flashback, part IV

We went back to San Pablo from Manila on November 4. We all took care of mom, made sure she took her meds at the right time. She was asleep most of the time, waking up only to eat a little, watch a bit of TV, chat for a short while and take her medicine. She also threw up a lot of liquid, even if she was already taking an anti-emetic.

There were times when she would be irritated if I push her to take three or four pills in successive hours. “Eh oras na eh!” I’d tell her.  I can see from her eyes that she was tired, that she didn’t want to live like this. 

On Friday morning, she complained about feeling cold so I asked Dr. Luna if this was a side effect of the treatment. He called me and told me to take mom to the hospital so the doctors can evaluate. We followed his advice and decided to take mommy to SPCMC. It was very challenging to put her in the pick-up because she couldn’t stand up anymore. She was dizzy and was very pale. For some reason, she asked me to call Tita Gina and tell her to be there at the hospital. I asked her why and she said “basta papuntahin mo.”

It was chaos at the ER. Mom was having tummy and back pains all at once. She didn’t want to take her Oxycontin, didn’t want to be IV-ed and didn’t want to eat. When she was taken into her room, she was hysterical and complaining of pain everywhere! She also had very low blood pressure so they put a nasal cannula on her, which was connected to an oxygen source. The doctor also gave her pain medication through IV but it didn’t have any effect on her. She was restless and was in drama mode. She said it was better to die than to feel that kind of pain, and that we couldn’t understand the pain she was in. 

I was trying to make her eat something and when I raised my voice, she apologized. “Ate, magsosorry ako sa’yo.” That’s what she said. I didn’t know for what but I told her it was okay.

That afternoon, some of her friends from high school (Tita Menchitt, Tita Nanette and Tita Nini) visited her. She wasn't able to speak with them but she did recognize who they were. Nahiya pa because she felt she wasn't presentable. "Nakakahiya naman sa girls," she said.

Mom was maligalig that whole evening and didn’t sleep at all. She kept dad up all night as well so early Saturday morning, dad texted me and asked me to come to the hospital early. I was up by 5am and was at the hospital by 6am.

When I got to mom’s room, I found her hallucinating and saying things like “Daddy bless me.” Later on she began shouting (at the top of her lungs) nonsense (well to us, at least). I remember her saying “misua.” I was scared because I thought something went wrong in her brain and she’ll be like this forever na! 

The doctor came and told us he will refer us to an internist so they can get some blood work done on mom. At around 9am, mom began calming down. I thought she was going to be okay but her breathing didn’t go back to normal. Her blood pressure also remained very low (they constantly checked).

I knew then that it was going to be the day. Lia and I were already crying at that point. I whispered to mom that it’s okay; she can rest now and we’re going to be okay. Then I asked dad, who went home to take a shower, to come back to the hospital soon because mom was getting very weak. When he came back, the resident doctor spoke to him and asked him if we wanted to put mom in the ICU. I told him no because mom was already exhausted. 

Right after we’ve made the decision, mom stopped breathing. The doctor and nurses came in and tried to revive her but to no avail. She was gone, and the ECG confirmed it. There was nothing but a flat line. Mom was gone. It was 10:02 on a glorious Saturday morning in November.

flashback, part III

It was around 2pm when I was finally able to talk to the doctor. He asked about mom’s history and checked the CT scans, the MRI results and the medical reports. When he was done, he said the diagnosis was correct and the only way to treat the disease was through chemotherapy. He explained everything clearly and gave us three drug combinations to choose from and told me that he hoped mom and the family will decided to go with chemo.

I could have broken down right there or when I went out the office or when I walked with Marge back to the LRT station but I was calm. I was sad but really felt strong from there to the entire duration of the bus ride home. On the way, I thought about the best way to break the news.

My siblings plus Tita Gina were with mom when I got back to the hospital. I felt anxious about revealing what the doctor told me but I know I had to get it done. I found it difficult to open my mouth but after I managed to say “Ayun nga. Tama naman ang diagnosis,” everything came out easily. Mom was calm but I could see she was sad and scared, too.

