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During the night my Mom fell down twice and I noticed blood coming from her rectum (which I have seen before from her using her fingers to put up her rectum). This morning I called an ambulance since she couldn't walk at all and I thought her bleeding was excessive.


So far she has been given 1 unit of blood and she told the doctor she wants to die meaning she doesn't want any more transfusions.


Doctor wants to know if I want her to keep receiving transfusions or not. I don't know what to do. I just got off the phone with the doctor and I said to give her another unit of blood and let's see what happens in 2 hours.


What do you think?

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Oh Jenna, great big hugs and prayers.

Hospice will keep her from suffering, please use the services they offer for you as well. They can truly be a lifeline during this difficult time.

May God grant you strength and peace for this journey, may He give you grieving mercies and comfort. May your mom be granted peace and comfort as she leaves this worn out body.

Hugs!
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JennaRose Jun 2019
Thanks for the support.  I left the hospital about 1 hour ago and my Mom looked better and was hungry so she ate a turkey sandwich.  She is still hooked up to morphine to make her comfortable and she did get the 1 unit of blood this morning.

My Aunt is sleeping over in my Mom's room tonight and I'm back home but only 10 minutes away from the hospital in case my Aunt calls me and I need to go back in the middle of the night.

I did tell my Mom earlier it that was okay to go and that I would be okay.  She thanked me for that.

Later on she cracked some jokes and seemed like her old self (still with dementia).

I don't know what to think.  It's such an emotional roller coaster.

I talked to the nurse on the way out and she said the doctor will re-assess my Mom in the morning.

Thanks again for everyone's support as it means so much to me.

Jenna
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Jenna, sit down and read your mother's Living Will.

Does it address the question of living with dementia? Does it talk about what sorts of life saving measures she wants taken?

Your mom has a life limiting disease and now she's apparently got internal bleeding. In her condition, I would not want to be scoped or have surgery. If they have to resect her bowel to stop the bleeding and she ends up with a colostomy bag for the rest of her life, will she be a happy camper?

Have you asked if hospice services might be appropriate? Is there the possibility of medicating her to keep her comfortable and not intervening?

I'm so sorry that you are having to make this very hard decision. ((((((Hugs)))))).
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JennaRose Jun 2019
I didn't read her Living Will but I do know it does say DNR.  It doesn't have any words with dementia in it. 

No, I would not want her to have surgery. 

Another doctor just called from the ER and she said the bleeding is not only coming from her colon but also from her upper intestine.  The only way to keep her alive would be surgery which I don't want my Mom to go through.

We talked about hospice where they would make her comfortable.  They said she is going to die, it's a matter of time now.

I need to calm down (was up all night) and I'm going to the hospital.  They will move her out of the ER to another room to make her comfortable.

Thanks everyone,
Jenna who is crying so hard right now
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I'm so sorry, this has to be excruciatingly hard. I will keep both of you in my thoughts today. ((hugs))
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Jenna: I just saw your response to BarbBrooklyn above. Oh, honey, I am so sorry. I hope you find comfort in that your mother will be cared for and be in no pain. May peace find you both. Sending you a hug.
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Oh, Jenna!!!!!!!!

Know that we are all here with you, holding on tight. (((((Hugs)))))))
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JennaRose - When my severely disabled son turned 13 he was in the hospital. Rainman had a perforated intestine. Two perforations actually - one in the upper intestine and one in the lower.

After we had taken him home from the hospital he developed a complication from the surgery. You know, one of those things they warn you about when they lay out the procedure, but you don’t really listen to cause they tell you it’s rare...

But this time it happened. At first they couldn’t find the problem and after a few days of tests they were ready to release him from the hospital. The night prior to going home Rainman crashed - crash team in his room, 11 people working on him, a doctor sitting straddled on his chest... Rainman is completely non-verbal but that night - for the first
and only time - my baby said two words appropriately strung together - “No, Momma - No!”. He said it repeatedly. It was the worst night of my life.

At 3:00am a surgeon specializing in intestinal/stomach procedures was helicoptered in. Right before they wheeled Rainman into surgery they handed me a release to be signed - that I authorize them to put Rainman on a colostomy bag if necessary.

As horrible as this sounds - I actually hesitated for a minute. The thought of Rainman on a colostomy bag was unimaginable. He would have hated that. He would have always been fiddling with it. Hell, to this day I regularly Q-Tip small wads of paper from in his ears... Can you imagine what he might have managed with a stoma?

