This is a LONG entry about the month of August and a trauma ICU patient...one we love and worried about for the entire month...
On Monday, August 3rd, Terry (Dave's dad) was bringing in the garbage can from the curb. He fell on a very huge and sharp piece of granite (a decor item in their yard). He broke some ribs and punctured a lung which collapsed and caused some internal bleeding. He was taken to the hospital and immediately put into the trauma ICU. They put in a chest tube to drain the blood. What was to follow was a month of rollercoaster rides, physically, emotionally, and mentally, not just for Terry, but for most of his family as well. John and Mark (Dave's brothers) gave Terry a blessing and the next day he seemed to be doing okay. He was calling Barbara at the balloon store and bossing her around. He seemed to be pretty fine, just needed to recuperate and not get pneumonia! They expected him home by the weekend. He wanted to get out of there ASAP!
Then a few days later the rollercoaster began. He DID get pneumonia, he got some infections, and then he started getting what they call ICU psychosis. He became disoriented, confused, delusional, anxious, argumentative, and paranoid (thinking he'd been kidnapped etc.). They put in a picc line to administer his meds and were waiting for his blood pressure to come up so they could do surgery to drain his lungs. Once the picc line was put in and he was getting meds, he seemed to be more of himself again, but he relapsed on the 9th to the psychosis. On the 10th they put in a breathing tube and started to sedate him (lightly). He still wasn't able to have the surgery he needed. The meds and lack of oxygen really took their toll. Poor Barbara! (Dave's mom). She had so much to deal with having Terry in such a condition and she needed to be running their store. Side note...we were all mad at Terry when he opened that store last year! He was working himself and Barbara into the ground. And running up debt to even make it a store - that doubtfully ever broke even. She had first put her foot down and said she wouldn't help him, but of course, she did. So now we were really mad that she had to deal with that on top of trying to be with him at the hospital! They are 84 years old this year! Okay, rant over...
Thankfully, John and April as well as Mark and Judy were there a lot at the hospital to be with Terry and Barbara, to talk to the nurses and doctors and always in the know and passing the word along to all of those who couldn't be there. Their oldest daughter Susan went over and spent a week or so visiting her dad and helping her mom at the store. John spent a lot of time at the hospital, and April too. John would spend some nights there, just sitting with his dad. How hard! Terry kept having fevers and infections, and he would get so anxious and pull at things that they finally had to restrain his hands. How awful for him! They kept him sedated a lot of the time. On the night of the 10th we got a great update! It was late in the evening and when John went in to see him, Barbara was there. Terry was awake and seemed alert. He was communicating with Barbara by writing on a pad (they untied his hand so he could write). He wrote "I LOVE YOU" at the top of the pad. He tried to scribble some things, and with blinks and nods, was doing his best to communicate. He asked questions about the family, the store, his treatment, and thought he wasn't out of the woods, it was great to have the real Terry back! He told John and Barbara to go home and get some sleep, and according to his nurses he had a very good night. Things were looking up! That psychosis part was really scary to me, it's bad enough being so physically injured and in pain, but to have that mental part on top of it, wow. But he seemed to be back in his right mind so that was good!
The next day, the 11th, he seemed anxious and it was probably because they were trying to wean him off the ventilator. It didn't work. He could not breathe properly on his own. They will keep trying. April was there during this and he was trying to communicate by writing but she couldn't make out his scribbles. We just feel so bad for him and what must be going through his mind to be in so much pain, not be able to breathe right, and not be able to communicate! His blood pressure would't stay up and his fever wouldn't go down. He just wanted to get well and get out of there. We continually prayed for him, had a family fast, and of course his name was put on temple rolls.
On the 12th they were FINALLY able to do the surgery to get the fluid out of his lungs. They got out 500 ML which sounds like a ton to me! He was groggy but awake after that. All his vitals were normal and he was resting. The doctors said it should be a couple days of recovery. Things were looking up again! He had had a good night, he was off blood pressure meds, he was breathing better, still not enough to come off the ventilator, but improving. He was resting well though extremely bored!
