Struggling at The End

Our dog Charlee Girl is fourteen and a half years old. She’s a sweet, compassionate personality and adores her family. When she’s been laying down a long time, she struggles to stand up—being the old lady that she is—but she pushes through her arthritic pain anyway just to greet one of us when we arrive home. About a year or so ago she lost her hearing, but she still looks to our faces when we talk to her, trying to read our body language. Dutifully she barks when she realizes someone is at the door, often after the fact since she can’t hear the doorbell. Despite her old age and accompanying health issues, she regularly proves she still has a will to live when she rolls around on her toys or attempts to chase a bunny in the yard.

In the past couple of years Charlee has had a number of ailments, but the most serious were pancreatitis and bladder stones. We thought each would be a fatal blow, but she survived. The pancreatitis was especially troublesome because Charlee is a very finicky eater. Unlike other dogs who will vacuum up anything you put in front of them, Charlee won’t touch most foods. It’s a struggle on a good day to get her to eat. So when she’s sick, it becomes much more complicated. As a result of the pancreatitis, we have to make sure she never goes more than eight hours without eating something. You’d think it would be easy to get a dog to eat. If she’s not in the mood to eat, Charlee will run away when she sees one of us preparing her food. She’s a small dog—something she despises in moments like these—so we’ll go after her and drag her out of her hiding spot and carry her over to her food bowl. Often we hand feed her every bite, sometimes shoving the food into her mouth. It’s not a fun struggle.

Around Thanksgiving Charlee came down with a bladder infection—common in old lady dogs—that just wouldn’t go away. The first antibiotics she was prescribed hurt her stomach. We understood this only by her moans and the fact that no matter what we did she refused to eat. There was a great debate in our house about whether this was Charlee’s last stand. Why force food on the poor old dog if she’s ready to be done with her struggle? But as we argued this, she would go charge into the living room and roll around on her toys and crouch down asking us to play with her. Her will to live is as strong as ever. So we gave up our fight and gave Charlee exactly what she wanted. Chicken and ground beef. It was a relief because she wants to eat it and we no longer have to hand feed her or shove the food down her throat. The vet said to mix in rice with it, but Charlee quickly learned to pick out the meat from the rice. So now we don’t even bother with the rice. She just finished up a second round of antibiotics and got the all clear from the vet.

Our family has agreed that Charlee is at the end of her life and our duty now is to make her last days—whether they be weeks or months—as comfortable and as happy as possible. Even though we know a diet of chicken and hamburger will cause a return of the pancreatitis, that’s what Charlee wants to eat so that’s what she’s getting. And we’re putting her on a doggy anti-anxiety med to help her manage her separation anxiety when we’re at work during the day and her “sundowning” behaviors at night. So long as Charlee continues to roll on her toys and chase bunnies, we’ll do our part to keep her alive. She has a strong will to live.

Life is a struggle. Literally.

On the other hand, in contrast to Charlee, is the daily struggle with my husband who thinks he’s dying and who is on the fence about whether or not he wants to live. Granted he is 73 years old and has a lot of health issues, some of them very serious, but he’s a long way from dying. That doesn’t matter because he has given up. He sits in a chair all day watching TV, smoking cigars, drinking sugar-filled sodas, and eating anything he wants. I stopped buying most of the foods and beverages he likes a long time ago but that only caused him to go to the store and buy those foods on his own. (Hey, at least he got out of his chair and away from the TV.) But it also gave him cause to complain that I no longer love him since I won’t give him what he wants. He has pointed out on numerous occasions that I give the dog what she wants but not my husband.

This last year has been one of the worst for my husband. He came down with an upper respiratory infection in April that turned violent and eventually the infection affected his heart rhythm. All these months later he’s still being doctored for it and has to take several pills each day to prevent a stroke or heart attack. At the time he was prescribed all these medicines he was too sick to manage the details so I did. I bought him two pill boxes—one for morning, one for evening—to make it easier for him. He often forgets to take the meds, even though the pill boxes are always right next to where he eats his meals. If I remind him, he complains that I’m “hen pecking” him. When he does remember, he loudly complains about how he hates to take pills. To me, him taking his pills is a matter of life or death.

