I sipped coffee and stared at the flames. My life was being altered and I knew it. What about my kids? How would this affect them? Some of them had experience after experience for a decade and a half with their Grandpa. Some of them, had barely started to trust and love and need him. Another has no frame of reference or relationship. He loves her nonetheless and all of them equally... My heart aches for all six.
I thought about my siblings. A few of them had asked that I make sure to let them know if I thought it was time to say the final "goodbye". I was confused and took the responsibility very seriously. Yesterday afternoon I was sure it was his final day. By evening, I was doubting again. He had a history of pendulum swings and I knew better days ahead were part of the pattern of his disease...
Mom woke up and was in the car before I could even finish my cup of coffee. She was ready to see her man! We checked out and drove the ten minutes to Flagstaff Medical Center. March 30th was starting off well for Dad. He had better color and had rested fairly well, although his IV had been placed inside his elbow and every time he curled up to get comfortable he set off alarms. First order of the day nurse would be to change the location of his IV.
NPO was the status posted outside his room again. No fluids, including water, and no food. Unfortunately for Dad, he actually had an appetite this morning. Again the green sponge-on-a-stick would be his only relief. He was fairly accepting of his new form of hydration by the time they took him for his second pneumothorax.
This time his transport person was a man named Kionoa. He was a large, muscular young man from Hawaii. Dad connected to his smile and gentle manner immediately. They spent the ride down to Radiology discussing the Big Island and Sears (the store, which is not us) and families... Dad's bed had a locking mechanism failure, which made him fun and challenging to transport. Kio made it fun, but was so incredibly gentle on the bumpy floor transitions and in and out of elevators. Kio would become Dad's favorite transporter and all of us would chat with him when we saw him around the hospital. We found that we truly were developing relationships with these staff members, which helped make the days bearable.
Yolanda assisted the radiologist on call again. This time two liters of fluid were drained off Dad's left lung. The procedure and tubing itself was just as painless to install and complete, but Dad was more tired and less able to hold himself in the correct position. He was visibly weaker after procedure number two. It sure sucks to see him so weak and hurting so much. Yolanda's ultrasound revealed that the right side had maintained fluid levels near what they had been, so the doctor would ultimately put off draining it for at least another day.
Back in his room, Dad had lunch and a nap. I grabbed a few minutes in the FMC cafeteria. I had watched the guy at the grill now for two days. His name was Joe and he knew everyone. Not only did he know everyone, he knew everyone's order. By the time I got to the front of the line to place my order, I had decided that Joe is who makes this hospital really run. Every doctor, nurse and tech is quickly served and with a friendly greeting. It had become obvious that the hospital from the leadership, down, was intent on being a morale boost. It showed in every aspect of care for my dad. On my way back up to Dad's wing, I ran into Dr. Lambret. He caught my eye and stopped his rushing. "Are you okay today," he asked. "I saw your Dad earlier today and I am watching for his results from the lab." I was surprised that he recognized me. He went on to explain that he was hopeful that the pneumonia was the result of the fluid buildup, not cancer cells, but he was waiting on confirmation. The "holding steady" of the right side was hopeful to him. I thanked him for his attentiveness and went in to Dad.
All of Wednesday was less traumatic than Tuesday, but not nearly as "peppy" as Monday had been. I recognized this as the pendulum swing. The only thing left to do was wait. We needed lab-work and definitive answers on cancer cell findings. The pneumonia protocol required Dad be hospitalized through at least Friday. We wouldn't have lab results from fluid draw number one until Monday. The doctor ordered and echocardiogram to check heart function. That much fluid could be the result of heart failure and preliminary blood work had suggested it. Dad passed, his heart was fine. The hospital massage therapist visited Dad for a 20 minute massage of his shoulders and feet. She was wishing she had more time. He was in such pain. While he had no verbal complaints, his body wasn't willing to lie to her. She promised to try to return before the weekend.
As the afternoon progressed, Dad's naps were bookended with visits from a couple of former colleagues. There was a Forest Service friend as well as a Fish and Wildlife friend. Both had heard via email that Dad was in Flagstaff. It was nice to hear stories of my dad that they had to tell, but I couldn't help noticing that they felt like real goodbyes. I couldn't shake the feeling that this might be it. Dad's brother and a sister had called. Did I think they should try to come now? I had started telling my siblings the same thing I told them: "If you're feeling like it, you should. I don't think you'll regret being here, but you might regret not being here."
I was still so unsure. The weight of communication was impressive. What if I mess up. What if a brother loses his job as a result of my advice? What if another loses an entire semester of college? What about the cost of plane tickets; would it be six months too soon to cry "wolf"? I just couldn't read the situation and the hope from the doctor earlier that day had made me question my own fears and emotions.
That afternoon one of Mom's neighbors had visited. It was decided that she would give Mom a ride the 70-something miles back to their home that evening, to take care of obligations on Thursday as well as to pack a few overnight things. Mom wanted Dad's actual shaving kit and we had purchased groceries that Mother Nature had kept cool with snow in the trunk for the last two day. Still, they needed tending. Mom's car was left for me and Mom headed to Blue Ridge.
After Mom left, Dad and I spent about an hour or so discussing some of his end-of-life options. He told me that I didn't need to worry, he had worked out an Advanced Directive with the doctor before we arrived that morning. He wanted to make sure to protect Mom and I from having to make that call. He didn't ever tell me what he had decided, specifically, and I didn't ask.
I did ask about awkward things such as: "Have you thought about where you want to take your last breath?" and "We briefly talked about where you want to be buried before, but Mom was unsure have you two made a decision?" He seemed weighted by the questions. We discussed what he would do if it was just him that he had to consider, and we talked about his feelings of responsibility to "lead his family well, even after his death". He didn't want Mom to make those decisions, but she was emotionally unable to weigh in, and they impacted her too. He felt a little stuck. He also recognized that those choices had impact on me and my siblings. He was extremely worried about finishing well, relationally. "I just don't know how to bring these things up with everyone Collene, and I'm not sure I have the energy to do it anymore..." He sounded defeated. Tears leaked out of the corners of his eyes. He obviously DEEPLY cared for each of us and he was feeling like a failure in this moment. I asked if he would be okay with me making a few calls and gathering some intel for him to make a decision. He asked, "Would you be willing? I think I need you to; it's just so hard to do."
I resolved to do whatever it took to make sure he died in peace, whether I had days or months, I'd do what needed to be done. That night, I found yet a third hotel in Flagstaff. This one, while not fancy or particularly comfortable, would end up being our "home away from the hospital" for the remainder of the time in Flagstaff and they did give us a reduced "hospital rate". I settled into bed, but I didn't sleep. I spent time into the wee hours of the morning calling siblings, relaying the message, and getting feedback. I'd be armed with intel next time I saw Dad and a plan would be set in motion before Mom returned from Blue Ridge.
Thursday would be a big day for Dad. His 87 year old mother would be flying in (for the second time in history) with his youngest sister. I slept, restlessly and for only about three hours, but it was enough to fuel the day. I had stuff to do...
Waiting on his second pneumothorax.
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