The angel of dope

Tonight I came home from a peaceful dinner with my older sister and my brother-in-law just in time to give Mom her 12th-hour pain med dose. My brother knew what time she was due for it, but hadn't given it to her (he'd also dodged giving her the liquid laxative she needs for pain-med-induced severe constipation). So I woke Mom, elevated the head of her bed, told her we had some medicine for her to keep her back from hurting, gave her the pill and then tried giving her the usual sip of water. She refused to sip and started chewing instead. No amount of coaxing or ordering could get her to sip water either from the bottle or through a straw; she just kept chewing and grimacing because of the bitterness. Great: 40 milligrams of oxycontin straight into her system. My brother wigged. He kept insisting I call Hospice to find out what happens when you chew up a 12-hour time-release pain med. Finally I glared at him and said "Fine. _I_ will call Hospice." I get so flipping tired of my siblings tossing back to me the heavy caregiving weight. He got the picture and punched the number. A nurse called back after a while and he talked with her, then conveyed the following:
- My mom will be really high for a few hours.
- Her breathing may be slowed way down, but probably won't be stopped.
- The med will wear off faster than normal, in 6 or so hours rather than 12.
- At that point, she can be dosed with 5-mg oxycodones til her pain is managed.
- Probably starting tomorrow we'll have to start her on liquid pain relief.
- This will mean an even sleepier Mom (read: She'll sleep 98% of the time rather than 90%)

My options are these:
1. I can attempt to sleep in my usual room, with one ear cocked all night toward the baby monitor. Probable outcome: no sleep and restlessness.
2. I can attempt to sleep in my snoring mom's room, in the queen bed next to her hospital bed. Probable outcome: no sleep and high frustration.
3. I can forget about attempting to sleep, stay up and watch bad sci fi, and check on my mom every hour and a half or so to be sure she's still breathing. At 3 a.m. I can check her pain level and at some point between 3 a.m. and 6 a.m. try to get some oxycodones into her (good luck, sucker, because she'll probably chew those as well). Probable outcome: no sleep but the satisfying buzz that comes from high volumes of bad sci fi.

It's not going to be a great night. I'm not happy about the likelihood that my mom will henceforth be taking liquid pain meds, which are morphine-based and have all whole new bunch of side effects for her and us to deal with (not the least of which is, as I mentioned, the All Sleep All the Time show). I wonder if perhaps I should have tried to wake her up a bit more before I gave her those pills tonight, if maybe then she would have known to swallow them rather than chewing them up. Damn. She's extremely sedated now, sleeping so deeply that her breath is growling in her chest. I wonder if the briefest of meaningful exchanges I had with her today were the last we were destined to share.

I forget when I stopped praying for my mom's recovery and started praying that her doctors would be able to manage her disease. I don't recall when I segued from that to praying for her comfort. But I do know that two nights ago I started praying for God to take my mother swiftly, because this way out was always her nightmare.

I wrote about being tired of my sibs dodging the medicine ball of caregiving rather than taking it up in equal measure when I'm here. The only way to get them to step up to the plate is by leaving. The Hospice RN said this morning that my mom has a few weeks of life left, and so I've decided to go home for a week or so starting day after tomorrow. My brother and sister know our mom needs 24-hour care. And they know what that care entails. I need to let them deal with it for the next little while, let them shoulder the escalating care level, let them be here when my mom needs diapering, let them deal with it all, all the time, and face it fully. I hope I'm not making a mistake, as I so want to be with her when she dies. But I desperately need a break. I'm depleted. I need to sleep full, long and deep for a long while, so much so that I almost envy my more overdosed mom.