Showing posts with label dying. Show all posts
Showing posts with label dying. Show all posts

Sunday, January 26, 2014

More From the Return to Pittsburgh




I am typing this as I sit in the laundry at Nature Coast Landing, the day after my return here. I'm not sure how much I am prepared to share of my time in Pittsburgh. We'll see where this goes…


As I shared in my last post, Daddy "gave permission" for me to come back. That should've been enough to let me know the end was approaching. When he and I talked in mid-November, I told him he had to be clear with me about when I should return. We talked about when my Mom died and how I wanted to be present with him when the end came. I cried. He comforted me. So, I should have been cognizant that when he told me I could come home, that he was telling me so much more. Unfortunately, even though my head got the message, my heart refused to hear it.


We all knew that he was dying, but the reality of it came in stages.


When I arrived home, I was struck by how gaunt Daddy was and how sunken his eyes appeared. His appetite was nonexistent. And though he continued to deny pain, he gave every indication that pain was his constant companion. But, I only recognized this because of my nurse's training, and still needed conformation by the Hospice Nurse.


Sunday night, I sat up at Daddy's bedside and we talked. He told me, "It's up to you now, kid." "What's up to me, Daddy?"  "Holding the family together."  "OK, Daddy. I'll do my best."  We talked about God and Jesus. About the unfairness of cancer.  About how he would once again be with people he loved whom he hasn't seen in this life for many years: Mummy, his Mom and Dad, and brothers. We talked and I prayed. I asked for God, in His mercy, to welcome Daddy into His arms and end his suffering. This is something I ended up praying several more times that week.


Monday the Hospice Nurse, Sarah, came. She discussed with Vinny and Jimmy and me, the fact that she felt Daddy was under medicated. This was confirmation of my gut feeling. Up until this time, Daddy had denied pain and so, no one pushed the issue, including the Hospice staff. That afternoon we began medicating for both his pain and breathing, every four hours.


Monday night was a very bad one for Daddy. We were having difficulty getting his pain under control. His breathing was very wet. He was unable to breath without the head of the bed elevated. Eventually, after medicating him every four hours, without seeming to provide any relief, at six AM, I looked in his medication box and saw that he had lorazepam to use to treat anxiety.  I medicated him with a dose.


His reaction was not immediate, but eventually, around a half hour after dosing him, he relaxed and fell asleep. It was the first time he had slept for longer than an hour in weeks. He managed almost six hours, altogether.


When Vinny came down, and I explained what I had done, he was unhappy, because apparently, the instructions he had received from Hospice said to give nothing without their OK, first. So, I called after the fact. Another of the Hospice Nurses, Lauren, said that it was fine and if I had called that's what they would've suggested. Whew!


While Daddy was sleep, Sarah called. She and I discussed the fact that I had medicated Daddy and that, at that point, he had been asleep for about two hours. Sarah said, "You do realize that he may never be fully awake again." 
That was a gut punch! No! I didn't realize it!


As soon as I got off the phone with her, I became a banshee, shrieking at the impending loss of my only Daddy, and the guilt of feeling  that I had pushed him toward oblivion. I called Raymond. I was sobbing so hard, that I woke my brother Dave, who was asleep on the second floor. Jimmy was certain that Daddy had passed at that moment. There are not words to adequately explain the pain of my grief in that moment.


Later, the local Catholic priest came and gave Daddy The Sacrament of the Anointing of the Sick, as Daddy had requested. Shortly after, Jonathan, the Hospice Chaplain came. He spent time talking with Vinny, Jimmy, and me. He shared some of the things Daddy had told him during his visits. He gave us advice that included the fact that generally, hearing is the last of the senses to go, so we should continue to speak to Daddy. Jonathan also suggested that if there were any unresolved issues for which we felt we need to ask for forgiveness, or to forgive, we should talk about them. He also suggested we continue to tell Daddy how much we love him, and assure him that we would be OK. Jonathan was a comfort. 


I left a little bit later to pick up my sister Janet, since she was off that day. When we got back to Vinny's, our brother Michael was there, as well as, our brother Bob and his wife Marcia. So, on that Tuesday afternoon and evening, Daddy was surrounded by seven of his eight children. Each spent time with him one on one.


