Restored and Made Strong

This past Monday, February 23, is the kind of day that you never want to endure. Before Mom arrived at the hospital a new team of doctors with fresh perspectives, following old clues and conferring with the previous Critical Care Team were in checking and evaluating Dad. The ICU has a rotating team of medical professionals each week. Dad was scheduled for a new dialysis port for the morning, with dialysis in the afternoon. With doctors continually reviewing the charts you would think they would have been able to fine tune the trouble spot for Dad's mysterious infection and fluid retention that made his belly so distended. The doctors had an answer and a probable cause but the outlook did not look favorable for a full recovery for Dad. They suspected a rupture or leak of the chyle duct. I had never heard of this anatomical term. I guess it would be left to Google. http://emedicine.medscape.com/article/190025-overview.
Their explanation made sense, that's all that mattered. They would continue to do everything they could to try and turn around Dad's condition for as long as we desired. They were on morning rounds and I felt Mom needed to be present before any further treatment plans were engaged. As she arrived Dr. Cox and his team were prepping to put the new temporary port into Dad's neck area.

As they performed the port procedure, we took a walk to the lobby to mail some greeting cards Mom had prepared, one for Dr. Pates who delivered me 46 years ago. He is the oldest practicing doctor in Idaho! No, I wasn't born in Idaho. He used to live in Belding. His daughter was celebrating his 85th birthday with a surprise. We wandered back to the family lounge where Mom read her book and I wrote a little bit into the blog. Nurse Jenn came and said they were all set and we could come back anytime. Mom headed back as I packed up the laptop. She was gone a couple of minutes then peeked over my shoulder and said the doctors were done for their morning procedures and could talk with us in the consultation room.

They explained in greater detail of the possible chyle leak, which in healthy patients can be controlled. In order to confirm the diagnosis more tests, ultra sounds, and ex-rays of specific detailed areas would need to be done. Surgery would be required, which Dad was not a sound candidate for, considering all of the recent set-backs. The doctor explained in certain pro-active(politically correct?) terms that he was pro-life and respected the patient and the family's desire for protecting the quality of life. It makes one wonder what kind of college and humanity courses on compassion these professionals need to acquire in order to maintain their composure in such conversations with a patient's family. They needed to know if we had any previous conversations with Dad prior to surgery regarding long term, life sustaining measures. Any that knew Dad would question that we had already pushed the limits on heroic measures with all that had already been done. Dad had already been going to dialysis 3 times/week for a few weeks prior to surgery so was already in gear for that plan. With all of Dad's recent complications, at best, if treatment was in the Lord's favor, we would be looking at a long term stay in a Nursing Home. Prior to this last infection Mom and I were prepared to inlist the services of Spectrum Health's LTACH
http://www.spectrum-health.org/cs/Satellite?c=eHA_Content_C&cid=1218817408142&ehapubname=Cont_Care&pagename=Cont_Care%2FCont_Care_Central_Template
for rehabilitation to get Dad back on his feet and in his OWN bed. Nursing Home? Ventilator Dependent? With Dad no longer responding to us, the doctors or physical therapists how much more could we make him endure? We had already felt we overstepped heroic measures with the respirator following his seizure on January 28. With a tearful, prayer of petition to God, we felt his answer had been in front of us already. Dad had been breathing on his own, yet needed the extra pressure support of the ventilator to complete his breaths. As the infection increased so did the dependency on the ventilator. Mom and I agreed that if God was calling, Dad should have the dignity to heed his call. We tearfully called my family together. Pastor Curtis from Spectrum's Pastoral Care brought us a Comfort Quilt, hand stitched by the Quilters Guild at Emmanual Lutheran, and prayed with us as we laid it over Dad's feet. Dave's sister Mary and daughter Christine arrived to join us in our time of prayer and grief. We are one in body as a family. We surrounded Dad with clinched hands, hugs, prayers, tears and laughter from 3:00-4:45pm, at which time God peacefully called him home.

