Tuesday, July 7, 2009

Tommy, can you hear me?


Ever feel like a pinball? Just ricochet violently from one post to another, and then get the paddle just as you start to relax? Is this my life life now?

Bed was blessed relief at 10pm Sunday night on June 29, 2009. Stretched out after the dog finished his cozy time on the corner and flew into his own little sleep area, I could just feel the muscles unwind. Ring. Ring. Ring. Uh-oh.

Dad fell getting into bed and could not get up. Ouch, I knew the night would be a long one. Relayed the message to my sweetie while getting the pants on, and the shirt. Grabbed the keys and downed a glass of water for the road. In days gone by it might have been a much stiffer beverage, but experience taught me that for long hauls and endless pacing back and forth in long corridors water was the tonic.

When I entered the familiar parental bedroom I saw the blood on the left arm from the huge slice the wooden bed-runner edge exacted during the fall. I still hear the complaint in the voice that whispered, "I can't get up." The nurse showed up about fifteen minutes later from the hospice organization. I had managed to pull my father onto the bed and swab his wound with some wash cloths. She wrapped the wound and called the ambulance. I pulled out the distilled vinegar to remove the blood stains from the carpet while we waited.

The ambulance arrived, and with great difficulty the paramedics moved my father out through the narrow hallway and into the ambulance. The meet up would take place at the chosen hospital. Nights at the ER are tough on the system. The staff are trained and qualified, and completely overwhelmed. Yes, I remember the waiting room filled to the max. Just like the many other times we had driven into the ER-zone over the past couple of years.

X-rays were painful and strained. With the short staff at 2AM I got to don the lead jacket and assist the radiologist. The verdict was a slight fracture of the hip. Not good news for a frail 84 year-old. Nothing more I could do that morning, so I drove home and supplied the details to my nearest and dearest. Bad break all around.

Monday was a wide array of emotions from my father in the hospital and calls to family members near and far. My sister was in Pennsylvania finishing up a sale of some major personal property to a Kentucky family. She was not sure when she would be able to get out. Might be six days, could be longer. I told her I would keep her updated.

Monday night dad began to feel both the pain medications and grim reality. He was all over the place and barely rational. By Tuesday, his body was under siege with an oxygen mask, catheters and IVs stuck in several locations while medications and plasma transfusions poured into him. He was gasping and struggling all day. He struggled so violently restraints had to be used after he badly tore up both forearms against the hospital bed supports. I was sure this was the end when I left Tuesday night.

Wednesday morning, with no call from the hospital, I went down to see what the condition was. He still had the oxygen mask, but was now calm and bandaged from the previous day's battle. He looked terrible, like some prize fighter had tagged him repeatedly for fifteen rounds, leaving him swollen and bruised and not knowing where he was or who he was talking with. Doctors said he was responding to their efforts and they tentatively scheduled hip surgery for the Thursday, July 2. I was dumbfounded. But, I reminded myself- I am not a medical doctor. We would wait and see how he progressed.

Many visits on Wednesday and not much improvement. Strange to converse with a person who can only register sounds just above a whisper in a hospital. Stranger still to get close, and hear he doesn't know where the hell he is, or who the hell he is talking to. But, surgery was still a distinct possibility for Thursday. I wasn't buying it, but stranger things may have happened somewhere.

Thursday found the patient still disoriented but lucid for moments. My youngest arrived at noon, and we went for a visit. Dad seemed to recognize the youthful face, and thanked him for coming. Tests seemed to indicate that surgery would be delayed until Friday while the surgeon discussed with the anesthetist what anesthesia should be used, and the cardiologist said no general anesthetic should be applied during the operation due to the fragile status of the patient's heart. I tried to inform my father of the events as they were going down, some stuck some did not.

Friday morning arrived after another long night of little sleep, and surgery was definitely going to happen. The team of doctors had determined that a local would be given and a quick surgical procedure would be performed to insert three screws into the fracture to secure the hip. The surgery went smoothly, and my dad seemed to be more cognizant of the events and people surrounding him all of Friday.

The weekend saw discussions of moving to a rehab facility amid fits and starts of temper and discomfort from the now week long hospital stay. The nurses and doctors had lost their appeal. They were now bosses giving directions and demanding effort and movements that caused some pain and distress on the injured party. Rehab departure dates depended on white cell counts getting back to reasonable levels.

Monday's exit was postponed until Tuesday. Tuesday morning saw my youngest son depart back to Sacramento. The patient was gloomy all day, believing he was never leaving the hospital. Tuesday's release was postponed until today. His arms continued to look very bad, and his hands shake uncontrollably most of the time. He needs assistance to feed himself, to shuffle with a walker 20 steps before being completely exhausted and crumpling back into his former prone position. The lucidity seems to come and go, but it may be the case that the end truly is in sight for him and it is overwhelming. The peace that the morphine brought has been replaced by a reality where there are few questions left to answer satisfactorily.

Of course, my dearest and I have lots of questions on our minds regarding what happens next to our immediate lives, which now seem hinged on each medical outcome of my father. The return home could mean moving in with him and having some hospice care resume. This is an option both of us have declared is not viable given our own household circumstance. My sister who will finally arrive Thursday afternoon, July 9, will not be able to fill much of a role as an elder care giver due to her occupational circumstance. If the rehab makes some progress the likelihood of dad living out the time he has in our home becomes a very real probability. There are nursing homes (convalescent hospitals or skilled nursing facilities) that might be a possibility but those are slight options. The relatives have been very supportive over the phone, but have no answers.

We wait and see. We bounce plans off one another here at home during the brief off moments, both acknowledging the hours are dwindling but looking at another paddle tanning our backsides into motion on a journey where we have no end date.

"Tommy, can you hear me?"

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