Serendipitous

I found out from my dad that I had relatives from the Dean side of the family buried in Iowa.  So after I finished my assignment at University of Iowa Hospital at the end of July, Tim and I headed towards Humboldt County in search of their gravestones.  We found several and it was quite thrilling to see where my ancestors decided to live out their lives.

We were well on our way home to Washington State, meandering and taking our time with a few destinations in mind like Devils Tower in Wyoming and Big Timber in Montana where my mother was buried.  But mostly just checking things out along the way until we were going to land in Friday Harbor for the month of September.  It was about mid August when I got the notice that I was called for Jury Duty and as it turned out it would be for the last week of September.  We had plenty of time to make arrangements around our quarantine, visiting our kids and brother and sister in law, our nieces and friends. I even got special permission to visit Les at Regency at the Park, the care center where he was a resident.  

I’ll be the first to admit I was getting cabin fever by the last week of September especially when I found out Jury Duty had been cancelled.  But by October 5^thwe were on the road again.  We’d already changed our plans from heading down south through Oregon to Crater Lake and eventually through the east side of California because of the continued wild fires.  Not wanting to get in the way and certainly not wanting to endure that dreadful smoke. (Thank you!! to all those firefighters)  Instead we decided to go east through Montana again and spend more time in Wyoming, Colorado and Utah on our way down to visit our friend Traci who lives in Austin, Texas.

We left Friday Harbor and made it to Rasar State Park to camp with Jan and Eric (Tim’s brother and sister in law) one last visit before heading over highway 20 towards Spokane.  I got a call early that morning that Les, my dad, was being taken to the Emergency Department because his stomach was hurting.  I had known about this for a few days but he’d also been complaining about similar symptoms for the past five years and after many workups throughout this time the doctors never could find a reason for this. Les mentioned to me the night before when we talked that the doctor ordered an ultrasound and was specifically looking for gallstones, thinking it was his gallbladder that was causing him discomfort. So I wasn’t really surprised when he went to the ED. 

Tim and I walked around Rasar State park, took showers and got all ready to go, just taking it leisurely when I got the call from the Hospitalist at St. Mary’s Hospital that he was going to admit my dad to the ICU.  He started talking about my dad’s Polst form or his “End of life” wishes. At first I was taking it all in and actually told the doctor I was a nurse and that I understood what he was saying but then I got nervous because he was saying “there isn’t a lot we can do”.   

The physician proceeded to paint a picture of limited time.  I told him we were on the way and that we’d be there in 6-7 hours.  We switched directions and headed towards Walla Walla via I-5 and then I-90.

We made it to Walla Walla around 7:30pm and I was able to visit Les in the ICU.  Of course he was doing a lot better than the grim picture I was expecting when I finally got there. His blood pressure was up, he was alert and cognizant and happy to see me.  But I could tell he was in pain and wasn’t feeling good. But as far as the dire end being imminent, it looked like he had dodged that bullet for now anyway. I waited with him until he got something for the pain, which ended up being about midnight and then I went out to our van in the parking lot where Tim was waiting for me.  Tim and I stayed the night in our van in the hospital’s parking lot.

The next morning I went to see Les and all he wanted was something to eat. That’s the Les I knew.  I was relieved.  We talked with the physician that was in charge of his care now and reiterated that his quality of life was being able to eat and watching TV. However, He was focused on the fact that Les had had a heart attack and some kind of infection, probably his gallbladder so they put him on a blood thinner and antibiotics and wouldn’t let him eat in case he would be a surgical candidate.

I came to realize how difficult it was to advocate for your loved one. I also came to realize how slow things move on this side of the hospital bed.  As a nurse by profession I could see both sides of this experience.  On the nurse side I frequently run my butt off all day and rarely feel like I get anything accomplished and on the patient advocate side of the bed, it took all day to find answers and figure out a plan of care, even then decisions were made slowly as consults were made, tests were performed and more waiting happened.

I felt good that I was able to get him something for the pain and he seemed more comfortable. He was feeling a little bit better and sleeping most of the day.  Apparently not sleeping real well at night.

It wasn’t until the surgeon told us that he wasn’t really a surgical candidate related to his other problems that we could move forward with his wishes.  He still hadn’t been given anything to eat.  Luckily there was a palliative care nurse practitioner that got involved and she was amazing.  I could tell she was hearing us and taking the end of life care seriously.  His hospitalist doctor finally acquiesced and Les was taken off antibiotics, heparin and given a pain patch.

The hospital team tried to get him back to Regency at the Park, but couldn’t get transportation that late on a Friday and apparently no transfers happen over the weekend.  So the plan was to move him first thing Monday morning. They let him have clear liquids; at least that was something.  In the meantime, I called Les’ pastor Walt Meske, he’s in his 90’s and has been a long time friend of my dads; he made a visit to see him. All the while dad had the western channel playing on the TV. 

I stayed with him all of Saturday, just ducking out to the van to eat lunch and then back again.  He slept the whole time but looked really comfortable.  I went out to meet Tim for dinner and we also watched a movie, when I went back at 8:30pm I noticed he wasn’t breathing when I entered the room.  The nurses’ aide came in and I asked how long it had been and she said it just happened.  She was so upset she told me she’s never had a patient die on her before.

 I stayed with him and cried.  I knew this was the last time I would get to see him. I know he didn’t want to die.  He was afraid to die but I never knew why.  I never asked.  He was such a cantankerous crank pot sometimes and yet I miss him so much it feels as thought there is a hole in my heart.

It was serendipitous that we were close enough to be able to be with him in the end.  And that visiting him was so much easier in the hospital than it was in the care center he was in. I know he would have liked to be back at Regency at the Park to be with all his familiar caregivers. And I’m sad we couldn’t make that happen for him.

I didn’t really get close to him until I was in my forties.  And as much as he was a pain in my ass, I will miss him calling me and telling me he’s out of snacks.  

And especially calling me and saying “Hey kiddo, this is dad”.