Pilar’s Last Days

Uncle Dante and Auntie Lita

Mama hardly said anything if at all from Friday through Sunday even though visitors came in and out through the day.  Uncle Dante and Auntie Lita were there every day. Others who came to visit were baby Annika and her mom, Carmela Marfil, Leonardo Wee, Irene Hassan, Vic and Chit Pabellon, the Mother Butler group, Caloy, Madie, and their children of course, who just lived upstairs, and other people who escape my mind now, so please forgive me if I forgot to mention you.

Annika - Apo sa tuhod

We purchased a bulb syringe to try to clear Mama’s throat of phlegm or saliva when she started choking from drinking fluids. She was also having difficulty swallowing by this time and took all her energy just to sip water from a straw when taking her medications. Because of the heat and humidity, the caregivers changed her clothes frequently which was no easy matter because these were house dresses and not hospital gowns. Under the circumstances, we did our best to keep Mama as comfortable as possible.

Mama was on oxygen by nasal cannula all day and night. By Friday, the oxygen was running low and Caloy with his trusty handyman, Erning found a wrench in case we had to switch the regulator from one oxygen bottle to a backup one if the delivery of a new bottle didn’t come on time. It turns out that the regulator came with its own wrench as Larry told us. We just had to find the box it came in. I tried transferring the regulator to the backup bottle but heard some hissing indicating a leak. Fortunately, the oxygen company delivery guy came shortly and showed us how to detect a leak by using soap bubbles. It turns out, I only had to put more muscle into it to tighten the valve. Well, we can always learn something new every day, can’t we?

With Madie and Ate Chit present on Saturday, they went through Mama’s dresses to pick out what she would wear at the end. They knew Mama’s preferences very well and picked out a pretty cream colored ensemble that Mama would have approved of.

With Notre Dame classmates at Palmeras Restaurant on Notre Dame day.

I had to leave Mama for a couple of hours Saturday night because my Notre Dame of Jolo classmates invited me to dinner at Palmeras Restaurant. It was going to be a mini reunion on Notre Dame Day!  Mimi and her son picked me up and we encountered the worst evening traffic on the way. The car could barely move at the corner of Nunez Street and Governor Alvarez Avenue. What normally would have taken 10 minutes took half an hour. The same group that met me at Amil’s the week before was there minus Nayda, but plus Delia and Fatmawati. Earlier in the day, Delia sent mangosteen, homemade durian preserve, native organic Jolo coffee, and itlug payukan (I will not translate that last one because it’s supposed to be illegal obtaining them anymore), to Mama’s apartment. We had Japanese cuisine that evening which I offered to pay for but my classmates declined again. An equivalent of less than 75 dollars fed 10 people Japanese food with much left for doggie bags! A great time was had by all but we had to say our goodbyes pretty soon. People don’t spend too many late nights out in that city. I thought it would be a few years before I would see my classmates again.

I was driven home by Mimi and her son after dropping off Delia at her hotel. I checked on Mama and the caregiver said she hadn’t complained of any pain while I was gone so I was relieved to hear that.

Sunday, I was out for my early morning walk again then attended mass at St. Joseph’s cathedral, where I saw Mama’s doctor with her family up front. On my way back home I stopped by Morning Sun Satti House to say goodbye to Solomon because I was leaving early Monday morning. I invited the Tupaz family to lunch and we went to Lantaka Hotel’s Sunday smorgasbord after they went to mass at 11 a.m.

A view from Lantaka Hotel showing the Port of Zamboanga and Santa Cruz Island beyond

When we returned home, the morning shift caregiver – Joanna reported that she was concerned about Mama’s low blood pressure so we monitored that closely through the day. It went as low as 70/40 which was cause for much concern even though Mama’s pulse was strong and constantly in the 100 to 110 range. When Joanna got that low reading she burst into tears. I rechecked it and it was similar even though I got 82 for the systolic. We couldn’t really do anything about it. Mama was having what is called fluid volume deficit due to lack of fluid intake, not to mention food. I told her to hang on and that I was leaving the next day to go back to the States, and that Larry will be with her in a few days time. But I had a feeling at that point that Mama wasn’t going to let me get off that easy in leaving Zamboanga. I can only imagine what she was thinking (“oh no you’re not!”). So I made a mental checklist of what I had to do if the inevitable happened while I was still there. Since arrangements for Mama were already done, all I had to do was contact my work supervisor via email in case I had to extend my leave, and rebook my flights. I also made a backup plan for Auntie Beth in California to call my supervisor in case she doesn’t get my email over the weekend. As for Mama, we can only monitor her. Because of her difficulty swallowing, I told the caregivers to hold all her maintenance medications because those were inconsequential at that point. Basically they were blood pressure and acid reflux medications plus multivitamins. Her blood pressure was already too low and there was no acid reflux because she wasn’t eating. She had to reserve all her energy to take the pain medications because that was all that mattered now.

