by Andy Halpin
With Annette home, the next stage was St. Luke’s and the treatment we all hoped would prolong her life. We were all anxious for the treatment to start as soon as possible. I contacted the hospital on a number of occasions to enquire when it would start. In the meantime, as I did not drive, a number of Annette’s friends and some neighbours volunteered to co-operate with the family to drive Annette to St. Luke’s each day. A rota was drawn up listing the days each person would be available. This was a gesture we were very grateful for. It would have been impossible to get Annette to St. Luke’s and back each day without incurring great expense and a lot of inconvenience, so let me put on record again our thanks and great appreciation of the help given to us and the generosity of all concerned, Fidelma, Maureen, Wally, Jennie, Valerie, Margaret and Tony, I sincerely hope I am not forgetting anyone.
When Annette came home in February it was less than eight weeks since she had first gone into hospital. In that time our whole world and way of life had been upended. Eight weeks before Annette seemed to be a healthy, confident, vibrant woman with many years of life still ahead of her. Her only problem was a sore throat which meant she had some difficulty swallowing, which we thought was nothing very serious. Now she was a shadow of her old self. I won’t say she was fearful, but she had a more nervous disposition. It was brought about not by the cancer, but by the constant fear that the trachie tube would become blocked by mucus. At this point the cancer was a lesser concern than the trachie. We did not venture out much between Annette coming home and the beginning of her treatment in March. This was principally because the weather was so cold and Annette did not want to get cold air into her tube. From time to time we did go for a short walk when it was not too cold and Robert took us out a few times for a drive. On a couple of occasions Annette drove her car around to Mass on Sunday mornings. She met her friends in the church choir and they were delighted to see how well she was doing. Her family and friends also came visiting during this time. Annette was delighted when some of her friends from her prayer group came and held prayer sessions with her. This was a great comfort to Annette. I believe she derived strength from these prayer meetings.
Annette’s feeding regime meant that we had to go to bed early each night. It took twelve hours for a bottle of food to pass through the peg in Annette’s stomach, and she also had to have water through a syringe. I set up the feed for Annette every night and helped her with her medication. It was just two Panadol and half a sleeping tablet. I filled and turned on the humidifier we had in the bedroom, to help prevent mucus building up in her tube. It was heartbreaking to do so and look on helplessly as the woman I loved seemed to physically diminish before my eyes. She never complained about the new way of living we were forced to endure.
I was devastated when I looked at Annette with the feeding tube hanging out of her and watched her trying to sleep while sitting upright in the bed. With these restrictions I could not even hold her close to comfort her, but I tried to get as close to her as I could without in any way dislodging the feeding tube. It was a terrible way to have to sleep. I had always held Annette close in bed and loved to snuggle and caress her body. Now we were forced to sleep at a distance.
Each morning when we woke up the first thing I did was to pull over the curtains so Annette could see the mountains which she loved. She then held my hand as she said a prayer of thanksgiving for getting through the night. As we had a little kiss and cuddle Annette would always say her little mantra, which she found so consoling and which gave her such comfort, “One day at a time, One day at a time.” Holding my hand and looking into my eyes she would say, “All is well, All is well.” The days of breakfast in bed served on the old silver hot-tray were over for good now. From the time Annette came out of hospital on 20th February, until her admittance to St. Luke’s on Wednesday, 8th April, this was our way of life.
Annette started her chemotherapy and radiation treatment on 10th March. It was due to last seven weeks, thirty-five sessions, Monday to Friday. Radiation would be administered on each of the five days and then she would have both chemo and radiation on the Thursday of each week. Before the treatment started Prof. Hollywood told us that after about two weeks Annette would get very fatigued and it might be necessary to admit her to St Luke’s as an in patient, he’d said that this was quite normal and nothing to get worried about. While Annette did feel very tired she did not get as fatigued as we had thought she would, so for four weeks she went to St. Luke’s each day for her treatment.
At the end of the fourth week, on Friday, 3rd April, as was normal, she went to see the doctors from Prof. Hollywood’s team for their weekly assessment. They were delighted with her condition and said they were happy for her to continue as an out-patient for a while longer, as she was not as fatigued as they had expected her to be at this stage of the treatment. This was great news for us and Annette was delighted. When I heard what the doctors said and when I saw how well Annette reacted to the news over the weekend, I was totally convinced that she would prove Dr. Kinsella wrong and survive the cancer.
Martin and Marie Byrne, Ciara’s parents visited Annette on the Saturday. Marie confided to me that before coming she had been afraid of the condition Annette might be in as they had not seen her since the previous September when we were all in Spain together, Ciara had kept them informed about events and they were both amazed and delighted at how well Annette looked and sounded that weekend. She really was in great form.
On the Sunday Robert drove her to Mass in the Priory and then took us for a short drive in the country. On the way home we stopped and she walked for twenty minutes or so around Tymon Park. Things were really looking good. I believed that all the positive things I had been saying to Annette, combined with the treatment and what the doctors had said on Friday, were beginning to have the desired effect. I was sure she believed she could get through this bad period and come out the other side.
