Dad was lying in bed awake when I arrived. He said they got him up early, gave him antibiotics, and he thought he might as well get dressed and head for breakfast. He was heading for the dining room when they stopped him and said the dining room won't open for another hour. I asked him if he was going to eat without me and he looked me in the eye, smiled, and said, "A man's gotta eat."
Since he was already dressed, our trip to the dining room was quick. His apple juice was in a little container and there was an empty glass in his place setting. I watched as he opened the apple juice and poured it into the cup without spilling a drop.
Mr. K got pushed in by nurse Julie and as she was leaving Mr. K said "Thank you", with a smile no less. Whaaaat!? Cate and Amelia must be working their magic on the old man.
Dad chose the oat meal over the cream of wheat and asked for some sugar to put on top. This was a first for me. My guess is the little amount he ate yesterday, the early up for breakfast, the apple juice and the sugar on oatmeal are signs he is hungry. When we got back to the room I showed Cate the Liquid Protein supplement if she wanted to give it to him. It might offer some higher quality calories in a form he can tolerate. I also watched and saw for the first time how he carefully placed the apple juice cup to his mouth, took a couple of small sips without having to use the napkin. As I watched with his coffee later, he was not so efficient.
Chuck came in and sat to our right. He asked how everyone was doing and Dad in particular. Dad gave him the "so-so" sign and said, "I'm not too sure yet". Chuck said, "Don't worry, will sit here a bit, talk it out, and you'll see it will be alright." It cheered me up anyway. A moment later as he was pouring milk onto his cereal, he looked up at Cate and spilled a little bit. As he cleaned up he said, "I caint look at a pretty women and do anything at the same time without making a mess."
We went out to the patio after not eating a whole lot. Dad had asked for some milk and we got him some. Cate went back to the room to get a blanket and Dad said, "This is the shits. I don't know if it wants to come up or wants to go down.", referring to the food he had just eaten.
We weren't out there ten minutes when the milk had wreaked its havoc. We had the same rush back to the bathroom as we had on Saturday. Cate help Dad clean up and we got him to swear off milk. While he was in there he also was able to throw some stuff up. Cate said it was very "mucousy".
I had a birthday horseback ride to go on had to leave. Cate asked Dad if he wanted a nap and he replied, "yeah, I can use a nap." I kissed him and said good-bye.
On a philosophical note, Cate had messaged while I was having breakfast to ask if I preferred to spend my morning time alone with Dad. She may not have meant it to come off this way, but it sounded a little apologetic. I told her I liked having her there. My position is similar to dinner at our house circa 1969. Mom would put all the food out and everyone would get what they needed. This is a situation where we are all going to have to get what we need with whatever time we have left with Dad. I'm filling my plate and I can see everyone else is too. The more people at the table, the better I like it. Like Mom, Dad will make sure there is enough to go around.
Sunday, September 30, 2012
Saturday, September 29, 2012
September 29th - Of Birthdays and Physical Therapy
Dad was sleeping when I arrived. I knew he had had a big day on Friday and contemplated letting him sleep knowing what a struggle it would be for him to just get out of bed. I sat next to him for few minutes and just watched him sleep. Hoping today would be better, I rubbed him awake. "What time is it?"
"Seven twenty. Do you want breakfast?"
"Yeah, we probably better", as he rolled over quickly and directed me to get him some clean clothes. I notice that his hearing aid was on the floor again and the case was in two pieces as if it had fallen from the night stand. (I made a note to ask Cate to put his hearing aid in the drawer because I suspected it was getting knocked over when he got up to use the bathroom overnight.) It was safe there for now and we spoke in sign as he put on a undershirt, golf shirt, shorts, and he settled into the wheelchair to wash his face. His used undershirt had a few blood-looking stains on the lower back, but I could see no wounds or scratches and assume it was the same type of "leakage" we had seen in his calves. He didn't use the toilet, just washed his face and combed his hair, but that gave me time to retrieve and wipe down his hearing aid.
In the dining room they had pureed his eggs. The cook said all his food today would be pureed. He took two bites and tearily said, "Oh crap, what do I do?" He sat there with the napkin to his mouth and eventually had to spit it up. As he sat there trying to recover from that he let me know he needed the bathroom. We rushed back to the room, just a little bit late, recovered, and headed back to the dining room. The place was cleared out but they brought us some milk, cranberry juice, coffee, and eventually a Danish (I have been calling them sweet rolls...). When I told the aid he was on dairy free he said, "No, I can have milk. I want the milk, I like milk." That was about the only thing he had for breakfast because by the time the Danish came he was full.
Mr. K was still reading his paper and Cate and Amelia came in. A few minutes later Mr. K left and we took the opportunity to talk about him behind his back, being the petty people we are. When I mentioned that Bill had told me Mr. K had been a minister Dad said, "They send some strange ones sometimes."
We all went out to the patio and while there Tina came by to get him for PT. I thought he had a good session. He worked hard. Tina said she was going to make a tape of Dad and play it for her more grouchy and intractable patients as motivation. She said Dad doesn't know how to complain or quit.
Chuck, aka Charlie Perkins, was hanging about the PT room. He was encouraging Dad as he did each exercise. After one particularly strenuous walkabout, Dad got back to plop down in the wheelchair breathing a little too hard to speak. When Tina asked him if he was doing all right Chuck answered for him, "Well, he doesn't want to go squirrel hunting!"
After PT Dad had his morning pills, just three I think, and we went out to the patio where the group was gathering to celebrate Cate's and mine birthday. Michael and Kristie had brought Grant and Kyle, whose energy levels seem to just invigorate the place. Too bad we can't transfuse that. Mary had made pumpkin pie. Chuck along with his wife, Elaine was it, came by to sit and chat and flirt with Amelia and Cate right in front of Catie's husband Lee. Ranae brought the coffee. There were a lot of tall tales told. Chuck serenaded us with a little music as we enjoyed the pie and coffee. About 11:30 Dad needed the bathroom and it was time for me to head home and catch up on some chores. I don't think Dad got much more than a bit of pie and I'm not sure he was in the mood for lunch. Perhaps tomorrow will be better.
"Seven twenty. Do you want breakfast?"
"Yeah, we probably better", as he rolled over quickly and directed me to get him some clean clothes. I notice that his hearing aid was on the floor again and the case was in two pieces as if it had fallen from the night stand. (I made a note to ask Cate to put his hearing aid in the drawer because I suspected it was getting knocked over when he got up to use the bathroom overnight.) It was safe there for now and we spoke in sign as he put on a undershirt, golf shirt, shorts, and he settled into the wheelchair to wash his face. His used undershirt had a few blood-looking stains on the lower back, but I could see no wounds or scratches and assume it was the same type of "leakage" we had seen in his calves. He didn't use the toilet, just washed his face and combed his hair, but that gave me time to retrieve and wipe down his hearing aid.
In the dining room they had pureed his eggs. The cook said all his food today would be pureed. He took two bites and tearily said, "Oh crap, what do I do?" He sat there with the napkin to his mouth and eventually had to spit it up. As he sat there trying to recover from that he let me know he needed the bathroom. We rushed back to the room, just a little bit late, recovered, and headed back to the dining room. The place was cleared out but they brought us some milk, cranberry juice, coffee, and eventually a Danish (I have been calling them sweet rolls...). When I told the aid he was on dairy free he said, "No, I can have milk. I want the milk, I like milk." That was about the only thing he had for breakfast because by the time the Danish came he was full.
Mr. K was still reading his paper and Cate and Amelia came in. A few minutes later Mr. K left and we took the opportunity to talk about him behind his back, being the petty people we are. When I mentioned that Bill had told me Mr. K had been a minister Dad said, "They send some strange ones sometimes."
We all went out to the patio and while there Tina came by to get him for PT. I thought he had a good session. He worked hard. Tina said she was going to make a tape of Dad and play it for her more grouchy and intractable patients as motivation. She said Dad doesn't know how to complain or quit.
Chuck, aka Charlie Perkins, was hanging about the PT room. He was encouraging Dad as he did each exercise. After one particularly strenuous walkabout, Dad got back to plop down in the wheelchair breathing a little too hard to speak. When Tina asked him if he was doing all right Chuck answered for him, "Well, he doesn't want to go squirrel hunting!"
After PT Dad had his morning pills, just three I think, and we went out to the patio where the group was gathering to celebrate Cate's and mine birthday. Michael and Kristie had brought Grant and Kyle, whose energy levels seem to just invigorate the place. Too bad we can't transfuse that. Mary had made pumpkin pie. Chuck along with his wife, Elaine was it, came by to sit and chat and flirt with Amelia and Cate right in front of Catie's husband Lee. Ranae brought the coffee. There were a lot of tall tales told. Chuck serenaded us with a little music as we enjoyed the pie and coffee. About 11:30 Dad needed the bathroom and it was time for me to head home and catch up on some chores. I don't think Dad got much more than a bit of pie and I'm not sure he was in the mood for lunch. Perhaps tomorrow will be better.
Friday, September 28, 2012
September 28th - Cate's Arrival
We knew this can only be classified as a "roller coaster" ride, so it's no surprise that this morning might not rate up there in the top ten of mornings. When I arrived Dad was with Wallen the OT who was helping him get ready for breakfast. She had a "grabber", an arm like device Dad could use to grab the edge of his pants to get them low enough to stick his feet through. He got his own pants on, although it was quite a chore. The thing in his esophagus was bothering him again. He asked for a cup in case he need to "bring something up".
Just as he was ready to head into the bathroom Catie arrived. Dad looked happy to see her as they said their "hellos". Dad went into the bathroom with the OT and I gave Cate a tour of Dad's spacious arrangements. One of my guilty pleasures in going through this whole experience has been figuring things out. Much of the time we all spend with Dad is one-on-one. Knowing how to read a mood or a comment, finding out where his hearing aid or suspenders might be, are part of the puzzle I put my mind to as relief from the thoughts of what he must be going through 24/7. With that in mind, I wanted to give Cate the necessary info, where the hankerchiefs were, how to set the brakes on the wheelchair, but then, and it was hard to keep quiet, let her and Dad interact to find out the rest of the stuff.
As Dad was in the bathroom, I noticed for the first time a picture of he and Mom in book like picture frame on top of the dresser. Had that been there before? On the top of the closet was a plastic tray that I presume was used yesterday and something I could use if Dad was having more gastric upsets. And, we could hear from the sounds in the bathroom that he was. He was telling Wallen that whatever "it" is, it "won't go down, and it won't come up". This is a little concerning because a) it was new and b) it was the first thing in the morning and I didn't think he had anything in his stomach.
