There was a lot of interest in last week's post about the medical-aid-in-dying (M.A.I.D.) drugs that were delivered to me and quite a few questions so I am going to answer them as best I can in this blog post.
If you have additional questions, please leave them in the comments below and I will check throughout the day and respond in the comments.
”I must add that the first thing I thought when I saw the photo was, 'Uh-oh, how difficult will these caps be to take off when it's time?'”
Ronni: Exactly, Wendl. When the pharmacist asked me the question about child-proof or easy-open caps, I had a sudden vision of myself ready to go, weak, tired or maybe in terrible pain struggling to get the caps off - maybe dropping a bottle in the process and spilling the contents.
A related issue was that I might forget where I stored them. It happens to me all the time in my dotage that I put something in a place I think I am certain to recall and then can't find it later. So I've written down the location of the M.A.I.D. drugs in a notebook I use every day and have told two people where they are.
"Just looking at those bottles is scary to me. I would have thought, one, maybe two, but good grief what is in that large bottle? Something to make a cocktail?”
And from Irma:
“4 bottles?? Is there a certain order to it?
Ronni: Yes, there is an order to taking the drugs. The first two are anti-nausea drugs, the others are the M.A.I.D. drugs all taken in a certain sequence with a specific amount of time between each that adds up to a total of an hour.
The powders are mixed with water or apple juice or whatever liquid I choose.
Oregon law requires that I must do the mixing personally and be able to drink the mix without assistance.
From Kate R:
”Will someone with hospice be with you assuming there is a sequence in taking the drugs? Does this insure a quick death? You've been very frank in sharing your journey Ronnie, so my questions are also very frankly asked.”
From Mary Smythe:
”Can you proceed to just take the drugs (I assume the instructions are there), or do the three people you refer to have to be present as witnesses?”
Ronni: There is no requirement that anyone be with me when I take the drugs but as I noted in the original post about the M.A.I.D. drugs, I do want three people with me – my good friend, my palliative care provider and, probably, my hospice nurse.
According to my doctor and the pharmacist, after drinking the final mixture (the big bottle), I will fall asleep within a couple of minutes. In fact, it is so quick my doctor advised me to be sure I have said my good-byes before I drink the last dose. Death usually takes place a few minutes to an hour later.
”Question now is, what degree of pain will allow you to 'pull the trigger?' Who will be there to decide for you when you can't? What suffering or remorse will we all have once we have lost you?
Ronni: I can't answer your third question, Yellowstone, but I surely hope no TGB readers will suffer or feel remorse. You have no reason for that. I even hope you won't be too sad. Death comes to all of us and we here at TGB have already had a long goodbye.
To your second question, the entire point of the medical-aid-in-dying law is that the patient and only the patient decides when the time is right to take the drugs. In fact, a physician had to certify that I am of sound mind before they could be dispensed. And the reason only I can mix the drugs with liquid and lift the glass to my mouth on my own is to help ensure that I have not been coerced.
Your first question, how will I know when the time is right, is important. I have discussed that with two doctors and a nurse all of whom have been present at patients' deaths by this means.
Each of them have told me that I will know. All of them said that with each person whose death they attended, they believe the patient chose the time well.
I don't believe the timing is about pain necessarily. It might be that I can no longer care for myself, am bed-ridden or can no longer do the things I enjoy like writing this blog.
I'm just going to trust that like all the patients they discussed with me, I too will know when the time has come.
Many commenters on last week's post mentioned my willingness to share what I'm going through. I made that choice soon after diagnosed in 2017 not quite sure, then, that it was the right thing to do.
But now I think it is important and that I have been able to contribute to the conversation around cancer, other ailments of old age and the inevitable end we all face.
That's not common – the conversation - at least not in the United States. Many people refuse to discuss death and dying so that when they are confronted with it – their own or a loved one's – they have no knowledge or understanding or even, I have noticed sometimes, a place to start.
Maybe these pages, ongoing for as long as possible, will help in that regard.
Nine states – California, Colorado, Hawaii, Montana, Maine, New Jersey, Oregon, Vermont, Washington state - and the District of Columbia allow medical aid in dying.
You can find local information by searching “death with dignity” and a state's name. Compassion and Choices is an excellent organization whose website is packed with good information about the subject.
From Tim Hay:
”How can we Thank You? We cannot.”
Ronni: You are right, Tim, you cannot thank me and there is no need. I get as much out of reader comments here as you do so things go both ways. What you can do is continue the conversation elsewhere when it is appropriate.
We need to make death and dying part of living, to not let it continue to be a secret. Medical aid in dying is not for everyone but it should be available to everyone which seems to slowly be happening in the United States.
Keep the conversation going.