Saturday, October 27, 2007

Update on my Dad

I didn't know that when he was originally checked into the hospital on Tuesday that there was already a degree of renal failure occurring. But at that time, the immediate problem was to discover the cause of the pain and fix it, which was done (perforated duodenal ulcer repair). While they were in there, they observed the liver and did a biopsy of the metastacized cancer cells.

First order of business was for my Dad to recover from the surgery.

On Wednesday, I spent the bulk of my day at the hospital with my brother Mike (the younger of my 2 brothers). We did our best to enjoy a visit with Dad while also trying to shore up his financial accounts. My Dad did not keep any organized records--there are piles of paper throughout his house--some are his mathematics musings--and others are past financial statements and various scraps of paper (sometimes written on paper plates!) with names and numbers on them. I found it amazing that my Dad was able to rattle off 6 account numbers and passwords from memory!

Dad was in and out of awareness/awakeness on Wednesday, and he wasn't making use of his pain control button and getting crabby, at which point his wonderful nurse instructed him to give himself more pain meds, and that got him resting comfortably and sleeping.

Thursday AM the nephrologist (kidney specialist) indicated to me that he was in worse renal failure than on Tuesday, and she began asking me questions (assuming I might need to make the decision) about dialysis. I don't consider that "heroic treatment," so I said that we should pursue that treatment.

I headed back to the hospital on the heels of my brother Mike, as the way things had been presented in the early morning was that things might be really bad. This time, we got to spend some quality time with Dad, but we also began trying to get an overall assessment of his condition as to what could/should be done. I spent a bit of time with a case worker to discuss Power of Attorney, and specifically, a DNR (Do Not Resuscitate) order. Dad's personal physician was scheduled to make a visit that afternoon.

Mike and I were visiting outside Dad's room and then went to return to him, when we noticed Dad's personal physician standing in the room having a discussion with Dad. Turns out he was asking Dad questions about his care, including whether he would want to be ventilated or resuscitated. Mike and I felt that Dad was being led on and taken advantage of in a weakened physical and mental state, and this got me rather upset.

In the meantime, I'm having phone discussions with my out of town sisters, Lisa and Carla, and well, you just wouldn't believe some of the things they said to me. I will chalk that up to the stress of the situation. I did start to feel like they are expecting me to make all current and future arrangements as well as be at Dad's bedside full time from here on out, which added to my stress.

I really felt like I was losing it, and decided to avail myself of the Chaplain's offer to talk. Turns out he generates Power of Attorney documents for patients who do not have them upon checking into the hospital, and so when he asked me what was bothering me most, I said the incident with Dad's personal physician leading him on and then insinuating that those verbal answers overrode and replaced the Power of Attorney declaration! The Chaplain assured me that, in fact, that is not the case. I don't want to have to get into a battle with medical personnel over what my Dad's wishes are. Effectively, at the point at which Dad becomes unresponsive, medical Power of Attorney goes into effect, and at that point, I hope that I can act according to how I think he would want me to. We are not at that point yet, but it could happen in hours, days or weeks. Who knows!

One of my sisters, the youngest in the family, Lisa (who lives in Indianapolis), arrived at the hospital around 5PM, and she was not in good mental condition (as none of us were!). She had taken my Mom's death extremely hard, being the baby of the family and all (they were very close indeed), and I don't believe that she had even seen my Dad since Mom's funeral. This is something I had discussed the week before all this happened, and I am sure she is feeling bad about the reason for her first visit post-Mom being Dad being in critical condition!

It became clear to me by this time that I was really stressing out after 3 days in hospital and trying to digest everything and be the focal point of communication and the Power of Attorney and all that. I rather ceremoniously stormed out of there after some harsh words were thrown my way. I am sorry for my behavior at that time, and I am learning in this process that we first need to forgive ourselves for our own failings, then forgive others around us. We are all doing the best we can!

