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My father in ICU

We have known for a long time that my father’s heart was weak, but this summer he started sleeping a good portion of the day and complained of chronic fatigue. His doctors discovered that he had an infected gallbladder and we had high hopes that having it removed would help him feel better. It didn’t.

The gallbladder was removed two months ago but my father continued to deteriorate. Three weeks ago he passed out in his doctor’s office and was promptly rushed to the hospital. His legs had became so swollen that they were literally oozing water or “weeping” as the nurses put it. His heart had become so weak he could no longer pump out his body fluid.
The Friday before last, the news had actually been good: my brother told me that he seemed to be rallying and there was talk of letting him go home soon. It seemed the medications we're starting to do their job. Then quickly things went south. On Saturday, he woke up confused in the middle of the night and ripped out a tube, spilling blood all over the floor.

On Sunday, he lost the ability to control his arms and legs, which twitched incessantly, and he could no longer keep food down. He was showing signs of multiple organ failure. In short, he had begun the process of dying. And even five years ago, that’s probably what would have happened. But the doctors performed emergency cardiac surgery, placing a temporary mechanical device that would assist his heart in pumping. It was the day of my parent’s 54th wedding anniversary.

The procedure bought him enough time to get him to the point where he could have the proper surgery, which installed a mechanical pump to assist his left ventricle.

But how much time is really left? I spent most of last weekend visiting with him in ICU. He is covered with tubes and monitors and still spends a good portion of the day sleeping. Though he is largely lucid, after he wakes up he often seem confused. The doctors say that "ICU psychosis" is a common and hopefully transient affect of this kind of surgery.

Each member of the family is dealing with my father's mortality in a different way. My mother, who has always been a tough cookie, adopts a very Midwestern attitude of "this is bad but I have certain responsibilities." My brother's is stoic in a different way: he bring his notebook and looks up every piece of jargon the doctors mention. My sister, however, is more fragile. Our father is, unfortunately, a large portion of her social world and prefers denial. She believes everything will soon be back to normal.

But I could see in my father's ideas that he is spooked by his brush with death. He said to me: "It's like I was visited by the grim reaper--and would have been taken away if four cardiologists hadn't been standing in my hospital room."

For myself, I know that my father's time is very limited. But more than that, the main thing that brought tears to my eyes as I spent time with him was the haunted look in his eyes.  Though I am overjoyed  he has been given this extra time, at moments I wonder if it's cruel to force my father to experience dying two times.

I couldn't help but dredge up those childhood memories of telling the other boys that my father was the strongest, smartest and wisest man in the world-- and it was infinitely sad to see how frail and gray and worn he had become in just three months. My father had always told me how much he hated hospitals because he and his brothers spent two year taking shifts besides the bed of my cancer-ridden grandfather. And with that hospital smell in my nostrils and the sound of monitors beeping in my ears, I found myself suddenly overwhelmed by a sense that life was fundamentally sad. 

Comments

( 8 comments — Leave a comment )
microbie
Oct. 3rd, 2013 01:39 am (UTC)
That is really tough, and I'm sorry that your family is suffering. I hope he gets out of the hospital soon. Hospitals are miserable places.
twfkat
Oct. 3rd, 2013 03:32 pm (UTC)
Agreed. I think your dad would feel much more relaxed if he was at home. I hope he can be out soon.
evelynne
Oct. 4th, 2013 01:47 pm (UTC)
I'm sorry you have to go through this. It's so hard watching a parent become so frail.

What do the doctors say about his prognosis? It's not clear to me why you think his time is still very limited. The initial time after surgery is scary to see even when someone is young and healthy, but some heart-assisting procedures really do give people a new lease on life. I'll keep my fingers crossed.
lipbylipby
Oct. 7th, 2013 12:13 am (UTC)
It's something we all have to go through, though that doesn't make it any easier. But the truth is I think my father absorbed significant damage to his body (he really was hours away from dying) and the person who holds the record for living the longest on one of these devices lived for seven years.
fyremaven
Oct. 6th, 2013 10:55 pm (UTC)
I'm so sorry to hear about your dad.

Being an ICU nurse I know from what you write that you have a good handle on everything going on. Sadly, each member of your family is dealing with it in a different way and that's common, too. It works out best for the medical staff to keep giving information till it's understood, and some might bury their head in the sand while others look up each term. Both are considered "normal."

For your dad, I feel the worst...he is at the center of all the attention but can do little to control it. In fact, basically he can do nothing at this point. ICU psychosis is also common and stems from a couple of factors. Partly it's very difficult to figure out what time of day it is inside an ICU. Lighting is mostly the same, the noise level certainly never goes down much, and there's just as much activity during the evening as other times of the day. That coupled with all the meds we put people on "to keep them alive" wreaks havoc with our natural body clock and with our brain waves, even. Just know that your dad can most likely HEAR you even when he is asleep or appears asleep so if you have anything to talk about in his room I recommend going outside the room to do it. Sounds basic, but no bickering with family or doing anything stressful...in fact, even normal conversation can mess up his ability to get some rest which is what his body REALLY needs.

Sounds like the hospital staff has kept you guys informed and that's good. I work full time in a hospital and I still don't like the hospital smells, so you aren't alone there. I will keep your dad and your family in my thoughts and prayers.
lipbylipby
Oct. 7th, 2013 01:15 am (UTC)
Thanks, Fyre. That's some interesting insight. I did look up "ICU psychosis" and, in the case of major heart surgery, it seems to be the result of not only environmental factors but also a side effect of the surgery itself. (Tiny bubbles of air released from the pumps used during surgery.) And there must be some depression involved, which is something my family is not equipped to deal with at all.

You're right about the conversation. My sister seems to think that visiting involves sitting next to my dad and constantly trying to talk to him. Why she thinks that he needs that is beyond me.

Thank for the interesting info and support...
fyremaven
Oct. 7th, 2013 03:12 pm (UTC)
I have had many patients that are in "medically induced comas" both after cardiac surgery and bad trauma surgery and the way i explain it to the family is like this: The MD wants your family member (i say "Dad" or "sister" or the appropriate term) to rest and that means EVERYTHING even his ears. Believe it or not he can still hear you and it's like you are trying to rest at home but you hear something just out of earshot...you are striving to hear it but the drugs are keeping you down...imagine that struggle going on and how much energy it is burning up. Energy that can be better used to HEAL." That usually gets through to everyone. And if it doesn't, sadly, I've had to resort to limiting visits if needed because the family is super important but the MOST important person is the one in the ICU bed. Period.

You can pm me or email if you'd like to ask anything about the equipment or other stuff but don't fully understand it...I would be happy the help you with that. Either fyremaven@aol.com (i'm debbie by the way! :)) or on here, either way i will get it. :D

Hang in there.
lipbylipby
Oct. 8th, 2013 01:31 am (UTC)
Thanks Debbie... I'm already using your authority as a nurse to tell my sister to stop being so damn chatty with my dad. Thank for the support and I may very well have some question down the road...
( 8 comments — Leave a comment )

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