He came out of the bathroom and we sat for a few minutes before he said, "Let's go try some breakfast". I brought the plastic tray along as Cate pushed and Dad gave directions. Dad didn't eat much, only about 1/2 a bowl of raisin bran, orange juice, a little sweet roll and a little coffee.
Cate sat on Dad's right side and Luther was pleased as punch to have a pretty girl next to him for breakfast. I think I even saw a smile for Mr. K. Luther is going home today. Later on the patio Dad would tell me that he thought we really "made Luther's day" and he would miss us. Luther did have a very sweet farewell, hoping Dad got better and that we would meet again.
Part of the experience is interacting with the other residents. On my way to pour coffee, one wheelchair-bound women was headed back to her room and asked me if it was okay to take an hour nap. I gave her permission with the caveat that I wanted to see her up and around later. What power I weild. If only they knew!
Cate got to meet Chuck who has a great opening line, "Can you sing?" Of course, I was happy to volunteer that she had the voice of a nightengale. Chuck weaseled a commitmnet out of Cate for his Sunday afternoon concert. Chuck then entertained us for awhile with conversation and invited Cate back to the room he and his wife share to "write them a country song together". "I got my guitar and we can sing and do whatever we want. Heck, everyone can come over and we'll all sing together. Who knows, if were not careful, we might just make ourselves happy."
After breakfast we went on a little tour of the place to get Cate familar. We went over to the pool and spa area and we showed her the Bistro in case she needed a bite to eat. We returned to the patio where we just sat and enjoyed the morning. Dad had one little "throw-up" fit, but not much came up. When it was time for me to go, Dad wanted to return to his room, which was being cleaned. He told me he hoped for a little nap and I kissed him good-bye, gave Cate a hug, and headed off to work.
On the administration side, Bill and Tom had a meeting with Pam about Dad's ability to stay. As long as he is on two antibiotics Medi-care will cover the expenses for the 100 days. They will be speaking with Dr. Hedari to see if Dad will need to continue the prescription. Confidence level is medium-to-high that he will. Dad may not be eligible for PT as some have reported he is showing no improvement and he has refused to go sometimes.
Yesterday afternoon Tom related one of those"priceless" moments with Dad, the Physical Therapist, and both ends of Dad's body that had me smiling and teary at the same time. Becci Bishop stopped by for a game of 5-Straight on the "Big Board" Billy had made. It sounded like they all had a good time.
Just as he was ready to head into the bathroom Catie arrived. Dad looked happy to see her as they said their "hellos". Dad went into the bathroom with the OT and I gave Cate a tour of Dad's spacious arrangements. One of my guilty pleasures in going through this whole experience has been figuring things out. Much of the time we all spend with Dad is one-on-one. Knowing how to read a mood or a comment, finding out where his hearing aid or suspenders might be, are part of the puzzle I put my mind to as relief from the thoughts of what he must be going through 24/7. With that in mind, I wanted to give Cate the necessary info, where the hankerchiefs were, how to set the brakes on the wheelchair, but then, and it was hard to keep quiet, let her and Dad interact to find out the rest of the stuff.
As Dad was in the bathroom, I noticed for the first time a picture of he and Mom in book like picture frame on top of the dresser. Had that been there before? On the top of the closet was a plastic tray that I presume was used yesterday and something I could use if Dad was having more gastric upsets. And, we could hear from the sounds in the bathroom that he was. He was telling Wallen that whatever "it" is, it "won't go down, and it won't come up". This is a little concerning because a) it was new and b) it was the first thing in the morning and I didn't think he had anything in his stomach.
He came out of the bathroom and we sat for a few minutes before he said, "Let's go try some breakfast". I brought the plastic tray along as Cate pushed and Dad gave directions. Dad didn't eat much, only about 1/2 a bowl of raisin bran, orange juice, a little sweet roll and a little coffee.
Cate sat on Dad's right side and Luther was pleased as punch to have a pretty girl next to him for breakfast. I think I even saw a smile for Mr. K. Luther is going home today. Later on the patio Dad would tell me that he thought we really "made Luther's day" and he would miss us. Luther did have a very sweet farewell, hoping Dad got better and that we would meet again.
Part of the experience is interacting with the other residents. On my way to pour coffee, one wheelchair-bound women was headed back to her room and asked me if it was okay to take an hour nap. I gave her permission with the caveat that I wanted to see her up and around later. What power I weild. If only they knew!
Cate got to meet Chuck who has a great opening line, "Can you sing?" Of course, I was happy to volunteer that she had the voice of a nightengale. Chuck weaseled a commitmnet out of Cate for his Sunday afternoon concert. Chuck then entertained us for awhile with conversation and invited Cate back to the room he and his wife share to "write them a country song together". "I got my guitar and we can sing and do whatever we want. Heck, everyone can come over and we'll all sing together. Who knows, if were not careful, we might just make ourselves happy."
After breakfast we went on a little tour of the place to get Cate familar. We went over to the pool and spa area and we showed her the Bistro in case she needed a bite to eat. We returned to the patio where we just sat and enjoyed the morning. Dad had one little "throw-up" fit, but not much came up. When it was time for me to go, Dad wanted to return to his room, which was being cleaned. He told me he hoped for a little nap and I kissed him good-bye, gave Cate a hug, and headed off to work.
On the administration side, Bill and Tom had a meeting with Pam about Dad's ability to stay. As long as he is on two antibiotics Medi-care will cover the expenses for the 100 days. They will be speaking with Dr. Hedari to see if Dad will need to continue the prescription. Confidence level is medium-to-high that he will. Dad may not be eligible for PT as some have reported he is showing no improvement and he has refused to go sometimes.
Yesterday afternoon Tom related one of those"priceless" moments with Dad, the Physical Therapist, and both ends of Dad's body that had me smiling and teary at the same time. Becci Bishop stopped by for a game of 5-Straight on the "Big Board" Billy had made. It sounded like they all had a good time.
Thursday, September 27, 2012
September 27th - Handsome as Ever & A Walker Workout
I always wonder what I'm going to find about four steps before turning the corner to enter Dad's room. Every day is different. Today he was standing in front of his closet with the door open looking to pick out a clean shirt. We found one with blue and white horizontal stripes that I commented would be "slimming". "Oh, good. I could really use that!"
We had the aid bring us a washcloth. While we were waiting I dampened his hair and gave it a combing. I stood back to admire my work and he asked, "How's it look?"
"Pretty good", I replied.
"Handsome as ever?", he asked.
"Handsome as ever."
When she brought the washcloth (I put an extra one in his hankerchief drawer) he went into the bathroom to wash his face. He had been using the walker this whole time. When he came out, he turned and headed for the door without slowing down. "You ready?", he asked, but he wasn't waiting for an answer.
At breakfast he had a 3/4 of sweet roll, most of his cereal, part of his scrambled eggs, all of his apple juice and coffee. This is the most I've seen him eat in a while. At one point he had taken too big of a bite of the roll and said it was stuck. I said, "Just take your time, we're not going anywhere."
With a smile he replied, "Yeah, we're not getting out of here." At which point Luther, our breakfast companion who leaves tomorrow, asked, "He's not getting out?"
"Not for a couple more weeks, Luther"
"That's too bad."
The talk returned to the Dodgers and Angels and the return of the NFL officials. When Mr. K, a big man who sits across the table and just eats, bark requests to the girls, and reads his paper, asked for more bacon, I ran across an article that said the price of bacon is going up because of the drought and lack of corn. I announced this to Dad and, of course everyone in our corner of the dining room hears what I say, and Dad says we should stock up - "Bacon keeps". I looked across the table to see if there was a reaction from Mr. K (is it mean to compare him to Jabba the Hut, okay, then nevermind). There was none, but the cook, Maria had a big smile on her face.
Looking down at breakfast Dad said, "I did pretty good. Let's go out to the patio." We got his walker, said our "good days" and headed off. The patio is a good distance from the dining room. About a third of the way there he stopped for a breather. At the sliding glass door he stopped for another. "Sometimes I think I can go farther than I actually can!"
We made it out to the patio and talked about his phone call with Anut Margie yesterday. They talked for 45 minutes. She is having cataract surgery next week and will try to make it out after that. We also wondered how Tom and Mary did with Grant & Kyle at the Fair. We pictured Grant throwing the softball at the milk bottles to win a prize.
Dad said his favorite memory was when Kevin got hypnotized and he related to me how Bill had been hypnotized once too. How did that guy stand on your stomach, Bill?
He mentioned that he had a pain on his left side and had gotten two pain pills (Two? I think that is what he said). I think this is the same thing I wrote about on the 23rd of this month only I mentioned it was on the right side. I think he was rubbing the same area as the last time he told me about it, so I may have been mistaken about it being on the right last time. The last couple of weeks, right and left, morning and night, and days of the week all seem to blend together.
We had about 15-20 minutes before nature made an urgent call. We hustled back to the room just in time. The sprint back to the room wore him out and after the bathroom he laid down. He said, "You go to work now, son. Thanks for your help."
I said "okay" and bent over to kiss him good-bye. He looked up and said, "I did good this morning, didn't I?" I agreed, gave him a peck on the cheek and left knowing there is still a little fight left in him.
We had the aid bring us a washcloth. While we were waiting I dampened his hair and gave it a combing. I stood back to admire my work and he asked, "How's it look?"
"Pretty good", I replied.
"Handsome as ever?", he asked.
"Handsome as ever."
When she brought the washcloth (I put an extra one in his hankerchief drawer) he went into the bathroom to wash his face. He had been using the walker this whole time. When he came out, he turned and headed for the door without slowing down. "You ready?", he asked, but he wasn't waiting for an answer.
At breakfast he had a 3/4 of sweet roll, most of his cereal, part of his scrambled eggs, all of his apple juice and coffee. This is the most I've seen him eat in a while. At one point he had taken too big of a bite of the roll and said it was stuck. I said, "Just take your time, we're not going anywhere."
With a smile he replied, "Yeah, we're not getting out of here." At which point Luther, our breakfast companion who leaves tomorrow, asked, "He's not getting out?"
"Not for a couple more weeks, Luther"
"That's too bad."
The talk returned to the Dodgers and Angels and the return of the NFL officials. When Mr. K, a big man who sits across the table and just eats, bark requests to the girls, and reads his paper, asked for more bacon, I ran across an article that said the price of bacon is going up because of the drought and lack of corn. I announced this to Dad and, of course everyone in our corner of the dining room hears what I say, and Dad says we should stock up - "Bacon keeps". I looked across the table to see if there was a reaction from Mr. K (is it mean to compare him to Jabba the Hut, okay, then nevermind). There was none, but the cook, Maria had a big smile on her face.
