Pain Meds 2

As I was describing the conversation and situation to a friend of mine, however, she made a very good point. Obviously, Dad is in some discomfort, whether its acute pain or not, and what would be wrong with obtaining more pain meds for him. As we talked, it seemed like more and more of a good idea. I'm definitely not one for drugging Dad up, but why not make him as comfortable as possible until the surgery?
We have such a bias against pain meds in this country. I have run up against it myself with my arthritis, and its made me wary. I don't like asking for pain meds, even in highly legitimate situations because of the stigma and because it makes me feel like a drug seeker. In the years that i've been in chronic pain, I've had to really fight both to get over my own pathology against asking for them(therefore asking for help) and I've had to fight against the prejudice and fear surrounding them.
I love being involved in hospice exactly because they support and promote comfort and the ceasing of pain through narcotics. If a person is dying, what possible harm could a few weeks of narcotics do to them. In this way, and through involving myself in hospice, I hope to make pain meds more acceptable, both for the dying and for those like me living in chronic pain.
I decided to do a brave thing. I called Dad's doctor, explained about the discomfort, and suggested that she prescribe a further course of pain meds for Dad, just until the surgery could be scheduled, and she actually thought it was a good idea. I was happy to be able to help my Dad out; it gave me an opportunity to fight for him, but also to fight for myself against society's prejudices and my own fears.

Pain Meds.

Dad's caregiver called the other day. He swore the night we took Dad to the ER that something else was wrong, that for a while something wasn't right in the area. Since the surgeon's visit when he learned he'd been vindicated about the hernias, he's been on the phone.
So now he's got the bit between his teeth and he's calling me to keep me posted on Dad's physical state and that he seemed to be in pain when they were cleaning the area. Apparently, Dad told them to leave him alone, which is unlike Dad as he's been getting more and more nonverbal. Personally, I'm not convinced that its the hernias giving him trouble. I think he might be sick of people poking him and changing dressings and stuff!
The caregiver wanted me to hurry up and schedule the surgery so that nothing would go wrong and Dad could be out of discomfort.
At the time of our conversation, I was suffering from a migraine, and also trying to finish up last minute Xmas stuff, so wasn't really in the mood to deal with him. I told him I'd get in touch with the surgeon as soon as possible, and hung up quickly.
TBC

Holidays.

I can't believe its already the 20th of December, this year is hurtling towards its end. They have a fake Christmas tree up at Dad's house, and some tasteful decorations. Its a nice tree, actually. Dad's caregiver stressed how important it was for the residents to feel involved in the change of seasons, which I agree with. It reminded me about how much Dad used to like Christmas.
He made a big deal of the holiday; he and my mom would go shopping in the malls at night when they stayed open late. Then on Christmas Eve day he would go out to the malls all day, getting home late at night and ferrying interesting packages straight to the basement. My sister and I would be jigging with anticipation. Then the next morning, we would have to wait until the living room was ready, and the tree was lit up before he let us out to see all the presents, wrapped and unwrapped. He always made sure there was an equal number of gifts for each of us, although we really didn't care after a certain age.
Christmas was never really the same after my mom died. We all tried for a year or two, but couldn't recapture that same magic. Every year when the holiday rolls around, though, I make the Christmas cookies my mom made and remember the lit-up tree and the stacks of gifts that my Dad took such pleasure in giving to us.

What Next?

I took Dad to the surgical center so they could check on his healing wound. His caregiver brought him over from the house and I met them at the hospital in the bright, new, glassed-in surgical center. We waited and waited, then were taken to a private room where we waited some more. To pass the time, the caregiver, who is from a former Soviet country, and I chatted about his past and experiences in America. We did a few stretching exercises with Dad and tried to engage him in conversation a little bit. He seemed to be in a good mood.
The caregiver was concerned about what he thought was a hernia in Dad's groin, so when the surgeon finally came in, we had him investigate the area. Luckily, the surgical site was healing nicely and he was pleased with its progress. Unluckily, he discovered that Dad had two hernias, one on either side of his abdomen! Apparently, hernias are not extraordinarily painful, but they can be dangerous if they become squeezed off and infected. So the surgeon recommended that within the following year we get them attended to.
All I could do was wonder at my formerly abnormally healthy father. Except for the dementia, of course, he was never sick, never had an injury, except for one broken arm from skiing. I'm not sure what the year is going to bring, but it seems as if it might be full of these physical problems for poor Dad. Little by little, that good health is being chipped away and it makes me sad. I guess it comes to all of us, but its hard to watch my formerly robust father get more and more frail and ill.

