4/26/10

4/26/10

So much for optimistic endings. Not long after I wrote that he seemed to be on the mend, we gave him his evening meds and started to move him to bed. He had been wheezing slightly all day, but when we got him moving the wheezing got so bad that I was really scared. I called Ethan, who told me to put the phone on Dad's chest. He could hear the wheezing through the phone, and told me that it could be serious and that we had to go back to the hospital. At 11pm on a Saturday night, exhausted from the previous day's events, this was the last thing I wanted to hear, but I called the ambulance.

I knew it would be a fast response when I reported someone with trouble breathing, but I wasn't prepared for all the people who showed up – first a policeman, then four firefighters who stood around the bed looking sympathetic but helpless, and then finally two paramedics. The ambulance, squad car, and firetruck made quite a spectacle outside Dad's building. Once again, they carried him down the stairs and we were off.

At the ER, they took a chest x-ray and the ER doctor told us that he had “really bad bilateral pneumonia” which frightened me but also puzzled me because Dad didn't seem that sick. His oxygen saturation was low at 89 (normal is 100), but he wasn't bluish the way my mother was when she had trouble breathing or coughing. They admitted him, but then we had to wait for hours in the ER for a bed to be available. While we were waiting, Dad was complaining about the late hour, saying, “I'm too old for this.”

At about 3:30am, they finally moved him up to the 9th fl. and JD headed home, promising to come relieve me in the morning. Once he was settled in his bed, he started asking me how far the village was from the port. As the story unfolded, it turned out that he thought he was at an island resort. “Is it expensive?” he asked me. “Yes,” I answered, thinking of the incredible cost of a hospital stay. He seemed worried by that, so I explained that it was paid for by insurance. “These trees are two hundred years old!” he told me, describing their beauty. Later, he invited me to hike with him on the mile-long forest trail. I had to keep him from getting out of bed to start the hike by telling him that it was raining and we would go the next day. Finally, he fell asleep, leaving me to sit there, impossibly exhausted, watching the sun rise.

Early in the morning, a doctor with an Israeli accent showed up. “It's not that bad,” he said, hurriedly. “They called me and said he had really bad bilateral pneumonia, but it's not that bad” and started to run away. I stopped him and explained that since Dad is blind/deaf/forgetful we need to have someone from our crew here all the time and asked him to clear that with security. He said he would.

Later, once JD had come back, two young female doctors came, the “team” who will be responsible for Dad's daily care. They said that they think Dad may have aspiration pneumonia, from getting fluids in his lungs when he chokes while drinking, which he does a lot. They ordered packets of a thickening agent, which we have to put in his juice, milk, soup and any other “thin” fluid so that it thickens to the consistency of nectar. One of the doctors said she was going to have physical therapy evaluate him, because “if he can't walk, he can't go home.” I was really shaken by that statement, and it must have shown on my face, because she quickly backpedaled, saying that she just meant he might have to go to a temporary rehab center to recover. I'm still worried about that idea, but my friend Brad told me that his experience is that these rehab centers really do try to get people on their feet and home as quickly as possible to save money, so I feel less concerned that it's someplace he might just languish and deteriorate.

Finally, around 11am, I staggered out into the rain and headed home. I needed to sleep, to prepare myself for work that evening, but I was so stressed that it was hard to sleep. I managed a couple of fitful hours and then showed up at work with the cognitive capacities of a snail. After work, I called Jaelynn for a report and found out that she and Dad were on an imaginary train trip. A hopeful sign: Dad started reaching for Jaelynn's girlfriends breasts. Not my favorite behavior of his, but definitely a return to his old ways.

When I finally got home, I felt like I do when I have just spent a couple of day in Central Booking after being arrested at a protest – a combination of sore, exhausted, hungry, stressed, and at my wits' end. I fell into bed and had a hard time getting up when my alarm went off at 10am today.

I got to the hospital today at 3pm, relieving Marie an hour early, to her obvious relief. She didn't say much, just that it had been a hard day and that Dad was seeing “things” all around. Dad was definitely doing some major hallucinating, and I think that was hard for her to handle.

At about 3:30pm, Dad decided that he had to pee and INSISTED on getting out of bed to do it, though he's been using a urinal without a problem for days. I couldn't talk him out of it and had to hang on to him while he tried to throw me off and yelled at me to get off of him. He got one leg out of the railing and I had to yell for a nurse to help, since they take a long time to answer the call light. I was really, really upset about having to physically struggle with Dad. He has never been anything but gentle and amiable with me and this new behavior was heartbreaking. Once the nurses got him settled, I sat there and cried and cried, which is how the physical therapist found me. Dad was sleeping, so I explained the situation, including the fact that Dad had been walking until thursday, and he said he would come back.

Dad needed a new intravenous line, and the nurses, having observed the earlier commotion, decided he needed to be calmed down before they could put some in, so they gave him a Haldol injection, which made me cry more because sedating demented patients to make them easier to work with is really against my values and I really didn't ever want it to happen to Dad. As it turned out, the nurse stuck Dad three times and couldn't get a new line in, so she decided to quit and let a doctor try.

Despite my overwhelming sadness about the current situation, and the feeling of having had the core of my existence suddenly displaced, we did have one funny moment. A nurse asked Dad my name, and he thought for a moment and then said, “Shakespeare.” It is true in an odd way – I'm named after a character from the Taming of the Shrew.

I am still really grateful for the support of my friends – Brad and Samantha joined the rotation today, shortening the shifts for everybody else.