It’s obvious he battles depression and he is being treated for that. But what happened this year is he was faced with his mortality for the first time in his life. Amazing given how old he is. But when others slam the door on Death’s face, he seems to have decided to leave the door open and think about how easy it would be to just step across the threshold. I cannot begin to understand the value in contemplating that thought when the truth is there is a lot of life left to live, but it’s going to take a little effort. It’s the effort part that prevents my husband from getting out of his chair.    

Right after Thanksgiving he came down with a chest cold. It was a common cold, nothing near as bad as what he had last spring. But with his heart issues, any sickness can quickly become life threatening. With all the meds that he takes, he’s limited in what he can buy over the counter to treat a cold. I suggested several times that he go see the doctor to get something for his cough but he refused. He did go to his regularly scheduled checkup with his cardiologist and learned his heart was not in a correct rhythm again. His meds were changed and now he’s back in a regular rhythm but he still has this cold. In the evening when we’re watching a movie on TV, he’ll sit in his chair and open his mouth and wheeze loudly to get my attention. I reached a point of having no patience and asked him, “What do you want me to do? Do you want my pity? My sympathy?” He didn’t answer. Later he told me he doesn’t think I love him anymore. Nothing could be further from the truth.

I want him to have a strong will to live. I want him to rise above all his aches and pains just to see another day come. I want him to have the same character that Charlee Girl has. But I can’t force him to go to the doctor and get an inhaler to make it easier to breathe. I can’t make him get out of his chair and exercise. I tried controlling the food brought into this house and that didn’t work. I can’t change his behaviors any more than I can force him to want to live. It breaks my heart that he doesn’t feel motivated to make his life better so he can live longer and we can be together longer.

My parents died when they were young so I’ve never witnessed these end of life issues up close. It’s a daily emotional struggle to watch my dog desperately fighting nature and illness in order to have one more roll around the floor with her toys while my husband sits in his chair whining about how life is unfair and he wants it all to be done so he can feel better.

This last year has given me a new appreciation for caregivers and for people who truly are at the end of their lives. I pray my heart withstands the loss of my Charlee Girl when the time comes. And I pray my patience and love will be strong enough to foster my husband into a better frame of mind so we can have many more years together.

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Number Two

It was precisely 4:15 in the morning on Wednesday, December 16, 1987, when I felt a tugging on my hand. I had been deep in sleep and was a bit confused as my brain made the switch from dreams back into the real world. The word surreal defined the moment, as I realized my cat was gently tugging on my hand with her mouth. She had never done this before and I was still too drugged with sleep to wonder what it was all about. I pushed her away and was hit with the overwhelming need to pee that only women pregnant in their ninth month can understand. And just as quickly, I felt as though I was going to vomit. Millie, the cat, jumped back up on my bed and began to meow at me, only it was more of a moan. Something clearly wasn’t right with her, but something clearly wasn’t right with me either. Again I pushed the cat away. I slowly rolled out of the bed and managed to make it to the bathroom and back.

I lay in my bed quietly, completely attentive to every sensation in my body. My two-year-old daughter was asleep in the next room and my husband was finishing up his night shift at work. He’d be home in about an hour or so. Kate was recovering from a bout of the flu, and I wondered if I had caught the bug. Pretty rotten timing on my part. Christmas was a week away, I was due to give birth any day, and the stomach flu comes into the house.

What if? I wondered. No, it didn’t feel like labor at all. But it didn’t feel like the flu either. Millie was once again on my bed, moaning and pacing. “What is your problem?” I asked her. Another wave of nausea hit me and I rolled over onto my side. I stared at the phone on my bedside table and decided to call the hospital and talk to the nurse on duty and get some peace of mind. As it turned out, the on-call nurse was the mother of one of my husband’s friends. She was always so practical and not one to exaggerate. Instantly I was comforted knowing I could trust whatever she told me. We talked through my symptoms and the fact that Kate had the stomach flu. We both agreed I just needed to take it easy, drink lots of fluids, and get some extra rest. As we talked, the cat was having another fit of moaning and I decided she needed to go outside. I stood up at the side of my bed, about to hang up the phone, and with a thud I felt the baby drop and my water broke. The nurse and I laughed. It wasn’t the flu after all! I told her I’d get my stuff together and I’d be headed for the hospital shortly.