That night was a bad one. Daddy was extremely painful, in spite of the various medications. Vinny, Jimmy and I tried everything we could think of to ease his breathing and make him more comfortable. We adjusted his position in bed, and even tried moving him to a sitting position on the couch, which he seemed to want. Nothing helped. As we were moving him back into bed, he cried out in pain. I began to tear up, and said, "Daddy, I'm sorry. We don't mean to hurt you." He looked at me with compassion and said clearly, "I know". That was the last time he spoke to me.


Later during the night, we called the Hospice Nurse, who suggested increasing his morphine dose, which I did. He seemed to rest more comfortably then.


On Wednesday, Michael was off work again, so I went and picked him up. He spent most of the day and evening at Vinny's and with Daddy, along with Jimmy, Dave, Vinny and me.


Daddy's breathing had continued to sound wet, in spite of multiple medications that were to help dry up some of his lung secretions. When I left to take Mikey home, I told Daddy I was leaving, but that I would be back in a little while. He was unresponsive, but still breathing loudly with wet rattles.


When I got back from taking Mikey home, Vinny was sitting with Daddy, and I noted that Daddy's breathing was quieter and easier. Vinny said it had been like that for about thirty minutes. I was glad that he was finally able to breath easier. His head felt cool, so I put his wooly hat on him. His hands were warm for the first time in many days.


At midnight, I medicated him. Vinny was sitting on the sofa. I laid down on the love seat. Daddy seemed to be resting much easier. I fell asleep. At three AM, I awoke. I went to the kitchen to prepare Daddy's four AM meds, but went back into the living room, to check on him, at three fifteen. He didn't seem to be breathing. I got my stethoscope and heard no breath sounds, but convinced myself that there was a faint heartbeat. However, he seemed stiff around his neck. I began to panic. Vinny checked and thought Daddy was gone. I called Hospice and waited for the nurse to call back. All the while feeling guilty that I had been asleep. 


The nurse arrived about forty-five minutes after she returned our call. She confirmed that Daddy was gone. She then called the coroner's office and waited for them to call back. Then she called the funeral director and waited for them to call back. Then we all waited for the funeral home to come. During the wait, the nurse disposed of unused medications, filled out paperwork and talked with us. There was a sense of unreality to that time.


Until Frank Perman and his staff arrived, that is. Then suddenly, everything became hyper-real. We left the room while they prepared Daddy's body for transport. Mr Perman talked with us about Daddy's wishes, briefly, and gave us a time to come to his office later on Thursday morning. 



I don't remember anything that we said or did after that, until much later that morning, January 9, 2014.  


Saturday, October 5, 2013

LIFE GOES ON


2013 October 5


Life Goes On


First, the update on my 88 year old Daddy. On September 30, my brother, Vinny, and I accompanied Daddy to his oncology appointment.  Daddy has been experiencing a cough which often produces mucus and blood. This is relatively new. He is apparently losing weight again. He has intermittent pain, although Dr. G, the oncologist, assures us that if this were cancer pain, it would be "persistent and progressive", rather than intermittent.  Daddy is also very frail, as he likes to say, "well below his fighting weight", and his balance and gait are unsteady. Add to that the fact that he is a stubborn old man, who refuses to use any steadying device when he's at home and only a cane when he goes out. Plus, if he begins to wobble, and you touch him to offer a steadying hand, he becomes angry. He is constantly at risk for falling, but refuses to acknowledge it. 


Since Dr. G is an oncologist, he tried very hard to explain to Daddy which symptoms were cancer related and which were related to aging and frailty. I'm not sure how much Daddy actually heard. The next step, with regard to the lung cancer, was a CAT scan, to check the progression of the tumors, followed by two doctor's appointments, one with Dr. G and one with a radiologist on the same day. Those will happen on Tuesday of this coming week. Depending on what the scan showed, Daddy may have 10 days of radiation therapy, in an attempt to slow the tumor's growth and control the bleeding. 



It is very difficult for me to watch my Father become a shadow of himself, and an angry shadow, at that. I can only imagine how hard it is for Vinny, with whom my Dad lives.