Last November 1, we went to Quezon for All Soul's day. We went
to see our deceased relatives especially our aunt who passed on earlier this year. Everything was nothing but an ordinary day of
laughter and jokes. We were kidding around and being our usual selves.
At around 5 in the afternoon, my brother called my
sister and I and told us that Mom's not feeling well and was having a difficult time speaking.
We immediately went back to our relatives' house. I assessed her the second I
got there. It's not just any hypertensive episode like what she had in the past.
There were obvious neurological affectations and these alerted me. Despite Mom's
refusal to be brought to the hospital, we all insisted otherwise.
As soon as we got to the ER at the community
hospital, I took her blood pressure (200/140). She had a projectile vomiting
and I thought this would give her relief because usually after vomiting, she
would feel better. But she didn’t. I monitored her from time to time. Asking
her who I was, where we were, but I got no response; nothing but murmured
words. I was checking her pupillary light reaction and comparing it with my
sister's. (I'm not really thorough when it comes to neurological assessment.
All I know were the basics which was taught during nursing school years ago.)
It was reactive and normal. She was spontaneously following verbal commands
which is a good neurological sign. Minutes later, I noticed that she was
snoring. It was very unusual because she doesn't snore when she sleeps. I tried waking her up again
but she nodded when I asked if she wants to rest. And so I stopped bugging her.
Later on, she had an energy surge. She opted to go
the restroom even when I insisted that she use a bed pan. But she was stubborn,
she got up walked herself to the restroom. My sister and the ER nurse followed
her. And there she shouted (still with slurred speech) that her deceased sister, was asking my mom to go with her.
As soon as she went back to her bed, I checked her
blood pressure; still at 200/120. But this time, she was drowsier than she was
minutes ago. There was noted lethargy and right sided weakness. I assessed her
pupillary light reaction and noticed that it wasn't reactive anymore. It was
already pin point. I referred it to the resident on duty, and she verbalized
that Mom's GCS went from 15 to 7 abruptly. She was deteriorating fast. The
doctor already made referrals to consultants and insisted an ICU admission.
But the community hospital didn't have a CT scan, which indicates the need for
my Mom to be transferred to the City Hospital. Before transportation, the
doctors informed me the need to establish an airway; intubation. I refused
because she was breathing on her own and I didn’t' see the point of it. But
with a fast deterioration in her GCS, she might stop breathing in the middle of
the highway during transport which will make intubation harder to do. And so I
consented. The doctor said that it was her mother in the same situation, she
would agree with the intubation.
It was so difficult and nerve wrecking on my part
that my Mom's life would depend on my words and decisions. Hey world, I'm just
21 for crying out loud.
They intubated her and facilitated transfer. I was
making calls that time; contacting my dad who was in abroad that time and our
uncle, Mom's brother, who was at Manila that time.
I was already trembling deep down my core. I wanted
to lose my sanity but I need to toughen up. I keep on wishing none of these was
happening; but it was.
In the van, they were bagging my Mom to help her
breathe and keep her oxygen saturation levels up high. As soon as we arrived at
the city hospital, CT scan was immediately done. The neurologist was there
waiting. My sister went with my Mom inside and I stayed outside as the doctor
asked the events that happened prior to admission.
When the doctor got the results, he explained it to
us. The results showed that there was a massive subarachnoid hemorrhage at the
left hemisphere due to a ruptured aneurysm of the left midcerebral
artery causing the brain to herniate. With minimal chances and an ounce of
hope, I told the doctor to put my Mom up for an OR procedure to evacuate the
bleed. He told me that even if I talked to the neurosurgeon, he wouldn't clear my
mom for the operation. With a critically low GCS, she is a poor candidate for
any procedure.
I suggested to clip the aneurysm if that was causing
the bleed. And the doctor told me, that there's nothing left to clip because it
is already ruptured.
And with defeat I begged him,
"Just save her."
"I can't."
And as he uttered those words, my world came crashing
down. My white flag is ready to be surrendered. We are all up for a battle we
are destined to lose. But I had to be strong for my brother and sister and the
whole family. I had to tell them the news. When they saw me tearing up, they
already knew. But they were still hopeful, and I wasn't because I know. My
knowledge and my faith were clashing against each other. It was during this
time that I wished I wasn't a nurse. I wish I didn't know what was happening
exactly. I wish I was hopeful. But I was on the other side of the road.
At around 2am, we lost her, she was in an
irreversible coma, GCS 3, there was no spontaneous breathing, and no brain
activity was noted as manifested by
fixed dilated pupils on both eyes.
My siblings and I decided that the only means of
revival to be done was the use of inotropics. We didn’t want to hurt her any
further. We kept her heart beating until her loved ones see her for the last
time.
We gave her a promise ring last October 16 during our parents' 25th silver wedding anniversary. We vowed to be with her forever, "til death do us part." But I guess forever ended way too fast.
Wherever you are now Mom, I know you're in good hands. You are home now with your family and Papa God. No goodbyes, I will see you soon. I miss you so much. And you will always be the woman that I will love the most.
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