My mind was racing like crazy now, wondering how I was going to clean up the mess of “broken water,” who I should call to watch Kate until her dad got home, who could take me to the hospital this early in the morning, and what in the world is going on with the cat, and I need to go pee again. I made it to the doorway of the bathroom when the first contraction hit me like a brick. Down to my knees I fell, out of breath and in complete agony.

Breathe!! My brain screamed to my lungs. On all fours, I breathed and puffed and got through the contraction, but I was exhausted. I rolled over and lay on the bathroom floor to catch my breath. There was still enough oxygen in my brain for me to realize I was in trouble and needed help. Unfortunately, it was 1987 and portable phones were not yet on the scene. The only way I was going to get help was to make it back to the phone in the bedroom or to the phone in the kitchen. I decided the phone in the kitchen was the best one to get to as it had a really long cord and I could probably stretch it down the hall to the bathroom.

I was about to get up and get the phone when another contraction slammed hard and took my breath away again. I puffed and focused as best I could and as soon as the contraction was done, I moved as quickly as I could to get to the kitchen phone. One of my sisters lived five minutes away and she could get to me the fastest. Her husband answered the phone.

“I’m in labor,” I told him. “Dave’s still at work and I need help fast.”

“We’re on our way.”

I hung up the phone and fought through the beginnings of another contraction as I made my way back to the bathroom floor. I lay there, knowing help was on the way, and tried to relax. And then I realized, the front door was locked. It was a steel door and there was no way anyone was getting in the house unless I unlocked it. Another contraction hit and I followed the breathing exercises I had learned when my first baby was born. I focused my thoughts on how long it would take me to get up, get to the split-entry stairs, get down the first flight to unlock the door, and then get back to the bathroom. Contractions had been about two minutes apart and I figured I could do it. As soon as I did my cleansing breath, I was rolling onto my side and making my way to the front door. What I hadn’t figured into my equation was the force of gravity. I made it down the flight of stairs and unlocked the front door, but was knocked to my knees again when another contraction came much sooner than I had predicted. I lay with my feet at the door and my body pressed into the steps, praying to Blessed Virgin Mary to help see me through this.

The contraction wasn’t fully over, but it had lessened enough that I could move and I crawled up the stairs, down the hall, and back into the bathroom. I knew another contraction would be coming and I wasn’t disappointed. I told myself to relax and breathe through it. I can do this! Help is on the way!

(Many years later my brother-in-law told me my sister was in such a hurry to leave her house to get to me that she forgot to put on a shirt. She got outside in the cold winter air and screamed. She ran back in and grabbed a sweatshirt while he got the car started.)

As the contraction ended I heard the front door fly open and hit the wall, then heavy footsteps on the stairs. My sister and her husband stared at me, and what a sight I was. My nightgown was a mess from when my water broke. And I lay half in and half out of the bathroom. My brother-in-law tried to tell me he could take me to the hospital (it was a thirty minute drive on a good day, and this was a bitterly cold and icy winter morning). I looked at my sister and told her to call an ambulance, just as another contraction hit. My sister bolted to the kitchen phone and my brother-in-law gave me his hands to hold onto. I squeezed his thumbs, evidently with super human strength, and he cried out in pain. My sister came running with the long-corded phone. The police dispatcher had put her directly through to the doctor at the hospital. My good luck was extended—the doctor on call that morning was my doctor.

And so we waited. I faithfully did the breathing exercises and the puffing to prevent pushing with each contraction. My brother-in-law sat in the hallway at the side of my head, trying to say soothing things to me but essentially had no idea what he was saying or doing. And my sister stood in the hallway on the long-corded phone giving updates to the doctor at the hospital. Once in a while she would come into the bathroom and look to see if a head was crowning. It was a complete miracle that Kate managed to sleep through all the commotion.

My brother-in-law couldn’t understand what was taking the ambulance so long. And he thought the police should have been there by then. (A couple of days later we learned two police cars had circled the house waiting for the ambulance to arrive first.) My sister was growing nervous that she might have to deliver the baby.