Looking down at breakfast Dad said, "I did pretty good. Let's go out to the patio." We got his walker, said our "good days" and headed off. The patio is a good distance from the dining room. About a third of the way there he stopped for a breather. At the sliding glass door he stopped for another. "Sometimes I think I can go farther than I actually can!"
We made it out to the patio and talked about his phone call with Anut Margie yesterday. They talked for 45 minutes. She is having cataract surgery next week and will try to make it out after that. We also wondered how Tom and Mary did with Grant & Kyle at the Fair. We pictured Grant throwing the softball at the milk bottles to win a prize.
Dad said his favorite memory was when Kevin got hypnotized and he related to me how Bill had been hypnotized once too. How did that guy stand on your stomach, Bill?
He mentioned that he had a pain on his left side and had gotten two pain pills (Two? I think that is what he said). I think this is the same thing I wrote about on the 23rd of this month only I mentioned it was on the right side. I think he was rubbing the same area as the last time he told me about it, so I may have been mistaken about it being on the right last time. The last couple of weeks, right and left, morning and night, and days of the week all seem to blend together.
We had about 15-20 minutes before nature made an urgent call. We hustled back to the room just in time. The sprint back to the room wore him out and after the bathroom he laid down. He said, "You go to work now, son. Thanks for your help."
I said "okay" and bent over to kiss him good-bye. He looked up and said, "I did good this morning, didn't I?" I agreed, gave him a peck on the cheek and left knowing there is still a little fight left in him.
Wednesday, September 26, 2012
Gone From My Sight
I am attaching a copy of a book that Hoffman Hospice gave us, it is called Gone From My Sight. Only read it if you are interested and want to know some possible things that Dad may go through. It can be a tear jerker, so please be warned. If you do not decide to read the various steps, you still might be interested in the story on the last page (page 14). It is just another look at the journey that Dad is about to embark on.
Love to all,
Bill
July 29, 2013 - I received a request to remove the book as it is copyrighted. Please see the request below for a link to the author. Bill
Love to all,
Bill
Sept 26 Hospice and Antibiotics
I just wanted to make sure everyone is aware of the direction that we are taking with Dad after our family discussion last Friday night.
We have decided NOT to move Dad to Hospice at this point in time, but may at a later point. Tom and I met with Hoffman Hospice on Monday for about three hours. They asked about Dad's history, diagnosis, wishes, etc. We asked about care and what that meant under Hospice. In reaching our decision we felt that we all wanted very similar things for Dad and that was to allow Dad to have the best quality of life for the whatever time he has. That meant to us no more lab draws or doctor visits and if possible, to take the picc line out and discontinue the antibiotics. Hoffman Hospice stated they cannot support IV antibiotics as they do not have nurses that can administer them given Dad's schedule and that typically it is not supported.
I called Dr Trang and asked his thoughts on Dad moving to Hospice and he mentioned that he had discussed it with Dr Heidari and was in agreement, if that was the family wishes. I then asked him about Dad stopping the antibiotics and he said he strongly advises us to not remove Dad from the antibiotics. That the infection is most likely still present and that it could return within two weeks. I asked him about pain management and he stated that no one could manage the pain and still allow Dad to have any quality of life, that they would most likely have to put him into an induced coma. I then mentioned that this seems to counterdict his previous statement of supporting Hospice as Hospice will not provide Dad with antibiotics. He stated that he would call any medical director at the Hospice of our choice and tell them that this would be required for pain management only. I asked him if we could move to an oral antibiotic or reduce the frequency and he said we would be rolling the dice again and he was not in favor of changing the course of treatment from his current regiment, that we should stick with what has proven to work. I thanked him for his time, support and understanding through this process with Dad. He stated we could call him anytime we need him.
Also we talked to the Hoffman Hospice RN and asked for her assessment of Dad and she felt Dad might have about three weeks. Later that evening I called Dr Memum and asked him his thoughts about moving Dad to Hospice and he said it was appropriate. I then stated that Dad had children that were out of state and could he tell me if he felt that Dad had days, weeks or months. He stated in his opinion that Dad probably has about two months, but that could change especially if his kidney fails.
So on Tuesday we informed Dad's nurse and Dr Memum (Rosewood Doctor) that we do not want any more blood draws or lab work, but that we will continue on the antibiotics. Dr Memum mentioned that we might as well not move to Hospice as we would have to move to private pay for everything and if we decide later on we can always bring in Hospice. Hoffman Hospice told us that they could have Dad on Hospice services with about 4 hours notice, given it is M-F 8 to 5 kind of timeframe and that they could do it outside those hours, it will just take a little longer.
So our official stance is that Dad is continuing his current course of treatments but that he does not wish to have the lab and blood draws anymore. We do not know how Medicare will respond, but we will cross that bridge when we come to it.
Please let me know if anyone has any concerns or disagrees with this course of action.
We have decided NOT to move Dad to Hospice at this point in time, but may at a later point. Tom and I met with Hoffman Hospice on Monday for about three hours. They asked about Dad's history, diagnosis, wishes, etc. We asked about care and what that meant under Hospice. In reaching our decision we felt that we all wanted very similar things for Dad and that was to allow Dad to have the best quality of life for the whatever time he has. That meant to us no more lab draws or doctor visits and if possible, to take the picc line out and discontinue the antibiotics. Hoffman Hospice stated they cannot support IV antibiotics as they do not have nurses that can administer them given Dad's schedule and that typically it is not supported.
I called Dr Trang and asked his thoughts on Dad moving to Hospice and he mentioned that he had discussed it with Dr Heidari and was in agreement, if that was the family wishes. I then asked him about Dad stopping the antibiotics and he said he strongly advises us to not remove Dad from the antibiotics. That the infection is most likely still present and that it could return within two weeks. I asked him about pain management and he stated that no one could manage the pain and still allow Dad to have any quality of life, that they would most likely have to put him into an induced coma. I then mentioned that this seems to counterdict his previous statement of supporting Hospice as Hospice will not provide Dad with antibiotics. He stated that he would call any medical director at the Hospice of our choice and tell them that this would be required for pain management only. I asked him if we could move to an oral antibiotic or reduce the frequency and he said we would be rolling the dice again and he was not in favor of changing the course of treatment from his current regiment, that we should stick with what has proven to work. I thanked him for his time, support and understanding through this process with Dad. He stated we could call him anytime we need him.
Also we talked to the Hoffman Hospice RN and asked for her assessment of Dad and she felt Dad might have about three weeks. Later that evening I called Dr Memum and asked him his thoughts about moving Dad to Hospice and he said it was appropriate. I then stated that Dad had children that were out of state and could he tell me if he felt that Dad had days, weeks or months. He stated in his opinion that Dad probably has about two months, but that could change especially if his kidney fails.
So on Tuesday we informed Dad's nurse and Dr Memum (Rosewood Doctor) that we do not want any more blood draws or lab work, but that we will continue on the antibiotics. Dr Memum mentioned that we might as well not move to Hospice as we would have to move to private pay for everything and if we decide later on we can always bring in Hospice. Hoffman Hospice told us that they could have Dad on Hospice services with about 4 hours notice, given it is M-F 8 to 5 kind of timeframe and that they could do it outside those hours, it will just take a little longer.
So our official stance is that Dad is continuing his current course of treatments but that he does not wish to have the lab and blood draws anymore. We do not know how Medicare will respond, but we will cross that bridge when we come to it.
Please let me know if anyone has any concerns or disagrees with this course of action.
September 26th - Raisin Bran For Breakfast
Dad was asleep when I arrived. The OT girl, Wallen, walked into the room with me. I rubbed Dad's leg like yesterday to wake him up and he winced in pain, no doubt because of the wild adventure he went on with Bill yesterday (but that's his story to tell). The pain was only superficial and he got up and Wallen helped him to the bathroom to get cleaned up. The slippers he has in his room did not fit him this morning because his feet have swollen a bit. They had removed the compression stockings.
While he was in the bathroom I heard him remark that he was "out of breath" and this was "a lot of work". Wallen was great with him and let him rest periodically. When he came out we put him in the wheel chair and headed for the dining room. We took the box of Raisin Bran Bill had brought. After I opend it I noticed there were single servings of Raisin Bran right there in the breakfast self-serve area. I added a little banana. Dad asked me what was in the news today and I gave him a few of the headlines. Luther helped us hold up the conversation by recapping the newest NCIS episode, talking baseball, and telling us of the impending visit from his son who lives in Yuma. Dad ate most of his cereal and a little roll before having a nature call that rushed us back to the room.
Dad's roommate is gone. The man with the broken hip went home. Dad now has rails on his bed so it makes it easier to get out of as he has something to push against. I felt a bit awkward when Wallen asked if Dad was still going to assisted living after his therapy here was over. I replied, "Once his therapy here is over it would great if he could move into assisted living." I'm just afraid to say anything clearly after the Bakersfield Heart Hospital episode. I really don't know if we are officially on hospice or treatment or what and try not to open my mouth to big for my foot to fall in it. I'm sure this will all shake out sooner or later in the way these things shake out.
After Dad got out of the bathroom he was exhausted and asked to go back to bed. I obliged and stacked some covers on him before saying good-bye and heading for work. My 90 minutes with him had gone by far too fast.
While he was in the bathroom I heard him remark that he was "out of breath" and this was "a lot of work". Wallen was great with him and let him rest periodically. When he came out we put him in the wheel chair and headed for the dining room. We took the box of Raisin Bran Bill had brought. After I opend it I noticed there were single servings of Raisin Bran right there in the breakfast self-serve area. I added a little banana. Dad asked me what was in the news today and I gave him a few of the headlines. Luther helped us hold up the conversation by recapping the newest NCIS episode, talking baseball, and telling us of the impending visit from his son who lives in Yuma. Dad ate most of his cereal and a little roll before having a nature call that rushed us back to the room.
Dad's roommate is gone. The man with the broken hip went home. Dad now has rails on his bed so it makes it easier to get out of as he has something to push against. I felt a bit awkward when Wallen asked if Dad was still going to assisted living after his therapy here was over. I replied, "Once his therapy here is over it would great if he could move into assisted living." I'm just afraid to say anything clearly after the Bakersfield Heart Hospital episode. I really don't know if we are officially on hospice or treatment or what and try not to open my mouth to big for my foot to fall in it. I'm sure this will all shake out sooner or later in the way these things shake out.
After Dad got out of the bathroom he was exhausted and asked to go back to bed. I obliged and stacked some covers on him before saying good-bye and heading for work. My 90 minutes with him had gone by far too fast.
My love letter to Dad.
