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Saturday, January 24, 2015

My Beautiful Boy

It hit me the other day, Ian is dying. As this hit me...I sat there wondering how it is possible that it is just hitting me...Ian is dying. Ian has been dying, slowly over time, slowly over time. I am not sure what brought me more to this realization yesterday, but it hit me right in the face, SMACK. 

I decided to look up the signs of death. According to caring.com, there are 10 signs death is near. These signs of approaching death are specific to the natural dying process (apart from the effects of particular illnesses the person may have). Not all symptoms show up in every person, but most people experience some combination of the following:

  • Loss of appetite - Energy needs decline. The person may begin to resist or refuse meals and liquids, or accept only small amounts of bland foods (such as hot cereals). Meat, which is hard to digest, may be refused first. Even favorite foods hold little appeal. How to respond - Don't force feed; follow the person's cues even though you may be distressed by a loss of interest in eating. Periodically offer ice chips, a popsicle, or sips or water.Use a moistened warm cloth around the mouth and apply balm to the lips to keep them moist and comfortable.
  • Excessive fatigue and sleep - The person may begin to sleep the majority of the day and night as metabolism slows and the decline in food and water contribute to dehydration. He or she becomes difficult to rouse from sleep. The fatigue is so pronounced that awareness of immediate surroundings begins to drift. How to respond - Permit sleep. Avoid jostling the person awake. Assume that everything you say can be heard, as the sense of hearing is thought to persist, even when the person is unconscious, in a coma, or otherwise not responsive. 
  • Increased physical weakness - A decline in food intake and lack of energy leads to less energy, even for activities like lifting one's head or shifting in bed. The person may even have difficulty sipping from a straw. How to respond - Focus on keeping the person comfortable. 
  • Mental confusion or disorientation - Organs begin to fail, including the brain. Higher-order consciousness tends to change. "Few conditions leave people hyperaware when they're dying," says palliative-care physician Ira Byock, author of Dying Well. The person may not be aware of where he or she is or who else is in the room, may speak or reply less often, may respond to people who can't be seen in the room by others, may seem to say nonsensical things, may be confused about time, or may act restless and pick at bed linens. How to respond - Remain calm and reassuring. Speak to the person softly, and identify yourself when you approach.
  • Labored breathing - Breath intakes and exhales become raggedy, irregular, and labored. A distinctive pattern called Cheyne-Stokes respiration might be heard: a loud, deep inhalation is followed by a pause of not breathing (apnea) for between five seconds to as long as a full minute, before a loud, deep breath resumes and again slowly peters out. Sometimes excessive secretions create loud, gurling inhalations and exhalations that some people call a "death rattle." How to respond - The stopped breathing or loud rattle can be alarming to listeners, but the dying person is unaware of this changed breathing; focus on overall comfort. Positions that may help: the head slightly elevated with a pillow, sitting up well-supported, or the head or lying body tilted to the side slightly. Moisten the mouth with a wet cloth and moisturize with lip balm or petroleum jelly. If there's a lot phlegm, allow it to drain naturally from the mouth, since auctioning it out can increase its quality. A vaporizer in the room might help. Some people are given oxygen for comfort. Br a calm, physical presence, stroking the arm or speaking softly. 
  • Social withdrawal - As the body shuts down, the dying person may gradually lose interest in those nearby. He or she may stop talking or mutter unintelligibly, stop responding to questions, or simply turn away. A few days before receding socially for the last time, the dying person sometimes surprises loved ones with an unexpected burst of alert, attentive behavior. This can last less than an hour or up to a full day. How to respond - Be aware that this is a natural part of the dying process and not a reflection of your relationship. Maintain a physical presence by touching the dying person and continuing to talk, if it feels appropriate, without demanding anything back. Treasure an alert interlude if and when it occurs, because it's almost always fleeting. 
  • Changes in urination - Little going in (as the person loses interest in food and drink) means little coming out. Dropping blood pressure, part of the dying process (and therefore not treated at this point, in tandem with other symptoms), also contributes to the kidneys shutting down. The concentrated urine is brownish, reddish, or tea-colored. Loss of bladder and bowel control may happen late in the dying process. How to respond - Hospice medical staff sometimes decides that a catheter is necessary,  although not in the final hours of life. Kidney failure can increase blood toxins and contribute to a peaceful coma before death. Add a bed pad when placing fresh sheets. 
  • Swelling in the feet and ankles - As the kidneys are less able to process bodily fluids, they can accumulate and get deposited in areas of the body away from the heart, in the feet and ankles especially. These places, and sometimes also the hands, face, or feet, take on a swollen, puffy appearance. How to respond - Usually no special treatment (such as diuretics) is given when the swelling seems directly related to the dying process. (The swelling is the result of the natural death process, not its cause).
  • Coolness in the tips of the fingers and toes - in the hours or minutes before death, blood circulation draws from the periphery of the body to help vital organs. As this happens, the extremities (hands, feet, fingers, toes) become notably cooler. Nail beds may also look more pale, or bluish. How to respond - A warm blanket can keep the person comfortable, or be or she may be oblivious. The person may complain about the weight of the coverings on the legs, so keep them loose.
  • Mottled veins - Skin that had been uniformly pale or ashen develops a distinctive pattern of purplish/reddish/bluish mottling as one of the later signs of death approaching. This is the result of reduced circulation. It may be seen first on the soles of the feet. How to respond - No special steps need to be taken.
NOTE - THESE GENERAL SIGNS OF IMPENDING DEATH CAN VARY IN SEQUENCE AND COMBINATION FROM PERSON TO PERSON. IF A PERSON IS OF LIFE SUPPORT (RESPIRATOR, FEEDING TUBE), THE PROCESS DYING FOLLOWS CAN BE DIFFERENT. THE SIGNS OF DEATH LISTED HERE DESCRIBE A NATURAL DYING PROCESS.

