Another day, another roller coaster ride!

Tuesday, October 6, 2009

Last night was a very difficult night. It started with some delirium and faded into a fitful sleep that continued over the next 14 or 16 hours. Around 1:00 or so this afternoon a new doctor arrived, Dr. LaPenna. This is the partner of the doctor that saw him yesterday, Dr. Campbell, whom we liked quite well and spent nearly an hour evaluating him and also was the doctor that did his pacemaker surgery six years ago. This doctor, seeing him for the first time, listened to his heart and lungs and said he can go home. We almost collectively fainted.

The problem is that this ward is the Cardiac Short Stay - virtually an outpatient care facility. Excellent as it is, it really isn't configured to make patients comfortable. To the doctor’s credit he listened as we explained that simply going home was not acceptable. Several very attentive people and a couple of hours later we were talking to a palliative care team.

In the meantime his condition improved considerably. He was as lucid as he has been and even demonstrated as much strength as he has had in a while; lifting his arms entirely over his head unaided, etc. He was quite coherent and able to express his end-of-life wishes fairly articulately. When he was asked what he wanted to do he didn’t miss a beat replying that he wanted to die at home. He wasn’t aware of all of the options available or even how hospice was able to help. After some explanation, however, he was agreeable to the concept. His spirits were quite good, though, and the “old Roy” that we are all used to was in full display. Some of the questions and discussions were understandably difficult for the rest of us but he was neither maudlin nor depressed in any way. He was surprised to hear that he had such a restless night and that he had been so delirious. His feeling was that he had “a pretty good night.” All the better, I suppose.

The palliative care doctor, Dr. Trexler, was pretty optimistic that there were meds that would prevent the restlessness and any agitation he might experience.  Despite our dismay at having been sent to Borgess at all, the staff has been nothing less than outstanding at getting hospice set up. At around 2:45 we called, Tami, my mom’s cleaning girl, to see if she could be at the condo by 3:30 to take delivery on the hospital bed. By 3:15 she called back to say the room was cleaned and ready and the queen bed was disassembled and stowed in the closet!

By 7:00 we were back at the condo and all but completely settled in. My mom rode in the ambulance and Sharon drove her car for her. David will come tomorrow evening to take Sharon back to Kalamazoo. It is hard to know what is next but whatever it is it seems much easier to face in this setting. It is certainly more comfortable for those of us providing care, especially my mom and that is no small part of this process. Thank you all for all of the prayers and well-wishes. I am truly humbled by the outpouring of support.