The decline of my father in law

[glatt]

Whee! What a fun thread title.

He wears a back brace for a spine fracture, and it had been working beautifully for a few years, but he began experiencing new back pains late last week.

On Sunday morning, we got a call from the assisted living place that they had called for an ambulance to take him to the ER because he was having trouble breathing.

We got ready to head off and drove across town an arrived at the ER about 45 minutes after the call. And the ambulance wasn't there yet. But it showed up about 10 minutes later, and we had to wait for another hour in the waiting room until they called us to come back there.

So once we got back there and saw him and talked to the nurses and doctor, it became apparent that they suspected pneumonia. He looked like crap. Trouble breathing and his skin was pale gray. But they had an oxygen tube in his nose, and he improved in color steadily the entire time we were there. The ER folks were really nice, and one of the nurses actually knew him because she's also a chaplain at his assisted living facility, so that was really nice because she spent extra time talking with us. Nice people.

Monday was frustrating because my wife, who has power of atty, couldn't get there until after she was off work, and there was nobody to talk to about him. But a nurse gave her a copy of the write up of his xrays and CAT scan. It was written in medical language, but with wikipedia, I was able to read it. Boy, was that a mistake. He had so many things wrong with him, the pneumonia seemed like the least of his troubles.

We knew he had a broken back. That's why he was in assisted living. But with a brace, he was pain free and able to walk for the last two years. Until last week. That's when he got a new break in his spine in an area not supported by his brace. His bones are old and very brittle. And this new break is causing intermittent excruciating pain. At one point he asked me to adjust his watch for him, and he raised him arm, and his eyes about popped out of his head in pain because just that slight arm movement wrenched his back.

And then there was the difficulty breathing. We thought it was pneumonia. But as I read the report, it turns out he has a "large" hernia in his diaphragm. So big, that part of his stomach and colon are up inside the hernia. But no sign of food blockage, so that's good. The nurse had told my wife that they wouldn't operate to fix the hernia. So I had images of his diaphragm being basically torn in half and this difficulty breathing being the new normal for the rest of his life.

The report said he also had some fluid around one small area of one lung, and some irritation in that area, so there really was some pneumonia. It was good they were treating that.

And of course, as an old man, he has a slightly enlarged heart, and there's calcification around there.

And he's got cysts on his pancreas.

So this report had me convinced that he would be dead in no time. The shredded diaphragm sounded horrible.

But then Tuesday, my wife called in sick, and spent the day at the hospital, talking to everyone. Turns out the diaphragm is just fine. His only real problems are the broken back, and the pneumonia. And the pneumonia is getting better. His doctor said the prognosis is "good." His doctor thinks he's a candidate for back surgery because he's been fairly active for the last two years, but the ortho surgeon thinks his bones may be too brittle and back surgery is too aggressive. This is the same day that the Washington Post came out with an article about how a recent medical review says 90% of back surgeries are not necessary. Is he gun shy because of the article? He wants to use a larger back brace that will support the new fracture. A more conservative approach. But let's do an MRI to see things better.

So Wednesday, my wife works. And goes there in the evening. They had ordered an MRI to really look at the back. FIL is unable to lie flat on his back. It causes immense pain. So they give him strong pain meds my wife remembers from watching Drugstore Cowboy. They try to lie him down and he is in extreme pain. The MRI is called off. He's in horrible shape. My wife comes home all bummed out having seen him suffer so much. She say out loud that she wants him to just die now. It's no kind of life. It's unbearable to watch him labor for breath, cough, wrench his back and then gasp in pain while his eyes pop out, and his face flushes red. And then he slowly, tentatively starts breathing again, only to be followed by another cough a few minutes later.

She is scheduled to be off today. She went to the hospital and I just got a call from her. He's going to get a surgery for his back to take the pressure off his spinal cord. In fact, the first she heard of this was when the anesthesiologist comes into the room and see her feeding him a milkshake. (That's another thing, he can't feed himself because raising his arms is too painful in his back.) Nobody knew the surgery was going to happen, so he ate breakfast and lunch. It's postponed until tonight. The surgery is deemed necessary because they are afraid of bladder and kidney damage if they don't do it.

I hope he either gets his back fixed, or dies on the operating room table.

It's amazing how fast this all happened. Just last week everything was fine. Now I'm wishing him death.

77 years old. He's had a full life. Let him go in peace with a little dignity.

These are all my thoughts. He hasn't asked to die. But he's got a DNR. Hmm. Maybe I should check on that. He had a DNR at the assisted living facility. I don't know if the hospital knows about the DNR.