My Dad died on January 28th, 2017 due to complications after a fall. He would have been 85 years old this year. He and my Mom would have also celebrated their 65th wedding anniversary. This is the third in a series of articles written about his final weeks.
Article 6, Dad’s Death – 10 Life Lessons: https://goo.gl/SXh5NX
Article 5, Dad’s Death – The Aftermath: https://goo.gl/6YILxK
Article 4, Dad’s Final Days: https://goo.gl/k4PH63
Article 3, Dad’s End of Life Dreams and Visions: https://goo.gl/x2zvqA
Article 2, Dad’s Recovery: https://goo.gl/80ZBAc
Article 1, Dad’s Fall and Surgery: https://goo.gl/M7Xm65
THREE WEEKS AND COUNTING
By Saturday January 21st, it was obvious Dad was exhausted from the lack of sleep. He was also beginning to lose his appetite. He had no energy and therefore wasn’t able to do his physical therapy. He slept on and off during the day then was up all night. After my Mom and Sister left the hospital that day, I decided to stay with Dad until I knew he was “settled.” I figured I would spend the night in the hospital if I had to. As the evening went on it was obvious Dad wasn’t doing well. Someone, maybe one of his nurses, had requested a “Rapid Response” nurse from the Intensive Care Unit (ICU) stop by. When she arrived, she hooked Dad up to an EKG. She listened to his heart and lungs. His heart rate was rapid but normal. His oxygen levels were very concerning. She said he thought something might happen if we didn’t move Dad back to the CCU ASAP. She jumped into action. I believe she saved his life that night.
Before I knew it Dad was being wheeled back down to the CCU. The Rapid Response nurse felt Dad needed to be on a machine called a Bilevel Positive Airway Pressure (BiPap). This machine would force air into his lungs. The mask fit over Dad’s head like a baseball catcher’s mask. Although not considered invasive, the pressure seal created by the mask could literally break his nose and facial bones. At that point I realized there was no choice. His blood wasn’t holding onto enough oxygen and as a result he was being fed oxygen by two masks at almost 100% each. This meant he could barely breathe on his own. This was my cue to spend the night in his room. I figured Dad would eventually settle down, fall asleep and then I could leave. What I didn’t know was it was going be a night I would remember forever.
A NIGHT TO REMEMBER
Once Dad was hooked up to the BiPap and done with all the other testing, I figured he would drift off to sleep. Unfortunately this never happened. He became more and more agitated as the night progressed. He tried to talk to me and the nurses, but the BiPap mask made it difficult for us to understand him. It was like he was talking through a giant voice scrambler. The more we didn’t understand him the more agitated and frustrated he became. At one point he started trying to pull off the mask. Although understood why he would do this, we had to ask him to stop. He wouldn’t listen anyone. After being told not to grab at the mask, he shifted to grabbing at his IVs. For my Dad’s safety, the nurses decided (with my concurrence) to place a pair of soft mitts on his hands so he wouldn’t be able to pull at the mask or his IVs. They actually looked like a baseball catcher’s mitt but they were soft. They (understandably) just made him more angry and agitated.
I started out by asking him nicely to listen to the nurses. It didn’t work. He thrashed and pulled at the mitts with more determination (I really didn’t blame him). I finally got to the point where screamed at him. It didn’t work either. I even broke down crying and begged him to stop fighting. I walked out of the room and prayed to God and the Angels to help him. When I walked back in he was still fighting. Nothing was working. I felt so inept at helping him. The nurses had other patients and could not stand over him all night. He wasn’t listening to any of us anyway. I was at a loss and began to sob uncontrollably.
By now it was after midnight. At this rate sleep was not coming any time soon. I sat down next to him. Once I did, he started talking to me. He said “Get me a beer”. I said, “Dad I wish I could but you can’t have beer in the Hospital.” He said “Get me a beer” and then began cursing at me. I thought who is this man? It wasn’t the Dad I knew and loved. He screamed at me (through that horrible BiPap mask) over and over to get him a beer. I felt like we were in a horror movie. All the tears I had been holding back for weeks rushed to the surface. What is happening? Was it the medication they had given to him? Was it the “hospital delusions” I had read about? Did it mean that Dad was in the last moments of his life? I hated to see him going through this. I prayed as hard as I could to God and the Angels to “take” him if it was his time. I even told my Dad (through my tears) it as okay for him to “let go” if he needed to. I couldn’t imagine what he was experiencing was normal; I knew he had to be dying. On and off throughout the night he would go from being delusional to being completely lucid. In those moments of lucidity, he knew his name, he knew where he was and he knew what was going on. Seconds later he would be screaming and thrashing.
