Part One of Three: Deathbed
Jan. 23rd, 2006 06:27 am![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
rickvsGot back on Tuesday from my father's memorial service. It's been about two weeks since I was told he was going back in the hospital with lung cancer and a staph infection; he'd been in recovery from his (nominally) successful throat cancer treatments.
I'll post this in three parts, so you may pick and choose what you wanna read. If you have issues with cancer, death, or hospitals, skip this post. I'm serious.
I intend to write two more sections: one with other details about my father's final week, then a separate Plaque post. This first one is the only one that should have any triggering/yucky details, so consider yourselves warned.
Friday, January 6th, I warned my bosses I might need to leave town quickly, depending on my father's condition from day to day. That weekend, after discussions with my mother, I planned to go out there in a month or so, to ease some of her caregiving burden, as I'd done during my father's throat cancer treatment last year. It made no sense to me for all of us kids to gallop out to Nampa, leaving my mother with little support a few weeks hence when we had to return to our jobs.
On the evening of Sunday the eighth, my sister called and told me I'd better get to Idaho if I wanted to see Dad alive at all. So Rachal and I arrived Monday night (subsidized by our neighbor Pat -- our local patroness).
We went to the hospital straight from the airport, and my father was still alive, but looked like hell. I could see his chest rising and falling under the sheet, but in the topography of the bed, his torso was a valley between the twin hills of his arms. His arms were not only raised on pillows, they were heavily swollen with fluid. (Oddly enough, his legs were downright spindly -- the fronts of his shinbones stood out as long rectangles, flush against the skin).
He kept his eyes closed nearly all of the next few days, only opening them briefly sometimes when he was spoken to. That first night was the worst -- his breathing was labored, he was constantly knitting his brow and grimacing, as if a wasp had landed on his nose and he couldn't move his arms to wave it off. He rarely did move his arms or legs, and when the nurses came to take his blood pressure, the cuff left a deep impression in his flesh. (I spent the week constantly smoothing out the wrinkles in his bedsheets -- they left creases in his skin if his arm lay on them for more than a few minutes. From the elbows down, the skin was so tight it was shiny).
Every few hours, someone would come in to vacuum the back of my father's throat. A muddy-looking mucus would build up there, and they wanted to get it before it moved down to his lungs. They always had to go through his mouth -- they'd tried putting the tube through one nostril, but when they removed it the day before I arrived, his nose bled copiously and he choked. Later in the week, his blood numbers got lower, which made him more likely to bruise and bleed ...all of which basically meant that if the fluid got to his lungs, there was nothing they'd be able to do. For my parents' purposes, a tracheal tube would fall under the heading of "heroic measures", and was therefore not an option. The vacuum tube the nurses would use was connected to a clear reservoir about the size and shape of a child's sand bucket. They replaced it on Thursday -- by then it was filled with what looked like diluted raspberry margarita mix.
Although I'm certain my father recognized me a couple of times during that last week, the most responsive I saw him was when he was awake enough to realize they were about to clear his throat. He'd shake his head and groan in negation -- a different sound than the growling noise he made while breathing a lot of the rest of the time. My father was still being fed through a stomach tube installed during his throat cancer treatments, and basically couldn't swallow at all. At home, he'd been rinsing his mouth to keep it moist, but in the hospital he'd rarely get any relief -- we spent more time vacuuming out what moisture we could find.
There were a couple of times that he tried to talk to me, but I was sure I knew what he wanted only a few times: once to raise the head of the bed, and several more when he wanted his oxygen mask adjusted. I'd rub lotion on the places where the mask chafed him, then on the skin of his arms, which seemed to quiet him.
Monday, Rachal and I stayed at the hospital all night, which let an old friend of my parents go get some sleep. We kept someone with him around the clock, and I mostly did the midnight-8am shift that week. The next couple of nights, my father was less agitated -- he was getting over bad reactions to the opiate they'd tried to give him earlier, and once they switched to a different painkiller, plus some Atavan, he seemed able to actually sleep sometimes. Rachal went down to the emergency room of the same hospital for migraines a couple of nights, so I spent a bit of time running back and forth, but would let the night nurses know when I'd be out, and they'd keep an eye on Dad each time.
My oldest sister and I agreed to switch shifts on Thursday night. Kristy was concerned that I wasn't getting to see much of our mother at all, and wanted to give our schedules a chance to overlap before I went back to Texas. By that point in the week, my father had shown some improvement in fighting the staph infection, and Mom was talking about getting him into a nursing facility.
I wasn't at all sure Dad's improvement was good news. Even though his blood pressure had come up from something like 80/40, the doctors and nurses were politely but uniformly certain that the prognosis was horrible, and I agreed. I was afraid that he might, against all odds, beat the staph infection, only to have the lung cancer kill him a few weeks or months down the road. In the meanwhile, I was sure he wouldn't get better, wouldn't get comfortable ...and wouldn't get lucid.