I lay there helpless on the bathroom floor. Another contraction hit and I heard familiar footsteps come up the stairs. My husband was home from work an hour early. That never happened! Another stroke of good luck.

“Thank God!” my brother-in-law shouted. “What are we supposed to do?”

Dave looked at him and shrugged his shoulders. “I haven’t a clue.”

I directed them both to a maternity book (about 600 pages long) that I had on my bedside table and told them to look at the chapter on emergency births. They looked at each other as if I had just spoken in Greek and another contraction hit. My husband knelt at my side and talked me through the breathing. What a relief it was to have him there.

And then the ambulance crew arrived. And right behind them were two police officers. The two EMTs crowded into the small bathroom with me and the two police stood in the hallway with my husband, my brother-in-law, and my sister—who was still on the phone with the doctor.

There wasn’t any time for introductions as another contraction came hard. The EMTs unpacked their bags and tried to create a somewhat sterile environment to welcome the baby.

“Okay, when the next contraction comes I want you to push,” the female EMT instructed me. I obeyed, but nothing happened. We tried it again and still nothing happened. My husband realized I was growing nervous and tried to calm me down. My sister was no longer on the phone. (Unknown to me, when there was no progress after the second push, the doctor hung up the phone and got in his car to come to our house. Except he had no idea where we lived. He had heard an intersection on the police radio and headed for that spot, thinking he would be able to see flashing lights. But we lived another mile away from that intersection, so he couldn’t find us. It was 4:45 in the morning and a friend of ours just happened to be leaving his house headed to work. The doctor flagged him down on the road and asked him if he knew us and where we lived. Our friend recognized the doctor and told him where to find our house.)

“Wait!” The female EMT shouted. “We need to sit her up. She can’t be lying flat.”

My husband and brother-in-law each took one of my shoulders and propped me up. A contraction came and so did the baby’s head.

“Stop! Don’t push!” the EMT cried out. My husband and brother-in-law lowered me back down. The EMT worked her fingers around the baby’s neck to free the umbilical cord. “Okay, go ahead.” I pushed with all my might.

The male EMT exclaimed, “It’s a girl!” and placed the baby on my belly. The female EMT shouted out, “Time of birth, 4:58.” When my first daughter was born, she had been born with the sack stuck to her skin. So they had wiped her down quickly before handing her to me. This newborn was covered in what looked like cottage cheese and her skin was tinted blue. I must have registered shock on my face because the male EMT took my hand and placed it on the baby’s back. “You need to rub her,” he said gently. The whole house grew quiet.

And so I rubbed life into that precious little baby. She turned pink and cried out. Everyone shouted for joy, and baby Kate was finally awakened by all the noise and commotion. My sister went and got Kate and brought her to the scene on the bathroom floor. Little Kate, at two years old, understood exactly what had transpired. “The baby came out!” she said. And then I heard the doctor’s voice. “Looks a little crowded in there,” he said.

“We just made room for one more,” the female EMT said. “We can make room for you too!”

“I can’t believe you’re here,” I said to him.

“Looks like I missed another of your births,” he joked. Yes, my first baby had come while he had taken his supper break and the doctor on call had ended up delivering.

He pushed on my belly and helped me deliver the placenta, then checked out the precious new bundle. (An hour after her birth, Rose weighed in at 9 pounds 4 ounces!) The doctor was satisfied that all was well and the EMTs began to pack up their things and bring in a stretcher to take me out to the ambulance and to the hospital.

My husband carried the newborn out to the ambulance. And as the police carried me down the steps to the front door, Kate yelled at them, “Be careful!” And then when we got outside, they debated if they should walk down the steps or down the front yard. They decided to avoid the steps. They took a few steps into the yard and proceeded to slip and fall, but I was strapped in and okay.

At-home births were pretty rare in our area in 1987, and Rose’s birth made the front page of the county newspaper on Christmas Eve. The whole experience sure proved to us the miracle of birth and the blessings of Christmas.