And the God of all grace, who called you to his eternal glory in Christ, after you have suffered a little while, will himself restore you and make you strong, firm and steadfast. 1 Peter 5:10

The hospital staff was generous with their compassion with regards to Comfort Care, making sure Dad and his family were comfortable and allowing privacy in our time of grief. His nurses Jenn and Bridgett monitored him quietly from their station, periodically coming in to make sure he was in a restful position.

Mary and Christine offered to drive our second car home, but Courtney said she was able. Dave and Courtney had picked Kelsey up at school so her friend Christopher had driven her car to his house, then later shuttled it home when the girls arrived. I drove Mom home in her Tahoe and Dave followed in our Expedition. She insisted that I stay at home with our girls. I didn't give her the option, I called my cousin Jim to come over. She said he didn't have to stay. We had already made a private decision that he would! He told her to get some sleep and he and Murphy would do their thing.

I felt sick to my stomach and had a horrible headache all the way home. Dave stopped at Walgreen's to get cold meds for him. I got out of the truck just to get air. Dave had made several phone calls to people while at Mom's. I wanted to make a couple more when I got home and spend some quiet time with my family, but all I could do was grab a bucket and curl up in my bed. With every twinge of pain from my pounding headache and the chill that overtook me, I was awash with grief and emotion. I could not help but think what kind of pain or the feeling of being cold my dad must have had at times while he lay in that bed unable to talk. My only comfort was knowing that Dad was no longer in pain. I realized I was about 10 hours past due in taking my blood pressure and anti-anxiety meds. I don't carry them with me. Courtney brought me water and Dave garnered my pillow, which I had left in the living room on Sunday afternoon, and another comforter because I was so cold. I finally fell asleep. I awoke at 12:04am feeling much better. I checked on my sleeping girls, let the dogs out briefly and went back to bed. I don't even remember if Dave snored ;) I did wake up every couple of hours though.

Tribute and Honor Arrangements

Johnson-Feuerstein Funeral Home
203 S. Pleasant St.
Belding, MI 48809
616-794-1630
toll free: 1-888-663-5633

http://www.jffh.com/

Funeral services will be at 10:30am, Thursday
at Johnson-Feuerstein Funeral Home
in Belding with Pastor Kendall Harger
of Shiloh Community Church officiating.

Interment with full military honors by the
Belding VFW Post 4406
will follow in River Ridge Cemetery.

Visitation will be Wednesday from 6-8pm at the funeral home.

Memorial contributions may be given to the Alvah N. Belding Library

Farewell to a Great Man

Monday, February 23, 2009: With heavy hearts we said an earthly farewell to our dad, husband and grandfather today. With all of us surrounding him in prayer, Dad courageously entered the woods of Heaven with Our God and Master of Creation at 4:45pm, from the Fred and Lena Meijer Heart Center.

Please uplift our family in prayer for peace of mind, as we struggle with Dad enduring 3 weeks of treatments and now as we open a new chapter in our life.

Thank you to all who have been a link in our chain. We are ever grateful for your thoughts and prayers.

I will post further information regarding services later today.

For to me, to live is Christ and to die is gain. Philppians 1:21

Sunday, February 22: Ex-ray was in at 6:15am. Dad was restless this morning and his blood pressure is up and down. Nurse Holly laughed and said Dad's morning meds look like pea soup. I agree...ewww! She mixed meds and benefiber and uses a huge syringe to plunge it through his feeding tube.



Physical Therapy came in early and had to deflate Dad's air bed in order to turn him and get him to the edge of the bed to sit up. The right corner of Dad's right eye is really blood shot and his left eye has a yellow film over it. I asked the doctors about it and they said the right eye was probably caused from a broken blood vessel due to coughing and the left eye was just residual blood. Neither should cause alarm. They still look nasty. Mom arrived about 9:00am. I skipped church because the doctors came into talk to us right when I would have needed to leave. I cut for home about 10:30am. Gwen Petrowski pre-arranged to cover my Sunday School class this morning. Thank you Gwen!