I tried going to sleep but because of the situation, I couldn’t. I expected a phone call or text message to come at any time, and it did at 1 a.m. The text message from Neneng just said “sir Noel”. I rushed to Mama’s apartment and saw that she had started gasping for breath. It was no longer the usual the respiratory pattern I had observed consistently during the past week that I had been there. I held her hand, felt for her pulse with the other and detected that her pulse rate had slowed down considerably. I whispered to her that we loved her and that it was okay to let go and to say hello to Papa for us. Part of me felt like getting a panic attack and getting out of there to avoid the situation. In Mama’s last few moments, I prayed to God to help her go peacefully and to give me the strength to handle the situation and not freak out. Thank you God for being so accommodating. Drawing one last deep breath, Mama left the earthy world and to her Maker’s hands, also reuniting with Papa, no doubt. The date was September 10, 2012, 1:05 a.m.

I called and woke Larry up a few minutes later and told him our Mama was gone, and he prepared to return to Zamboanga on the next available morning flight.

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Missing Caregiver, Irene Hassan, Ateneo High School and Zamboanga Malls

Wedding Pic in Mama's Room

Larry texted me Tuesday night to expect a new caregiver Wednesday morning who would be taking care of mama on the day shift. Well, she never showed up or called to give a reason. I even prepared a few basic interview questions which I never got to use. Neneng, the night shift caregiver hadn’t had a day off since she was hired a few weeks before but never complained about it. She pulled me aside briefly and told me that the helper – Andrea, hadn’t been paid for the month. Well, Larry and I didn’t know her salary and Madie mentioned an amount. We decided to ask Mama, who of course gave us the correct amount. The helper got paid from money found by Madie in Mama’s handbags and other hiding spots in the apartment a few days before (more were found later).

Also on Tuesday evening, I sent a text message to Kuya Vic Pabellon saying that Mama had gone home. Well, gone home was ambiguous so he texted me back to clarify what I meant. I said Mama was back at her apartment.

When Mama was having so much pain on Wednesday, she told us to call Irene Hassan. Who was Irene Hassan? Mama never mentioned her to me in our telephone conversations and Madie didn’t remember meeting her either. We searched the Zamboanga telephone directory and a few of Mama’s address books but couldn’t find Irene’s name. It was Madie who found Irene’s number in another address book later. I gave her a call and it turns out Mama wanted her because she knew what to do with pain since she took care of her own mother who also had cancer. They were able to keep her painless to the end. Irene came to visit Mama the next day and gave us guidance about how to handle the pain and some spiritual advice as well.

                When Larry found out that the new caregiver didn’t show up, he contacted more people in Zamboanga by phone and managed to find another one. He was able to do this despite having to work that day.  Thankfully, Joanna showed up the next day and got to work right away. Finally on Thursday - Sept. 6^th, Mama had round the clock care in her apartment.

There were hardly any houses in this new housing subdivision

          I cut my upper lip shaving Thursday morning and when I went to see Mama, she asked me why my tooth was bleeding. I told her it was a shaving accident. That same morning I rode with Caloy while he drove his son David to Ateneo De Zamboanga High School. He also showed me the new housing subdivisions in the area. I was surprised at how sparse the housing was, because the way they advertised it on the internet gave you an impression that there were a lot of houses there already. Caloy said that people were wary about buying land and building houses there because they might be considered wealthy and thus a target of kidnappings. On the way back, I asked him to drop me off at Western Mindanao Medical Center so I could get some copies of Mama’s medical records. I put in the request and the clerk said the copies would be available the next day after 2 p.m. I took a long walking route back home via Governor Alvarez Avenue, Canelar Street, downtown, then back to Mama’s apartment. On the way, I stopped for lunch at Savory Restaurant. I had a bowl of lomi noodle soup which the cashier said was good for 3 people. Well, he didn’t know how much I was capable of eating and finished the whole bowl myself. I needed the fluids and calories after all the walking I did that morning. Their lomi was not as good as the one Larry and I had at the Aristocrat a few days before.

                I met Joanna, the new caregiver when I got back home (Neneng texted me that she showed up while I was at WMMC). She was a recent graduate of practical nursing school and was just waiting to get her license. Mama hadn’t complained of pain since the previous night and it appeared that the round the clock dosing of painkillers finally took effect. From that time on, she never complained of pain again. That made a return visit to the doctor unnecessary. We couldn’t say the same about how much nutrition she was getting because even though we encouraged her to have more intake, the next several days it was just mostly Prosure and medications.

                I continued my search for Tramadol and for a pill cutter. None of the pharmacies had a pill cutter. We also took a thumb mark of Mama for an authorization letter giving us permission to buy medications for her using her senior citizen card. Whenever the caregivers ran low on supplies, I did the shopping. That’s how I found my way to Southway, Gateway, and Mindpro malls.

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