Thursday, August 03, 2006
Me Stressed?
If you had a visit from a doctor, district and MacMillan nurse to discuss a possible catastrophic outcome of an illness, with a 5 day timeframe, and to advise you on what to do in the event, would you:
a) find it jolly useful and reassuring.
b) cover your ears because you know you'll lose your perspective on life.
I’m referring to Rob of course and before it happened a) would have seemed the obvious choice, but live it and the answer's b). He had a small bleed from his tumour recently, which could be a 'herald' bleed, meaning that in 6 to 10 days the carotid artery will rupture. If that happens, whoever’s with him should stem the blood flow as much as possible (with dark coloured towels prepared in advance and kept discreetly out of sight – or perhaps round your shoulders under the pretext that you’re feeling a chill), inject a sedative (kept in a place known and easily accessible to all and not under last night’s leftovers in the fridge), hold Rob's hand whilst talking calmly and reassuringly to him and call the ambulance. The rupture would of course be fatal, but the object of this exercise is to “make Rob’s last moments as stress-free as possible”, although for those who have any difficulty at all with multi-tasking, memory or anxiety, it's not hard to imagine the stress levels involved dealing with all those instructions. I know a great deal of thought has gone into this, and I’d love to know of anyone who has done this successfully, but I have a few problems with it. Firstly, Rob will not accept he’s going to die and the visit only served to annoy and give him stress and put him and us on a countdown. Then there’s the time factor. It can’t take more than a few minutes to die from a rupture of that sort, so even if you take the best scenario - that you’re in the same room with him, the towels and the injection when the artery bursts, you grab the towels, fetch the syringe, fill and inject quickly (barring any handshaking), hold his hand and call for the ambulance on the mobile phone glued to your side – it’d be pretty difficult. Now imagine the much more likely scenario that you’re making tea, taking a shower or answering the door, none of which will be in the same room as Rob, and you really now need two people. So the regular hospital visit that I make with Rob, this time has me conjuring up images of being blinded on the motorway by arterial blood and causing a major pile-up so I ask my loved one to drive while I sit in the back, hand placed casually on a towel, staring at his tumour. I take a shower and whisper “you’re on call”. As Rob gets irritated with his Dad if he asks if he’s ok when he gets up in the night, when it’s our turn to stay overnight we resolve to lie still and quiet when we hear him, but as that's at least half a dozen times there’s no possibility of sleep. So instead of chilling out together with cooking, videos or chat, I’m surreptitiously doing mental checklists of nearest towel, mobile, syringe and watching for any of the subtle changes that could indicate the rupture is imminent. A quick run through of the exercise has convinced me that it’s not really possible to do all that in the time available, and in view of the fact that this might not be a 'herald' bleed, is it really a good idea to turn the whole family into nervous wrecks for the sake of a good last five minutes? We’re almost at the end of the critical period, so I’m looking forward to getting back to ‘normal’ stress levels.
a) find it jolly useful and reassuring.
b) cover your ears because you know you'll lose your perspective on life.
I’m referring to Rob of course and before it happened a) would have seemed the obvious choice, but live it and the answer's b). He had a small bleed from his tumour recently, which could be a 'herald' bleed, meaning that in 6 to 10 days the carotid artery will rupture. If that happens, whoever’s with him should stem the blood flow as much as possible (with dark coloured towels prepared in advance and kept discreetly out of sight – or perhaps round your shoulders under the pretext that you’re feeling a chill), inject a sedative (kept in a place known and easily accessible to all and not under last night’s leftovers in the fridge), hold Rob's hand whilst talking calmly and reassuringly to him and call the ambulance. The rupture would of course be fatal, but the object of this exercise is to “make Rob’s last moments as stress-free as possible”, although for those who have any difficulty at all with multi-tasking, memory or anxiety, it's not hard to imagine the stress levels involved dealing with all those instructions. I know a great deal of thought has gone into this, and I’d love to know of anyone who has done this successfully, but I have a few problems with it. Firstly, Rob will not accept he’s going to die and the visit only served to annoy and give him stress and put him and us on a countdown. Then there’s the time factor. It can’t take more than a few minutes to die from a rupture of that sort, so even if you take the best scenario - that you’re in the same room with him, the towels and the injection when the artery bursts, you grab the towels, fetch the syringe, fill and inject quickly (barring any handshaking), hold his hand and call for the ambulance on the mobile phone glued to your side – it’d be pretty difficult. Now imagine the much more likely scenario that you’re making tea, taking a shower or answering the door, none of which will be in the same room as Rob, and you really now need two people. So the regular hospital visit that I make with Rob, this time has me conjuring up images of being blinded on the motorway by arterial blood and causing a major pile-up so I ask my loved one to drive while I sit in the back, hand placed casually on a towel, staring at his tumour. I take a shower and whisper “you’re on call”. As Rob gets irritated with his Dad if he asks if he’s ok when he gets up in the night, when it’s our turn to stay overnight we resolve to lie still and quiet when we hear him, but as that's at least half a dozen times there’s no possibility of sleep. So instead of chilling out together with cooking, videos or chat, I’m surreptitiously doing mental checklists of nearest towel, mobile, syringe and watching for any of the subtle changes that could indicate the rupture is imminent. A quick run through of the exercise has convinced me that it’s not really possible to do all that in the time available, and in view of the fact that this might not be a 'herald' bleed, is it really a good idea to turn the whole family into nervous wrecks for the sake of a good last five minutes? We’re almost at the end of the critical period, so I’m looking forward to getting back to ‘normal’ stress levels.