Dad received a unit of blood today. He had another Paracentesis performed with another 5 1/2 liters removed! Arrghh!!! Dad was snoozing soundly after the procedure so Mom called and said she was coming to visit. I was excited because for once I could treat her to a meal. I had put a roast in when I got home then I took a long nap. Courtney added carrots when she got home around 1:00pm. I was just starting to make noodles when Mom called. She loves beef and noodles, so it is a good day. Mom headed back to the hospital about 6:00pm. Nurse Sue and Tech Christopher started their shift by removing Dad's temporary dialysis port. The doctors don't like to leave them in for a long duration as infection can occur. A new one will be placed on Monday before dialysis.



Mom creeped out a little after 9:00pm. Family acitivities kept me busy at home so I didn't get up to the hospital until after 10:00pm. I called Mom and when I walked back to the room Sue and Chris had the door closed. I checked with the desk supervisor and she called Chad, who was in the monitor room. They were shaving him and hadn't started his bath yet. I knocked and snagged my bag with Dave's laptop so I could chat with Kelsey and Courtney for a few minutes before bedtime. Dad was awake on and off through the night. Sue sat and visited for a few minutes during a break. She peeked in to say she leaving for lunch. Dad was getting kind of restless. I had his right wrist restraint off which is near his respirator tubes. He rested his hand on his forhead and rubbed his fingers across his eyes. I asked if he had a headache and he winced. Sue arranged for some Fentanyl and Nurse John came in to give that dose. I hate seeing Dad in a fog but really don't want him in pain either. It is better for him to rest at night so he is more alert for all of the crew in the daytime and for Mom.

Nahma Nurse

Saturday, February 21: Dad was restless this morning and Nurse Holly gave him a dose of Ativan while I why dozing. His blood pressure dropped lower than should be for going into dialysis in a short while and he was very lethargic. Holly suctioned him which usually wakes him up and brings up his blood pressure. What a way to wake up...bah! Jim McMillan called just as Mom was walking in Dad's room. He really wants to be able to help Cindy with Murphy when he can. He reminded me that he has a ramp for Murphy :) Mom said that Sally B called and was only 4 hours to her sister's house and it was 75*.

Nurse John started dialysis a 9:30am. He is such a hoot to carry on conversation with. He and Patty are so good at running Dad's dialysis. We are always happy when they are scheduled! Physical Therapy popped in toward the end of dialysis but was not able to work with Dad today due to his schedule. I went for home to spend some quality time cleaning and hanging out with my family. Once again I tried napping to no avail. John was finished about 2:15pm and had taken a 1/2 liter of fluid off. Shortly after John left, Dad's blood pressure monitor set to beeping. His bp was 193/113! He had not had bp meds due to dialysis and Nurse Holly was at lunch. The nurse covering called and was able to administer his bp meds. Within 20 minutes his bp was in line where it needed to be.

Dave is trying to get rid of his cold so he hit the bed for a nap. Despite the snowstorm that has finally arrived, I took Courtney & Kelesy to Alpine for a beauty supplies run to the Meijer Outlet, Marshall's and Ulta. Everybody contain your excitement...lol. Mom called just before 7:00pm and was going to leave for home because the weather wasn't getting any better and Dad was resting. Dave was lounging on the couch in front of the TV when we got home. Kelsey had already called Chris Mulder and he arrived to watch Nascar and hang out until Liz was done with work. Liz had got to our house shortly after I left for the hospital. When I called Mom at 9:30pm she said the roads were horrible, especially near Paulson's house. An oncoming car swerved right into her lane. She was able to tap her breaks and stop and put her Tahoe into low gear. I told her Dad's blood pressure was a little low and I hadn't talked with the nurse yet. Courtney went to a birthday celebration at friends at Calvin College. She made arrangements to stay over with her friend Courtney M and go to church with her in the morning.

When I got back to Dad's room I chatted with Nurse Suzanne, answering questions as to when and how long Dad has been enduring cancer treatments. Dad's bp balanced out. Our conversation led me to comment that Mom and Dad had gone to their home in the U.P. for few weeks after Dad had his drainage tube of 9 months removed in September. She exclaimed, "I lived in the U.P. for 15 years!" Interesting...I asked where. She said between Escanaba and Manistique! I told her our northwoods home was in Nahma. She laughed and said she and her husband and kids had moved two years ago from Nahma Junction! Oh, my word! That is literally a few miles from our house.
She grew up in Milwaukee and her husband grew up in Cooks. Her father-in-law, Harold Carly is 92 years old and still lives there. The Disney melody comes to mind...'It's a small world after all!'