Dad was done with his planning meeting and came back that evening. We all talked and eventually decided to go with chemotherapy. We chose the Cisplatin + Paclitaxel combination.

We couldn’t waste time so I called Dr. Luna that Thursday and told him about our decision. He asked for my mom’s weight, height and age, calculated the dose needed and immediately ordered the drugs. They will be delivered to us directly once mom is admitted at Manila Doctors Hospital. 

If mom was going to have at least six sessions of chemotherapy, then I needed to be there. So that day, I sent an e-mail to my office and filed my resignation. I requested for a waiver notice period, which they granted. 

Mom was fine throughout the day. Kuya Jon and Auntie Myrna even visited her. She told them the truth. I admired her courage. In the late afternoon, however, she complained again about stomach pain. She kicked and banged the wall, screamed and sobbed. She was given medication but it didn’t work immediately.  I couldn’t help but cry myself. I prayed and prayed that the pain subside soon. I think it did, eventually. I can’t remember anymore. 

Upon mom’s discharge from SPCMC that Friday, we went straight to Manila so she can be admitted at Manila Doctors. She wore her brace so she could sit comfortably throughout the 2-hour journey. She was alright for the most part but when we were at Osmeña Highway, she complained of tummy aches again. Fortunately, the traffic wasn’t so bad that day and we soon found ourselves at Manila Doctors.

The nurse took mom to imaging for an x-ray before he led us to our room. Just as we were settling down, B arrived! I was so glad to see him I almost cried when we hugged! His embrace was just what I needed.

The nurses prepped mom for the chemo session. They put her on IV, checked her vitals and did more tests overnight. They gave her various pre-chemo meds too. 

The first session began on Saturday, October 31. It was done by Monday morning but not without several flushes on mom’s IV (which made her grab my hand and squeeze it until it was blue). 

Before we were discharged, the doctors often checked on her vitals. The pain management docs came up with a schedule of taking Oxycontin and Oxynorm so that she won’t feel any kind of discomfort. The goal, they said, is for mom to not feel any pain. Since she was heavily reliant on drugs, she was just asleep most of the time. 

At that point, she couldn’t eat as much as she used to because she was throwing up. She was still constipated, and the edema got worse. The swelling has gone from one leg to both legs and her tummy. And every morning upon waking up, her breasts would be swollen too.

She was cleared for discharge by Tuesday but we didn’t go home until Wednesday. Just before we left, she complained that she finds it hard to swallow. The nurse said it might just be a psychological symptom. 

At that time, it seemed to me that her body was slowly shutting down. I knew she wasn’t going to get well and what we were doing was just managing the disease. But I strived to focus on taking care of her. I just wanted her to be comfortable and if possible, enjoy the remaining days of her life.  

flashback, part II

Mom passed away exactly two months ago.

*****

When Mommy was discharged the following Monday, she still hadn’t made up her mind whether to undergo chemo or not. We took her home and since Daddy needed to attend a very important meeting in Ortigas, I, together with Miko and Paolo, were tasked to take care of her. (Lia was working.)

Mom stayed in my (and Lia’s) room since the cable TV was there. She needed something to keep her busy when she’s awake and when she wakes up in the odd hours of the night. We made sure to follow the prescribed times that she needs to take Oxycontin. The doctor also gave her Oxynorm for breakthrough pain. I gave her sponge baths, changed her clothes, and cooked and fed her healthy food. She was fairly comfortable.

On Tuesday morning, while she was eating breakfast, I told her I would be getting a second opinion from a doctor in Manila. B and Ate Laddie helped me get in touch with Ate Day, Ate’s friend, whose mom underwent chemotherapy for her breast cancer at the PGH. Ate Day’s cousin, a doctor who just underwent training at the PGH, recommended I talk to Dr. Ricky Luna, an OB-Onco. Mom agreed. Dad too. Ate Day set an appointment with the doctor on my behalf.

