and she goes...

since her discharge from the hospital she'd been sleepy and groggy through the day. and at night, she'd cough non-stop through the night. i supposed that affected her rest at night and made her sleepy in the day for most of the time, she couldn't keep herself awake. this was rather unusual as i noted she was rather lively when in the ward. things did not seem right and i decided to keep her at home instead of sending her to the rehab center monday morning. took me a while to convince her to rest at home as she kept saying the rehab center manager will be unhappy if she didn't attend the activities. after some coaxing, she agreed to rest at home and i bade her farewell when i left for work. i promised to return home with lunch as she bade me goodbye sleepily.

was at work and conducting a briefing when i noted 3 missed calls at 1015am from my mum's phone. 1010am was the last missed call. i returned the call to hear my maid panicking and telling me mum was very breathless and that she didn't know how to manage. i dropped everything and rushed home. i called the ambulance and informed my brother as i headed home. something told me it would be serious this time round.

once home, i found her sitting on the toilet floor and the maid trying hard to clean her up. she was semi-conscious and had vomited all over the toilet floor. i managed to calm the maid down and gave mum a change of clothing. as we did so, the ambulance arrived and the staff quickly evacuated her to the hospital. that was about 10.55am. she was quickly send in for resuscitation. once the ambulance arrived at the hospital. not too long later, the doctor came out and asked for some details about her medical history and the events that led to the morning. he updated me that things did not seem optimistic and that she's very ill. sensing the gravity of the situation, i told him that we would not want any invasive treatment such as intubation should her condition deteriorate. the doctor was surprised by my seemingly in-depth knowledge of the treatment options and asked if i was in the medical profession. no, i said, these are things i picked up from the years of looking after her. the doctor told me she couldn't be transferred to the usual hospital that she got her treatment as hers was a emergency case and that she's very ill. he added that blood tests showed that her kidney deteriorated significantly over the last 6 days and was functioning at 5% of a normal healthy kidney at that moment. the blood potassium was 7 times higher than normal and that he'd give her some injection to try to bring her potassium level down. i understood and asked him to do whatever he could. she needed to be warded he said and i asked that she be placed in a "c" class ward.

by then my brother had arrived. there was nothing much he could do except to wait. after updating him with the situation, he said his preference would be to put mum through dialysis. he added that his friend survived kidney failure after going through dialysis. he said he wanted mum to be able to at least survived a few more months to allow him to resign and look after her (that was his work-related plan). i felt uneasy with this input as invasive treatment was something we had agreed a couple of time previously that mum did not want to go through. but to manage him, i agreed to revisit the issue with the doctor although something in me told her she wouldn't last. nonetheless, for me, dialysis or otherwise, i still clung on to a little hope that the potassium level would drop from the injection. she was placed in the observation room as we waited for the ward to be prepared. when my mum was eventually transferred to the observation ward, he went in to see her and that, he kinda accept that there was not much we could do for her. it helped him come to terms with the finality of her life. i went in to see her after that, she could hardly manage her breathing. despite her confused state, she recognized me and told me she's feeling very breathless. i told her to rest and not to talk as it would make her more breathless. after calming her down, i told her her kidneys were damaged and that we were treating her with medicine. she simply nodded and kept still as she struggled with her breathing.

after arranging the ward and completing the admission administration, i left the maid with her and went back to office. there was nothing much i could do and i thought i might as head back to office to close whatever outstanding issues that needed my attention. i told myself i needed to be ready to drop everything and attend to the funeral if she should leave suddenly. i got at least 2 calls from the doctor through the afternoon. they kept asking if i wanted to put mum through dialysis and kept telling me that there was a chance the kidney might recover partially - 30-40% normal level, so they advised. i initially said no, but after two or three times of talking and saying that dialysis could help, i relented. ok, put her on dialysis but no further than that.

i was on my way out of office at about 5.30pm when i got a call from the senior doctor. has i spoke with him, i sensed he was concerned about my decision to put mum through dialysis. after explaining the full details to me, he acknowledged that his junior doctors should have better explained mums condition to me. he opined that there would be no benefit for her to go through dialysis. in fact, the procedure would be highly painful and traumatic for mum and it might just cause her heart to fail immediately. i agreed to retract my decision for the dialysis and let her be, that is also in line with her wishes. with this decision, the senior doctor adviced me that given her current condition, we should be mentally prepared for her to leave anytime soon.

not long later, my maid called. she sounded flustered as she said "sir, you better come, sir, ah ma very chuan (breathless)". i told her i was on my way but needed to bring the dog to pee first. i was calm, i was needed at the hospital, yet i needed to attend to my dog too. i reached the hospital at about 6.25pm to find mum barely conscious. her bed curtain was all drawn and when i saw her, she had vomit all over her clothes. the maid was trying to hold the nebulizer to her mouth and as she struggled to place the mouth piece onto my mum's mouth, her tears were flowing non-stop. i took a look at the spo2 level - 74% it registered. it's not good. with the nebulizer, it should be in the high 80s or 90s. i told the maid to remove the mouthpiece. the ventolin mix was finishing and she was still struggling to get every final drop into mum. to me, it was clear the end was near and it was futile doing all these. i went up to mum, held her hand and told her i had arrived. i am not sure if she could hear me, but she seemed a little more calm as i connected. i stroked her forehead and asked her to relax and simply held her hands. as all these happened, i noted that mum was not in the dangerously ill list,  this meant her visitors would be restricted to only 4. it's not right, she's seriously ill and they have not placed her on the dil. i got it changed immediately and after that, the nurses cleaned mum up and gave her a new set of clothing given that my family would be arriving soon. not too long after that, my brother arrived with his family and an old neighbour.

by about 6.55pm, mum was already unconscious. my brother went up to her and called her. she continued panting. it was then that he finally accepted that mum's time was near. my neighbour, who was a practicing nurse, suggested for my brother to tell mum to leave if she needed to and that she should not have any more worries. mum's panting slowed down, her face was calm and as she continued breathing. the doctor, who was doing her rounds, came up to us and explained mum's condition to us. we were looking at mum as the doctor explained. and in the midst of the explanation, mum took her last breath. her last two breath was very measured, very calm and she drifted away gently. the doctor quickly asked us to excuse her as she checked on mum. she said that mum's heart beat had stopped and that mum was not longer breathing. as a procedure and to determine the time of passing, she needed to do a final ecg.

as she did all these tests, i texted my sisters that mum had passed away.