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sharyn

The dying process

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Okay, I can't not ask these questions... I have held off for weeks now and just can't any longer. I am so upset about the way my Dad died and I keep thinking by giving him the morphine we "made him die". Daddy had a massive seizure at home from a brain met, he never really was completely coherent after that... they never even expected him to wake up. A few days before the siezure, he was having trouble catching his breath and he was "wheezing"... we called the onc who gave him a Z pack which didn't really help... then the seizure... his breathing in the hospital was not awful, but the doctors felt that he was having difficulty as he was complaining he couldn't take a full breath. They did a chest xray and saw some fluid (he was on antibiotic IV at this point)... They explained the fluid "could be" from the IV drip, so they cut that down a bit. They suggested morphine to help make him more comfortable and "unaware" that he was having trouble catching his breath... my problem is this.... I feel like I killed him... I feel like I let him down by not insisting we try something, anything else.... I have talked to the doctors about this numerous times while Daddy was on the drip... he lived for 4 days after starting the morphine. I am just haunted by this and need to know other peoples experiences. Love, Sharon

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Sharon....your post brought tears to my eyes....bless your heart.

My Mom was also on morphine, however, orally....not a drip. The last few days we really did have to increase the dosage to deal with not so much pain, but anxiety. They also gave me a med to give her for anxiety (ativan, I think)....but her discomfort was also related to difficulty breathing. I've wondered about the morphine, too....but it's sort of a chicken and the egg argument. Did the morphine hasten the death or was the morphine increased because of symptoms related to the dying process.

No one can really answer our "why" or "what if" questions.....we both served our parents with love, honesty and dignity. The only guilt that we *should* feel is if we did something to INTENTIONALLY hurt our loved one.....I know I didn't.....I know you didn't.

Our parents are looking down at us with great love.......knowing that we did our best.

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Just want to ad that Morphine actually makes it easier to breath. It also helps you relax so that you don't waste energy and need more Oxygen. I hope that helps. Donna G

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Sharon. Please know that you did not kill your Daddy. I felt the same way when my Tim started not taking any food (at first) and then would only drink orange juice and ice water, and then even stopped asking for anything. I felt like maybe I was starving him to death by not forcing him to eat. Then I read a paper hospice gave me explaining the dying process. I realized we have no control over this dying process; it is the last part of our life here as we know it.

Please know that you did all you could do, you need not have any guilt feelings. Your Dad still loves you and my Tim still loves me.

Cyndy

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Dear Sharon,

This was a hard post for me to read because I have the had the same feelings for almost 17 months, however I know we are here to help each other...I dont know where the guilt comes from because I have it still too...Maybe because we were completely helpless during the whole process and we thought they would be coming home...

I think we had hope until their last breath, I know I did..I still say to myself everyday "what happened Dad, where are you" I always wonder if the doctors did the right thing because it did happen so fast..Without getting into too much detail, I too wonder about the morphine..

What I really want to tell you is dont blame yourself, nothing is your fault..THe guilt will tear you up inside if you let it, dont do this to yourself..Your dad loved you so much he would hate knowing that you are feeling this...

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Please know that you did all things right, in my dad's case, there is no relationship between the death and the morphine. My dad just took the minimum dosage (Oral) around 4 days before his gone. He left this world 4 days after the first dose of morphine. So I don't think morphine kills as my dad took the minimum dose.

At end of his days while he was walking into death, he gradually can't eat, he easily choked while eating and drinking then everyday just declining. We insisted to feed him food and my beloved dad insisted to eat as we all treat this as a need to get enough energy to maintain being strong. But nurse strongly requested us to tube-feed him (milk) as it's easy for him getting choke and pnuemonia if food goes into lung. Lastly, we quited to feed him and my dad agreed to get the tube-feed. He left all decision to us as at that moment, he can't speak out already. He can just move his right side body and his head. He can't see, he can't talk.

I will forever remember the last few hours, nurse can draw the milk through the tube out from his stomach, nurse told us his stomach was not working any more as he is dying.

Sharyn, please know that when one's dying, all the functions are declining to a stage that it's automatically stopped. This is not your fault or other's. Please forgive yourself and others then you will feel much much better. Guilty and Anger do hurt you.

