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I Watched My Mom Die A Terrible Death. Then The Police Started Asking Questions.

I'm not an expert on death, but a decade ago I held my mother's hand and watched her die a terrible death. My mother fought a rare degenerative neurological disease for six arduous years. At the end, her mind was strong but her body was failing her in every way.

We're approaching the 10-year anniversary of her death, and I'm only now able to write about it. I couldn't talk about what happened that day for a year. So perhaps I shouldn't have been surprised by the flood of emotions I felt when I read about an elderly Florida woman who shot and killed her terminally ill husband in a hospital room. 

My mother had progressive supranuclear palsy, a progressive degenerative disease similar to ALS. PSP patients develop balance issues, vision problems and swallowing difficulty. They have frequent falls, until they need to use a wheelchair, and often choke and develop aspiration pneumonia as the disease progresses. PSP is rare ― my father and I had to explain the disease to numerous doctors and medical staff when my mother's falls or bouts of pneumonia led to hospital stays.

In the weeks before my mom's death, we brought up the topic of hospice. She was in near-constant discomfort, if not pain, from arm and hip injuries after falls. She received most of her sustenance through a feeding tube and could just barely sip some wine and eat a bite of chocolate without choking and coughing spasms. She began to have a gray pallor. But she wasn't ready for hospice yet. She emphatically shook her head "no" when we suggested it was time. We upped her ibuprofen dosage to help with her pain and soldiered on.

The day she died, I was at my 6-year-old's soccer game and got a call from her nursing assistant saying she was having intense abdominal pain. I spent the day with her, along with my dad who arrived home from a business trip a few hours after I got there. We called her doctor, fetched and administered a prescription to assuage her stomach symptoms — and watched her grimace and shift around in her chair uncomfortably. I asked her tentatively several times that day, as I watched her suffer, if we shouldn't consider going to a hospital. She vigorously shook her head no. My mom was done with hospitals.

As the day dragged on, something was clearly very wrong. She moaned and sweated and, at times, writhed in pain. I would have given her any drug I could get my hands on. We didn't have narcotics or medical marijuana. I kept asking if she was OK, if we should go to the hospital, and she kept demurring. I think she knew this was the end — and she powered through it, the way a woman powers through childbirth, to get to the other side.

When she suddenly stiffened and her face turned purple, I grabbed her hand and began to sob. We believe her heart stopped. Her doctor later surmised that she may have developed an ulcer from the ibuprofen and may have been bleeding out internally.

After she died, my father and I stared at each other, tears streaming, wondering what to do. He called a coroner whose information he had saved and who was trained in the careful harvesting of brains for donation to science. Mom had wanted her brain sent to a lab conducting research on PSP. We called our immediate family to deliver the news. And then, on the advice of the coroner, we called the police.

That day was an out-of-body experience, really. The police arrived and began asking an exhaustive list of questions about my mother's death. What was her diagnosis? What medications did we give her that day? They asked to see the detailed Excel spreadsheet my father maintained listing all her medications — as if they could make sense of it. Could a doctor confirm her condition? Could we get through the after-hours phone labyrinth to reach her doctor, so the officers could confirm her condition? 

In that way you fold the innermost part of yourself into a tiny piece in times of trauma, my dad and I numbly answered their questions. My heart began to race, as I realized they were trying to determine if we helped her die. And if we needed to be charged with a crime.

I've come to know a bit more about death since my mother's passing. I've come to know that PSP patients with the means to do so find their way to Switzerland or the Netherlands, where euthanasia is legal and can be accomplished in a peaceful, dignified manner, in the company of loved ones.

I've come to know that sometimes hospice nurses and other medical staff blur the legal lines at the end of a suffering patient's life, administering the necessary doses to provide relief from unbearable pain and hasten the end.

Medical ethicists and experts can parse out these issues. But I can't stop thinking about that elderly couple, faced with a horrific reality, deciding their best recourse was taking a firearm into a hospital room. I can't stop thinking about that 76-year-old woman desperate to end her partner's suffering, pulling the trigger and ending his life. And I can't stop thinking about the law enforcement officers who forced their way into a barricaded room, threw that devastated woman onto the ground, and tossed her into the yawning maw of the criminal justice system.

I don't have many regrets in life, but I regret the way we managed my mother's death. It wasn't peaceful or serene ― it was excruciating and torturous.

We humans spend countless hours talking about and reading about and pondering how to have a good life. Perhaps, in this country, we could dedicate a little more careful contemplation to how to give someone a good death. 

Joanna McFarland Owusu is a writer/editor based in Dallas. Joanna was a federal government analyst in a former life, and is a longtime policy stan and news junkie. When she isn't reading the news or writing, Joanna spends most of her time Uber-momming two teenage sons and an elementary-aged daughter around town.