Dad spiked a fever again about 1:00am. More meds to control that and more questions as to where is it coming from?! He has had a couple a really good days with no fever.

Floating on a Bed of Air

Friday, February 20: The Thursday overnight guard was mostly uneventful. Dad had a fairly tiring day on Thursday, and I hadn't been able to sleep at home so I was able to close my eyes a little easier in the super recliner.


Nurse Patty was in shortly after the ex-ray crew, ready to rock Dad's morning with dialysis. He had a really good run this morning and Patty had few issues with the machine. Mom arrived at 10:30am and he only had 30 minutes left of his dialysis! She said that Ken had called to check on Dad. She made an early stop at Leppink's Supermarket to pick up hot dogs, bologna, and turkey...for MURPHY! I left about 11:00am for errands before heading for home. The docs came in right after I left. They told Mom everything is looking good but it still will be a long road.

Mom's friend Sally S surprised Mom again about 12n. They went down to the cafe for sundaes while the Physical Therapy team worked with Dad. Sally visited with Mom until 4:00pm. Its refreshing for Mom to have someone else to talk to. Nurse April and Tech Emily got Dad cleaned up after working so hard with PT. Dad was very active today. When Mom told Dad, "I love you," he smiled and winked at Mom. When he is alert he has pretty good control of his eye contact.
Mom said there was a Kin Air Bed waiting to be moved into his room later.


Dave is whipped from the cold that he has procured. I wonder who he picked that up from? Its surprising he wasn't sick earlier than now. Despite him feeling like he just got hit by a Mac truck, he changed the wheel and tire on Kelsey's car. He had called me earlier to make a phone call and order a wheel from Bakers. He had picked up a used tire from Schneiders in Marne. Kelsey had a chunk out of her wheel and it went into the sidewall of the tire. Somehow supper hour and sleep seem like a perfect match. I think my whole family napped at some point during the early evening hours. I remember waking up hearing Kelsey and her friends talking. I was still tired. Dave told me he had taken care of the beef ribs that I had set to cooking earlier. Mom called and was leaving soom after 9:00pm. By the time I got my body into gear, I didn't get to the hospital until 11:30pm. Nurse Kara and the tech were getting ready to give Dad his bath and transfer him to his new air bed. It was a team effort by a few staff members.


His bed looks like a giant pool float set down into a hospital bed frame. It is inflated based on his height and weight. He seems to be able to rest more comfortably now.

Strength and Reassurance

Last night Dad was supposed to have Kris, whom we have never had, for his nurse but the gentleman next door required her undivided attention. He has more monitors than a pop-star. I think he was deserving of her TLC. I had arrived just as they were preparing to give Dad a bath and get him boosted in a new position for a couple of hours. I chilled in the waiting area calling Mom, per her order, and texting Courtney & Kelsey goodnight ILY's. When I was able to chat with the nurse I thought it was Dan, but he introduced himself as Justin, Floor Supervisor. Charge Nurse Dan was attending Dad before Mom left, but he was called to assist in another room also. Justin is another outstanding nurse. He was attentive to every beep and bonk on Dad's monitors. He has definitely earned his stripes as a Floor Supervisor! Kris was covering for Justin during lunch and also was top-notch at making sure Dad was comfortable.

I commented how nice it was to see so many male nurses. Justin told me there is a higher ratio of male nurses in Critical Care. Kelsey has a couple of guy friends going into Nursing. My advice for you: Go rock the world with this awesome desire that God gave you!!!