Number Three

The winter of 1991 came early with a three-day blizzard beginning on Halloween dropping nearly thirty inches of snow. As is usually the case after a nasty storm like that, the following days were filled with sunshine and brutal cold. And, as luck would have it, I caught a cold. Given that I was about 34 weeks pregnant, I couldn’t take any serious cold medicine, and so over the course of the next few weeks the cold turned into a cough turned into bronchitis. I had nothing within me to fight it. All I could do was wait for the baby to be born and then hit hard with antibiotics. At least, that was my plan.

My doctor had other ideas. He knew how tired I was from being sick and from getting ready for the holidays and he worried I wouldn’t have the strength to deliver the baby on my own. Ha! I was determined to deliver that baby or die, probably the exact thing the doctor was concerned about. And, the doctor had another concern. The two of us had been patient-doctor for fourteen years and because my previous two babies had come into the world too rapidly for him to attend in person, I think he was defending his pride a little and didn’t want a third strike. So a history of rapid delivery combined with a sick momma and a doctor taking a personal stand resulted in the doctor ordering an inducement for December 9.

On one hand I didn’t want to be induced. It wasn’t natural. I thought we would be messing with both Mother Nature and the Divine and I just wanted no part of that. On the other, I was too sick to care. By December 2, I was not getting any better and so the doctor told me to start taking Sudafed. He also told me his colleagues thought December 9 was too early to induce and they wanted to give me a few more days to feel better, so it was pushed back to December 16. One problem. That day was my second daughter’s birthday and I didn’t choose to have the kids share the same birthday. The doctor consulted with his colleagues and they agreed to change the date, to Friday, December 13, 1991. No! Not on a Friday the Thirteenth! My doctor laughed at me. This man who knew so much about me couldn’t believe I was superstitious. He gave me a lecture combining science and religion and basically delivered the message that I had no choice.

Funny how life likes to throw you a curve ball when you think you’ve outsmarted Mother Nature. With the morning of December 12 came a fever of 101 degrees, sore throat, chills, and a very irritated digestive system. Basically, I had a very nasty cold and stomach flu. I was so afraid that if I didn’t get better fast the doctor would cancel the inducement. My husband had worked the third shift the night before so he was sleeping. I sent my oldest daughter to school and then laid on the couch while my four-year-old played around me. At lunchtime I ate some soup and then woke up my husband to take care of our youngest. I crawled into bed and tried to rest as best I could.

At 1:30 the phone rang and the township needed my husband to go out and plow and sand the roads. Nothing was happening with me, so he left. Ten minutes later the school called to let me know my oldest daughter was now sick. I couldn’t go get her, so I arranged for my in-laws to go pick her up. When she got home, I put her on the couch and told her little sister to play doctor and make her big sister feel better. I went back to bed.

At 3:00 I started to feel some kind of pains. Because there wasn’t any pattern to them, I told myself it was just more false labor. Within a half hour, it was clear these were contractions and they were consistently ten minutes apart. But they just didn’t feel like the real deal, so I wasn’t too concerned.

At 3:45, my husband came home and we talked for a while about what to do. We decided I should call the doctor and let him know what was going on. So at 4:30 I called and left a message and the doctor called back right away. He wanted me to come in as soon as I could get to the clinic. So we tracked down my niece who was going to be our sitter and she came to our house. We headed out at 5:15 but the clinic was now closed so we went to the hospital. The doctor was waiting for us and he checked me right away. By that time my contractions were six minutes apart but still very tolerable. I wasn’t dilated any more than I had been at my previous appointment—about one and a half. He told us to go in the lobby and wait an hour. So we did.

During that time the contractions got closer and closer but I still wasn’t in any pain. I knew I wasn’t in active labor. At 7:00 the doctor came out to check on things and my contractions were staying consistent at three minutes apart. He decided to admit me. That took a while but finally I was in a bed with a fetal monitor, contractions still at three minutes apart and fever still at 101. As I laid there and relaxed, the contractions got weaker. I tried to sit up to keep gravity on my side but that didn’t seem to help. The doctor checked in with me around 10:00 and said he was spending the night in the hospital to be close by. He was convinced I would have the baby by morning.

It was a quiet night but I wasn’t getting any rest. Everyone knows you don’t go to the hospital to sleep. About 3:30 in the morning my fever broke and the contractions stopped completely. I was so disappointed, and so worried that they would call off the inducement.