Dear Dad:
Bill shared with me yesterday that he has been doing a lot of reading about end of life.. I had not.. I have spoken to two people who have recently gone through this and felt that reading about it would only compound my sadness. But after talking to Bill I decided to start reading more about it. It has made the sadness a bit more profound, the loneliness of being so far away more difficult and yet, so much more grateful to have you as my dad. I am stronger in my faith that a loving God knows best and have a deeper gratitude that God placed me in to this loving family with parents who loved so completely. One of the most compelling realizations that I had while reading the articles was the signs of the dying process and the specific idea of reconciling with ‘regrets’. I realized that in all of the wonderful conversations I have had with you dad, you have never once expressed any regrets. I thought about that for a long time and then recognized that I think is the best lesson you have ever taught me. Whether I was getting in trouble as a teenager ~ which was in no way as dramatic or long term as some people think ;-/ ~ or moving to Los Angeles to ‘be on my own’, taking the leap to move to Utah, even though I would be so far away from family, going back to school at 50, or any other decision I have made, you and Mom were always there to say either “learn from it, and then it isn’t a mistake” or “go for it, you never know until you try”. What a wonderful example of how to live and now, how to prepare to die. To be able to see pictures or hear stories from the boys now, as they spend time with you, about the adversities you face each day during this illness, are awe-inspiring. To have the past few visits with you be so loving and thoughtful, to remember sitting on the side of your bed and holding you while we cried together, then fifteen minutes later being spanked in a game of 5 Straight, as you bucked up for me, has helped me to focus only on remembering the life I have being Bill Harrer’s daughter… not the sadness I have now at the pending loss of not having those moments with you anymore.
I will always cherish one special memory; our visit to Hawaii and, most specifically, our visit to Pearl Harbor. As I look at the pictures of your grandchildren listening so intently to you as you described the day the base was attacked, I am reminded of the power of that day. We were all together and on that day especially, I realized that you had had a life before being my dad. I don’t know why it hadn’t occurred to me before then, but that day especially was an epiphany for me. I remember watching my Christopher stare at you with utter awe and Nick turning to me after saying, “I want to be a Navy Seal”. Even though he was unable to fulfill that dream (which he still aches for), it was because of you, dad and the admiration they have for you.
So, THANK YOU Dad, for being the man who set the bar for the man I wanted to marry and the sons I wanted to raise. Thank you for being the man that would inform my daughter on what to expect from a hard-working, honest and decent man. Thank you for always looking forward and only looking back with gratitude, love and fondness for the opportunities you were given and the choices you made from those opportunities. Thank you for giving me the strength to spread my wings and explore what life had in store for me, it took me around the world and settled me exactly where I was meant to be. I am so grateful that you are you and I am so blessed that my eyes are open enough to recognize the true sparkle of who you are. You are truly a one-in-a million man. I am so proud of your accomplishments, your service to family, God and Country. Most importantly dad, thank you for providing such a strong, loving home where now, we can all face this difficult time together. That home is always in my heart, no matter where I am or how far away I might be and because of you, I know we will all make it through this painful experience together, with love and comfort. I love you with all my heart, and then some. Your Daughter, Cathi.
Tuesday, September 25, 2012
September 25 - Compression Stockings and Wedding Days
Thanks for the nice comments, guys. I do see them and appreciate it. Writing this helps me process stuff, too.
Dad was asleep and the aide was trying to wake him up when I arrived this morning. I said hello and he asked for a couple of more minutes sleep. The aide said she would come back in five. Dad said he was freezing, so I started rubbing his legs and he told me how good that felt. He slowly woke up and asked about the time, it was 7:10, and he said "okay let's get up", smiled at me, and didn't move. About a minute later he threw the covers aside and sat up by himself. Another aide came in to put compression stockings on his legs. These things are like tight nylons and the aide had to wrestle them on Dad. It took about ten minutes to put them on. I was helping hold Dad in the upright position. The aide was working up a sweat and Dad had her cracking up when he asked if she needed a break. There was also alot of jokes about wanting a different color, or don't they have something in a fishnet that would match his slippers.
We made it to breakfast for some scrambled eggs and sweet roll. He was a little teary toward the end of breakfast. Dad was complaining about being cold, so after our scintillating conversation about the new season of NCIS with Luther at breakfast, we headed out to find some sun.
We found a sunny spot on the south side of the patio and I sat down on some nearby steps as Dad soaked in the sun. Out of the blue, (because we haven't been discussing medical stuff at all for the last week), he asked what we were going to do, stay here, or go home. I hadn't yet spoken to Tom or Bill about what occured Monday after I left, and I asked Dad if he had spoken with someone from hospice or the doctor. He said he spoke to a women in red about hospice. I asked him what he wanted to do and he said he would just as soon stay here, "No use moving everything back to the house and have people coming in and out." Then he asked me what I thought and I told him I agreed. I was a little confused when he asked a few minutes later if I thought he should "go to hospice". I then did my best to explain that hospice was for the end of life and their job was to make the end as comfortable as possible. Talking about the end as you can imagine brought tears to both of us. I went on to tell him there would be no more doctors' visits, no more pills, no more blood tests, and no more PICC line (sorry Bill). He said, "this hospice does have its upside."
About this time the sprinklers came on and we moved back to the patio and talked a little more. He started to cry, but pulled himself together and said he had had a good life. He said what a good job everyone of the kids had done for him during all of this. I wanted to get him thinking about something else for a bit and I asked if he remembered his wedding day. He told me about his day and all the pictures they had to take. I asked if he had had a bachelor party and he said, "Oh, I'm sure Frank would have made sure I did." Did he try to get you drunk? "Oh, yeah, I think he succeeded."
One memory led to another and we gradually worked our way back to the present when Bill came by. I told Bill we had a few questions about hospice and Bill explained that Dad would stay on the PICC line antibiotics based on information he got from Dr. Trang. They also talked about getting Dad a heating pad to keep him warm, It was getting late and once again, I hated to leave, but kissed him on the cheek and said "good-bye".
Dad was asleep and the aide was trying to wake him up when I arrived this morning. I said hello and he asked for a couple of more minutes sleep. The aide said she would come back in five. Dad said he was freezing, so I started rubbing his legs and he told me how good that felt. He slowly woke up and asked about the time, it was 7:10, and he said "okay let's get up", smiled at me, and didn't move. About a minute later he threw the covers aside and sat up by himself. Another aide came in to put compression stockings on his legs. These things are like tight nylons and the aide had to wrestle them on Dad. It took about ten minutes to put them on. I was helping hold Dad in the upright position. The aide was working up a sweat and Dad had her cracking up when he asked if she needed a break. There was also alot of jokes about wanting a different color, or don't they have something in a fishnet that would match his slippers.
We made it to breakfast for some scrambled eggs and sweet roll. He was a little teary toward the end of breakfast. Dad was complaining about being cold, so after our scintillating conversation about the new season of NCIS with Luther at breakfast, we headed out to find some sun.
We found a sunny spot on the south side of the patio and I sat down on some nearby steps as Dad soaked in the sun. Out of the blue, (because we haven't been discussing medical stuff at all for the last week), he asked what we were going to do, stay here, or go home. I hadn't yet spoken to Tom or Bill about what occured Monday after I left, and I asked Dad if he had spoken with someone from hospice or the doctor. He said he spoke to a women in red about hospice. I asked him what he wanted to do and he said he would just as soon stay here, "No use moving everything back to the house and have people coming in and out." Then he asked me what I thought and I told him I agreed. I was a little confused when he asked a few minutes later if I thought he should "go to hospice". I then did my best to explain that hospice was for the end of life and their job was to make the end as comfortable as possible. Talking about the end as you can imagine brought tears to both of us. I went on to tell him there would be no more doctors' visits, no more pills, no more blood tests, and no more PICC line (sorry Bill). He said, "this hospice does have its upside."
About this time the sprinklers came on and we moved back to the patio and talked a little more. He started to cry, but pulled himself together and said he had had a good life. He said what a good job everyone of the kids had done for him during all of this. I wanted to get him thinking about something else for a bit and I asked if he remembered his wedding day. He told me about his day and all the pictures they had to take. I asked if he had had a bachelor party and he said, "Oh, I'm sure Frank would have made sure I did." Did he try to get you drunk? "Oh, yeah, I think he succeeded."
One memory led to another and we gradually worked our way back to the present when Bill came by. I told Bill we had a few questions about hospice and Bill explained that Dad would stay on the PICC line antibiotics based on information he got from Dr. Trang. They also talked about getting Dad a heating pad to keep him warm, It was getting late and once again, I hated to leave, but kissed him on the cheek and said "good-bye".
Monday, September 24, 2012
September 24th Tennis Morning & Pictures
Dad was getting wheeled out of the bathroom on my arrival. I was actually 5-10 minutes earlier than I usually get there and here he was all up and dressed. The OT had helped him do his morning stuff. Since he was ready to go, we headed for breakfast. Tom was scheduled to come by soon and take Dad to watch some tennis and have coffee with his friends.
We turned the corner to head toward the dining room and one of the employees looked straight at me and raised her hand and said, "Hey, I got the..." whatever thing she thought I wanted. She excused herself, she thought I was one of her co-workers. She went on her way and I took a knee in front of Dad.
"Dad, do you remember about a week ago when you told me about the physical therapist that came by?"
"Yes"
"And, how you felt terrible because you thought it was me. You were talking to him just like you would talk to me. You felt terrible and confused when at the end of the session you found out it was actually someone else. And you said you must be getting pretty bad 'cause you couldn't even recognize your own son anymore."
"Yeah."
"Well, some woman who works here just walked up to me like I worked here too. You're not the only one seeing someone who looks like me. She works here and can't tell us apart!"
"Good. At least I'm not going crazy, too."
We headed off to the dining room. He told me about having Sunday dinner with Tom and that after I left on Saturday, Lori, who I think was one of Jim's first girlfriends, came by and brought some flowers. "You know that has to have been over thirty years we've know her. That's GOTTA be some kind of record!"
He ate fairly well - scrambled eggs and part of a muffin. We tried to talk about the football referees and how they were ruining the game. He kept thinking it was basketball. Oh well, wasn't it last year those refs ruined that game?
Just as a side note, if his kidneys have failed him, the components the doctors measure in his blood, the BUN and creatinine, you know the ones that have been slowly going up. Well, if they continue to rise we can expect his thinking to become a bit more mumbled. They may have taken those tests today and Bill may get the results.
After breakfast it was back to his room for a quick pit stop, and his morning meds. While he was in the bathroom, his roommate remarked on the level of his determination.
We loaded him in Tom's car and got him to the tennis courts. His friends were pleased to see him and they got to visit for awhile. Dad watched for about 15-20 minutes just sitting in the sun.