Although Dad was resting comfortably, I could not fall asleep. As I watched out the window looking to the East up Michigan Street all I could see was some slight dusting of snow. The forecasted snowstorm had passed us by. My eyes finally drifted shut about 4:00am. Dad began stirring around 4:30am! I did nod off but was awake when ex-ray arrived at 6:15am, then wandered to the family lounge. Someone's support crew was trying to find respite in a couple of chairs pushed together. Both TVs were blaring, cartoons on one and news on the other. I saw school closings listed for the lakeshore cities so I know it was snowing somewhere! I turned both TVs off. Despite the lights at least she was minus the noise. Kelsey told me last night to call at 7:00am not 6:45am. I saw 6:45am come, but dozed until 7:10am...oops. I'm just her kick, in case she hits the snooze button which she rarely does. She was moving & ready to leave for school :)

At the changing of the guard, Nurse Rob resumed his daytime duties. Mom arrived just as the doctors came in to check on Dad's progress. They scheduled a paracentesis, poking the belly with a long needle, http://www.webmd.com/brain/paracentesis-17042 for later in the day. The Heparin drip was stopped. Dad was restless and moving quite a bit. Having a sore bottom would certainly make anyone want to be in a different position! The petite PT crew was in for another round with Dad. Considering the requirements for the job, you would totally expect a Physical Therapist to be tall, 200+ lbs, with a muscular build. I have never encountered a PT with that description. They have all been small framed, with muscles from nowhere. When I look at them I think of a gymnast :) They have been great at working with Dad. They came in and worked with him 2 different times today. Each time they are increasing the time frame they will work with him. They also suggested they will look into a 'stretcher chair' to help Dad get more mobile.

During the belly tap this afternoon, they drained off 5 1/2 liters of fluid equal to 12 lbs! Mom and I thought they were just drawing off enough, like a syringe full, in order to culture it. That is like carrying around 24 cups of coffee!!! Where's the bathroom, already? Mom said he rested nicely after he returned from Radiology. I think we all would!

I always ask Mom if we can bring her some lunch or dinner from home. She is content to find something from the cafeteria that she enjoys. After her oatmeal in the morning, she is actually a fairly light eater. We savored our lasagna dinner, garlic bread, salad, homemade applesauce and cookies. I brought Mom some of the cookies for her snack tomorrow.

Kelsey and I went to Jenison to show respect to Vern, Jana, Brianna & Kaylee VanHalm, in the passing of Vern's father. On February 15, 2009, at the age of 76, Tunis Henry VanHalm joined His Heavenly Choir. May God bless your family with His sustaining grace. Jana said she had talked to her friend Gigi, who had been Dad's nurse... ??? I felt dumbfounded, then she told me her formal name was Gabriella. I reassured Jana that she was an awesome nurse! We have really been blessed with some terrific care givers here.

When I talked to Mom around 7pm, she said if Dad settled down she would leave for home before I got to the hospital. Mom called Courtney to say Jaci is Dad's nurse and is taking good care of him so she left about 9:15pm. I dropped anchor at 10:15pm. hmm...I wonder if she got Murphy's golden arches burger? I forgot to ask :)

There were 3 doctors checking in with Dad from his paracentesis today. We discussed some details. There is the possibility the excess fluid could be caused from recurring cancer, since that has been an ongoing issue, or from liver failure, or something all together different. It is definite that Dad will not be undergoing any surgery anytime soon. He is still very weak and his prognosis for full recovery is not looking in his favor. When test results do not show difinitive answers, a time will come when we need to honor Dad and give him the dignity he would desire.

It breaks my heart to not be able to have a two sided chat during the midnight hour. Dad and I have had the 'farewell' chat many times before. He has been a cancer survivor for 9 years! Being in ICU reminds us daily of 'sudden good-byes' without a farewell. Being an only child, my Mom and Dad have rocked my world with love for over 46 years! I am frustrated that our household has been a recurring petri dish of colds and sniffles, or worse. We have not spent as much time as a family with Dad in the past year because of his high susceptibility for infection. Although, we talked frequently on the telephone, sometimes about nothing and other times we were surely going to save the world! Our girls are 19 & 16 and we have never had a full family photo taken. I go back to my 3rd grade Sunday School lessons, through our prayers of petition we need to take time to listen and hear God's answer.

A greeting card from Mom's cousin Wanda inspired these words:

We are reminded that God who created us can put our world together again.

We ask Him to bring us strength and reassurance as we lean on Him and rest.