The doctor came in to see me again in his morning rounds and we talked about how neither one of us got much sleep, and how disappointed we both were that the baby was being so stubborn. The doctor was reluctant to continue with the planned inducement but I argued that my fever had gone and I was already on the schedule for it. He agreed.

I was eager to get the show on the road but it wasn’t until 11:00 when the nursed hooked me up to an IV with Pitocin. Within a half hour contractions started. Things were going well and by 1:30 contractions were again three minutes apart. But at 2:00 things started to slow down and an hour later the nurse discovered the IV pump wasn’t working properly. She consulted with the doctor and he said I needed to start all over with the minimum dose. With the afternoon shift change, the new nurse was determined to bring a baby into the world and she was shocked at the “off the charts” contractions my body was having as shown on the monitor printout, except I wasn’t feeling anything at all. I was as relaxed as one could be given the circumstances. Even though I hadn’t slept, I did feel better from being so well hydrated but the nurses were getting a bit peeved with how often I needed to use the bathroom. With the IV, the contraction monitor, and the baby’s heart monitor, it wasn’t a quick or easy process and not one I could do on my own.

Evening arrived with no baby. I wasn’t progressing—dilated only to a 3—and the nurse was growing concerned about how long I had been receiving the Pitocin. She said I wasn’t uncomfortable enough. At 8:00 the nurse said she would give me one more hour and then turn everything off and send me home. Every fifteen minutes she amped up the dosage but still no progress. I was so depressed and frustrated and tired. Even so, as tired as I was, I quickly discovered I still had energy to fight. The nurse was resigned to the fact that I would be sent home and I refused. I told her I was a walking time bomb now that they had messed with nature and I insisted I was going to stay there until a baby came, if it took a week. The nurse and I argued and she said she’d have to consult with the doctor. I was so disappointed. And frightened. I was convinced the baby would be born at home on the bathroom floor in the middle of the night. We had gotten lucky the first time that had happened. I didn’t think we’d be as lucky a second time.

And then, at 8:55, I felt and heard something pop inside me and I felt the baby fall. Instantly I felt the hormonal switch in my body turn on, just as if someone had entered the room and turned on the lights. I told my husband to call the nurse. He didn’t believe me. I had to ask him a couple of times and finally he went and got the nurse. She came in a few minutes later and I told her to check me. She didn’t believe me either but she checked just the same. As soon as she inserted her fingers, the bag of waters gushed out and the nurse swore.

Immediately I was in hard labor. I was still only dilated to a 3, but I knew things would go very fast now and so I asked the nurse where the doctor was. He had gone home for supper. I told her to trust me and to call the doctor back to the hospital. I was somewhat surprised that she did as I asked.

Another ten minutes passed and the nurse came in to tell me the doctor had arrived and would be in to see me in a few minutes. I was in the middle of a hard contraction. I could see the shock on her face. Twenty minutes later I had an urge to push and breathed through it. Two more times I was able to breathe through the pushing urge but I knew I wouldn’t be able to for much longer. I called the nurse again and told her to check me again. She really didn’t want to but I kept insisting. I knew I had to be at a 10. Whatever I said or did to convince her, she finally checked and she smiled ear to ear. “You are amazing!”

An alert was put out for the room. I was ready but they weren’t. The bed had to be prepared and supplies put in place. All the while I fought the urge to push. I was too tired to stop it. And it was unlike anything I had experienced before. I knew it had to be the effects of the Pitocin. Finally the doctor came in and he told me to go ahead and push. The urge to push was so strong that I couldn’t tell if there was a contraction. It was like my body was in one solid, long contraction. Just when I thought I couldn’t handle any more pain, the baby was born, at 10:04 p.m. on Friday, the Thirteenth of December, 1991.

Another girl. Beautiful. Dark brown hair, almost black. Gorgeous eyes with very long lashes and perfectly formed lips. At seven pounds, nine ounces she was the smallest of my babies. I was so relieved she was born in the hospital, and so grateful everything worked out as it should. She was our second child to be born just before Christmas. As I held her in my arms and welcomed her to the world, I was reminded that there is no greater blessing, no greater connection to the reason for the season.