This week I have had to take two of my closest family members to be seen by medical experts. I have faced making difficult decisions on their behalf knowing that my choices for their care would affect me only indirectly but potentially have negative effects on their quality of life.
You might, Dear Reader, have been following the story on this blog of my poor Oscar and the idiopathic damage to his nose. In which case you will know that I took him to be seen by experts in animal ENT at the Royal Veterinary College this week. (Oscar is a dog.) Of the limited treatment options available to us, there were two radical options. The first was to try and block the blood supply to the damaged parts of Oscar’s nose to reduce the risk of further catastrophic nosebleeds. This would mean either tying off the carotid artery or sending a plug up through the blood supply in his leg to try and block off the blood vessels in the correct part of his nose. The latter carried the risk that the plug would get lost or block the wrong part of Oscar’s nasal blood supply, in which case there was a small possibility that he would not make it through the operation. Either of these solutions would be temporary, as Oscar’s body would be likely to grow more blood vessels in a more difficult-to-reach part of the nose, meaning that we would be faced with the same nosebleed problem further down the line. Dogs with idiopathic destructive rhinitis are often put to sleep not because of their disease but because of the terrible impact of the sudden and disastrous nosebleeds on the carpets, sofas and wallpaper of their homes.
I thought and thought about this. Some might say that Oscar’s just a dog. But anyone who has ever loved and nurtured their pet at home will understand that they are not just another animal. Like it or not they very quickly become part of the family and dogs, who are especially sensitive and empathetic to the family dynamic, become like another child. This is, indeed, why people love their dogs so much and why they want to keep such demanding time thieves in the first place. Anyway, my dog, who cannot speak for himself or let me know exactly how much discomfort he’s suffering, needs me to do the right thing for him.
I was not sure that I could put him through the artery-blocking temporary solution. Another big operation, more shaving and cone-wearing just for the sake of a few more months? And with what quality of life? It turns out that things have not reached that point yet and that Oscar’s medication seems to be improving his condition but I have wrestled with my conscience and I think that we must aim for the fullest possible life for Oscar. So, while he is still happily wagging his tail and enjoying his walks and he does not seem to be in any pain and he still functions well as a wonderful family member then we should do anything we can to make him comfortable. But if it ever comes to a point where he is in intolerable pain or limitations on his dogness, then I think I could not be so selfish to keep him alive for the sake of my own vanity. We can make those sorts of decisions for our pets but not our humans.
Later in the week I had to take my mother to the memory clinic. I have witnessed a gradual deterioration in her brain function and memory for several years but I’ve not really been sure whether this was due to a crystallisation of her existing personality due to age (and let’s face it, that does happen,) or to something more sinister. It’s been a long time coming, this diagnosis, partly due to my reluctance to label my mother and thereby take on a whole raft of complicated problems, partly because every time she talks to nurses and doctors she seems suddenly to be able to answer all their diagnostic questions about dates and current affairs and calculations perfectly well. This must take some effort on her part as she reverts to her degraded, disinhibited mental state almost immediately when she is no longer on her guard. My mother denies that there is anything wrong with her brain or that there are any impairments to her mental function other than those that are normal in older people. Her perfectly understandable attitude does not help the situation.
The upshot of this week’s meeting was a diagnosis of some dementing illness and the doctor prescribed a drug which I have to supervise to assess any possible side effects. The drug will sedate her a little and can cause drowsiness, and this makes me uneasy. At the moment, my mother can cook her own meals and she makes full use of her Freedom Pass to travel to London and go to visit friends. It can lead to risky behaviour, though, that I described in The Visit earlier in the year. If the drug to help my mother’s memory sedates her and makes her drowsy, will she still be able to go out and enjoy the same quality of life? I suppose that it is the dementia doctor who has made this decision and not me, but I still worry that I have now played a major part in making life a little less fun for my mum.