Susan - Interview 17

Age at interview: 79

Age at diagnosis: 46

Brief Outline:

Susan's mother was diagnosed with pancreatic cancer in May 2009. The doctor told her mother that her condition was terminal and that there was no effective treatment available. Susan's mother developed pneumonia and passed away peacefully in August 2009.

Background:

Susan is an administrator/secretary. She is divorced. Ethnic background/Nationality: White British.

More about me...

In late March 2009 Susan’s mother said that she had pain in her abdomen. Then she felt pain in her back too. She also had diarrhoea and constipation, which her GP said was due to irritable bowel syndrome. Susan’s mother also had diabetes.

 

Gradually the pain got worse. Susan’s mother thought it was due to indigestion. She could still eat but did not feel well. In May she felt worse, so she went to her GP again. She saw three different GPs within a week. An X-ray showed that there was something unusual in the region of her back. Susan’s mother went back to her GP, who noticed that she had jaundice. She was then admitted to hospital for eight days, where she had an endoscopy. 

 

Susan’s mother went home. Ten days later she went to see the consultant at the hospital. She was told the shocking news that she had terminal pancreatic cancer. The doctor also told her that there was no effective treatment for her condition.

 

Susan’s mother stayed at home. The district nurse helped her with symptoms such as constipation, and the Macmillan nurse helped with pain relief. Susan’s mother took morphine and paracetamol. This relieved the pain, but gradually she needed a higher dose. In August, just before Susan’s mother died, she needed an even higher dose of morphine, but on this higher dose she started to hallucinate. The dose was reduced a bit, so that she was having just enough medicine to keep her comfortable but not so much that she had hallucinations. Susan’s mother also lost a lot of weight. 

 

On Friday 14th August Susan’s mother was only semi-conscious. Susan’s brother called an ambulance and her mother was admitted to hospital. She became weaker and her blood pressure dropped and her breathing became shallower. The doctors said that Susan’s mother had pneumonia. She was given intravenous antibiotics but she passed away peacefully on 15th August. Susan was glad to have support from a hospital chaplain. Susan helped to arrange her mother’s funeral. 

 

Looking back, Susan is not sure that her mother was fully aware of her treatment options. Susan does not think that her mother knew enough about the treatments that might have been available at specialist hospitals. Susan feels that the doctors should have encouraged her mother to try some form of treatment. On the other hand Susan acknowledges that her mother had been given notes about treatments that were available at a specialist hospital (notes found on the internet by a friend), and that she had decided that she did not want to prolong her life unless she was going to have a good quality of life. 

 

Susan was interviewed for Healthtalk in 2010

 

When Susan's mother was in pain one night her GP called to increase the dose of morphine. The higher dose caused hallucinations.

Did the GP pop in sometimes?

 

Once or twice. He was actually called, called in.

 

Was that for any particular reason, was that to help with pain control?

 

Yes it was. That that was about a week before my Mum was admitted to hospital. You know my Mum started getting pain in the night, and the doctor was called out to see my Mum at home. And he, he put the, the medication, the morphine up, and the dose it went a bit too high, and my Mum was hallucinating.

 

That must’ve been distressing for your Dad wasn’t it?

 

It was, and I saw my Mum and it was as if she wasn’t herself you know. She was you know dazed.

 

How did she, do you think she minded being like that, or, did she feel distressed too?

 

I don’t know how aware she was. But she, you know, but she still managed to get up you know get out of bed and said, “I want to go toilet.” And she went in the toilet. And then she went back to bed.

 

So she could manage to walk alright?

 

Yes.

 

But she was a bit confused in her mind?

 

Yes. But morphine, it is a drug, you know, like heroin, but it’s a prescribed drug.

 

So it was a matter of trying to get the balance right?

 

Yes.

 

Did the GP ever suggest that she would go to the hospice to have the medication, the medicines balanced?

 

No.

 

Because sometimes hospices specialise in that, don’t they?

 

Yes. 

After Susan's mother died she felt that she needed a counsellor because her culture made her feel she couldn't express her emotions.