Thinking back to the last few days, I realized this hit me because of a conversation I had...a hard conversation but a good one to say the least. Through this conversation I realized a few things and wanted to find out more such what signs of the dying process. When someone begins the dying process it doesn't mean that it is today, it doesn't meant that it is tomorrow or it doesn't mean that it is in a couple of weeks or months, although it could mean that. Looking at the signs above, Ian has started some of them...he goes back and forth with his eating, some days he will eat one meal and that would not even be a meal for you and I, sometimes we have the excessive fatigue and sleep, and occasionally the social withdrawal, the smiles are not there as often and neither is the sparkle in his eyes. 

One of the other things I realized through this conversation is when someone dies their physical presence is no longer with us but their soul is. According to Chabad.org, the soul is the self, the "I" that inhabits the body and acts through it. Without the soul, the body is like a light bulb without electricity, a computer without the software, a space suit with no astronaut inside. With the introduction of the soul, the body acquires life, sight and hearing, thought and speech, intelligence and emotions, will and desire, personality and identity. Realizing this has helped me with my journey in acceptance and being "okay" with the process.

Remember treasure, dream and live.

66 comments:

Anonymous said...

Thinking of you
Brenda Bforsma Hanson

Anonymous said...

Marci you are the bravest person I have ever known. My heart goes out to you and your family. XXX
Jenny Baker

Anonymous said...

Love you xoxo
Julie Kaplan

Anonymous said...

Thinking of you. You are amazing (I'm sure you have never heard that from anyone before).

Anonymous said...

Thinking of you.
Vivian Chait

Anonymous said...

Thinking of you and thankful for your thoughts.
Lara Truman

Anonymous said...

Thinking of you all!!!!
Sherri Asher

Anonymous said...

Wow. Quite a read. It hurts my heart. But thank you for contributing to take us on this journey with you. I'm not nearby, but always here however you need to be!
Elena French

Anonymous said...

Xoxoxoxo
Karen McClelland

Anonymous said...

Baruch Hashem Marci
Bryna Bernstein

Anonymous said...

Thinking of your family Marci. Xo
LISA SMOLEN

Anonymous said...

Hugs
Michelle Levine Davis

Anonymous said...

Thinking of all of you.
Monique Erdos-Gertner

Anonymous said...

Thinking of you and your family.
Amy Sober Russell

Anonymous said...

Love heart
Linda Butler

Anonymous said...

Thinking of all of you.
Jennifer Larsen Orlando

Anonymous said...

Please know your family is always my prayers. I am inspired by your ability to share your family's journey and to celebrate Ian's life through all of the joy and sadness. Your words are a gift to so many of us on our own journey. Thank you.
Jill Pelovitz

Anonymous said...

Thinking of you.
HELEN WEISMAN DAGILIS

Anonymous said...

I must have read your first sentence 15 times before I could move on to the next. Your strength is simply amazing my friend as is Ian, Becca and Brian's. You guys are always on my mind. Hugs sent across the miles.
Maureen Jack Herban

Anonymous said...

Thinking of all of you.
Lanaye Hoover

Anonymous said...

*hugs* Marci. Thinking of you all.
Heather Schmidt Young

Anonymous said...

You are always in my thoughts and prayers.
Stacy Berman Lunenfeld

Anonymous said...

Love you! ! Xoxo
Heather Lev

Anonymous said...

Your courage and strength is inspiring! Thank you for sharing! Your family is always in my thoughts!
Laurie Fox Schimmel

Anonymous said...

Xo
Melissa Klawans Cohen

Anonymous said...

This is so sad and brave to write about. I'm speechless. I can only feel deeply for you and your family. God bless you all
Nancy Polack Kaplan

Anonymous said...

Marci you are a strong person, hugs to you, Brian, Becca and Ian
Sharon Kinstler Selko

Anonymous said...

So powerful. I can't even imagine what you all are going through.
Annelise Sullivan

Anonymous said...

Hugs and prayers to your entire family
Sara Alima Ostrow

Anonymous said...

You are the strongest person I know.
Carolyn Hack Kaplan-Solomond

Anonymous said...

you are an inspiration to me. My thoughts and prayers are always with your family. I have bee sick for 7 months,and finally I think I have a diagnosis and treatment will start soon, but when ever I cried for myself I tried to remember how strong you are. My love to your family
Arlene Stein

Anonymous said...