But, I did sign. Rainman, other than his severe autism and slight cerebral palsy - was a very happy and generally really healthy guy.

Now, I absolutely am not saying - your mom is 93 - lived long enough and to go ahead and let her pass. I do not mean to imply that at all.

About a year before my mom died she was hospitalized for a fall. Because my mother had a very detailed, very strict Advanced Directive, her doctor had me sign a form saying I authorized an antibiotic to treat some cellulitis she had on her calf. Because - the antibiotic was technically a life saving measure - if left untreated the infection eventually turn into sepsis. But, seriously? I just couldn’t let my mom pass from something that was so easily treated.

Internal bleeding from a busted diverticula is not so easy to treat. ESPECIALLY in a 93 yr old woman who is already suffering from dementia. And, a colostomy bag and stoma? I can’t even imagine. Sheez - the difficulties and dangers don’t even start there. They start with the anesthesia and it just gets worst from there. And, I do mean for your mother firstly and then her family and caregivers second. Gut surgery, while fixes some things, makes a whole lot of other things more complicated and difficult. Whatever quality of life your mother still has at her age - with dementia and with the usual declines and limitations that go with living that long - that will pretty much disappear. In addition, with gut surgeries- one tends to eventually lead to another.

Rainman made it through the surgery with out a resectioning and
colostomy bag. THANK GOD!!! The surgeon said it was 50/50 so he took Rainmans autism into consideration. This meant removing a large section of his damaged intestines which in turn - has lead to a live of eating a certain way and
me keeping track of the specifics or Rainmans bowel movements as if I was documenting the details in curing cancer. The surgeon told me it won’t be a matter of something going wrong in his intestines again - it’s a matter of when.

Even with his restrictions, Rainman is now healthy and happy. I’m not sure your mother would have the same outcome. I so sorry. But take what time you’re able and think it through. Refer to your mothers Living Will. What would she choose - if she were able?
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Another Update:

Mom had the endoscopy procedure done and a partial colonoscopy which revealed 2 bleeding ulcers, one in her upper stomach and the other in her rectum. The doctor closed them both and mom is doing good. Cause of bleeding was found which is good news.
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BarbBrooklyn Jul 2019
WOOOOOT!!!!! that is such great news, Jenna! I'm so happy for your mom.
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Oh wow, a simple fix when everyone was imagining something dire. Well, at least you've had your practice run😜
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Another update:  Mom is going to be released from the hospital today and is coming home.  A physical therapist will be coming to the house as my Mom is a little weak from the lost of blood and being on a liquid diet up to yesterday.

I'm so happy she is coming home!!  My Aunt is also thrilled as my Mom and Aunt both play cards every afternoon and they miss that (my Mom is a real card shark and always beats my Aunt, ha, ha!).  They also love to watch Wimbledon as my Mom knows most of the players.

Jenna
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Palliative care, now, hon, because you know where your mom stands on the issue. Do not do further transfusions if she doesn't wish to have them. There are many worse ways to go if one has to go, and at a certain age we do have to. When Mom is strong enough work with her on details of what she would want if this happens again. At what point does she want you to refuse treatment for her? And so on. I am happy you don't have to face this now, but clearly you will. You know she doesn't now want a lot of care and intervention. Good luck and hugs to you both. I am glad she is better.
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JennaRose Jun 2019
Hi AlvaDeer,

My Mom chose to have further transfusions, I wasn't even there.  Right now she wants to find out what caused the bleeding in the first place and wants the tests.  She had the CT-Scan this afternoon and the doctor explained to her about the scope to find out if she has a bleeding ulcer.   My Mom wants to have this done.

If (and I do dislike the if word) my Mom didn't want these tests done as well as receiving transfusions then I would respect that.

I was prepared to lose my Mom yesterday but during her comfort care (getting a morphine drip) she changed her mind.  My Mom is a very strong-willed woman and she wants what she wants.  All I can do is respect her wishes no matter what they are.

She has suffered from stomach pain for a while now and if she does have a bleeding ulcer I think she would be relieved as she wouldn't have that pain anymore.

Tomorrow early morning she will have the scope put down her throat and then we will take it from there.  The gastro doctor pressed on her stomach this afternoon and my Mom said it hurt in the upper area.

Again, it's a waiting game.   My Mom and I will talk about everything after we get back the results of her tests and take it from there.

Thanks for caring,
Jenna
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