Saturday, April 2, 2017, 1409

I got “the call” about my Dad from my sister, Michelle.

She asked the doctor to speak directly to me and handed her the phone.  The doctor told me I needed to get out here as soon as I could.  Dad’s sodium levels were critical causing him to hallucinate and be delusional.  His lungs were really bad – the x-ray was almost completely white.  The doctor thought Dad may need to be put on a bi-pap breathing system just to help him until I could get to town.

Heather and I immediately looked for a flight, but there were no more flights available to get me to Texas on Saturday.  The best I could get was a 0708 flight Sunday morning through Dallas Fort Worth, set to arrive in Killeen at 1258. But Mother Nature didn’t cooperate, and I was stuck in Dallas for a couple extra hours.  It felt like an eternity.

I wrote a poem on the first leg of my plane ride to see Dad.  I have written a few poems in my life, all inspired by life events.  I was a wreck the whole flight.

My brother-in-law, Tom picked me up at the airport in Killeen.  After a quick hug and throwing my carry-on in his truck, we were on the road.  At first it was a fairly quiet ride. A little small talk and some comedy radio, but not as much talking as we normally do.  It picked up a bit after a while. The ride seemed to be taking forever.

When I finally got to the hospital on Sunday, Dad was already doing a little better.  I got to visit with him for a few hours and headed to Michelle’s house to get some rest – it was going to be a long journey.

Monday, April 4, 2017

Monday, he was even better, surprising the doctor and staff.  After I explained that he needed to eat and drink or he would never be able to get out of the hospital, he seemed a bit more determined.  He even ate some of his dinner – the first real food he had eaten in weeks.

Between bites of his dinner, Dad turned to me and said, “I don’t think I want to do any more cancer treatments, Michael.”  I wasn’t really surprised since all of the medical personnel has commented that the treatments are likely the cause of his nausea, lack of food tasting good, burning/indigestion, pain, etc.

We all thought Dad may be able to get past this hurdle and just continue to treat his other health conditions.  We just needed him to eat and drink, do his physical therapy, and hang in there.  Then he could get discharged and go back to the nursing home and live out the rest of his life with Patricia until the cancer took him.

Tuesday, April 4, 2017

And then Tuesday came and it was another good day.  Dad was able to move from his bed to the chair with help. He sat there for quite some time before asking to lay back down.  He also did his PT.  Although he tried to eat, he couldn’t seem to do it.  Overall a positive day, but his sodium levels were increasing again.

But then as the next meal came, Dad fully regressed to the “I just can’t eat anything” mode.  I explained that he was going to go right back to where he was with the delusional behavior and hallucinations if he didn’t eat and drink.  So then he asked me try the mixed berry Ensure; he was really getting sick of the apple flavor. I told him tasted good so he tried it and said it wasn’t too bad. Maybe this would be enough nutrients.

Wednesday, April 5, 2017

Wednesday brought more challenges. It seemed the lack of drinking enough  was allowing the sodium to get back out of control.  He sat in the chair next to the bed for a little while, but complained of being weak, short of breath, and tired.  And then, when the CNA and I were helping him from the bedside porta-potty, he became extremely weak and complained of chest pain and that he couldn’t get enough oxygen.   The doctor came in and assessed him.  He ordered sub-lingual nitro tablets for the chest pain, and an EKG.

Dad’s mouth was so dry that the nitro tablet didn’t dissolve at all.  They switched to a nitro patch and the pain subsided.  The EKG was run, and of course it was pretty much useless considering Dad’s pacemaker was working, pacing a perfect 70 bpm, but it was definitely an abnormal EKG.

Later in the day, Dad complained of more chest pain.  They got the doctor to come back in.  He examined Dad and simply explained to him that he really could not be sure if the pain was cardiac related, his aneurism, the cancer, or his pacemaker.  Dad seemed to understand.  The doctor said to all of us in the room that he really couldn’t do any more, he ‘couldn’t fix’ Dad.  The doctor asked Dad what he could do to make him more comfortable, and Dad simply said “morphine, I just want to sleep.”   The doctor ordered it and they put Dad back on high flow oxygen.

I stepped into the hall with the doctor.  I asked what he thought about everything.  He candidly said that he wouldn’t be surprised if Dad didn’t make it through the night.  He was really in bad shape.  His lungs were just not clearing up fast enough and his sodium level was continuing to climb.

I spent the night in Dad’s room. I couldn’t help but watch him most the night.  He seemed to be fairly comfortable, but never in a true sleep. Everything you hear about not being able to sleep in a hospital due to the noises and constant interruptions from the staff are all true.  It seemed like nothing is coordinated so first the vitals would be checked, then 10 minutes later the blood sugar needed to be measured.  No more than 20-30 minutes after that, the respiratory tech would be in.  And then the simple welfare checks from his nurse and CNA.  It was a long, but seemingly eventless night.

Thursday, April 6, 2017, 1045

The Doctor came in on his rounds. He was initially pleased and very surprised that Dad was looking better. Lungs sounded slightly better, but he kept him on high flow oxygen to rest up.  I told the doc that Dad hadn’t eaten anything for breakfast and complained of being weak and tired.  I asked if Dad could sleep a little more, and he said Dad could sleep as much as he wanted.

The doctor asked the typical questions – are you comfortable, do you have any pain? Dad responded that he was good, but tired and just wanted to sleep.  He said to try PT later in the day as tolerated/able.

