*~*All Organic - All The Time*~*

Thursday, February 12, 2009

Passed On

They took the cpap mask off him this morning, and he was gone within the hour.

I never did make it to the hospital. I was going to go today, since the littles were back in school and while I'm still sick (actually, getting worse grr) oh well, I was going anyway after hubbie left for work this morning. But my mom called to tell me he'd passed. And I had to call the older kids, who didn't make it out yesterday, but were going to go today.

Really am glad it didn't linger on, for my mother's sake. She made a hard, hard decision. I'm really at peace with it, although my only regret, for his sake, was that he didn't get to see his last grandchild born. :(

Me and my dad in 1978 (yes, I know - gotta love the plaid 70's pants and glasses! lol)

Wednesday, February 11, 2009

DNR Orders

My dad fell on Christmas morning on the ice and broke his foot. He's in his early 60's, diabetic, has PAD (peripheral artery disease), has had high blood pressure since he was in his 20's, is 80 lbs overweight, and has undergone both a corotid artery surgery and a quadruple bypass in the past ten years...

So, they did a surgery on his foot, put a plate in. And a day after he was home, he had what they thought was a stroke or a blood clot. This was three days ago. Things looked okay at first - he couldn't talk and had a hard time swallowing (they gave him one of those "suckie" things like dentists use for the saliva...) but he was lucid and alert, and could respond, nod or shake his head, when asked questions.

Now... however...

The doctor finally defined this incident as a "large stroke." (My mom said "massive" - I think it makes her feel better to say "massive" - but my sister and niece heard "large.") They want to put him on a breathing machine and a feeding tube now. But when he was lucid (two days ago) he said no machines, no tubes. (He's always said no machines, no tubes...)

But he's not lucid anymore - can't nod or blink anymore. He's deteriorating quickly. His lungs are full of fluid because he can't swallow. The usual dose of the meds to clear them - 20 units - they doubled to 40. It didn't work. They doubled that to 80 units. It didn't work. Which led my niece (an ICU nurse) to believe his kidneys weren't functioning even though the blood levels showed they were. Now they're talking about dialysis. They want to put in a tube to feed him (directly into the stomach, instead of through the nose, which they can only do for a week.) My sister, her husband and my niece all sat down with Mom and the ICU doc (I'm still sick, and so are the kids, so I can't go) and talked about all this, after which my mom signed a DNR and said no tubes.

My nephew is mad - he says we should put in all the tubes and let him heal and get better. But the docs are saying, because of his other conditions (diabetes, triglycerides, high blood pressure, previous surgeries, circulation issues) the meds they'd normally prescribe wouldn't work, and they have to go other routes. They say they don't know how much functionality he will be able to regain even if we do put him on the machines.

But the thing I keep coming back to is the not talking. He can't communicate. The only thing he lives for is communication, frankly, and I think he knew, when he couldn't talk, couldn't swallow, that his "life" was basically over. Honestly, I think he knew it last week when we talked before his foot surgery and he told me he wanted to hold out to see this baby. He mentioned that his heart doc had told him two months ago, she wanted to do some sort of surgery, going in through the groin, because things weren't "circulating properly." He refused, he told me, because he was afraid he'd die during the surgery, and he wanted to see the baby first. I think he knew he was going to go, one way or another, before then, and didn't want it to happen. His one regret maybe.

But I think he's clear, now that this has happened, or at least he was, when he could make that call, that he doesn't want to stick around anymore. That it's time.

He's right handed. His whole right side is shot. He can't write well with his right hand anyway (he's dyslexic and never learned to read or write past a 4th-5th grade level), let alone trying to re-learn with his left. He can't read to begin with, he's nearly functionally illiterate, even with his one good eye. He can't swallow, so he can't eat. (The man lives to eat!) He can't talk - and I mean, seriously, who could ever shut him up before? That's all he does is talk and argue and debate! And the only way he could use his beloved computer before the stroke was doing it voice-activated - because of his dyslexia and learning disablities. Now that he can't talk, he couldn't use it at all.

It seems to me that anything that might motivate him to keep going is pretty much gone, and he knows it. And he's just going to be really pissed off a few months down the road if we DO put him on machines against his wishes and he DOES recover some capacity and awareness. Like we want my mom having to take care of an incapacitated, pissed-off dad who can't communicate? What good does that do anyone? Ugh.

I told my mom I was fine with honoring his wishes. And that no one could make another call (i.e. putting him on machines) except her, but if she did, I would understand that, too. She said she didn't want to be alone - and I said it wasn't about being alone, because my sister and her husband would take her in in a heartbeat - it was about not having a partner, really about not having DAD. That was apparently the perfectly right or wrong thing to say, I guess, depending on your perspective, because then she had to go cry... which she said she hadn't really done yet. So I let her go do that.

I imagine his last days will be this week or next, if she doesn't make another decision than the one she's already made.