Wednesday, June 20, 2007

I've discovered MDOD thanks to Babs, RN. I was reading through their archives and found a blog titled “Mean and Nasty”. It was about this sweet lady, who had been admitted through the ER to the hospital and been diagnosed with metastatic Colon Cancer. She was one of those patients who was polite, thanked every Nurse and Doc and Tech for whatever service they provided her, apologized for being “trouble”, etc.
911doc, and several commenters to that blog has opined that if she had been a “Mean and Nasty” person, she probably would be healthy as a horse.
That inspired this blog. I'm hopin' that if I start out slow, and write about this in bits and pieces, it will help. So, please bear with.
Three years ago next month I started spending a lot of time @ Scott and White hospital in Temple. I wasn't sick, but my Daddy was. He'd had Renal Cell Carcinoma in 1991, lost his Left Kidney and some lymph nodes, but after 5 years and no recurrence had been pronounced “CURED”. So he didn't think too much of it when he started havin' back pain. He went to the chiropractor. Chiropractor took some rays, saw some misalignment, and started some adjustments.
When I went to Canyon Lake to spend Father's Day w/ Daddy and Mom in '04, I laughed at Daddy when he took a bag of frozen corn and put it between his back and the sofa cushion. He shook his finger at me [as he was wont to do] and told me that's what the Doc had told him to do when it was achin'. I thought about it and it made sense. So, I quit makin' fun of him. After all, at 77, he was entitled to some aches and pains. We had a grand time for 4 days, drivin' all around the area, seein' the sights and just enjoyin' each others' company. Lookin' back, I am so very grateful for that vacation.
He told me he was goin' over to Scott & White after July4th to have some “tummy” problems checked out. I told him Dearly Beloved and I would be in Terlingua 'til the 7th and I'd call when I got back to where I had cell phone coverage. Well, we hit the outskirts of Alpine, and I had a bunch of messages on my cell. One was from him. Seems he was goin' back to S&W for a biopsy of a mass they had found in his stomach. I called and he was due to check in at S&W the day after I was gonna get back home.
I called the person who had been subbin' for me at work and arranged for them to cover for me a few more days. We got home, I did enough laundry to last for a few days, got in my truck and headed for Temple after a few hours sleep.
I walked into his hospital room just as they were takin' him off for the biopsy. But I got to kiss him and then Mom walked in and she kissed him good-bye. Then she and I went down to the cafeteria and had some breakfast and she brought me up to speed on what was happenin'. The “tummy' trouble he had mentioned to me back in June had been blood in his stool. A lot of blood. Enough that the gut doc went lookin' for and found a mass in his stomach. What Daddy hadn't told me on the phone, b/c he knew I'd come runnin' on NO sleep was that after the biopsy, he was scheduled for a whole body scan. The Doc was afraid his cancer had returned.
A week later we got the news...Stage 4 Metastatic Renal Cell Carcinoma. Big, huge, Alien like tumors in the Thoracic and Lumbar spine, threatening to collapse his spinal column; another tumor in his left lung, one in his stomach, one in his liver and a tiny one in his right lung. The cancer was gonna kill him, no doubt about that. Just a question of time.
The more immediate danger was the collapse of his spinal column, leaving him a paraplegic or even a quad for his final months of life. You see, those tumors had completely eaten away the bone, the tumors were all that were holding up T4, T7, and L2. And since RCC tumors bleed if you look at them too hard...we were havin' trouble findin' a surgeon willing to cut.

Now, let me explain a few of things. Except his first bout with Cancer, Daddy had always been an amazingly healthy man. He had Sleep Apnea, and a minor seizure disorder and was overweight. But, NO heart disease, no hypertension, no diabetes, no thyroid disorder, he didn't smoke, drink, or do any drugs, unless a bowl of Blue Bell every night counts. He had one of the most positive attitudes about his life of any person I've ever known. He was grateful for everything he achieved and had. He loved God, his family and most of his fellow men. All through this ordeal, he claimed he felt fine. Until the last few weeks.
He was in and out of the hospital throughout July, August and September. He became a favorite of the Nursing staff on the Oncology Floor. And I attribute this to his manner. He greeted the Nurses with a smile, called them by name, asked for things and services politely, or we did on his behalf. He thanked the housekeeping staff for cleaning his room! Not because he was “suckin' up”, but because that's just how he was.