Did you find overall the counselling helpful?

 

It was helpful because I find that, you know, that a lot of the time I’m just not able to talk, talk you know about my Mum, like at work I’m just not able to talk about her. 

 

It, it’s just our culture. But I need to talk. I feel that the British culture doesn’t allow me to express my feelings and emotions as much as I want to. 

 

You say it’s our culture. How do other people react when you, when you said that your mother was very ill. How did they react when you said that perhaps she had cancer or something? Did they find it hard to talk to you?

 

When, when I broke the news they were okay. But, I just felt I just could not keep you know, you know keep talking about it. And I feel I can’t, I’m not allowed to get too emotional, it’s just the culture.

 

Mm. So you’d like to be able to talk about her?

 

Yes.

 

Would you like to say more about how she passed away etc?

 

Yes.

 

But you find that hard because of our culture?

 

Yes. Yes I do.

 

So it was nice to have a counsellor you could talk to?

 

Mm. Mm Yes..

 

But has that finished now, the counselling?

 

It’s finished, yes.

 

Would you be able to have any more if you wanted it?

 

I’m thinking about it.

 

Two months after Susan's mother had been diagnosed with pancreatic cancer she developed pneumonia and died in hospital.

How long was she in hospital before she passed away?

 

My Mum was admitted to hospital on the Friday 14^th August so she was in hospital for two days. Friday the 14^th after I finished work, I went round to see my Mum, and she was in bed, and she was only semi-conscious, she wasn’t you know fully awake. And my brother called an ambulance, and the ambulance came. And the ambulance man said, “I think she’s got an infection.” And I sat in the ambulance, you know, while my Mum was being taken to hospital. A lady was driving the ambulance and a man was the paramedic, with my Mum. And my Mum was taken into the hospital casualty and they laid my Mum on a temporary bed and I heard my Mum say, “This is the end,” as if she knew she was going to pass away.

 

Did they look after her well in the casualty department?

 

Um…

 

How long? Was she there for a long time? And what happened?

 

They left her in the temporary bed for I think maybe about 20 minutes. And then the porters came and took her to the intensive care part of the hospital.

 

Is that where she stayed?

 

And she stayed there for a bit, while she was undergoing assessment.

 

And then they took her to another ward did they?

 

And then they took her to a ward. They took her to a private room.

 

It was nice that you could have your own room.

 

Yes.

 

And how was the nursing care at that time?

 

The nurses were checking her, you know, every so often. And you know my Mum was being monitored regularly.

 

Did the doctor come and talk to you and your father at that time? Was your father there?

 

My father was there, and my brother stayed home but my Dad and I were in the hospital. And the doctor did talk to us, he said that he wasn’t sure whether my Mum would pull through in 24 hours.

 

Did he confirm that she had an infection?

 

He said that she’d got pneumonia. And he said the cancer had spread.

 

Did she have any treatment for the pneumonia, or did they decide, or did you decide not to treat her?

 

They were giving her antibiotics intravenously for the pneumonia.

 

But she didn’t pull through.

 

She didn’t pull through.

 

I’m so sorry.

 

But she was in hospital from Friday evening until Saturday you know, evening. And she passed away just before 6 o’clock.

 

In the evening?

 

Yes. And I called a hospital chaplain on Friday night and he came and he said a prayer for my Mum and he anointed her with oil on the forehead. He started saying the Lord’s prayer, and my Mum started saying the Lord’s prayer, so she, although she wasn’t fully conscious she was sort of semi-conscious, but she was also struggling to speak as well. My Mum, she was talking a lot, but she was struggling.

 

You know, I couldn’t really hear very much of what she was saying. I didn’t understand what she was saying.

 

Was she quite comfortable do you think? Was she given any painkillers?

 

She was given morphine, morphine by injection in the hospital.

 

So she was comfortable?
 
Yes. And she seemed a bit restless as well.
 
So it was a comfortable, peaceful ending for her?
 
Yes.
 
That’s good, that must be a comfort to you?
 
Yes, but …, I don’t know how my Mum was feeling you know before she passed.