TURN FOR THE WORSE
Sometime in the very wee hours of the morning Dad reached out to me. He put his hands on either side of my face and said “It’s so beautiful here.” He was calm and peaceful. He smiled and his face seemed full of wonder. He couldn’t mean the hospital room. I figured he must be hallucinating. It was all too much to handle.
Finally by about 5:15 am on Sunday January 22nd, Dad started to fall asleep. I waited until about 6:30 am to make sure he was going to stay asleep then called my sister. As soon as she answered the phone, I started crying. I asked her to come down to the hospital. Something was really, really wrong. At around 7:00 am the day shift nurses started appearing. The Rapid Response nurse from the night before walked in to see how Dad was doing and I burst into tears. I told her “I think my Dad is dying.” I explained what had happened throughout night. She jumped into action again. She wanted to evaluate the blood tests and chest X-ray that had been taken hours earlier.
As she walked out, my sister walked in. I explained what had been happening. Dad’s blood test results and chest x-ray were not good. His lungs were almost completely cloudy. That meant he was getting worse not better. We were worried and scared. The pulmonologist came in and told us that it didn’t look good. The next step for my Dad’s care would be intubation and a ventilator. This would happen in the Intensive Care Unit (ICU). Even if they did these procedures, there was no guarantee Dad would get better. His quality of life would be forever changed. We would need to have a “Do Not Resuscitate” (DNR) on file if we chose not to pursue these next steps. The pulmonologist asked if we discussed the options or the DNR with my Dad. How about my Mom? To be honest, we really had never discussed it as a family. Fortunately my sister and I were on the same page but it wasn’t our decision. I had to talk to my Mom. Not wanting to have this conversation with her over the phone I decided to drive home. Despite my exhaustion and the torrential CA rain, speaking with Mom in person made the most sense.
I left the Hospital and prayed the whole way home. My sister stayed with my Dad. I called my ex-husband and told him it didn’t look good. I suggested he might want to stop by the hospital. I called my oldest daughter and asked her to meet me at her Grandmother’s house. I figured my daughter would be a calming presence for my Mom. Once I got home I told my Mom we needed to talk. I told her that Dad was not doing well and we had to make some decisions. She listened and agreed that intubation and ventilation was not the approach my Dad would want us to take. We held each other and cried. I called my sister and let her know. Then I tried to take a short nap before heading back to the Hospital. I tossed and turned but got a couple hours rest – enough to help me feel confident that I could safely drive back to the hospital. The rain poured like the sky had opened up. When we got to the Hospital my Dad was sitting up watching football with my sister, brother-in-law and ex-husband. He seemed much better. He was still asking for a beer but had added pizza to his request. We were all in shock. We spoke with the nurses and decided not to stay with Dad at the Hospital that night. I worried that my presence on Saturday night had contributed to my Dad’s agitation (I found out this is how he got every night so it had nothing to do with me). The nurses assured us they would call us if something happened. I told them I would be back early the next morning.
When I arrived very early Monday January 23rd, Dad was sitting up in bed. The nurse said his chest x-ray was improved and so they were probably going to remove the BiPap machine. This meant he would go back on a regular oxygen mask. I was beyond relieved. My Dad was ecstatic. He even asked me to take a picture of him with the BiPap mask on since he was sure he would never have to wear it again. If only that had been true. They removed the BiPap and put the “regular” oxygen mask over my Dad’s face. He was much alert, cognizant and most importantly, peaceful.
The cardiologist arrived for her rounds and asked Dad how he was doing. He said he was stressed. This was completely understandable after everything he had gone through since returning to the CCU. When Dad processed to describe why he was stressed, he said he had been in four different countries over the last few days. He had been to Mexico, rode on train and was arrested. He said had been to Florida as well. The cardiologist looked at me and I looked at her. We had no idea what was going on. My Dad continued to discuss his travels and how he was feeling very anxious after such a trip. The cardiologist politely replied by saying it was no wonder Dad was so stressed after such an experience. I really admired the way she handled her response to Dad.