It was time for Max and I to head for work, we had to leave, but they were all going for coffee at Burger King and then back to Rosewood.
Here are a few more pictures:
We turned the corner to head toward the dining room and one of the employees looked straight at me and raised her hand and said, "Hey, I got the..." whatever thing she thought I wanted. She excused herself, she thought I was one of her co-workers. She went on her way and I took a knee in front of Dad.
"Dad, do you remember about a week ago when you told me about the physical therapist that came by?"
"Yes"
"And, how you felt terrible because you thought it was me. You were talking to him just like you would talk to me. You felt terrible and confused when at the end of the session you found out it was actually someone else. And you said you must be getting pretty bad 'cause you couldn't even recognize your own son anymore."
"Yeah."
"Well, some woman who works here just walked up to me like I worked here too. You're not the only one seeing someone who looks like me. She works here and can't tell us apart!"
"Good. At least I'm not going crazy, too."
We headed off to the dining room. He told me about having Sunday dinner with Tom and that after I left on Saturday, Lori, who I think was one of Jim's first girlfriends, came by and brought some flowers. "You know that has to have been over thirty years we've know her. That's GOTTA be some kind of record!"
He ate fairly well - scrambled eggs and part of a muffin. We tried to talk about the football referees and how they were ruining the game. He kept thinking it was basketball. Oh well, wasn't it last year those refs ruined that game?
Just as a side note, if his kidneys have failed him, the components the doctors measure in his blood, the BUN and creatinine, you know the ones that have been slowly going up. Well, if they continue to rise we can expect his thinking to become a bit more mumbled. They may have taken those tests today and Bill may get the results.
After breakfast it was back to his room for a quick pit stop, and his morning meds. While he was in the bathroom, his roommate remarked on the level of his determination.
We loaded him in Tom's car and got him to the tennis courts. His friends were pleased to see him and they got to visit for awhile. Dad watched for about 15-20 minutes just sitting in the sun.
 |
| The game goes on. |
It was time for Max and I to head for work, we had to leave, but they were all going for coffee at Burger King and then back to Rosewood.
Here are a few more pictures:
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| Al asking Dad if he wants to get out and hit. Dad hit him. |
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| Tom, Frank and Dad watch intently. Max checking for foot faults. |
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| The Motely Crew. |
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| Nedra making sure Dad is comfortable. |
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| Dad helping to call lines. |
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| I think he wanted to be out there. |
Sunday, September 23, 2012
September 23rd - The Talk (Hospice)
Dad was asleep when I arrived this morning. When I woke him up he said he had not slept too well because he had a pain in his side. I told him it was time for breakfast and he said "Okay, let's do it". He got up and headed to the bathroom. As I looked around his room, I noticed he had a portable toilet next to his bed. I remembered that yesterday at breakfast he had told me that he thought he had scratched himself or something on his left side. I got a clean change of clothes and figured I would get to see if there was anything going on when he took off his shirt.
When he came out of the bathroom he told me he was not changing his shirt, "It's Sunday, no one will notice". "Okay"' I said, "but you'll have to lift your shirt so I can make sure there is are no scratches or sores". His abdomen his was distended, but there were no marks or anything.
At breakfast he had scrambled eggs, sausage, apple juice, and coffee. There was also half a strawberry. I chopped up the eggs and as he was eating I noticed he picked up the strawberry. He was going to put the end with the green leaf in his mouth and I said, "That's the strawberry", he replied with a smile, "Oh, I thought that was the sausage." He ate most of the sausage and about half the eggs. He didn't seem to have as much trouble swallowing as yesterday.
On the way back to the room one of the nurses remarked that it was good to see him up. She told me about the pain in his side and that she had given him a pain pill. We took the morning meds in the hallway while he was sitting up. I was afraid if he laid down it would be harder to swallow and he would be harder to wake up when Tom came by.
Much to my surprise, when we got back inside the room, he asked if he could sit up. I said "Do you want to sit outside?", and he said "sure". We had one of those moments I'll cherish forever sitting out in front of the roses just watching the world go by. We sat in silence most of the of 45 minutes, although he would occasionally ask about something in my life or comment on the excessive noise the crows were producing.
Tom came out and we had "the talk". We explained as clearly as we could. There were a few tears shed. I wish I could say I definitively knew where he stood, but I was a bit confused as he said he would like to go home and continue the battle. Tom and I spoke much later about this and agreed we should let the doctor at Rosewood do the evaluation as an impartial observer, and then let the hospice administrator also do a private evaluation so our prejudices don't overly influence Dad's decision.
At about 10:30 Dad said he wanted to take an hour nap before lunch. Tom and I went out to the patio and talked about how it went. I then called Ranae and Tom made a call and I started this blog post. It was 11:45, and thinking it would take 20 minutes or so to get Dad ready for lunch, we headed back to his room.
His bed was empty! The bathroom? Empty? Where did he go? His roomate said "He went tooling out of here on his walker and that he would let me know how lunch was!" Sure enough, we made the turn at the hallway and there he was. We got him seated and they brought out his food. He ate a little more than breakfast AND had half of his cookie---which he said "wasn't very good". Tom asked him if he wanted to come over for Sunday night dinner and he nodded "sure".
One the way out Tom complimented another resident, "My those are lovely slippers!" She had no idea what he was talking about, but Dad responded, "Thank you! You can't go wrong for $10". Ah, the joys of conversing with the hard of hearing!
Tom had taken Dad's suspenders off for his nap and Dad asked me to hold his pants up on the way back. "My pants fell down on the way here. I'm sure it's nothing they haven't seen before, but I don't want to put them through it again." When we got back to the room he wanted to sit outside again. We sat for about 30 minutes before he went in to get his IV and some shut eye.
Tom and I went over to the pool and had some lunch. There was a family there having a 91st birthday for one of the residents. At about 2:45 we went to check in on Dad. Dad's roommate was having a "picnic" in his room and Dad was sound asleep. The nurse came in to check his O2 levels and pulse, 96 and 72 respectively. Dad said, "What a pretty nurse!" Wait! Was this the same guy who could not tell a sausage from a strawberry just seven hours ago?
Dad asked about our lunch and we told him about the 91 year old's birthday. We then asked if he still wanted to go to Tom's for Sunday dinner and he said "yes" and that he wanted Chinese, "his favorite". Good luck with that one Tom, or should I say Mary. My day was done, I kissed him on the cheek and said "Good-bye".
When he came out of the bathroom he told me he was not changing his shirt, "It's Sunday, no one will notice". "Okay"' I said, "but you'll have to lift your shirt so I can make sure there is are no scratches or sores". His abdomen his was distended, but there were no marks or anything.
At breakfast he had scrambled eggs, sausage, apple juice, and coffee. There was also half a strawberry. I chopped up the eggs and as he was eating I noticed he picked up the strawberry. He was going to put the end with the green leaf in his mouth and I said, "That's the strawberry", he replied with a smile, "Oh, I thought that was the sausage." He ate most of the sausage and about half the eggs. He didn't seem to have as much trouble swallowing as yesterday.
On the way back to the room one of the nurses remarked that it was good to see him up. She told me about the pain in his side and that she had given him a pain pill. We took the morning meds in the hallway while he was sitting up. I was afraid if he laid down it would be harder to swallow and he would be harder to wake up when Tom came by.
Much to my surprise, when we got back inside the room, he asked if he could sit up. I said "Do you want to sit outside?", and he said "sure". We had one of those moments I'll cherish forever sitting out in front of the roses just watching the world go by. We sat in silence most of the of 45 minutes, although he would occasionally ask about something in my life or comment on the excessive noise the crows were producing.
Tom came out and we had "the talk". We explained as clearly as we could. There were a few tears shed. I wish I could say I definitively knew where he stood, but I was a bit confused as he said he would like to go home and continue the battle. Tom and I spoke much later about this and agreed we should let the doctor at Rosewood do the evaluation as an impartial observer, and then let the hospice administrator also do a private evaluation so our prejudices don't overly influence Dad's decision.
At about 10:30 Dad said he wanted to take an hour nap before lunch. Tom and I went out to the patio and talked about how it went. I then called Ranae and Tom made a call and I started this blog post. It was 11:45, and thinking it would take 20 minutes or so to get Dad ready for lunch, we headed back to his room.
His bed was empty! The bathroom? Empty? Where did he go? His roomate said "He went tooling out of here on his walker and that he would let me know how lunch was!" Sure enough, we made the turn at the hallway and there he was. We got him seated and they brought out his food. He ate a little more than breakfast AND had half of his cookie---which he said "wasn't very good". Tom asked him if he wanted to come over for Sunday night dinner and he nodded "sure".
One the way out Tom complimented another resident, "My those are lovely slippers!" She had no idea what he was talking about, but Dad responded, "Thank you! You can't go wrong for $10". Ah, the joys of conversing with the hard of hearing!
Tom had taken Dad's suspenders off for his nap and Dad asked me to hold his pants up on the way back. "My pants fell down on the way here. I'm sure it's nothing they haven't seen before, but I don't want to put them through it again." When we got back to the room he wanted to sit outside again. We sat for about 30 minutes before he went in to get his IV and some shut eye.
Tom and I went over to the pool and had some lunch. There was a family there having a 91st birthday for one of the residents. At about 2:45 we went to check in on Dad. Dad's roommate was having a "picnic" in his room and Dad was sound asleep. The nurse came in to check his O2 levels and pulse, 96 and 72 respectively. Dad said, "What a pretty nurse!" Wait! Was this the same guy who could not tell a sausage from a strawberry just seven hours ago?
Dad asked about our lunch and we told him about the 91 year old's birthday. We then asked if he still wanted to go to Tom's for Sunday dinner and he said "yes" and that he wanted Chinese, "his favorite". Good luck with that one Tom, or should I say Mary. My day was done, I kissed him on the cheek and said "Good-bye".
Saturday, September 22, 2012
September 22nd Afternoon Where to Go From Here?
Bill, thanks for you thoughtful post. Let me just say that there is no way you should have feelings of being a "bad person". The effort you and Deb have contributed has not only demonstrated you've tossed your ante into the pot, but that you are "all in" to boot. Those feelings you have, I am certain, are shared by not only the rest of the family, but people down through the ages who face this very same dilemma with people they truly love.
By the time Tom arrived we were in Physical Therapy. Tina was noting how she had had about a week off and it appeared as if Dad had not improved strengthwise. She instructed us to talk to his doctors if we were going to get him into assisted living. Dad was in great spirits during PT. Tom and Tina were joking around and Dad was playing right back. While struggling to do the exercises he gave it all his effort. Tina even remarked that he was one of the few patients she has that doesn't give up.