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Sharon,

Many of us would like answers to what cause death,

we often try to take the blame on our shoulders, when

it is the sickness itself that is responsible.

You helped you father, you still love him, and always will.

J.C.

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Sharon,

My situation is a little different than yours because I was not "there" for my dad's last moments as you were. But I hope you can come to a place where you can feel that you (and your family) and the doctors did the very best for your wonderful dad based on the information you had at the time and the situation that you were dealing with.

A few weeks before my dad died I was reading a book by the mother of a little girl who died after her battle with cancer. She explained that at the diagnosis the child's doctor spoke to both parents and said ... the most important thing was to know that they had done the very best with the information that they had at the time.... This doctor was dealing with his own child also fighting cancer and he knew the helplessness that family members feel as well as the blaming that they do to (to themselves).

I know my mom wonders if she should have done things differently or not but as part of the support I could offer her, I reitterated (sp?) this same statement to her.

I think your Daddy felt the love and care from you and the rest of his family. That is something that is so valuable and I hope you can continue on from here knowing that that love made his moving on easier. You are a wonderful daughter and have been through so much this past year and longer. Take good care of yourself and rest easy knowing that you did the very best for your dad.

With all my love and prayers for you,

Karen

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Sharyn,

When my MIL was dying of pancreatic cancer, she was having trouble breathing because she was in pain. I gave her morphine under her tongue and it eased the pain for her. She died about 4 hours later in a much more comfortable state.

I believe what you did for your dad was a blessing to him. Take care.

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This was also very hard for me to read. I have been having these same thoughts since mom passed. It just really seems like things got so much worse when she was started on the liquid morphine. She had had a morphine patch for quite awhile but she became so much more incoherent and then slipped away from us only after the other morphine was started. I'm not convinced we killed her with the morphine but it all seems so coincidental to not have me at least wondering. I do know that she was extremely anxious on that Saturday (she died the next Tues) about her difficulty breathing. And I understood the morphine to have been started to help with both issues- helping her to breathe and helping her not be anxious about her breathing.

I'm sorry I don't have comfort or answers. Just common ground it seems.

Amy

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Sharon...I think each and every one of us that have lost a loved one has feelings of guilt. We always seem to think there is something we did or didn't do, as the case may be. Dennis was at home when he died. He was't able to communicate his pain level to us at the end but when he was extremely restless, I would administer small a small dosage of morphine under his tongue. This would seem to calm him some. It made me feel better, as I knew the pain would be less...if he was feeling pain. Sharon, we can't second guess these things. I am sure the medication was not the cause of your father's death. All of us have those "what-if's" that continually seem to haunt us. As part of our healing process, we have to learn to tell ourselves that we did the best we could do for our loved ones. I am so sorry you are dealing with this. I am so glad you posted your feelings. Now you know how many of us think about the same things. It's all normal and part of the long journey!!! I'm keeping you in my prayers.

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Sharyn,

I remember reading your posts before I took a long break, and I remember reading about how much you cared for your Dad, and what a wonderful daughter you were to him. I think you did all that you could, and it was just that time. Dont feel bad, or feel like you did something wrong.... you didnt... I hope the pain goes away soon, I know you miss him...

Jamie

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Sharon, I don't want this to sound callous or unfeeling, but I've read your post several times, and what strikes me every time is the same thing as my first impression, so I'm just going to say it. So what if you did? So what if you helped ease your father out of this life in a painless manner, and helped make the last moments of his life easier? So what?

Rather than kicking yourself in the teeth over this forever, I think I'd look at it in a different perspective and think of what you did FOR him, not TO him. And the list of things you did FOR him will be endless, as you know.

We're all human. Not a one of us is perfect. Not a one of us always knows the right thing to do at the right time and in the right way. We do our best, and that's what we live with.

You loved your father. You did the best you could for him. That's what matters, ultimately.

Be peaceful about him -- his life, his death, and the wonderful memories you will always have.