END-OF-LIFE DREAMS & VISIONS
After the cardiologist left his room, I had an opportunity to ask my Dad if he remembered what had happened Saturday night. Since it had been somewhat “strange” I was curious how much he remembered. Given his most recent “travels”, I had no idea what to expect. What he told me left me speechless.
Dad said he had been at a wedding reception that night. Not just any wedding reception but an Italian one. Dad’s father was Italian so this made sense. He said we were all there. My Mom, sister, brother-in-law, children, even the nurses, etc. Everyone was wearing white. He said we were there because family was so important. He said family meant everything. I agreed. He said he kept asking me to get him a beer because we were at this wedding reception. He said he was growing frustrated with me because I kept saying no. (Note: Remember I thought we were in a hospital room Saturday night not at a wedding reception.) His frustration led him to calling me a few names and actually striking out at me. He said “they” told him he had not treated me like he should have. He said he was sorry. He started to cry.
While this wedding reception was happening, Dad also knew the nurses and respiratory therapists were coming and going in and out of his hospital room. When they would come in, Dad would stop being agitated and become very calm. He would speak to them coherently and answer their questions. Once they would leave, he would go back to being angry and combative. From what he was now explaining to me, it’s like he was in the hospital room and at the wedding reception at the same time. It was so hard to fathom.
Dad said after the wedding reception was over, he and I ended up in a very large church. In the church were people from all over the world and of every ethnic background. They were all dressed white. He sat in one of the pews and listened to the singing. He said they were in different languages but he understood what they were saying. He said the music was so beautiful. He said they performed for quite awhile. During the performance Dad looked over and I was sitting across the church aisle in another pew. He said I was crying and begging him to listen to the nurses about not pulling at his mask and IV. I told him this is what had actually happened in his hospital room. Once again it seemed like the events of Saturday night were happening in parallel.
Back at the church, the singing was over and then a large group of children gave a wonderful “production.” He said everyone clapped and cheered. Dad was then led to a room where a man was making a beautiful white gown. This gown was being made for him out of sparkling light. He said it was like diamonds. Dad said he watched the man make this garment for quite awhile. He said it was never finished or given him to wear. He said he would tell me more about it later, but unfortunately that never happened.
The next thing Dad said he remembered was he was taken with other people to a white room where they were “looked over” by doctors and nurses. Every person had a turn. When it was his turn, the nurse had him lay on a table in the middle of the room. The doctors and nurses looked over his body and checked his wounds to make sure they were healing after his hip surgery. Dad said when they got to the largest wound, they somehow were able to unzip it. He said when they did small gold nuggets came pouring out of it. He said the nurses caught the nuggets and then placed them in a pouch. Then they took this pouch and weighed it on a scale. They said the wight of the pouch showed Dad had done many good deeds in his life. He said he was told to do more good deeds so that when he came back (the next time), he would have more gold (good deeds) to be weighed.
At that point I basically sat there with my mouth wide open. I didn’t know how to react. Dad told his story like it had really happened. He also knew what had been happening in the hospital room Saturday night. It was like he was in two places at the same time. Through all of it, I was there with him, in both places. Wow. All I know is that I had been praying like heck through the events of Saturday night.
Because Dad had been talking non-stop, which wasn’t good for his lungs, I suggested he rest. At that point he closed his eyes and drifted off to sleep. Once he fell asleep, I was still in total disbelief. Being a spiritual person, I could only surmise Dad had some sort of End-of-Life Dreams and Visions or ELDVs. It was overwhelming. I felt so blessed I had been there to hear my Dad tell this amazing story.
RELIEF SETS IN
Around lunchtime, the pulmonologist came in and said that Dad’s lungs had significantly improved since the previous day. He said Dad was moving in the right direction but it was still day-for-day. For the first time in awhile, Dad was beginning to seem more like himself. It felt like Dad may finally be getting better. Everyone in the family thought Monday was a huge turning point.
Deep in my gut, I just didn’t feel it quite yet.
Sending you love, comfort and peace!