Cookies and cars.

I took my partner to see Dad on Monday and to drop off some xmas cookies and blankets. Dad was sitting quietly in the living room of his house. We gave his caregiver the tin of cookies, explaining that the peanut-butter ones with the chocolate on top were his favorite, ones my Mother used to make for him.
My partner and I sat with Dad for a little while, and my partner, who can engage and talk to anyone, began chatting to Dad about cars and engines and the Corvettes and Corvairs my Dad used to own. I was watching Dad's eyes, which at first were flat and unfocused. But as my partner talked about engines I saw Dad's eyes literally come into focus and I felt like he was really LOOKING at us. I thought it was funny that it took a discussion about car engines to bring him back from whatever quiet world he inhabits now.
I also feel like there was a little recognition for me, as I sat there with him, talking to him. I felt his eyes focus on me, just a little, and an expression came onto his face that I recognized. It was humor, and just the glimmer of an idea that I was connected to him. Whatever was going on, whatever he was thinking or feeling, recognition or not, it was lovely to see him engage for just a little bit.
I should have known it would take something car-related to make it happen.

Personal Post

Thankfully, Dad seems to have suffered no more pain episodes. We have an appointment next week to see the surgeon again, but the caregiver tells me everything is healing up. I went to see Dad again on Friday last week to check on him but also to make sure he had been given his pain meds.
A trusted friend of mine suggested that one of the reasons the caregiver hadn't given him the oxycodone was because he stole it. Trust me when I say this was not a reassuring thought! This was not something that had occurred to me but I had to acknowledge that it definitely happens. I found it hard to believe that the caregiver, who I had no reason not to trust and who seems to really care for Dad and have his best interests at heart, would do something so nefarious. But you hear stories all the time about dishonest caregivers and bad adult family homes. It just opened up all my fears again and guilt and doubts about having put Dad in the right place.
Its so hard to know who to trust, but I just can't be there 24 hours a day. Few people can. At some point, you have to trust you've picked a good person and a good place and rely on faith. While at the same time making a few surprise visits to make sure everything is going okay.

Emergencvy Room

Tuesday morning I went to see Dad. And he did not look good. He was pale and washed out, his eyes were staring and wide, he looked frail and uncomfortable and it was obviously hard to move. I thought that the surgery had taken so much out of him, it was terrible.

I sat with him for a little while, not really talking, but stroking his arm and just being there. I had to go to work, so I made sure his caregiver had everything he needed and I left. At 4:00 I got a call from the caregiver; Dad was sweating profusely, pale, hadn't urinated all day and seemed to have some lumps in uncomfortable places. Could I please come get him and take him to the emergency room?

I knew I couldn't ask my sister for any more help, since I was now back in town. We finally got it worked out that he would drop Dad at the ER in Bellevue, but he couldn't stay since he only had one other person on shift. I picked up my boyfriend and we made our way through traffic to Bellevue. When the caregiver and dad shuffled in to the ER, I was shocked; he looked even worse than the morning. It looked like he could hardly stay on his feet. A nurse must have caught sight of how badly he was looking, she came over andd hustled Dad and me into a private room. Poor Dad, the expression on his face as yet more people pulled him around, took clothes on and off, inserted things in his veins. He couldn't say anything, but I could tell how deeply humiliated he was.
TBC

Why is it always the holidays? 3

My sister she can be very good in a crisis. Fortunately, she's been to the ER a few times herself so she knows how it works. She was able to join Dad and deal with the doctors. I still received a few calls, however, when the anesthesiologist couldn't find her and needed to know if Dad had drug allergies and whether he had a health directive.

Its strange, with Dad becoming more frail and because of my hospice work, I've become more aware of health directives and DNR's. It's always difficult to think of it in terms of your loved one, though. I know that because of his religious and philosophical beliefs, Dad would not want huge measures to be taken for him. We even talked about it once on one of our walks.

He had his surgery, and spent the next few days in the hospital recovering as much as was possible. He was discharged on Saturday and brought home to his house by my sister; apparently a smile of relief appeared on his face as soon as he was brought into his room. When I went to see him Tuesday morning, I was shocked at how frail and wrung out he looked. The surgery, bodily dysfunction and hospital stay had clearly been very hard on him. He was healing, but he still didn't look well, and was clearly still uncomfortable. It was good to sit with him for a while, and I left feeling better that HE was feeling better. Unfortunately, however, Dad wasn't done with me yet.