His Oncologist, found Dr. Seguin, an orthopedic surgeon who found an interventional Radiologist and a gas passer with a PLAN.[ you just gotta LOVE teachin' hospitals, don't ya?] They put their heads together and decided that what they'd do is a pre-surgical procedure to cut off the blood supply to the tumors in his spine. If they were successful..then the next day the Orthopedic Doc could go in and stabilize Daddy's spine with rods. That way, he wouldn't wind up a quad or a paraplegic for whatever time he had left. They explained the odds to him. While Mom left the room on a made up errand, I urged him to go for it, whatever the odds. I knew Mom would be a "Nervous Nelly" about the risks. But I also knew it would kill something in Daddy's soul to be paralyzed. I didn't come out and say that. What I said, lookin' Daddy in the eye, with nary a tear, was, “I think it's worth whatever risk you have to take, Daddy, to avoid bein' paralyzed. But it's YOUR decision and whatever YOU decide, I'll stand beside you.” He nodded once and answered, “I love you, Baby.” I leaned over and hugged him and started cryin' then, “I love you, too, Daddy.”
He had the pre-surg. procedure, and it worked. That night Dearly Beloved, all my brothers and their wives, my kids, some of my nieces came in. The surgery took about 13 hours. Scott & White does a great thing. During long surgeries, like Daddy's, the OR calls the waiting room every couple of hours and gives the family an update. That made the waitin' a lot easier to bear. Not easy, just easier.
When it was over, the Surgeons came to one of those itsy, bitsy, consult rooms. What with Mom, me, 3 bros, and 2 exhausted surgeons, it was a wee bit crowded. But they told us they had “debulked” the tumors, put in the rods to stabilize his spine and although he bled a lot, he came through like a champ!
After he was transferred from recovery to ICU. Mom and I went in to see him. Then my Bros and I took turns during each visiting period going in with Mom. We finally convinced Mom to go home with us. There was no place for her to stretch out in ICU waiting, no recliners, no couches. We swore on our children's heads that we all pile in the fastest vehicle and break land speed records between Killeen and Temple getting' back over there if any calls came in. But she looked worse than Daddy did by that point, and he wadn't gonna win any prizes.
For four days, they kept him doped to the gills on a cocktail of Fentanyl; Morphine; Sweet Ringers and blood [the first day]. He did not loose his sense of humor while stoned. His internal filters, yes, his sense of humor, no. When the Dearly Beloved went in to see him on Day Two with me, DB said, “Derwood, you're lookin' good!” Daddy looked up at him and quipped, “J, you look like Crap!” And, considering that we'd all been getting up at the butt-crack of dawn, sittin' around the hospital all day, eatin' crappy food two out of three meals a day, sleepin' not enough on strange beds, worryin', and just generally bein' a collective bundle of nerves, Daddy was right...we all looked like crap.

That surgery was at the beginning of September. I had been shuttling back and forth between home and Killeen or Temple since July. Every time he went back in the hospital for another test or whatever, I went down. I was following good advice from one of my oldest and dearest friends. She had lost her Daddy several years ago. She told me to spend as much time with mine as I possibly could. My job was just that, a j-o-b. I talked it over with Dearly Beloved, who was bein' a ROCK through all this. I gave my notice in August and arranged for subs for most of that month. I did spend every moment I could with him and I've never regretted a single second.

The first time I went to Killeen after he came home from the hospital, he was sittin' in the circular driveway on his Walker w/a seat. The lung tumors were growin and robbin' him of air by then. I pulled up next to him and said, "They told me there was a Sick Guy here I needed to visit, can you tell me where he is?" He chuckled, "Well, I'm recovering from Back Surgery, other than that, I feel fine!" By the time I parked and got my bags out, he had walked through the garage and we met in the house. I gingerly hugged him.