Di

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sharon,

wow have I struggled with this same thought.

for mom, she wore the morphine patch and she started out ok on it. Mom had (so we were told) a heart attack at the end from all the strain on her heart from all the fluid that she ended up retaining due to a bad reaction to a second line chemo (taxotere) we never had her in the morphine coma like state.

dad on the other hand was. We were told that there was no more to be done. he was in allot of pain and dads onc. recommended we keep him "comfortable" on morphine. We asked every single nurse over the 5 day period that dad was in the hospital hospice wing "are we killing him" they all told us NO. that the cancer was everywhere and we were keeping him in a dream like state and he was not aware of us or pain or hunger or anything. I never knew for sure if the decisions we made killed him. one of dads brothers told us we were and did kill him because in hospice when he got so bad and so "coma" stated they removed fluid and nourishment. that just killed us to watch him that way.

when he passed, it was without movement or incident. it was just his heart beat slower and slower and then his chest stopped moving and there was nothing.

gosh this is painful to write and think about this.

so i don't know either if I killed my dad too. I will struggle with this until I go to the great beyond and find out from the source i guess.

but I can sure empathize with your pain.

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When I get down, which is often, I read this.

May I go now?

Do you think the time is right?

May I say goodbye to pain filled days

and endless lonely nights?

I lived my life and done my best.

An example I've tried to be.

So can I take that step beyong the light

and set my spirit free?

I didn't want to go at first.

I fought with all my might.

But something seems to draw me now

to thet warm and loving light.

I want to go, I really do,

it's difficult to stay.

But I will try as best I can

to live just one more day.

To give you time to care for me

and share your love and fears.

I know you're sad and are afraid,

because I see your tears.

I'll not be far, I promise that,

and hope you'll always know,

That my spirit will be close to you

Where ever you may go.

Thank you so for loving me

and know that I love you too.

That's it's hard to say goodbye

and end this life with you.

So hold me now just one more time

and let me hear you say,

''Because you care so much for me,

you'll let me go today.

?????

J.C.

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I too have these feelings but mine even incorporate many more questions of what if? I have never ever told anyone this and perhaps I haven't because it sounds so far fetched and quite frankly it sounds like a lie but here goes.....many months before Robert was diagnosed I walked past him in the hall in our basement and this wave came over me that he needed to have a chest x-ray. Don't ask me why, and don't ask why I didn't say that him at the time. I feel guilt about that a lot. I feel guilty about making him (??) quit smoking because what if his body was use to that and him stopping triggered the cancer? Should we have gotten a 2nd opinion earlier, should I have made them prop him up in bed once he got to Hospice Inpatient? I knew his body was filling up with fluids and that he was only comfortable sitting up. Instead I just watched him and I too administered morphine into his body when I knew it stopped his prostrate from working from previous experience. I just wanted the pain gone from him and to let his soul go. My soul is tortured and I question myself too. I guess it will be my burden to carry. I try to make up for all my shortcomings by being a good mother but I'm failing there too. I feel like I want to go on and get out of this horrible dream. I think Alex would be better off without me but then I realize I'm his saving grace as he is mine. I'm really pissed at God lately and feel like I'm losing ground fast.

I wish I had great words of wisdom for you. I imagine we all feel guilt about 1,000 different things but like someone else said Cancer killed them, not us.

Thanks for bearing your soul - I guess it makes me feel not so alone.

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Do you know about the morphine dosage they gave him? I was also wondering the same before my mother died and the palliative dr. told me they never give a lethal morphine dose. A high morphine dose may reduce the respiratory frequency but it doesn't normally cause death...

Anaïs

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I appreciate your asking this question. My brothers and I did a lot of research during our father's battle with lung cancer. When reading stories of the dying process, I realized that there were many instances when death occurred shortly after morphine was administered. So I started reading and asking questions about morphine. What I learned was that morphine represses, or sedates, the respiratory system.

One doctor told me that morphine helps with "air hunger," when the patient breathes as deeply as possible but still doesn't feel like he's getting enough air. He basically explained what I had concluded, that the morphine doesn't open up the air passages or allow the lungs to inflate better or improve breathing at all. It just slows everything down so that the patient isn't aware of the air hunger.