CHAPTER TWENTY EIGHT
All this positivity changed the next morning as we were getting ready to go to St. Luke’s. Annette was in the bathroom, washing herself, when she began to cough. She became distressed. I heard her and went in to see what was wrong. On a few previous occasions she had had difficulty dislodging mucus from the tube and I had to suction her to get it up, so at first I was not too concerned. I brought her into the bedroom and sat her on the bed. I then got the suction machine ready.
Annette was visibly upset and seemed to be in more discomfort than when we’d had to use the suction machine before. I inserted the suction tube into the tube in her neck and tried to move the mucus but nothing happened. Annette was getting more distressed. The mucus was not coming up and her face began to change colour. I got frightened and rang the ambulance service. After ringing for help I kept trying to clear the mucus. I inserted a new suction tube and finally succeeded in getting the mucus up. Annette began to feel better and she did not want the ambulance to come so I rang them again. I told them everything was alright and we did not need them. But as soon as I put the phone down Annette began to get caught again. I got to work on the suction machine again. Annette seemed to be getting worse and her colour changed.
David, who was going to drive us to the hospital that morning, then arrived. He came up to the bedroom and was shocked at what was happening. I was having no success at clearing the mucus and Annette was now turning a deep red/purple colour. I told David to ring for an ambulance as I continued to try and suction Annette. When David made contact with the ambulance service I took the phone. I explained that although I had just cancelled the previous call things had changed and we now wanted the ambulance as soon as possible.
Within a few minutes the ambulance had arrived. I continued to try to help Annette until the ambulance men took over. They tried to suction Annette, but to no avail. All this time Annette was conscious, though in a very distressed state. I was on the verge of panic as I watched the ambulance men. After failing to clear the tube the medics decided to bring Annette to Tallaght
Hospital. They put a breathing apparatus on her and took her downstairs. I went in the ambulance with her and David followed in his car. She was whisked straight into the emergency room. The doctors started working on her immediately while I gave the details of her illness.
In all this time Annette had not lost consciousness, though later she said she did not remember the ambulance men treating her. After a few minutes of being suctioned with a tube similar to the one we had at home a larger one was brought in. This succeeded in clearing the large plug of mucus which was blocking Annette’s tube. As soon as the mucus was dislodged Annette began to recover. Within five or six minutes she was almost back to normal. She did not remember much about the incident and thought she had been unconscious.
David, who had been waiting outside the emergency room, then came in. We waited until Annette had fully recovered and then we went home. Needless to say we did not go to St. Luke’s that day as Annette was very tired after such a stressful morning. She rested for the rest of the day and seemed to be back to normal by evening time.
The events of the day cast a cloud over what had been a great weekend, but as Annette had recovered well from the experience and seemed to be ok again, we thought it was just a slight glitch in her recovery. We went to bed that night with plans to resume her treatment in St. Luke’s the next day.
Annette had a reasonably good night after her stressful day and was fine the next morning. She got up and was ready without any bother. Her friend Maureen Monahan drove us to St. Luke’s that Tuesday and the treatment went as normal.
Before we left the hospital we were asked to wait to see Annette’s doctors. They had been informed about the previous day’s events by Tallaght Hospital. After a short discussion with Annette the doctors suggested that in view of what had happened it would now be advisable for her to come into St. Luke’s as an in-patient. They stressed this was not because she was any sicker, but just so that they could monitor her trachie tube and see what had caused the blockage. This was a blow to us after what had been said the previous Friday. But as Annette’s well being and safety were paramount, she agreed to be admitted the following day.
That night she packed a bag to bring with her the following morning. Another friend of Annette’s, Wally Maloney, drove us to St. Luke’s on the Wednesday. On arrival Annette was allocated a room and, after settling in, she had her radiation treatment. She was back to herself again after Monday’s events. I stayed with her until about nine o’clock that night. We took a walk around the hospital and visited the church. The Easter weekend was coming up and no treatment would take place from Good Friday to the following Tuesday. We had hoped that Annette could come home for the weekend after her Thursday sessions of chemo and radiation but the doctors felt it would be best if she stayed in, so they could keep a watch on her trachie tube.
I went down to St. Luke’s at about ten o’clock on Thursday morning. I went straight to Annette’s room, but she was not there, so I went to the chemo ward thinking she would be there. I was told by a nurse that she was still in the radiation dept. As I entered that section Annette was just coming out from her radiation treatment. She was in good form and told me she was getting the chemo in her own room, so we walked back there together.
David and Mina then came in to see her. Annette was very glad to see them but while they were there she started to have difficulty with her tube again. I called a nurse to give her aid. It did not seem as bad as on Monday, Annette was not having as much difficulty breathing nor was her colour changing. After the nurse attended to Annette she seemed to be ok again and we went back into the room.
After a while David had to leave but I was glad that Annette seemed to be alright again. She gave David and Mina a kiss before they left.