Mommy then told me what she went through from February, when she was diagnosed, to May, when she had a complete hysterectomy. It was easy to find her records because dad did a fantastic job in filing them neatly. I saw everything there – the medical reports, the films, the receipts, the hospital bills, the insurance claim forms, all from February to May. I felt a bit guilty for not being there with her during those months, but I decided to just focus on the present. I’m not going to let her give up without a fight.

I was about to feed mom her dinner when she complained of extreme stomach pain. I knew it was serious because she couldn’t lie still and was crying. I asked her if she wanted to go to the hospital and she said yes.

I called the San Pablo City Medical Center to request for an ambulance but the girl on the end of the line said there wasn’t any driver available. I decided to call my mom’s sister, Tita Gina, and ask for help. They immediately when to our house and helped us get in touch with the city hall’s ambulance, which fortunately was available that evening. After a few minutes we were at the ER. Lia was with us and the boys were left at home, on standby in case I’d need someone to pick me up.

To help ease mom’s pain, the doctor ordered the nurse to push medication through her IV. The first drug didn’t agree with mom. She said she felt hot outside but cold inside. The stomach pain didn’t go away too. She felt very uneasy and was unable to calm down. After a few hours, the doctor decided to push another medication through her IV. It worked somehow because she was finally able to sleep. It was past midnight. Tita Gina stayed with us through the night. She watched over mom and let me sleep because I had to go to Manila the following day.

Mom felt better when we woke up Wednesday morning. I went back home to have breakfast and get ready so I can be on my way. I prepared her records, stopped by the hospital and hopped on a bus to Manila. Lia went on leave watched over mom with the boys while I was gone. Tita Gina needed to go to work.

Marge met me for lunch and accompanied me to Dr. Ricky Luna’s clinic at Padre Faura. I needed her to navigate and to be my friend. I needed all the positive energy I can get. 

flashback, part I

Mom's 40th day is coming soon. I'm ready to tell the story now.  

******

When I went back home on the last week of August, I didn't know nor had even the faintest hint that it would be the last time I'd see my mother as I knew her all my life. 

I didn't know anything. 

My mom was diagnosed with cervical cancer in February and she chose to keep her battle with it a secret to everyone except my dad. She had a total hysterectomy last May after several sessions of chemotherapy, radiotherapy and brachytherapy (internal radiotherapy), and was then declared cured. According to her journal entries which I would read days after she passed, she was praying for and looking forward to a healthy, wealthy and happy life with us, her family. Mom was grateful.

No one knew she only had six months to live.

When I came back here for a week-long vacation last August, she was her cheerful, enthusiastic self. Mommy was so full of life no one would think she won over cancer just a few months back. She cooked for us, cleaned the house, and even went with me to the salon when I had my nails done. Everything seemed normal. I went back to Singapore on August 31 and life went on as usual. 

I called home one evening a couple of days after Ondoy just to ask how everyone's doing. Paolo picked up and I asked him to get mom. I waited for a minute or so before she was on the other line. When I asked her why, she told me her back hurts and it's painful to stand straight and walk. I asked if she saw a doctor already and she said yes. The doctor said the pain was due to muscle spasms caused by a re-alignment of the spine. She said she was already taking pain meds and was advised to undergo physical therapy. We had a quick chat then I told her to go back to bed and rest. I prayed she'll feel better soon.

After a few days, I called again to check up on her. I was expecting her to be better by then that's why I was shaken up when I heard her sobbing on the end of the line. She said her back is still very painful and the pain meds aren't working. She feels a bit relieved after her physical therapy session but only for a few hours. After we spoke, I had a nagging feeling that I needed to go home. I slept on it and decided, with B's permission, that I will go home to take care of mom and help her out.

I arrived in the Philippines on October 18. I wasn’t prepared to find her in terrible pain, her usually dyed hair showing streaks of grey, her smiling face replaced with a constant frown, and instead of hearty laughs, she gave out whimpers. When I first got home and saw her, I couldn't accept that my mom was in so much pain. I wasn’t even able to kiss her hello because I was scared. I tried acting normal but I knew I can't go on denying the fact that she’s terribly sick. 