I had a haircut at 11 and returned at noon. Dad was in bed sleeping and disinterested in lunch. Tom and I went outside and discussed at length Bill's concerns and what would be the best way to proceed. We walked over to the Bistro and got lunch and sat by the pool. It was quite pleasant. Bill's blog post came over the iPad and I read it to Tom. We had another extended conversation about Bill's concerns. We took turns debating both sides and also considering what we thought best for Dad. I know that you all realize the trust and respect we have for any and all your concerns and we do our best to act as though you were here having the discussions with us.
By the time we got back to Dad's room at 2:15 he had not touched lunch and said he just wanted to sleep until dinner. He did ask for an apple juice, which Tom went and got and he drank about 1 1/2 ounces. Tom had also got a vanilla pudding. Dad said he didn't want to spoil dinner.
I spoke with Julie the nurse, a very sweet gal, and while she is no expert on hospice, she thought if we considered the antibiotics "pallative" that they might be able to still provide them. I asked her about severe pain and she related to me the story of one client who received pain meds every hour to control pain. I asked if that person could feel the pain and she said she didn't think so.
Then, I thought about Dad without antibiotics. I think that there is an almost equal chance of any or all of the following happening as there is of the infection returning (geez, John where did you learn to write? Does that last sentence make any sense?) If the antibiotics are contributing to muscle weakness, could he get stronger? Would fluid buildup be less? Might his kidneys improve? Would the diarrhea go away? Would he have a little more energy? Would his eyesight improve? Might it give him a little better quality of life before the cancer really kicks in?
I don't know the answer to any of these and there is always the "trade off" with the antibiotics. Tom and I will meet up again tomorrow morning and give it a go when Dad will hopefully have a little more energy. As always, we'll stay close. Love to all.
By the time Tom arrived we were in Physical Therapy. Tina was noting how she had had about a week off and it appeared as if Dad had not improved strengthwise. She instructed us to talk to his doctors if we were going to get him into assisted living. Dad was in great spirits during PT. Tom and Tina were joking around and Dad was playing right back. While struggling to do the exercises he gave it all his effort. Tina even remarked that he was one of the few patients she has that doesn't give up.
I had a haircut at 11 and returned at noon. Dad was in bed sleeping and disinterested in lunch. Tom and I went outside and discussed at length Bill's concerns and what would be the best way to proceed. We walked over to the Bistro and got lunch and sat by the pool. It was quite pleasant. Bill's blog post came over the iPad and I read it to Tom. We had another extended conversation about Bill's concerns. We took turns debating both sides and also considering what we thought best for Dad. I know that you all realize the trust and respect we have for any and all your concerns and we do our best to act as though you were here having the discussions with us.
By the time we got back to Dad's room at 2:15 he had not touched lunch and said he just wanted to sleep until dinner. He did ask for an apple juice, which Tom went and got and he drank about 1 1/2 ounces. Tom had also got a vanilla pudding. Dad said he didn't want to spoil dinner.
I spoke with Julie the nurse, a very sweet gal, and while she is no expert on hospice, she thought if we considered the antibiotics "pallative" that they might be able to still provide them. I asked her about severe pain and she related to me the story of one client who received pain meds every hour to control pain. I asked if that person could feel the pain and she said she didn't think so.
Then, I thought about Dad without antibiotics. I think that there is an almost equal chance of any or all of the following happening as there is of the infection returning (geez, John where did you learn to write? Does that last sentence make any sense?) If the antibiotics are contributing to muscle weakness, could he get stronger? Would fluid buildup be less? Might his kidneys improve? Would the diarrhea go away? Would he have a little more energy? Would his eyesight improve? Might it give him a little better quality of life before the cancer really kicks in?
I don't know the answer to any of these and there is always the "trade off" with the antibiotics. Tom and I will meet up again tomorrow morning and give it a go when Dad will hopefully have a little more energy. As always, we'll stay close. Love to all.
Bill's Thoughts Sept 22, 2012
Thanks John for the update, it is very helpful as we cannot see what Dad is going through without your help.
I had a discussion with Tom this morning and felt I should also share my thoughts with you. First, I know Dad is in a terrible place health wise and what the outcome will be. I feel guilty because I don't want him to die and I feel guilty because I do want him to pass on, not sure if that makes sense or not, but either way I feel that I am a bad person for thinking these thoughts.
I do know that I don't want Dad to suffer anymore than he is or has and there is very little likelihood that he will improve. I have been reading everything I can find on end-of-life scenarios to better understand or identify when Dad's time is near. There are not a lot of good articles, but the ones that did give some insight tell me that we should expect:
- Profound weakness, this means unable to get out of bed or to even turn over in bed.
- No interest in food or drinking, with several sources stating that a patient can live 30 days without food or about 2 weeks without liquids.
- Trouble swallowing food or pills
- The patient will be very drowsy, often sleeping most of the day
- arms and legs will feel cool to the touch as the patients circulation slow downs
- The patients fingertips turn blue as due to the lack of oxygen.
I share this with you because I want you to know what to expect and to try and understand the process. I am sorry if this is more detail than you might want or if it causes you uneasiness in anyways.
I see that Dad has some of the signs listed above and I am going to call Dr Heidari and Trang to see if they can give me more specific details as to what to expect in this process.
I told Tom that I do not want to stop him from having a conversation with Dad about how he would like to spend his remaining time and for them to spend as much time doing whatever Dad feels up to. I am against taking him off of antibiotics until I can get more answers. I want to ensure that if Dad does live a few more months that he will not have the infection come back. That might mean keeping him on his current antibiotics until such a time that it does not matter, which could be now, or switching him to another, less invasive antibiotic, or to have the doctors tell me that they believe the infection has been reduced to a level that Dad should not have to worry about it coming back.
If he needs antibiotics, more specifically his current ones through the picc line, I would like to see if we could reduce the dosage back. I am also not against switching to an oral antibiotic if the doctors feel that it would be adequate.
I am also going to check with Hoffman Hospice to see if they will or will not administer Hospice while Dad is on antibiotics. I believe that if Dad needs to be on an IV antibiotic that we will not be able to get him 24/7 care at home and that Rosewood may be the best alternative, but that is jumping the gun.
I believe Dad also gets to make the decision, but we need to provide him with as much information as possible to make the decision. I have, as most of you have too, seen Dad in tremendous pain when the infection came back. I also believe that Dad, while he has gotten much weaker, is still fairly strong and is not within a couple days of passing away. But I am not God, and only he knows for sure.
I will be heading down Monday morning to spend time with Dad and to help in anyway in assisting Dad along this journey. In my opinion there is no good choice or a selection of painful choices. I do not want to be a roadblock for anyone spending quality time with Dad, but also do not feel that Dad sleeping 20 -22 hours a day in his own bed right now if necessarily better.
I appreciate you letting me share my thoughts and again, I hope I have not offended anyone as I truly believe we all want what is best for Dad and that we all love him very much.
Love to all,
Bill
September 22 Breakfast
Dad was up and in the bathroom when I arrived. The diarrhea is back. I know they gave the anti-diarrheal yesterday and I made sure he got one this morning. It took us half an hour, but he dressed and walked, yes walked, to the dining room. This is the kind of stuff that truly amazes me. He had to rest three times while buttoning his pants, but grabbed the walker and headed for breakfast walking right past the wheelchair.
He did eat a little more than yesterday: a couple of spoonfuls of oatmeal, scrambled eggs, and part of the waffle and sausage. The conversations overheard in the dining room are precious. Two women chatting over coffee, "the physical therapist worked me very hard yesterday. Does she realize how old I am?". Then the 82 year old asked the 96 year old if she still drove. "yes, I have two more years on my license. Don't you?" Then in response to the 96 yo saying the driving tester did not even make her take the driving part of her test, the 82 yo said "He probably feared for his safety!"
I glanced at the blood test results from the other day. Dad's BUN was a little lower and the creatinine was 4.0. His platelets improved a tad to 37. His B/P was 120/80. I also looked at some of his liver numbers and the ones I saw were in the normal range.
I spoke briefly with nurse Julie and she said Rosewood does provide hospice. The first step is to have the doctor evaluate him to see if he is a candidate (she said unfortunately, almost everyone here is a candidate), then we would speak with Pam to let her know which organization we prefer, and Dad would have to stop physical therapy.
Dad is resting in his room after taking his morning meds. Julie ground them up in applesauce to make them easier to swallow, but it sure spoiled the taste of the applesauce. Tom just called. He is due to meet me here in a few minutes.
He did eat a little more than yesterday: a couple of spoonfuls of oatmeal, scrambled eggs, and part of the waffle and sausage. The conversations overheard in the dining room are precious. Two women chatting over coffee, "the physical therapist worked me very hard yesterday. Does she realize how old I am?". Then the 82 year old asked the 96 year old if she still drove. "yes, I have two more years on my license. Don't you?" Then in response to the 96 yo saying the driving tester did not even make her take the driving part of her test, the 82 yo said "He probably feared for his safety!"
I glanced at the blood test results from the other day. Dad's BUN was a little lower and the creatinine was 4.0. His platelets improved a tad to 37. His B/P was 120/80. I also looked at some of his liver numbers and the ones I saw were in the normal range.
I spoke briefly with nurse Julie and she said Rosewood does provide hospice. The first step is to have the doctor evaluate him to see if he is a candidate (she said unfortunately, almost everyone here is a candidate), then we would speak with Pam to let her know which organization we prefer, and Dad would have to stop physical therapy.
Dad is resting in his room after taking his morning meds. Julie ground them up in applesauce to make them easier to swallow, but it sure spoiled the taste of the applesauce. Tom just called. He is due to meet me here in a few minutes.
Friday, September 21, 2012
Sept. 21st - We Meet Luther and Talk About PT
Dad was up and in the bathroom when I arrived. I made sure there was a cup of coffee on the table and then went back to his room. He dressed himself in a clean shirt and put on a sweatshirt. I didn't ask him why, but took it that even though it was comfortable in his room, he was having a problem staying warm.
We had a new guest at the dinning table, a gentleman by the name of Luther Hankins. Luther is quite the talker, I only wish he would speak a little louder. Luther told us about the pain in his left arm, the trip to the Heart Hospital that does NOT take GEM Care, the subsequent trip to Memorial, before ending up at Rosewood for a few days of observation (this was the short version).
Dad was working on his French toast and ground bacon. He continues to struggle with getting the food down. Luther was a welcome distraction as he told us "Well, I'll be quiet now and let you guys enjoy breakfast", as he paused a whole 60 seconds before going into the 49ers, his time in Japan during the Korean Conflict, and his trip to Washington, D.C.