Thursday evening, I was at the hospital for a few hours so that my mother and our family friend could attend one of the college basketball games. (My parents were close to one of the players -- he was eventually one of my father's honorary pallbearers). For the couple of hours Rachal and I were there, until my sister came on at midnight, we listened to my father's breathing. It sounded like someone blowing bubbles into a glass of chocolate milk, and the respiratory technician told us that it had moved into his lungs; it was unreachable for a simple throat vacuum procedure. Earlier that day, Dad had been as alert as he'd been all week, but now he was resting/sleeping/unconscious from the effort, and couldn't be roused enough to get a good cough going to clear any of it up.
By the time we left Kristy there that night, we'd all told Dad that it was okay for him to let go. Next morning, the phone woke me up before 5 am. I let Mom answer it, but started getting dressed. Dad had died quickly -- relatively quickly, anyway. From the time he started breathing irregularly till he stopped completely was less than fifteen minutes. Kristy told anyone who asked over the next few days that he didn't suffer, and I follow her reasoning, but I can't quite gloss over the preceding few months. Best I can say about it is that I'm aware it could have been a lot worse.
When we all ended up over at the hospital, we couldn't stay too long. Mom had agreed to donate Dad's corneas and heart valves, and the donor folks only had a window of a few hours. So we stayed, and a few of the folks from my parents' church and school showed up (some of whom had visited every morning that week), and we said goodbye. Then we packed up the stuff from his room and went home.
My father wished to be cremated, and when my mother dies his ashes will be buried with her in Ohio. I'm still fairly boggled that the funeral home asked us to bring a set of clothes for him to be cremated in. I understand the concept of maintaining the dignity of the deceased (indeed, my Uncle Tom wanted so much to remember his brother as he was alive that Tom wouldn't enter Dad's hospital room after he died, nor attend his memorial service). But if any memories present a hurdle to me remembering my father as he had lived, they're gonna be the memories of him circling the drain in the hospital, not looking relatively spiffy in the funeral home for the five seconds it took me to identify him for his cremation. He was quite presentable in his wooden box, but the purpose would have been served as well if he'd been covered in a sheet -- I'd just spent part of my week helping the nurses change his bedsheets, after all. I guess dressing him up in the funeral home comforts some folks, but it didn't do much for me.
At least my mom got to rid herself of one of Dad's outfits that she was less than enamored of. She sent me home to Texas with as much of his other clothing as I could fit on the plane :>
Okay, that's it for now -- somewhat more cheery details should be posted soon.
I'll post this in three parts, so you may pick and choose what you wanna read. If you have issues with cancer, death, or hospitals, skip this post. I'm serious.
I intend to write two more sections: one with other details about my father's final week, then a separate Plaque post. This first one is the only one that should have any triggering/yucky details, so consider yourselves warned.
Friday, January 6th, I warned my bosses I might need to leave town quickly, depending on my father's condition from day to day. That weekend, after discussions with my mother, I planned to go out there in a month or so, to ease some of her caregiving burden, as I'd done during my father's throat cancer treatment last year. It made no sense to me for all of us kids to gallop out to Nampa, leaving my mother with little support a few weeks hence when we had to return to our jobs.
On the evening of Sunday the eighth, my sister called and told me I'd better get to Idaho if I wanted to see Dad alive at all. So Rachal and I arrived Monday night (subsidized by our neighbor Pat -- our local patroness).
We went to the hospital straight from the airport, and my father was still alive, but looked like hell. I could see his chest rising and falling under the sheet, but in the topography of the bed, his torso was a valley between the twin hills of his arms. His arms were not only raised on pillows, they were heavily swollen with fluid. (Oddly enough, his legs were downright spindly -- the fronts of his shinbones stood out as long rectangles, flush against the skin).
He kept his eyes closed nearly all of the next few days, only opening them briefly sometimes when he was spoken to. That first night was the worst -- his breathing was labored, he was constantly knitting his brow and grimacing, as if a wasp had landed on his nose and he couldn't move his arms to wave it off. He rarely did move his arms or legs, and when the nurses came to take his blood pressure, the cuff left a deep impression in his flesh. (I spent the week constantly smoothing out the wrinkles in his bedsheets -- they left creases in his skin if his arm lay on them for more than a few minutes. From the elbows down, the skin was so tight it was shiny).
Every few hours, someone would come in to vacuum the back of my father's throat. A muddy-looking mucus would build up there, and they wanted to get it before it moved down to his lungs. They always had to go through his mouth -- they'd tried putting the tube through one nostril, but when they removed it the day before I arrived, his nose bled copiously and he choked. Later in the week, his blood numbers got lower, which made him more likely to bruise and bleed ...all of which basically meant that if the fluid got to his lungs, there was nothing they'd be able to do. For my parents' purposes, a tracheal tube would fall under the heading of "heroic measures", and was therefore not an option. The vacuum tube the nurses would use was connected to a clear reservoir about the size and shape of a child's sand bucket. They replaced it on Thursday -- by then it was filled with what looked like diluted raspberry margarita mix.