Strong and kind and gentle. Hugs
Jamie Nathanson Miller

Anonymous said...

Carolyn Hack Kaplan-Solomond, I tell her that ALL the time.
Susan Weinberg Lewis

Anonymous said...

Thinking of you often and wishing you love and comfort.
Marci Phillips

Anonymous said...

Hugs, love and prayers always for you all!
Julie Onnembo

Anonymous said...

I know you don't think so, but you really are amazing, Marci. {{{hugs}}}
Alicia Katznelson Broth

Anonymous said...

Marci, my thoughts and prayers are with all of you. Ian and your family's strength, courage, and determination have been a tremendous inspiration to me.
Lori Kaplan

Anonymous said...

((((HUGS)))) Marci. You and your family are in my thoughts.
Donna Lithgow Stollings

Anonymous said...

Xoxo you're family is in my thoughts..
Tanya Tanya Tanya

Anonymous said...

Your family is amazing! You have experienced a roller coaster with so many ups, downs, twists, turns and tunnels few of us will ever experience. All good and bad on this ride of life. Prayers to you all!
Pauline Church Yamin

Anonymous said...

Marci Weinberg Scher Chris and I have been praying for you and your amazing family! When we saw you guys at thanksgiving, we think about you more often and want you all to know that we love you all and pray for peace and serenity for your family!
Lisa Reid Miller

Anonymous said...

You and your family are in our prayers. You are one of the strongest and most courageous women I know.
Renee Valentino Block

Anonymous said...

Thinking of you all!
Diana Engler

Anonymous said...

This is an impossible situation....impossible to accept one's child's death. But I know that you can do this, Marci. Ian's - and your family's journey - has been one you would never have chosen, but you can do this. I will hold your hand as long as you need.
Michelle Kampler Schwartz

Anonymous said...

Thinking of you
Oksana Yurchuk

Anonymous said...

Sending hugs and love and prayers to your amazing family.
Dori Zvili Ray

Anonymous said...

Sending hugs and love and prayers to your amazing family.
Dori Zvili Ray

Anonymous said...

Thinking of you
Alexandra Kaplan

Anonymous said...

You are truly a remarkable person. But you've had Ian to learn how to be remarkable from.
Anne Polakoff King

Anonymous said...

Prayers, hugs, love to you and your family.
Kristin Howlett Mazzarese

Anonymous said...

Sending love, strength, & peaceful thoughts to all of you. My heart aches for you, but know that the amazing memories you've worked so hard to create & share as a family will forever be with you no matter where this journey takes you.

Hugs!

Wendy Elover

Unknown said...

Thinking of you and your family. Prayers!'


Denise Z Beveridge

Anonymous said...

Hi thinking of you and your family! The last post about Ian was so touching! Stay strong!!!

Denise Zemlak Beveridge

Anonymous said...

Thinking of all of you. Love and prayers.
Heather Smith Macchia

Anonymous said...

Hugs!
Irina Brusilovsky Goldsmith

Anonymous said...

Marci, I am sending lots of love and thank you for sharing this journey with us. I don't know what else to say...you are all in my thoughts and prayers. Xoxo
Rachel Heath Wallace

Anonymous said...

Marci this was so touching. Always thinking of you.
Jodie Slatow Nahum

Anonymous said...

Prayers and love always to all of you!
Samantha Gitli Schaefer

Anonymous said...

You are in my thoughts and prayers. You have a truly amazing family filled to the brim with love
Rene Hurley Carfi

Anonymous said...

Love to you and big hugs too!
Lara Wynne

Anonymous said...

My thoughts and prayers are with you and your beautiful family!
Tara Donnelly-Walulik

Anonymous said...

What can I say? You are an amazing Mother & person! Sending you hugs!
Carole Miller Glick

Anonymous said...

You are the most amazing person. Sending to all of you. Love to your family.
Marlene Ettlin

Anonymous said...

Lauri Harf Greenberg
Thinking of you Marci and your family during this incredibly difficult time!!! Xoxo

Emily Michelson Levin
This is certainly a difficult realization and process. You are quite an amazing and inspirational person Marci. Ian and Becca are beyond fortunate to have you as their mom. My thoughts and prayers continue to be with you and you family on this journey. Xo

Rebecca Goldstein
Thinking you you and your family during this time. What an incredible mom you are. Sofia sends her thoughts and prayers too.

Harry Blacker
Love you Marci. Stay strong!!

Anonymous said...

Marci- I want to tell you that you and your family are incredible people. My thoughts and prayers are with you and your family. You are inspirational.

As I read this it brought me back to when I cared for my mother during her battle with ovarian cancer. I became her caregiver for her last month or so. I was given this information by the hospice nurse who delivered the refills of morphine to the house. Eventually I saw all of these symptoms. The symptom that brings back the best memory was the sudden burst of energy. My mother decided just before she died that she wanted to get up and have a dance with me. So we did. I'll never forget it.

You are strong. I am saddened by your trials but I am proud of you for being the person that this has made you.

Kevin Ruark

Kelly O'Connell said...

Sending lots of love to you all!