On the 14th (This is when Susan was there now)...they thought the drainage tube could probably soon come out and that he would soon be off the ventilator too. He got another infection though his fever was gone. He was awake and alert and like having Susan there holding his hand. He can't communicate at all.
15th, not much change. They did take out the drainage tube. He failed the breathing test again so still no ventilator out. He is beginning to swell.
16th, no change. They keep him lightly sedated. Barbara and Susan told him about how busy the store was, he squeezed her hand. He liked hearing about that.
17th, two weeks since his fall. Still not passing the breathing test. If the ventilator can't come out in a couple of days, they will do a tracheotomy. To make it easier for him.
18th, they were able to remove the breathing tube! They turned it off and he was breathing okay, then they tested his oxygen level and it was good! They took the tube out. Blessed day!!
20th - good day! Terry had the nurse dial Barbara at 6:15 am! He talked to her for a bit. They are starting to get him mobile...crushed his meds into some applesauce! That must have tasted so good to him to eat some real food! We couldn't even imagine how happy he must be! On with the next stage of the healing process!!
The next day, it all came crashing down. He took a turn for the worse. We couldn't believe this. It was all going so well! He was suddenly in worse condition...his kidneys were not functioning and his swelling was getting worse. He had pneumonia again. We had a family meeting that night over the phone for those of us who couldn't be there. Things were not looking good and some "uncomfortable things" had to be discussed. Margie was in town (Utah) and heading back to California the next day. She invited Dave and I to go with her and we decided we better. Things were not sounding well and we wanted to see Terry in person. I knew in my heart that things were not going to get better. Kidney failure is a big one, and though the siblings didn't call it that, I thought of the family meeting as an "end of life" discussion. Making the plans for "what if."
22nd, Saturday night after we got there...Barbara took Dave and I and Mike (Dave's brother) and his wife Margie down to see Dad. We went in first. Terry was asleep. Barbara tried to wake him, but he was out. Sedated most likely. She talked to him and we said hello, but there was no response. Mike and Margie went in and took a turn as well.
Sunday morning we went back. He was a little awake, we tried to talk to him, his eyes made me so sad! The confusion was there. He was flapping his hand (which was restrained) and we didn't know what that meant. We told him we had come to see him and that we were visiting with Barbara too. His head snapped up at the mention of her name, so there was some recognition, but then he just fell back into the staring and drifting off. It made me so sad. I can't even imagine how it must be to be in his position. It broke my heart.
Sunday I made dinner at Barbara's while everyone else went to church. (we hadn't brought church clothes, thinking we would be at the hospital all day). Dave went to support his mom. We had a nice dinner afterwards. Besides Mike and Margie, Dave's brother Matt and his sister Gail were here too. In the evening John and April and Mark and Judy came over. We had a dessert potluck! It was a fun evening visiting with everyone and hopefully buoying up Barbara. Tough times...
Monday morning the 24th we went over to the hospital before our flight back home. Barbara and Margie were there, Mike came soon after. Dave went back to see his dad with Barbara (only 2 are allowed at a time). His swelling was down a bit, and the pneumonia was a little better. They put in a feeding tube passing his stomach and going right to the intestines (I think, something like that!), they are preparing for the tracheotomy the next day. He was awake and shook Dave's hand, grabbed it and held on really, and Barbara would just say, "today is a good day!" Mike and Margie had their visit and then we were all returning home that day. We took Barbara to lunch first, then she went on to the store, we went to the airport and Mike and Margie drove back to Fillmore. Matt and Gail were still there and helping immensely with the store. Matt is looking for a buyer so we can just get rid of it all!! It was hard to leave, but we are so glad we went!
25th - Tracheotomy day. According to John, Terry was pretty "with it" that morning. He was alert, swelling was down, when Barbara held his hand his eyes lit up. They gave him meds, checked for bed sores (none...yay!) and took him in for surgery. The procedure went well. He should be a lot more comfortable and they can teach him how to talk with that in. And of course it can be removed later should he recover from all of this. Another positive step and an "up" on the rollercoaster ride. They said he would be uncomfortable for a couple of days.
