The decline of my father in law

glatt · 10-31-2013, 12:13 PM

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.

footfootfoot · 10-31-2013, 12:30 PM

Shit.
My sympathy to you and Mrs. Glatt. 77 seems young to me, but what do I know? It is hard to watch someone decline and be unable to do anything about it and also knowing that the getting better isn't really being better, just continuing being a little longer.

My SIL, who is a nurse, said pneumonia is called "the old man's friend" in that it helps them die.

Maybe the kind thing to do is not to treat the pneumonia.

Quote:

Pneumonia is called the old man's friend because, left untreated, the sufferer often lapses into a state of reduced consciousness, slipping peacefully away in their sleep, giving a dignified end to a period of often considerable suffering.

glatt · 10-31-2013, 12:55 PM

Thanks. It sucks.

Life goes on for us. We're super busy The kids have so much stuff scheduled. But there's this cloud over everything.

limey · 10-31-2013, 01:55 PM

Sorry to see this Glatt. It must be tough on you and the missus. X

Sent by thought transference

Clodfobble · 10-31-2013, 02:47 PM

Sorry.

I remember reading an article once about how most doctors refuse the end-of-life medical care that is considered standard for old people. Having seen what they've seen, they choose to minimize suffering and go (what turns out to be only slightly) earlier.

lumberjim · 10-31-2013, 03:54 PM

Wow. Sorry man

Pico and ME · 10-31-2013, 04:14 PM

That's really horrible Glatt. Why didn't the pain meds work? Cant they give him something to relieve him of all that pain? After the surgery, really push better pain meds.

Big Sarge · 10-31-2013, 04:56 PM

I'm so sorry for him and your family. I hope his surgery brings him some relief from the pain

zippyt · 10-31-2013, 05:41 PM

Damn what a Bummer !!!
And Mrs Glatt cant get off work to help her Dad ???? Is that leagle ???
I thought there was a Family leave act passed a few years ago , Dadz be family so whats the deal ???????

Stay strong !!!!

glatt · 10-31-2013, 07:43 PM

Well, today was good. Wife's brother showed up, from NJ, so he can help. And he's staying with a cousin so we don't even need to host him.

Surgeon wanted to try an MRI again before doing surgery, but the technicians refused because it went so poorly last time. So no surgery today or MRI, but he's been all drugged up, so feeling no pain and sleeping.

That meant we could focus on Halloween and hang out with friends tonight. A good night.

Pete Zicato · 10-31-2013, 08:10 PM

Sorry you have to go through this, Glatt. I hope things improve for your FIL.

Griff · 10-31-2013, 08:12 PM

Sorry man, stay strong.

orthodoc · 10-31-2013, 08:28 PM

Oh, glatt, I'm so sorry to hear this. It's so hard to watch a loved one in pain. I'm glad the meds they're using now are helping.

The $64,000 question is whether surgery will stabilize the new fracture enough to give your fil pain relief and restore a decent quality of life for him. It sounds like his MRI shows major pressure on his spinal cord, and that's not a good thing.

Pneumonia is indeed the old man's friend. Sometimes it's the kindest route, and sometimes not. It depends on the realistic prospects of relief from surgery.

Please feel free to pm me anytime. I'll be online here and there over the next few days; I'm traveling, but will check in. Best wishes for all concerned.

glatt · 10-31-2013, 08:36 PM

Thanks, ortho.

Clodfobble · 11-01-2013, 08:26 AM

Quote:

Originally Posted by zippyt

I thought there was a Family leave act passed a few years ago , Dadz be family so whats the deal ???????

FMLA can be very useful, but there are two major caveats for the employee. First, you are not paid while you are gone, you are simply guaranteed to be allowed to come back when you are done caring for your relative. Second, you are not guaranteed to be given your same job when you come back. I think it has to be at comparable pay, but they can put you in a different department or position at their discretion.

10-31-2013, 12:13 PM	#1
glatt ™ Join Date: Jul 2003 Location: Arlington, VA Posts: 27,717	The decline of my father in law 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.