I decided I needed a day away from the hospital, and knowing that Lisa would be there on Friday was of much comfort to me, although I still didn't sleep well. It felt good to just WORK, but I have to say I have never in my life (even during Mom's illness and passing) felt so completely and utterly exhausted. I know that I need to continue caring for myself if I am to get through this inevitable life process.

They did the first hemodialysis treatment on Dad yesterday. The way this goes, they must build up to a 3-5 hour treatment, because it is stressful on the body.

I suppose we won't know how much improvement there might be in Dad's renal function for a few days now.

This evening, my 2 brothers and 2 sisters are coming to my house to discuss the situation. I have already prepared a fairly organized list of tasks (there are SO many!) that need to be done relating to Dad's current and future care and quality of life issues. I know this will be a tough discussion, but it needs to happen, as all these things need to go on even as we all are doing our best to visit with him and care for him ourselves. When I look at things this way, it doesn't seem AS overwhelming, but it is very apparent to me that I need a lot of help and cannot do all these things myself.

Mike and I plan on being at the hospital as much as possible tomorrow and will see how that goes. There is additional information we need from Dad while he is still lucid. This is not morbid to me--it is just how it is. The very most important thing is that I want to understand his wishes with regards to his medical care and disposition of his body upon death. He has said things to me over the years that I thought to be true; perhaps he has changed--I am not sure. But I want him to feel like it is good for him to talk about these things with me and feel comforted that I will act the way he would want me to.

I am 100% exhausted, mentally and physically. Tonight will either make that better or worse. For now, I will hope for the better.

Tuesday, October 23, 2007

Here We Go Again

I just got home from an exhausting day in a hospital. This time it's my Dad. Admitted early this morning with excruciating pain. I guess he had lied over the past few days when telling me and other siblings that he was feeling better, from what he thought was a bladder infection.

"Free air" was detected in his abdomen, and a CT scan showed lesions on his liver, so surgery was called for right away. After he came to, the surgeon came to talk to me, my brother Tom, and Tom's wife Robin (who is a nurse), so thankfully I had some company. They found and repaired a duodenal ulcer, which was the primary cause of all the pain Dad was in, but then they discovered metastatic cancer on the liver. A biopsy has been done to determine the origin of the cancer, but the net net is that things are not good.

I have power of attorney (medical and financial) as soon as I have the physician declare the need, and I want to be prepared for whatever may come to pass from here on out--whether it's quickly or slow and painfully. Tom and I went to Dad's house to see if we could find the financial records and passwords. I have a pile of paper to go through. I don't think Dad's going back home. He is going to need daily care from here on out regardless, upon learning he hasn't been taking too good care of himself, and I'm sure plenty of this is due to the stress of losing his wife just over a year ago. Oh yeah--yesterday was my birthday. Happy birthday to me! And Friday is Dad's 81st birthday. Happy birthday to him!

Even before we knew surgery was imminent and then a preliminary diagnosis, today I decided that this weekend, which was to be a casual get together with a "birthday theme," was going to turn into a family meeting of the siblings. I have already declared to my 2 brothers and 2 sisters that I cannot handle this all by myself. Don't get me wrong--I will handle as much as I can possibly handle, but this time I'm asking for--no--DEMANDING--help. Making the calls today was very painful. I have learned how to know how broken up my siblings are over the phone by the different speech mannerisms they portray. I lose it myself, but I want them to feel like they can unload on me. This is not fun. It wasn't fun a year and a half ago with my Mom, and it isn't fun now.

Driving home tonight, I had the thought that my role in all of this crap is to somehow be the pillar of strength. As much as I "feel" this right now, I think I shoulder a lot of it for my brothers and sisters, and I want them to be able to feel like I'm at least sort of holding things together.

I find it interesting that I knew there had to be more reason for me to take a break/kick things down a few notches in my triathlon endeavors than me just needing a physical break. Perhaps the universe was asking me to get some rest to steel myself for this current challenge. I have just been starting to feel strong again and able to run without feeling like I've got no power. Go figure!

So in writing this, I am once again asking all you out there to be strong for ME.

Peace. Love the ones you love. We aren't here very long at all!