Although I'm certain my father recognized me a couple of times during that last week, the most responsive I saw him was when he was awake enough to realize they were about to clear his throat. He'd shake his head and groan in negation -- a different sound than the growling noise he made while breathing a lot of the rest of the time. My father was still being fed through a stomach tube installed during his throat cancer treatments, and basically couldn't swallow at all. At home, he'd been rinsing his mouth to keep it moist, but in the hospital he'd rarely get any relief -- we spent more time vacuuming out what moisture we could find.
There were a couple of times that he tried to talk to me, but I was sure I knew what he wanted only a few times: once to raise the head of the bed, and several more when he wanted his oxygen mask adjusted. I'd rub lotion on the places where the mask chafed him, then on the skin of his arms, which seemed to quiet him.
Monday, Rachal and I stayed at the hospital all night, which let an old friend of my parents go get some sleep. We kept someone with him around the clock, and I mostly did the midnight-8am shift that week. The next couple of nights, my father was less agitated -- he was getting over bad reactions to the opiate they'd tried to give him earlier, and once they switched to a different painkiller, plus some Atavan, he seemed able to actually sleep sometimes. Rachal went down to the emergency room of the same hospital for migraines a couple of nights, so I spent a bit of time running back and forth, but would let the night nurses know when I'd be out, and they'd keep an eye on Dad each time.
My oldest sister and I agreed to switch shifts on Thursday night. Kristy was concerned that I wasn't getting to see much of our mother at all, and wanted to give our schedules a chance to overlap before I went back to Texas. By that point in the week, my father had shown some improvement in fighting the staph infection, and Mom was talking about getting him into a nursing facility.
I wasn't at all sure Dad's improvement was good news. Even though his blood pressure had come up from something like 80/40, the doctors and nurses were politely but uniformly certain that the prognosis was horrible, and I agreed. I was afraid that he might, against all odds, beat the staph infection, only to have the lung cancer kill him a few weeks or months down the road. In the meanwhile, I was sure he wouldn't get better, wouldn't get comfortable ...and wouldn't get lucid.
Thursday evening, I was at the hospital for a few hours so that my mother and our family friend could attend one of the college basketball games. (My parents were close to one of the players -- he was eventually one of my father's honorary pallbearers). For the couple of hours Rachal and I were there, until my sister came on at midnight, we listened to my father's breathing. It sounded like someone blowing bubbles into a glass of chocolate milk, and the respiratory technician told us that it had moved into his lungs; it was unreachable for a simple throat vacuum procedure. Earlier that day, Dad had been as alert as he'd been all week, but now he was resting/sleeping/unconscious from the effort, and couldn't be roused enough to get a good cough going to clear any of it up.
By the time we left Kristy there that night, we'd all told Dad that it was okay for him to let go. Next morning, the phone woke me up before 5 am. I let Mom answer it, but started getting dressed. Dad had died quickly -- relatively quickly, anyway. From the time he started breathing irregularly till he stopped completely was less than fifteen minutes. Kristy told anyone who asked over the next few days that he didn't suffer, and I follow her reasoning, but I can't quite gloss over the preceding few months. Best I can say about it is that I'm aware it could have been a lot worse.
When we all ended up over at the hospital, we couldn't stay too long. Mom had agreed to donate Dad's corneas and heart valves, and the donor folks only had a window of a few hours. So we stayed, and a few of the folks from my parents' church and school showed up (some of whom had visited every morning that week), and we said goodbye. Then we packed up the stuff from his room and went home.
My father wished to be cremated, and when my mother dies his ashes will be buried with her in Ohio. I'm still fairly boggled that the funeral home asked us to bring a set of clothes for him to be cremated in. I understand the concept of maintaining the dignity of the deceased (indeed, my Uncle Tom wanted so much to remember his brother as he was alive that Tom wouldn't enter Dad's hospital room after he died, nor attend his memorial service). But if any memories present a hurdle to me remembering my father as he had lived, they're gonna be the memories of him circling the drain in the hospital, not looking relatively spiffy in the funeral home for the five seconds it took me to identify him for his cremation. He was quite presentable in his wooden box, but the purpose would have been served as well if he'd been covered in a sheet -- I'd just spent part of my week helping the nurses change his bedsheets, after all. I guess dressing him up in the funeral home comforts some folks, but it didn't do much for me.
At least my mom got to rid herself of one of Dad's outfits that she was less than enamored of. She sent me home to Texas with as much of his other clothing as I could fit on the plane :>
Okay, that's it for now -- somewhat more cheery details should be posted soon.