We did get in a few conversations on our own about physical therapy: "They said they couldn't find me and when they did (putting his fist up like a boxer) they really put it to me." And, Mary's visit for dinner, "She was giving the cook a few tips on how to make cake. She makes great cakes and they could learn a lot. I hope they were paying attention, the cake isn't very good around here." After a couple of spoonfuls of oatmeal, a few bites of the toast and bacon, half a cup of coffee, and all of his juice we headed back to the room. I asked him if he wanted to take some liquid protein to get some nutrition and he said "Yes". I knew it was going to be a struggle because earlier he had mentioned that even water was having a hard time getting down. Realizing it was going to be difficult for him to swallow I backed off and said, "we don't have to" and he replied, " No let's do it. At least it will be sitting on top". I gave him one tablespoon and he chased it with some water.
He couldn't wait to lay down and get covered up in bed. I told him the nurse would be in any minute to give him his morning pills and he replied, "I'll just pretend I'm asleep". Julie came in a few seconds later and it took about ten minutes to give him the five or six pills in applesauce. When she announced "This is the last one", he had the strength to smile and applaud.
There were no new labs in this morning. His BP remained low at 106/60 and Julie did not give the Atenenol. Tom spoke with Dad's Physical Therapist and Vanessa about the assisted living apartment yesterday. He also went to the Dr. Hedari appointment at 3:15 even though Dad was too weak to attend and remained in his room at Rosewood. I have not spoken with Tom on the outcome of any of those visits.
We had a new guest at the dinning table, a gentleman by the name of Luther Hankins. Luther is quite the talker, I only wish he would speak a little louder. Luther told us about the pain in his left arm, the trip to the Heart Hospital that does NOT take GEM Care, the subsequent trip to Memorial, before ending up at Rosewood for a few days of observation (this was the short version).
Dad was working on his French toast and ground bacon. He continues to struggle with getting the food down. Luther was a welcome distraction as he told us "Well, I'll be quiet now and let you guys enjoy breakfast", as he paused a whole 60 seconds before going into the 49ers, his time in Japan during the Korean Conflict, and his trip to Washington, D.C.
We did get in a few conversations on our own about physical therapy: "They said they couldn't find me and when they did (putting his fist up like a boxer) they really put it to me." And, Mary's visit for dinner, "She was giving the cook a few tips on how to make cake. She makes great cakes and they could learn a lot. I hope they were paying attention, the cake isn't very good around here." After a couple of spoonfuls of oatmeal, a few bites of the toast and bacon, half a cup of coffee, and all of his juice we headed back to the room. I asked him if he wanted to take some liquid protein to get some nutrition and he said "Yes". I knew it was going to be a struggle because earlier he had mentioned that even water was having a hard time getting down. Realizing it was going to be difficult for him to swallow I backed off and said, "we don't have to" and he replied, " No let's do it. At least it will be sitting on top". I gave him one tablespoon and he chased it with some water.
He couldn't wait to lay down and get covered up in bed. I told him the nurse would be in any minute to give him his morning pills and he replied, "I'll just pretend I'm asleep". Julie came in a few seconds later and it took about ten minutes to give him the five or six pills in applesauce. When she announced "This is the last one", he had the strength to smile and applaud.
There were no new labs in this morning. His BP remained low at 106/60 and Julie did not give the Atenenol. Tom spoke with Dad's Physical Therapist and Vanessa about the assisted living apartment yesterday. He also went to the Dr. Hedari appointment at 3:15 even though Dad was too weak to attend and remained in his room at Rosewood. I have not spoken with Tom on the outcome of any of those visits.
Thursday, September 20, 2012
Sept 20 - Strawberries and Showers
Dad was up and in the bathroom when I arrived. I went to the dining room and poured him some coffee so it would cool by the time we got there. It only took me three days of watching him burn his tongue to figure that out. Yes, folks, I'm THAT quick. When I got back to his room, the nurse had said something to him in the bathroom and there was no response and I wondered if he had his hearing aid in. It wasn't on the nightstand and so it must be in his ear. I was noticing the IV caps and kleenex on the floor and as I was picking them up, there was his hearing aid - on the floor. There was not a battery in it and I scanned the floor and found not one, but two batteries (one still had the little tape on it). Since the aid itself had been on the floor and Dad was still in the bathroom, I just went ahead and cleaned it and changed the filter. That was the first time for me changing the filter, but I think I did it right. I put the extra battery back in Dad's blue bag.
He ate half a muffin, a bit of eggs, and touch of coffee cake. He would take a bite and then wait with the napkin up to his mouth and at first I thought he was having a teary session, but that didn't seem consistent with our "good morning". I then realized he was having difficulty getting the bites of food to go all the way down. When I asked him if that is what was happening he replied, "the food just doesn't want to hit the bottom". We talked about the weather, the space shuttle return to California, and that his diarrhea was back bright and early this morning. You know, the usual breakfast conversations.
We had taken the wheel chair to breakfast. I asked him if he had had a rough night, the diuretic being on my mind, and he said, "no, it was a pretty good night actually." When we got back to his room his roommate who has a broken hip was being tended to and we met up with Mari Beth in the hallway for Dad's Nephro drink and morning meds.
She checked his BP twice because it was low (100/50) and decided to forego the BP med. Dad was having problems getting the pill down and Mari Beth got a little applesauce and that seemed to help. While we were doing this she mentioned that the blood results would now automatically go to Hedari, Saike, and Nguyen. She asked me if he was going to see the oncologist again. I said I hoped so and that we were focusing on the infection and kidneys for now. She was worried about his platelets which continue to drop. She informed Dr. Memon that the last three tests had shown a decrease from around 50 to 34. Blood will be drawn today for kidney function.
The room wasn't ready when we got back so we went for a little walk. The PTherapist met us in the hall and told Dad she would be seeing him later. He pretended his hearing aid wasn't working. We headed for the patio and when I did my fakie right turn to the PT room he played along and said,"no!,no!,no!" We went out to the patio where we found a rosemary plant. I bruised a leaf and asked if he could smell it and he said "yes, that still works". Right next to that was a strawberry plant in a planter and when I told him he said, "oh, so that's where they get the strawberries from". Then I said it was a pretty small plant and he replied, "That's why I only get half a strawberry".
We finally got back to the room, he had just laid back in his bed and the TA came in and told him it was shower day. "Would you like a shower?" "Oh, yeah!". He directed her as to the clothes he wanted and I walked him to the shower room and kissed him good-bye.
He ate half a muffin, a bit of eggs, and touch of coffee cake. He would take a bite and then wait with the napkin up to his mouth and at first I thought he was having a teary session, but that didn't seem consistent with our "good morning". I then realized he was having difficulty getting the bites of food to go all the way down. When I asked him if that is what was happening he replied, "the food just doesn't want to hit the bottom". We talked about the weather, the space shuttle return to California, and that his diarrhea was back bright and early this morning. You know, the usual breakfast conversations.
We had taken the wheel chair to breakfast. I asked him if he had had a rough night, the diuretic being on my mind, and he said, "no, it was a pretty good night actually." When we got back to his room his roommate who has a broken hip was being tended to and we met up with Mari Beth in the hallway for Dad's Nephro drink and morning meds.
She checked his BP twice because it was low (100/50) and decided to forego the BP med. Dad was having problems getting the pill down and Mari Beth got a little applesauce and that seemed to help. While we were doing this she mentioned that the blood results would now automatically go to Hedari, Saike, and Nguyen. She asked me if he was going to see the oncologist again. I said I hoped so and that we were focusing on the infection and kidneys for now. She was worried about his platelets which continue to drop. She informed Dr. Memon that the last three tests had shown a decrease from around 50 to 34. Blood will be drawn today for kidney function.
The room wasn't ready when we got back so we went for a little walk. The PTherapist met us in the hall and told Dad she would be seeing him later. He pretended his hearing aid wasn't working. We headed for the patio and when I did my fakie right turn to the PT room he played along and said,"no!,no!,no!" We went out to the patio where we found a rosemary plant. I bruised a leaf and asked if he could smell it and he said "yes, that still works". Right next to that was a strawberry plant in a planter and when I told him he said, "oh, so that's where they get the strawberries from". Then I said it was a pretty small plant and he replied, "That's why I only get half a strawberry".
We finally got back to the room, he had just laid back in his bed and the TA came in and told him it was shower day. "Would you like a shower?" "Oh, yeah!". He directed her as to the clothes he wanted and I walked him to the shower room and kissed him good-bye.
Wednesday, September 19, 2012
Sept 19th - Time for a Haircut and Nikki's Wedding
Arrived shortly after 7 and Dad was still hooked up to the IV. I asked if he wanted breakfast and he said "yes. and I want to go to the dining room". I asked the assistant to please wake him up for meals and they said they would "make a note of it". Then Mary Beth unhooked him and he got up, dressed, cleaned up and off we went. He had pancakes, a muffin, apple juice and coffee. While we were in the dining room I tried to show him the pictures of Nikki's wedding but he couldn't quite see them. We did talk about it and he said it would've been nice to be there. We talked about it and he was quite impressed that Dan cooked his own reception dinner.
While in the dining room a woman came in, was it Shannon, from the beauty shop. She wanted Dad right after breakfast for a haircut. She's nice. It was kind of a long walk from the dining room to the beauty shop. Dad said it seemed like he was shoveling snow this morning.
Asked about the diarrhea he said, "yeah, it must be better, I don't remember having it this morning". The diuretic starts today. We'll see how much he has to get up and pee. He does have a new roommate. Mr. Riley broke his hip and can't get out of bed yet. Seems like a nice man...could be a talker. That might be good for Dad.
While in the dining room a woman came in, was it Shannon, from the beauty shop. She wanted Dad right after breakfast for a haircut. She's nice. It was kind of a long walk from the dining room to the beauty shop. Dad said it seemed like he was shoveling snow this morning.
Asked about the diarrhea he said, "yeah, it must be better, I don't remember having it this morning". The diuretic starts today. We'll see how much he has to get up and pee. He does have a new roommate. Mr. Riley broke his hip and can't get out of bed yet. Seems like a nice man...could be a talker. That might be good for Dad.
Tuesday, September 18, 2012
Sept 18 quick note
Tom is taking Dad to Dr. Saike today @ noon. I got a peek of the blood results from yesterday: 3.6 on the creatinine and 70+ on the BUN. Dad had a small breakfast consisting of waffle, chopped ham, and muffin. He really likes the coffee....