10-31-2013, 01:55 PM	#4
limey Encroaching on your decrees Join Date: Feb 2004 Location: An island within the south-west coast of Scotland Posts: 7,016	Sorry to see this Glatt. It must be tough on you and the missus. X Sent by thought transference __________________ Living it up on the edge ... of civilisation, within the southwest coast of

10-31-2013, 02:47 PM	#5
Clodfobble UNDER CONDITIONAL MITIGATION Join Date: Mar 2004 Location: Austin, TX Posts: 20,012	Sorry. I remember reading an article once about how most doctors refuse the end-of-life medical care that is considered standard for old people. Having seen what they've seen, they choose to minimize suffering and go (what turns out to be only slightly) earlier. __________________ My book My other book My spirit animal

10-31-2013, 03:54 PM	#6
lumberjim I can hear my ears Join Date: Oct 2003 Posts: 25,571	Wow. Sorry man __________________ This body holding me reminds me of my own mortality Embrace this moment, remember We are eternal, all this pain is an illusion ~MJKeenan

10-31-2013, 04:14 PM	#7
Pico and ME Are you knock-kneed? Join Date: Jul 2008 Location: Middle Hoosierland Posts: 3,549	That's really horrible Glatt. Why didn't the pain meds work? Cant they give him something to relieve him of all that pain? After the surgery, really push better pain meds. __________________ Jesse LaGreca in 2012 “Seven Deadly Sins: Wealth without work, Pleasure without conscience, Science without humanity, Knowledge without character, Politics without principle, Commerce without morality, Worship without sacrifice.” – Mahatma Gandhi

10-31-2013, 12:55 PM	#3
glatt ™ Join Date: Jul 2003 Location: Arlington, VA Posts: 27,717	Thanks. It sucks. Life goes on for us. We're super busy The kids have so much stuff scheduled. But there's this cloud over everything.

10-31-2013, 04:56 PM	#8
Big Sarge Werepandas - lurking in your shadows Join Date: Jun 2008 Location: In the Deep South Posts: 3,408	I'm so sorry for him and your family. I hope his surgery brings him some relief from the pain __________________ Give a man a match, & he'll be warm for 20 seconds. But toss that man a white phosphorus grenade and he'll be warm for the rest of his life.

10-31-2013, 05:41 PM	#9
zippyt LONG LIVE KING ZIPPY! per Feetz Join Date: Mar 2003 Location: Arkansas Posts: 7,661	Damn what a Bummer !!! And Mrs Glatt cant get off work to help her Dad ???? Is that leagle ??? I thought there was a Family leave act passed a few years ago , Dadz be family so whats the deal ??????? Stay strong !!!! __________________ "Success is getting what you want. Happiness is wanting what you get. " Brother Dave Gardner

10-31-2013, 07:43 PM	#10
glatt ™ Join Date: Jul 2003 Location: Arlington, VA Posts: 27,717	Well, today was good. Wife's brother showed up, from NJ, so he can help. And he's staying with a cousin so we don't even need to host him. Surgeon wanted to try an MRI again before doing surgery, but the technicians refused because it went so poorly last time. So no surgery today or MRI, but he's been all drugged up, so feeling no pain and sleeping. That meant we could focus on Halloween and hang out with friends tonight. A good night.

10-31-2013, 08:10 PM	#11
Pete Zicato Turns out my CRS is a symptom of TMB. Join Date: Jan 2010 Location: Chicago suburbs Posts: 2,916	Sorry you have to go through this, Glatt. I hope things improve for your FIL. __________________ Talk nerdy to me.

10-31-2013, 08:12 PM	#12
Griff still says videotape Join Date: Feb 2001 Posts: 26,813	Sorry man, stay strong. __________________ If you would only recognize that life is hard, things would be so much easier for you. - Louis D. Brandeis

10-31-2013, 08:28 PM	#13
orthodoc Not Suspicious, Merely Canadian Join Date: Oct 2006 Posts: 3,774	Oh, glatt, I'm so sorry to hear this. It's so hard to watch a loved one in pain. I'm glad the meds they're using now are helping. The $64,000 question is whether surgery will stabilize the new fracture enough to give your fil pain relief and restore a decent quality of life for him. It sounds like his MRI shows major pressure on his spinal cord, and that's not a good thing. Pneumonia is indeed the old man's friend. Sometimes it's the kindest route, and sometimes not. It depends on the realistic prospects of relief from surgery. Please feel free to pm me anytime. I'll be online here and there over the next few days; I'm traveling, but will check in. Best wishes for all concerned. __________________ The greatness of a nation and its moral progress can be judged by the way its animals are treated. - Ghandi

10-31-2013, 08:36 PM	#14
glatt ™ Join Date: Jul 2003 Location: Arlington, VA Posts: 27,717	Thanks, ortho.

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