antibiotic but the nurses had realised that mum was allergic to it. For this reason the only option was to get the hospital to bring their significantly greater resources to bear on the problem.

I arrived at the hospital later in the morning and after going into the Emergency Ward I spoke with a doctor, who discussed with me the implications of mum's advance health directive (AHD). I had gotten a copy of this document the day before and had scanned it and emailed it to my cousin, who works as a physiotherapist and often works in hospitals. The doctor talked with me about the options available and I told him that I had thought a lot about what to do if the drugs stopped working for mum. In effect, mum would be put in a ward and given palliative care to ensure her comfort, but more intrusive methods of maintaining consciousness would not be performed.

The doctor told me that I was holding up well in the circumstances, but it's been clear to me for a long time that this kind of process would be inevitable at some point in the not-too-distant future. The truth is that mum is burning the candle at both ends. Because of her blood disease (myelodysplastic syndrome) she takes medications that make it more likely that she will contract infections, so when it comes down to it you're trying to do two things that are basically incompatible, with the same body. And then there was the cellulitis in her right leg that was causing constant problems.

Today I stayed in the building as long as possible but it was getting late and I had to get home to do some chores and get ready for the next day. The plumber is coming in the afternoon tomorrow to try to fix the mixer tap in the shower in the second bathroom. I will try to get up to the hospital tomorrow morning to see how mum is getting along, but for the rest of today she's going to have to go it alone. In the end we're all going to be alone anyway. We face the end alone just as alone we face the many trials during our lives that really test our mettle. Sleep well, mum.