My brothers and I were fortunate, I suppose, because we had in-depth discussions about this issue before Dad reached the stage when we had to make a decision. We made our decisions believing that by administering regular doses of morphine, we could be hastening his death by sedating his respiratory system to the point that he didn't have the strength to breath.

We also came to the conclusion that the first priority in Dad's dying process was managing his pain -- while trying to balance pain management with mental clarity. We staggered morphine with hydrocodone, experimented with dosages, and watched Dad for signals that he was feeling pain. We only administered enough pain medicine to keep him comfortable, but not enough to keep him confused and sedated all the time. That was quite a balancing act the last 2-3 weeks, but Dad experienced very little pain, and we are grateful for that. At the same time, we were able to have some clear communication with Dad, and one of my brothers in particular is extremely grateful for that.

Doctors, nurses, hospice, every medical professional we saw for the last 5 months of Dad's life wanted him to be on morphine every 8 hours -- even though Dad told them very clearly that he was not in pain, and he was not having difficulty breathing. In fact, Dad had very little problems with his breathing, right up to the end. It was such a curious thing to us that morphine was being recommended so strongly to "proactively" manage pain that Dad would have at some point in the future. After a rather horrifying experience giving Dad all 12 medicines that were prescribed "proactively," we stopped all medications unless, and until, there was a clear need for them.

Without writing a book (sorry this is so long), I will say that I have concluded that morphine is prescribed and recommended as much as it is because the medical professionals are trying to be compassionate. I think they know that morphine could well shorten a dying person's life, but, as Di puts it, that may be a good thing for that patient.

Of course, it would be a rare hospice nurse or oncologist who would even infer such a thing for fear of being accused of euthanasia.

I personally gave Dad his first dose of morphine to manage pain that was distressing him terribly, and my hand was shaking when I did it. He immediately went into a mental fog that lasted until we brought the pain back under control and switched back to hydrocodone. No pain, mental clarity was better, breathing was fine. At the end, one of my brothers made the decision to give Dad a dose of morphine for reasons that are unclear to the rest of us, and Dad died 30 minutes later. It didn't matter, of course, because Dad was certainly dying and if the morphine shortened his life, it was only by hours.

Sharyn, I will repeat what others have said. You did not kill your father. Cancer killed your father. If the medications provided your father with more comfort and peace, but may have shortened his life by hours or days, isn't that a choice you would have knowingly made? Whatever you did, you did with the greatest of love, and you could not have saved your father no matter what you did or didn't do. Please do not feel guilty.

I suppose my greatest concern is that medical professionals know, or suspect, that morphine hastens death by a small measure, but they do not give that information to care givers so that they can make conscious, informed decisions.

On the other hand, I may be completely wrong. I may never know. Just food for thought. I hope no one is offended by this.

Pam

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Dear Sharyn,

Dont you ever question yourself as you did exactly what you felt was right and I am sure it was. The posts that have been written to you have been so heartfelt and right. There has never been a question of your love for you Father in fact it was evident that you adored him. Di even wrote so what if it did hasten things a bit but made him more comfortable. Isent that whats important??? Given the choice to give my loved one a drug that may hasten their death or let them struggle and live a bit longer..... well anyone can tell you that answer. You did the right thing. Please know that!!! Your Dad would be so hurt if he knew you were questioning yourself and hurting and feeling guilty. YOU know that is true Sharyn. Grief will play all kinds of tricks on you believe me, I know. Try hard to stay strong girl and know you will always be Daddy's little girl.

Hugs and kisses

God bless you,

Jane

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I have read all your post over and over again. I thank you for sharing your stories... most helped, some made me question my decision even more. JC, the poem is beautiful, I have printed it and put it on my refrigerator- I will also be sharing it with the rest of my family. I guess in the end, I have to respect that in my heart I know Daddy did not want to suffer, I know he always said, "put a pillow over my head and help me out of here". If that morphine was the "pillow" I guess I did what he wanted, Maybe time will make this easier. You are all so wonderful to take the time to right such long and thoughtful responses, I guess I am not alone in my guilt and doubts and that is a comfort. Thanks for your compassion. Love, Sharon

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Guest AvaJoyce
. . . You are all so wonderful to take the time to right such long and thoughtful responses, I guess I am not alone . . .