Because of the religious beliefs of someone close to him, he promised he wouldn't do anything to actively end his life. After he came home from the hospital the last time, I was never left alone with him. I would have made the end easier or at least quicker if I had been. I have no shame in admitting that.
He had signed up with Hospice and was on a Morphine pump. But it wasn't holding the pain. When I pointed this out, the Nurse said, "Well Ms. B, he's getting all the morphine he can get without receiving a fatal dose. If he is allowed to get anymore it would KILL him." "The CANCER is already killin' him. What difference does a few days make?" She, and Mom, looked at me like I was the cruel one.

Two weeks before he died, he quit eating. A week before he died he quit drinking. That's a hell of a way to have to take control, but it's the only way he had left to him. I'll always carry a measure of guilt that I didn't find SOME way to make it quicker for him. Because that's was no way for him to have to go.
Thanks for lettin me finally get this off my chest.


Kate said...

Because it's a blog, there has to be words when there are really no words to say.

*hugs* - great big ones - to you.


MauserMedic said...

I've worked in hospitals most of my adult life. My wife has worked in one for the last 15 years. We both hope that when it's time, there's some one there who understands that love doesn't mean making you last as long as possible no matter what. From what I've seen, the type of commitment in time and emotion you gave your father towards the end gives a great deal of comfort to the recipient. I'd bet he was proud that you turned so well as to give that much of yourself. I hope I'm as fortunate when my time comes.

phlegmfatale said...

You are a beautiful reflection of a remarkable man. I'm sorry he suffered so and I agree it was a cruelty to force him to endure that. My aunt did that to my maternal grandma two years ago, and it was heartbreaking. Grandma was a worn-out husk and yet my aunt insisted on ferrying her almost daily to a hospital 100 miles each way for procedures and tests. I could see in her eyes months before the end that she didn't want to hold on. I understand not wanting to let go--I don't want to lose loved ones, either--but at some point there is a question of mercy and quality of life.

Hugs to you, Hols. I know this was difficult to write. You did all you could, you are a good daughter and were a tremendous comfort to your dad throughout his life, and especially at the end when he most needed to be supported and understood.

Bless you both.

Anonymous said...

I am amazed at how “bloggers” can share something so personal with total strangers and yet make them (me) feel like I am listening to a close friend. Even the comments you receive are eloquent. Thank you.

HollyB said...

Well, as I finished writing, through my tears. I realized that what I REALLY needed to say was that I felt guilty for NOT finding a way to end it sooner for him. Other peoples wishes be DAHMNED!
Saying that lifted a giant weight off my soul.
Thanks to all y'all for your kind thoughts.
I've been holdin' on to my grief, tightly, since October 24, 2004. Now, I can loosen up some.

Ambulance Driver said...

The greatest testament to a man is the character of his children and the quality of his friends.

And by that measure, I am sure your Dad was a great man.

Bad things happen to good people all the time, Holly. The only saving grace in all that grief is the affirmation of all the blessings bestowed on your family - close bonds, support of each other, the demonstration of your Dad's dignity and courage in the face of so much pain.

And the people that cared for him got a chance to see his light as well. I'm sure they were the better for having cared for your Dad, too.

Strings said...

I have to say Holly, I have some idea how you feel. I kinda watched my mother die by slow stages: had any other member of the family been responsible for the decisions, she would've lingered in pain the entire time. As it was, Dad made sure she had whatever pain meds he could give her, and my mom-in-law stayed with her the entire time.

When Dad goes, it'll be incredibly hard. Thankfully, he made MIL his power of attorney. And made me renew my promise to help him out if he can't take care of things himself.

My sympathies for the grief and guilt you have felt, darlin'. But you did the best you could.

LisaK said...

I think you are an amazing daughter.

I understand how you feel. My dad died a year after a debilitating stroke. I probably would have had it end sooner if I would have had a choice too. I do appreciate every minute I got to spend with him.