It was extremely difficult to see her in so much pain but if I were to help her, I knew I needed to face the truth. So before I slept that night, I cried then prayed for strength. I asked God to work through me so I can help my mom and my family.

The following day, dad took mom to the hospital. We decided it would be better if she's confined and could get her nutrients intravenously. Before they left, I was able to give her a bath, helped her put on her clothes, combed her hair and tied it up in a pony tail. It felt good being able to take care of her. 

When we visited her that evening at the hospital, she was feeling better. She had color on her cheeks again and was smiling! The doctor gave her Oxycontin, an opioid and a very powerful drug to control the pain. I was optimistic. I didn't know then that Oxycontin was used to treat cancer pain.

Mom had her MRI that Thursday at Calamba. When they returned to San Pablo, she manifested other symptoms: her left leg and feet were swollen and she was having a hard time controlling her urine. The doctors didn't tell us anything except that we have to wait for the MRI results.

It was Saturday morning when the ob-oncologist came in and said my mom needed to undergo chemotherapy. We were shocked and confused. My mom - because she thought the cancer was gone, and me, because I didn't know she had cancer in the first place. The doctor said the MRI showed black spots on the marrow on my mom's lumbar spine (where the pain was) and she had tumors close to major arteries. She said doing a biopsy would be too costly and risky and can only be done in Manila. The best next step, she said, was chemotherapy. Mom told the doctor she'll think about it.

When the doctor left, my mom cried and told me and Miko (who was also there at that time) the whole truth about her diagnosis and three-month battle with cervical cancer. She said she was scared but she still managed a smile. We all managed to smile, not knowing what were ahead of us.

trying to deal

So much has happened since my last journal entry. 

My mom had the MRI and the results said that there has been a recurrence of the cancer tumor and it has metastasized to her bones. That's the reason she has been feeling severe pains on her lower back. Her edema is caused by swollen lymph nodes at her groin area, which signifies there's something wrong in her pelvis area. That's the cancer saying "hi, I'm back."

I've cried a couple of times out of disbelief, denial and pity for my mom. She's in so much pain. Although we still get glimpses of the Mayen who was full of life and always bungisngis, most of the time her forehead is wrinkled and instead of laughs, we hear sobs. I really pray the doctors will be able to manage the pain so she can concentrate on getting well.

We've decided to bring her to Manila Doctors Hospital and have Dr. Ricky Luna supervise her chemotherapy. She just finished her first cycle of Cisplatin + Paclitaxel yesterday and she's already feeling the side effects. She gets nauseous and then vomits, feels heavy and has even more swollen feet. I hope these will subside in a few days time.

The doctor said we will only be able to evaluate the effectiveness of the therapy after the third session. If it's working, mommy should feel it. The swelling of the lymph nodes should be gone and her bone pain should decrease. I pray that she'll get better days ahead. My spirit breaks each time I hear her wail in pain.

I'm trying to hold on. I do miss my life a few months back. I was so carefree then, focused on myself and the little goals I have. Now I suddenly have this huge responsibility of being with her and taking care of her. There are moments when I wish this didn't happen and for everything to go back to the way it was. But I know that's not possible. This is my reality now. I have to accept the fact that my mom is sick.

No one requires me to be here. I went back because I wanted to. I'm staying because I want to. I know I can't be in peace if I go back to Singapore, knowing my mom is in so much pain and needs my help.

I want to believe my mom will get better, but sometimes, when she's crying, I realize that it would be alright if God takes her too. I just want her pain to be over, whether she gets well or she moves on. Either way is fine with me. But of course, I'd rather her get well and be around.

This is a difficult time for our family and I am touched by friends and relatives who have expressed their concern and support and offered their help. It is during times like this when your true friends reveal themselves and I am thankful that there are plenty who have said they're praying for us and we are in their thoughts.