You're not alone.

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Sharon,

You made the best decision with what you had available at the time. You can play out the scenario a million different ways, but the story would ultimately end the same. It was his time. He went out easily, not in pain and fear, but ready and easy - a slow drift into an unknown sea.

Don't beat yourself up, I am sure there was someone to meet him and help him on the journey. The transition was gentle, what more could he ask for?

You can ask the "what if" questions forever, nothing will change except your anxiety level will climb. Try some of these: What if what happened is what was always destined to happen? What if I gave my father exactly what he needed when he needed it? What if "Random Fate" was going to take him with a beer truck on his 17th birthday but something else came up? What if I had never known him because he died before I was born?

Work through the grief - and check into counseling. Talk to a professional that can assure you that everything you feel is "normal" and that you will make it through this with time. Not OVER it, THROUGH it.

Be gentle to yourself, I'm sure your father wouldn't want you beating yourself up...and no matter what, you still have his support. If you were mistaken, he has forgiven you - that's what daddies do.

Take care,

Becky

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Well, I hope that when my time comes that someone will be there to help me along.. put me in a fog.. it's like Rich posted a quote from Woody Allen...something about "I don't mind dying, I just don't want to be there when it happens."

I prefer something other than morphine, myself. I have had that drug for this and that and I am not that fond of it. I like the stuff they gave me after I had my gallbladder out...ooooohhh, now that was nice. I have never felt so good. and I mean good :!: in all my life. I felt like I was in heaven already.

I have had a little time to think about this subject. It has been more of a reality for myself than for any of y'all, probably, so I have been a little closer to seriously thinking about what I personally would want. And the answer is that there would be a trade off for time spent suffering or time spent on this yummy stuff that might just get me into the arms of my Lord and Savior just a little faster. Hmmmm.... not that hard of a choice for me... I choose # 2.

Problem is. I don't have anyone around who would love me enough to hang around and make sure that #2 happens!

So for all of you who have been there when a love has passed away: God bless you and God bless the person who left. Can you imagine a better death than being surrounded by love??? I can't. And I am somewhat jealous that you were there to experience and to witness something so Holy, in my opinion, as the powerful existence and profound presence of the Master, Himself, as His power was there deciding when the final breath would be. What a Spiritual and Holy moment. I cannot imagine.

Now. You just started me to thinking about that yummy stuff I got a few years back. I am going to have to look up my hospital records to see what it was...and put that in my living will, cuz it sure did put a smile on every cell in my body.. !!!

Hope this helped a little.

Cindi o'h

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Well said, Cindi. One of my worst fears is NOT being able to die peacefully and as pain free as possible.

But, you know there is also another side to this -- the incredible FREEDOM that this gives you at the same time we worry and fret and dread tests and recurrence, etc. It's like, "ok, I know you might get me, but something will, so it might be you, so give it your best shot." Haha. Dare ya to try! :P

There have been some things I've not been happy about in my work for a while, and now -- guess what? I have the FREEDOM to handle and solve them for the first time. Or at least I feel like I do. Because I have a really good handle on the options now that I didn't have a year ago.

So, when it's my time, so be it. In the meantime, Sharon and all of you out there in her shoes, God bless you all for being there in our last moments and doing your BEST. That's all a person could ever ask for, and we're truly blessed to have it.

Di

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Wow, this post has meant a lot to me. Sharyn, I do know how you feel, you are not alone. Thanks to those of you that offered words of validation, they are so appreciated and thanks Sharyn for posting it, that was very brave of you. My mom was in a morphine induced coma for 3 days. I felt like I placed her in that position. One minute I thought we were giving her morphine to relieve her pain, the next minute they are asking for her direct orders and telling me to call the family for the last goodbyes. I had to make decisions I never thought I would have to make. I knew we were doing the right thing, but then in the back of my mind was the nagging thought that I didn't. Thank you for this post. As hurtful as it is to revisit, it helped to know that its a common occurence and one that shouldn't be filled with regret. Sharon, we did the right thing. It was done out of undying love for our parents.

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