After the doctor left, I took the opportunity to go to Michelle’s house to shower and change.  I met Shell for lunch after that and we talked about what needs to happen next.  We still needed to get Mom set back up on hospice, and approved for residency in the nursing home.  We needed to figure out how to assess what Dad wants to do.  Our plan had been to get him “well enough” to move  to the nursing home with Mom.  But we saw how much he was suffering and I could see in his eyes that the fight was nearly gone.  We decided it was time to speak directly to Dad about everything.

When Michelle and I got to Dad’s  room, we could see how uncomfortable he seemed to be.  He opened his eyes and looked at us as we walked up to him.  He was weak but alert.   After a couple of minutes, I started the conversation.  I asked him if he knew how sick he was and if he could remember the recent events that led him to that moment. He nodded slowly with his eyes closed.

I continued by saying that we had been trying to get him strong enough to leave the hospital and spend time with Patricia, but to no longer receive any cancer treatments just as he had decided. And then I told him that not eating or drinking had really taken a toll on his body and ability to heal.  I explained everything the doctors had said and that they are basically making some of his health issues worse by treating others; basically, he was in a continuous cycle, chasing each symptom as they all just slowly worsened.

My father turned to Michelle and said, “I don’t want this anymore.  Please kids. Please.  I want to meet my maker.”  Michelle told him we understand and just wanted him to know that, and that it is his decision on what he wants to do. We told him he needs to tell the doctor his wishes.

Thursday, April 6, 2017, 2037

I decided it was time to read Dad my poem so I asked if it would be okay and he nodded his head, eyed closed.

Dear Dad,

I’m not sure I ever told you just how much you mean to me

You taught me all of life’s lessons – do my best, work hard, and be all that I could be

You watched me grow and listened, never judged, and guided me

You had your dreams and vision of what my life could be

I didn’t always seem to listen, but I heard you loud and clear 

It was just that life was pulling me away and then back near

All along your wisdom was not lost, it actually worked on me

My life is like you dreamed of, and I hope that you could see

I became the kind of man you knew I someday could

Loving, giving, kind and caring – just as you said I should

I try to help those around me, just as you did so I could see,

Life is more about the people we touch than it is about just me

Now I see you suffering, in body and in mind

And all that I can think of is, how can life be so unkind?

But I know that God is watching and has his own grand plan

To set you free from all the pain, reach down and take your hand 

And if you’re time on earth with me is done, I need you just to know

We will all be okay, you can rest easy and let go

God will take you up to heaven with your mother and your dad, and both your brothers too

God knows how much I’ll miss you, but I know he needs you too

As I read, I was holding back tears and my voice shook a bit.  When I finished reading and grabbed Dad’s hand, he said, “Thank you.  I love you, Michael.  We had a good life, didn’t we?”  I agreed and he smiled a little.  I asked him if he would watch over and protect my girls and he softly said “Yes, of course” which made me smile.

Friday, April 7, 2017, 0730

Dad gestured for Michelle and I to come closer.  He held our hands and softly whispered something but we couldn’t hear him. He gathered a bit more strength and said, “I love you both so much…you were my dreams…we had a good life…I just want to go in peace.”  We told him we loved him too, and reassured him that we understand and will make sure he stays comfortable.

They started Dad on a continuous morphine drip for comfort and discontinued all of his normal daily medications that night.

Friday, April 7, 2017, 0845

The Boston Scientific field rep came in to disable the defibrillator function of Dad’s pacemaker.  Dad opened his eyes and smiled, reaching out his hand and held her hand.  At first she didn’t understand and then just kind of giggled and said, “oh, okay.”  She was explaining how she was leaving the pacemaker function alone and only turning off the part that would shock Dad.  He raised his right hand with his thumb up and smiled. We all chuckled a little and Michelle told her that Dad has been shocked a few times in the past and had a very vivid memory of it. The rep simply replied, “I’m sure he does.”  Michelle said it is a story he likes to tell.

Friday, April 7, 2017, 0935

They pushed an extra 2mg of morphine and removed the hi flow oxygen to put him on a normal nasal cannula.  They asked if he was comfortable and he nodded.

Many of the nurses came in to check on Dad throughout the weekend, even though he wasn’t their patient.  Even in his final days, his personality shined through. His humor and smile, the way he looked at people and showed he appreciated them, made a connection with each of them.

Saturday – Sunday, April 8-9, 2017

For the next two days, my sister and I stayed with my Dad. I took showers in his hospital room bathroom.  I was afraid to leave and Michelle knew it.  She would go out and get us drinks and something to eat. I stayed with Dad, often just staring at him.

Sunday morning, Michelle went home to shower, get me clean clothes, and bring Patricia back to see Dad.  While she was gone, Dad was showing some signs of possible discomfort so I called in the nurse and she gave him more medications.

When Michelle got back, the nurse was about to administer his next scheduled medications intended for the break through pain to ensure he was comfortable. I jumped in the shower. I hadn’t shaved in a couple of days, but something told me to skip it.

When I walked out into the room, Dad took a different kind of breath and then a long pause. Michelle thought he had passed. As I approached Dad and took his hand, he took one more breath. It was his last.

 

Sunday, April 9, 2017, 1458 Central

My father passed away Sunday, April 9, 2017 at 1458 Central time. He was comfortable and peaceful just as he asked for, and we promised.

 

I’m going to miss you, Dad!  Tell everyone I said hello, and I’ll see you soon.