A fabulous start to the day, but what a crummy finish

IMG_5954 (1)September 3, 2018. I arrived at the hospital at 7:30 A.M. Dad’s breakfast tray was sitting on the bedside table, but the meal seemed rather skimpy. When I compared the contents of his tray with the slip that accompanied it, I saw that he was missing the cranberry juice, cereal, and coffee. Toshia, Dad’s aide, contacted the kitchen and requested that they bring the missing items. While she was in the room, I asked her if she could get Dad repositioned in his bed so that he could eat. She said that she would request assistance from Isabel, Dad’s nurse.

At 8:15 A.M., just as Isabel and another nurse had just finished repositioning Dad in his bed, Angie and Beverly from physical therapy arrived. During the few minutes that it took for them to rearrange the furniture for Dad’s session, the missing items from his breakfast tray arrived. Once again, Dad’s breakfast would cool off before he could eat it.

fabCrummyCross4Dad was alert, cooperative, and had a great physical therapy session, and Angie said that tomorrow he should be able to spend time sitting in a chair. At the end of this session, I was feeling very positive and was encouraged about his progress. Mom and Stan arrived at 9:15 A.M., just as Angie and Beverly were wrapping up Dad’s session. I was disappointed that they had missed Dad’s best physical therapy session since his surgery.

I reheated Dad’s coffee and laid out his meal for him. He was able to hold the cup and drink his coffee without any assistance from me, and I was thrilled that he was also able to hold his dish of pears and eat them with a spoon without my assistance.

fabCrummyCross1At 10:30 A.M., the nephrology team arrived. They said that Dad’s lab results were good and that he had cleared 650 ml fluid in the last 24 hours. I was pleased that they were satisfied, but based on previous conversations with other nephrologists, I thought that they would have wanted him to produce more urine. Regardless, I was pleased that the day seemed to be progressing well.

Dad had been very alert and his dexterity had improved, so at 10:45 A.M., he and Stan decided to play a game of cribbage. For the past few years, the guys enjoyed their cribbage tournaments, most of which were won by Dad, and they were eager to play again. However, holding cards was a bit more difficult for Dad than holding cups, silverware, and dishes. After a bit of fumbling, Dad told Stan that he was also having trouble seeing the 15s, so the guys abandoned their plan for a game of cribbage before Stan returned to Houston. I think that I was more disappointed than they were. Being able to play a game of cards would have been a significant milestone for Dad. Truth be told, it was a milestone that I needed.

When Dr. Hunt, the attending physician, came by a few minutes later, he told me that he had had the nurse give Dad something last night to help him to sleep, and he wondered if it had worked. Because Dad had been so alert this morning, I assumed that he had had a good night’s sleep. Unfortunately, while the doctor was in the room, Dad became very drowsy and couldn’t tell the doctor anything other than that he was in Temple. It was uncanny how Dad seemed to be sleeping or very drowsy whenever the doctor was present, and I wondered if it was a Pavlovian response.

5364Dad was awake and alert when the respiratory therapist arrived with a spirometer, a little gizmo to improve his lung capacity. He was supposed to inhale for ten breaths, but he fell asleep after the eighth breath while holding the spirometer in his hand. The timing was unfortunate because he now needed to take his morning meds. Had Isabel entered the room before the respiratory therapist, Dad might have been able to swallow his pills with Nepro, but now I was afraid to give him any liquid. Isabel suggested that we crush the three pills and administer them with pudding, which worked. He complained about the taste, so I had him eat a couple more spoonfuls of pudding to get rid of the nasty taste of pills in his mouth. Within moments he was sleeping again.

Today was Labor Day and Stan wanted to return to Houston ahead of the post-holiday traffic, so he, Mom, and I left the hospital at noon. Dad’s lunch arrived before we left, but I doubted that I could get him to eat it now. I left it on the bedside tray and planned to have him eat it when I returned.

oximeter2Mom and I were back at the hospital by 1:00 P.M. I reheated Dad’s lunch and called for the nurses to reposition him in the bed so that he could eat. While they were in the room, he kept trying to remove his oximeter and we had a difficult time trying to redirect his attention. When I was finally able to feed him, I could not get him to open his eyes. I tried shaking him, shouting in his ear, and singing, but nothing worked. By this time, it was 1:40 P.M. and I gave up trying to get him to eat his lunch.

Mom and I were still sitting in his room at 2:40 P.M. when Isabel and Toshia came in to bathe him. Until they were finished, Mom and I sat for about 45 minutes in the 6 North waiting room. While we were there, we met a couple of brothers, one of whom had recently recovered from pancreatic cancer. He was now recovering from a minor infection and was being released tomorrow. His was a fabulous story that lifted our spirits.

fabCrummyCross2At 4:30 P.M., the nurse came in with Dad’s afternoon pills, but he was very drowsy and I was pretty sure that we wouldn’t be able to get him to swallow them. She grabbed some chocolate pudding from the kitchen and mixed in the three crushed pills. Fortunately, I was able to get him to swallow a few more spoonfuls of the pudding concoction, ensuring that he got the required dosage.

Fifteen minutes later, the respiratory therapist returned. I told her that the breathing thingy that she had brought Dad earlier had been knocked to the floor by someone in housekeeping. She left the room and brought us another spirometer, although I wasn’t confident that it would get much use. I was pretty sure that we had a couple of these thingys in the bathroom closet at home, still in their original packaging.

fabCrummyCross2Dad’s dinner arrived at 5:45 P.M. He was scrunched down into his bed, so I used the call button to summon assistance to reposition him. After just a short wait, Isabel and Toshia arrived and took his vitals and repositioned him in the bed. He had been talking nonsense for a couple of hours, which continued while they were in his room. Try as I might, I was unable to rouse him enough to feed him.

It was getting late, and I didn’t think that more time with Dad would yield any different results. I used the call button again to summon the nurse so that I could speak with her before I left, but after waiting for more than 15 minutes, I started wandering the halls in search of a nurse or aide. I finally found a nurse and told her that I was leaving and that I had been unable to feed Dad. She said that they would try and I reminded her that because he was an aspiration risk, he needed to have both eyes open when eating.

fabCrummyCross3I also told her that I wanted to speak with a neurologist tomorrow. It seemed to me that Dad had changed dramatically around noon, and his current condition seemed different from anything that I had experienced with him during this or any previous hospital stay. It also concerned me that the change had seemed sudden and occurred when he was using the spirometer. She said that she would add a note to Dad’s chart.

fabCrummyCross5Mom and I finally left the hospital at 6:30 P.M. I had been so happy and optimistic about his progress this morning, but now I was very weary, discouraged, and concerned. On the way home, we saw a rainbow over the hospital, which I hoped was a good omen. After Dad’s sudden change, I was open to all signs of good luck.



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