26th - Gail went with Barbara to the hospital. The woke Terry and he felt really warm. He wasn't talking or smiling. He did squeeze Barbara's hand. He was still swelling and they were waiting to hear from the kidney doctor. They are talking about starting dialysis...
27th - No improvement. They tried to wean him off the respirator but weren't successful. When they cut back his pain meds he gets agitated and uncomfortable. His kidney function still borderline. He is retaining fluid and looking very puffy. They turn him on his side every two hours to help with bed sore. He does not like that!
28th - Terry was not doing well. Barbara is having a hard time too. Very emotional and understandably so! They scheduled a meeting with the doctors and nurses to discuss pallative care. His kidneys are basically shut down so they are discussing dialysis. To me, pallative care means end of life care, keeping them as comfortable as possible until they pass. Barbara thought he was dying and asked the nurse if it was imminent...the nurse said NO. And I am thinking, yes he is...kidneys shut down, pallative care??? They are keeping him sedated most of the time because he gets agitated otherwise. I am thinking he must still be in pain, from the tubes, bed sores, and the initial broken ribs! No one has ever spoke of those again. April and John took turns going in the room with Barbara. April said that Barbara just stared sobbing. The ventilator is doing all the work and he is not responsive at all. She felt like he did squeeze her hand as she talked to him and told him how much we all loved him and gave him a kiss. She said at one point he opened his eyes and looked right at her, he seemed focused on her, but had no idea if he knew her. They did decide to start dialysis. They had to do a procedure to put a port in his neck. After that was done they did the first dialysis.
29th - Terry was resting. Dialysis went well, they got 3 liters for fluid out of him. They planned to do another session this day. Barbara thought he looked 100% better today. This again was another good news day and we felt like things COULD get better. Steve (Dave's brother) and his family flew in from Indiana. Steve said that Terry was a little awake, not much change. He got a little irritated and his ability to communicate was not there. But his swelling was down. John sat with Terry that evening and said they did dialysis again and got another 3 liters out. His kidneys are not producing at all and that even though he is on dialysis, they should be doing something. He's still puffy and swollen. They tried lowering his sedative but he gets too agitated so they increase it again and let him sleep. This is also the night the power went out! Everything went black! The generator kicked in about 5 seconds later. The nurses were in there quick! One had been there 10 years and never saw that happen!
30th - Dialysis again. No change. Not responsive. My greatest fears are being realized. He is NOT going to get better.
31st - John and Barbara met with the doctors again. Dialysis continues, his blood is getting clean but his tissue is still retaining fluid. His kidney output is zero. His heart has not been a problem before (the keep testing it because of his pacemaker and heart problems in the past) but this day they did a stress test that should be in the low hundreds and Terry's was 1000 and has been as high as 2000! His heart was working very hard and this was news to Barbara. They tried lowering his pain meds to get him alert enough to do basic tests (squeeze my hand) and he failed all of the repetitive requests. His eyes were half open but he stares straight ahead and does not acknowledge anyone. Glassy eyed. So heartbreaking!
September 1st - Terry's heart is failing. The kidneys never responded and he is unable to wake up. The decision was made to discontinue pain meds and dialysis and remove his respirator. Barbara, Steve, Mark, John and April were all there. April said it was a very peaceful passing. They had a prayer about an hour before he passed away. Barbara was holding his hand while he passed and shortly afterwards gave him lots of kisses. April said it was incredibly sad, but we were all grateful he wasn't suffering anymore. We knew this was coming, but we are never prepared for it. Terry and Barbara have been together since they were 18. They are 84 this year. We are now concerned for Barbara and what will happen with her. I will post pictures and obituary and graveside service pictures in the next post. The only picture of Terry not alive is the one in his casket. All the others are while he was being cared for in the ICU. He received wonderful care and we are beyond grateful to all those who were part of that. We are especially grateful to John, April, Mark and Judy for being there a lot when the rest of us couldn't. And of course Dave's other siblings who flew or drove there to help as much as they were able during the course of his month in the hospital. We are sad to lose this wonderful man, but we know he is pain free and in a better place with loved ones!