Multiple Sclerosis Drug Shows Promise Preventing Earliest Symptoms Of Degenerative Disease

Topline

Researchers on Wednesday said an existing and approved drug might be able to stop multiple sclerosis in its tracks before people experience any symptoms of the disease, preliminary findings that offer a very early ray of hope that patients could one day be spared the worst parts of the devastating and incurable neurological condition or even avoid it entirely.

Researchers said an existing drug shows promise against multiple sclerosis. Getty © Provided by Forbes Researchers said an existing drug shows promise against multiple sclerosis. Getty Key Facts

Early research, which was presented by Frenay at the American Academy of Neurology's 75th Annual Meeting on Wednesday, suggests teriflunomide, a drug already in use to reduce the number and severity of multiple sclerosis relapses, can also stall the onset of symptoms in those with scans showing early signs of the disease.

Accounting for other factors that can affect the chances of developing symptoms, the researchers found that people taking a daily dose of the drug, teriflunomide, had a 72% lower risk of experiencing their first symptoms compared to those taking an inactive placebo.

Multiple sclerosis, often known as MS, is a degenerative and potentially disabling neurological condition thought to be caused by the immune system mistakenly attacking the protective layer that surrounds nerve cells, which disrupts signals to and from the brain and can trigger symptoms including dizziness, vision problems, paralysis and muscle weakness.

While there is no single diagnostic test for MS, MRI scans can sometimes reveal a hallmark pattern of scarring in the brain, spinal cord and other parts of the nervous system (in plain English, multiple sclerosis means multiple or many scars).

Signs of similar damage are sometimes found in the scans of people who do not have any symptoms of multiple sclerosis—termed radiologically isolated syndrome—and many will later go on to develop MS, said Dr. Christine Lebrun Frenay, of France's University Hospital of Nice.

Lebrun Frenay said the results, which have not been published or peer reviewed and are based on a study of 89 people with radiologically isolated syndrome followed over two years, signal early promise for delaying nerve damage in MS patients, "which decreases the risk of permanent neurologic impairment and debilitating symptoms."

What To Watch For

With more people having brain scans for reasons like headaches or head injuries, Lebrun Frenay said "more of these cases are being discovered, and many of these people go on to develop MS." While the findings must be replicated in larger groups of people, such detection could make it possible to stave off MS in many people should the drug's promise pan out. Lebrun Frenay said it is important clinicians are "cautious when using MRI," however, so as to avoid misdiagnosing people with MS. French pharma giant Sanofi, which makes teriflunomide and supported the study, did not immediately respond to Forbes' request for comment on the findings or its future plans for the drug.

Key Background

Multiple sclerosis is the most common disabling neurological condition of young adults, according to the National Institute of Neurological Disorders and Stroke, with symptoms typically starting between the ages of 20 and 40 years. The precise cause of the disease is not known but experts generally believe it involves the body's immune system wrongly attacking nerve cells. Environment, genetics and exposure to viruses like Epstein-Barr are all thought to play a role and women are more often affected (estimates vary but MS seems to occur between two to four times more often in women than men). The course of the disease is different for each person but symptoms range from muscle weakness, tingling and dizziness in the early stages to mental and physical fatigue, mood changes, cognitive problems and paralysis in the later stages. Many people living with MS will experience transient symptom attacks or flare-ups, where new symptoms can emerge or old ones worsen, followed by a period of remission. There is no cure but there are treatments that can help reduce the number of relapses and reduce their severity.

Big Number

1 million. That's how many people are estimated to be living with multiple sclerosis in the U.S., according to a 2019 study funded by the National Multiple Sclerosis Society. A different study estimates a total of 2.8 million people live with the condition worldwide. Data is patchy, however, and the true burden of the disease could be substantially higher and the number of people living with MS has been rising in recent years.

Further Reading

Moderna Starts Human Trials Of mRNA Vaccine For Virus That Likely Causes Multiple Sclerosis (Forbes)

Global spread of autoimmune disease blamed on western diet (Guardian)

The Medicine Is a Miracle, but Only if You Can Afford It (NYT)


Demystifying Parkinson's: Must-knows Of The Disease

The exact underlying cause is not known for sure. However, the disease result from nerve cells in the basal ganglia, an area of the brain that controls movement, becoming impaired and/or dying. These cells produce dopamine, a neurotransmitter that regulates movement, equilibrium, and coordination. So, neurons produce less dopamine when they die or become impaired. Those with Parkinson's also lose the nerve endings that produce norepinephrine, which regulates the sympathetic nervous system. However, what is not known is what causes the cells to become affected in the first place.

Even though the exact cause of Parkinson's disease is still unknown, it is thought to be a mix of genetic and environmental factors. Genetics may play a significant role in some cases, while toxins or other environmental factors may play a role in others. Also, oxidative stress, inflammation, and an abnormal buildup of proteins are being looked into as possible causes of the illness.






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