As Annette had had another blockage of her trachie a doctor had to see her before she could have her chemo. We had to wait for one to be available to check her. As we waited we spoke about the trouble the trachie was causing. Annette said she was not even thinking about the cancer, her whole concern was the trachie. She was afraid that it would become so blocked that it would not be possible to unblock it. The trachie nurse had assured us that this just would not happen, that it had never happened in the nine years she had been in the hospital. Eventually a doctor came and examined Annette. He said there was no reason for her not to have the chemo as everything seemed to be alright now. The doctor said he would go and get the line ready for the chemo. As he left the room Annette turned to me and uttered the last words I would ever hear her speak, “I think I’ll go to the toilet first before they start.” With those words Annette walked out of my life. She went into the bathroom as I sat on the bed to wait. After a moment or two I heard a banging noise from the bathroom. I ran in and found Annette holding the sink trying to get her breath.
I don’t remember what happened next. I think I may have brought her out of the bathroom. All I remember is seeing Annette lying on the bed, surrounded by nurses as they tried to tend to her. Her head was propped up on a pillow and the nurses were trying to suction her. I remember looking at her as she seemed to fall into a state of unconsciousness. Her head dropped down on her right shoulder and her eyes were shut.
I was then pushed out of the room as more nurses and doctors came running from all directions. I was told to sit in a small room across from Annette’s room. The door was open and I could see all the activity over at Annette’s room. There were nurses and doctors going in and out, with equipment being brought in. I don’t know how long all this went on, maybe half an hour.
Then Prof. Hollywood came into the room where I was waiting. He said he wanted to prepare me for the worst. He said that Annette might have had a cardiac arrest. They were not sure at that time but she was on a ventilator and when they took her off it she might not be able to breathe on her own. He said he just wanted to prepare me for what might happen. Prof. Hollywood was then called back to Annette’s room leaving me alone to ponder over what he had just said, though I don’t think I really fully comprehended it as my mind was really in the ward with Annette.
More activity began to take place. Nurses and doctors were running back and forward. I was left in the room alone. I tried to get into Annette’s room to see her but I was prevented from doing so by a nurse who was standing just inside the door. Through all the people in the room I could just about see Annette lying on the bed. Then I was again taken back to the other room and told to wait there.
Another period of time passed before Prof. Hollywood came back to me. He said they were going to move Annette back to St. James’s Hospital. They had taken her off the ventilator and she was continuing to breath unaided, but they did not have the facilities to treat her in St. Luke’s. An emergency ambulance would arrive shortly to bring her to James’s.
I asked Prof. Hollywood what had happened. He said he was not sure, it may have been a heart attack or it might have been a blockage of the trachie tube. They just did not know at that point but that it was best she was taken to St. James’s. When the ambulance came I was not allowed to go with her. A taxi was called for me and as I waited for it to arrive I phoned David. I told him what had happened after he left and that Annette was on the way to St. James’s. I think I may have called Gina and Robert but I am not sure.
The taxi took forever getting to St. James’s, due to very heavy Holy Thursday traffic. I got out of the taxi at the roundabout in Rialto and ran the rest of the way because the traffic was at a standstill. As I ran towards the hospital gate I met David. He was also running, having parked his car further up the road.
As we made our way into the hospital I told him that things did not look too good. I explained that his Mam was unconscious when last I saw her and I did not know if they could do anything.
Annette was already in the emergency room when we got to the hospital and Gina and Robert were already there. They said they had seen her being taken in and she did not look good. We were not immediately allowed to see Annette. We were left waiting in a
room outside. Gina or Robert had phoned Annette’s family and very soon we were joined by Caroline, Claire, and Louis, followed shortly by Marie and her husband Maurice and her brother Liam.
After another while we were allowed into the emergency room, two at a time, to see Annette. She was unconscious but she looked relaxed and comfortable, not the least distressed or in pain. When we asked what had happened nobody seemed to know. We were told that Annette would be moved up to St. John’s Ward as soon as possible. Further tests would then be carried out to determine what had happened.
What had started as an irritating sore throat was now a life threatening illness. I was totally shattered and confused, as I stood looking at Annette in her comatose state. Less than a week before we had been told she was doing so well that she could continue to attend St. Luke’s as an out patient. What had gone wrong? Nobody seemed to know.
We were told to expect the worst by the medical team as they could do no more for Annette. They could only keep her pain free and comfortable but I still did not expect or believe Annette was going to die. I truly believed she would come out of this coma and continue her recovery. But that was not to be, it was just the blind refusal to accept reality of someone who does not want to lose the one he loves.
Later that evening Annette was moved to a room in St. John’s ward. She remained there until her passing in the early hours of Easter Tuesday morning. The last four days of Annette’s life were beautiful. She had a private room where all the family and her friends came to be with her and say their goodbyes. Although we did not know if she could hear us or understand what we were saying, we stayed with her, played music, lit candles and said prayers.
After Annette was moved to St. Johns we were told she may have suffered brain damage, as she had stopped breathing for a time in St. Luke’s. But we carried on as if she could hear and understand everything we were saying. We lit the room with candles and brought in lots of music, including her own compositions and some flowers. We made the room as much like home as we could.