Monday, September 17, 2012
Monday report from Tom Eye Doctors
Tom asked me to post this:
Tom took Dad to two eye doctors today. The second one put a contact like protector that will dissolve in a couple of days. Hopefully this will protect Dads eye from further irritation. Dr. Saike is scheduled for Thursday as is Dr. Hedari. Tom is going to call Dr. Hedari and see if he really needs to see Dad.
Pam just returned my call about the dental hygine. I am hopeful that will be done this week. Details still up in the air.
Tom took Dad to two eye doctors today. The second one put a contact like protector that will dissolve in a couple of days. Hopefully this will protect Dads eye from further irritation. Dr. Saike is scheduled for Thursday as is Dr. Hedari. Tom is going to call Dr. Hedari and see if he really needs to see Dad.
Pam just returned my call about the dental hygine. I am hopeful that will be done this week. Details still up in the air.
Thursday, September 13, 2012
Sept 13, 2012 Update on Doctors Visits
Well today is going much better than yesterday. Yesterday Dad was suffering from severe eye
pain, probably due to the erythromycin medication they are putting in his
eye. I talked with the nurse and doctor
last night and requested that they discontinue the use of that cream and it is
causing the severe pain. Dad said he was
doing much better today and his whole attitude is better when he is not in that
pain.
One of the interesting things yesterday, is I asked the
nurse that provides the medication to see what she was putting is Dad's
eye. I was right outside Dad's room
where she had a cart that she pulls medication and provides it to Dad. I was surprised to see that Dad's medication
is not in a single container, but just one of 50 medications in the drawer. The nurse would pick up various bags with descriptions
on them and throw them back in when they were the wrong one. She was able to show me the Lacri Lube and
erythromycin, but could not find the Refresh.
She found a bottle and showed it to me, but I pointed out that it had
someone else's name on it. She stated
they must have just run out and she would have to get more. I suspect they had not been giving the
Refresh, but I have nothing to base it on.
I did have a good meeting with the Dietician at Rosewood and
we worked on Dad's diet. They are going
to puree his lunch and dinner, but not his breakfast and he will get scrambled
eggs on a regular basis for breakfast. I
asked Dad how it went this morning and he said they pureed his eggs this morning. I talked to the dining room supervisor today
at lunch about breakfast and she said she would get it straightened out and
then they served Dad a pureed soup that was milk based, even though his lunch
slip said no milk products. Dad had
taken a couple of spoonfuls and really liked the soup, so he wasn't crazy about
it when I had them take it away. They
did replace it with Chicken Noodle soup, which he said was ok. I told Dad he needs to speak up when they
mess up his order, but I don't think he will and I am worried that they will
continue to need corrections.
I watched Dad do Occupational Therapy both yesterday and
today. He gets OT five times per week
and PT six times per week. He seems to
really enjoy it and they are excellent with him. Today I was in there when they had three
patients and I can tell you attitude is a big part of the healing process and
Dad has a great attitude. They gave Dad
a three pound bar and had him lift it over his head 10 times for three reps,
then he had to extended his arms holding the bar for 10 times with three
reps. The nurse then asked him to do the
same but curls and she had to go help a patient get into bed and said she would
be right back. Well Dad finished his
reps and then he decides to make up his own exercise, combining the lifting
motion over his head and then extending it straight out. He completed three reps before the therapist
came back. They have him standing and
taking steps, then holding a ball and twisting at his waist. He was a little unsteady at first, but
quickly was able to get and maintain his balance.
Dad is still sleeping about 18 hours a day and would sleep
more if he is not going to PT/OT and meals.
I was talking to him about trying to play 5 straight or creating a card
for Nicole on my laptop and he said he wanted to try the card for Nicole. By the time I got my computer out and powered
up, he was sleeping, so I let him sleep.
I just heard from Pam, the Social Activities Director that
the hygienist that Dad was suppose to see does not take medicare patients like
she told me they did. She said they were
looking into other options for Dad including bringing in the person John had
lined up and they would pay for it. When
she asked the cost, she gasped, so I am not sure what is going to happen. She was going to talk to her manager and let
me know. Jim, after John got someone
lined up, when I went to tell the nurse that we were bringing in someone, she
asked 'why aren't you using our hygienist?'
I told her that you were told they didn't have one and she said they
did. Well, it looks like they might not.
Today we saw Dr Heidari, he said Dads kidney function is
down to 18% and his platelet count is down to 45. He was very concerned about both. He asked what was the current plan for the
pet scan and we said that Dr Trang wanted to clear up the osteomyelitis before
proceeding with chemo, so we were not sure it made sense to move forward with
the pet scan. He reiterated his concern
regarding chemo, but then we discussed the gallium scan and pet scan. Both are very safe for Dad and should not
impact his kidneys. He said a MRI with
contrast would be the best test for Dad to see if the osteomyelitis is gone,
but that anything with contrast would be too hard on Dad's kidneys so the
gallium test is the safest and best test given Dad's condition. He also felt that if we wanted to do both
test that Dad should tolerate them both well and that we wouldn't need to wait
any specific time between tests. He also
said that he believes Dad will need at least another 4 weeks for antibiotics
and probably longer. And even when Dad's
test come back clear, that he will still recommend that Dad be given
antibiotics if he decides to move
forward with any chemo treatments.
Dad's gallium scan is scheduled for Oct 1st at 10 am with
follow up appointments at the 2nd and 3rd, but we do not have any specific
times as of yet.
Dr Heidari also felt that we should have Dr Saike see Dad
sooner rather than later as his kidney function is low plus his legs and
abdomen are swollen. Dad says his breathing
is not currently impacted, but this would be something to watch for over the
next week. Tom called Dr Saike's office
and his first available appointment is Oct 18th. Tom is working with his office to get that
date moved up. John said that he would be
willing to take Dad to the appointments and Tom thought that was a good idea.
Dr Heidari changed Dad's medication back to how they were
before moving him to Rosewood or the Heart Hospital. As of tonight he back on Daptomyacin every 48
hours and Zosyn every 6 hours. He was on
Zosyn 3.75mg and will now be on the 2.25mg.
Dr Heidari felt the Zyvox is not a good long term antibiotic and since
Dad has been having further eye problems that the Zyvox might be a contributing
factor. Tom asked if giving Dad the
Zosyn and Dapto over 4 hours was better or made no difference and Dr Heidari
said that it was a better way to administer the medication, but that it is not
good for a patient to be tied to a bed for so long. That is better if Dad can get up and move around
more and get some physical activity.
I am heading home tomorrow (Friday) about 1:00 pm and will
be back on Oct 1st unless I am needed sooner.
Jim, I changed the phone in Dad's room to the one he had at his house,
so if you call him he can put it on the speaker and should be able to hear you
well. We tried it with Cate and it
worked well. Cate is planning on coming
down around Oct 16th and staying until the morning of the 21st (this is still
tentative). Tom will be leaving on Oct
12th for 33 days or until Nov 15th. Jim
if you can give me an idea when you might be coming down, I will try and fill
in any missing gaps and John, I hope you don't mind covering the weekends
during this time period. John will take
Dad to any Dr Nguyen and Dr Saike appointments and Tom will take Dad to Dr
Heidari's appointments. I do not know if
either has plans for Dr Trang's appointments.
Dr Heidari is every week, and the others are every couple of weeks or as
needed. Oh and Tom has made an
appointment for Dad for an ophthalmologist, Dr Ling. This is a Dr that Dad used to go to. He did not like the eye doctor that we found
for him and so we are switching and going to try Dr Ling.
I am sure I am missing something, but it is late and
tomorrow is another day.
Love to all, Bill
Gallium and PET Scans
Bill asked me to do some research on Gallium scans and PET scans for the purpose of determining the levels of infection and cancer in Dad's body. Here are some of my early thoughts:
And this may be completely irrelevant (audacity of hope, and all that) but I did run across this article on the curability of Mantle Cell Lymphoma. Granted it was a small study of subjects younger than 89 (they averaged 66), but it did talk about 5 year survival rates.
http://www.docguide.com/mantle-cell-lymphoma-curable-intensive-immunochemotherapy-presented-ash
- Gallium citrate appears to be no more dangerous to the kidneys than the antibiotics Dad is currently taking. It is often used to diagnose kidney function and nephritis.
- After the Gallium is administered images are taken at regular intervals the first day than once a day for three days. Each set of images takes about 30-60 minutes to produce.
- Sometimes Gallium scans are also used to determine the level of lymphoma and there may be some value to Dr. Nguyen which may preclude the necessity of a PET scan. However, Gallium is mostly used to diagnose the level of non lymphocytic lymphomas and may not be acceptable to Dr. Nguyen. (my understanding is Mantle Cell is a lymphocytic lymphoma).
- There are two other types of scans that may also be used, indium leukocyte imaging and technetium granulocyte. The indium scan is NOT appropriate, but I would be curious to hear what Dr. Hedari and Trang feel about the technetium scan.
- IF the Gallium scan does take place, please let the testing institution know he has diarrhea and NOT to administer laxatives (this is sometimes, not always, but sometimes done to clear the Gallium from the body)
- Does he agree with the timing and purpose of the Gallium scan currently scheduled for October 1st?
- Is the Gallium scan the most accurate in identifying the clearance of the SBO? What about technetium granulocyte scan?
- Is this test going to significantly impact Dad's remaining kidney function?
- What if the test still shows positive signs of SBO? Do we just continue the same antibiotic regimen? Will we need a future Gallium scan?
- Can we concurrently scan for the level of lymphoma to eliminate the need for the upcoming PET scan?
- Are there any suggestions he could make about this procedure to give Dad's ENT and Oncologist more and better information?
- Is the PET scan hard on Dad's kidney?
- Is there a safe time period between the Gallium scan and the PET scan that should be observed?
And this may be completely irrelevant (audacity of hope, and all that) but I did run across this article on the curability of Mantle Cell Lymphoma. Granted it was a small study of subjects younger than 89 (they averaged 66), but it did talk about 5 year survival rates.
http://www.docguide.com/mantle-cell-lymphoma-curable-intensive-immunochemotherapy-presented-ash
Tuesday, September 11, 2012
Sept 11, 2012 Doctors and Settling in to Rosewood
Tom and I spent the afternoon with Dad today. We got to Rosewood about 9:45 and left about 3:30 today. When we got there Dad was sleeping in his bed, though he was dressed in shorts and polo shirt. He said he had gotten up and ate breakfast and came back to take a short nap before the doctors appointment. We got Dad up and had him brush his teeth. He was unable to put toothpaste on his toothbrush, so I helped him out. The rest he seemed to do well, including getting out of bed with the use of the walker.
He did walk to the car with the aide of the walker (this is an older style walker with wheels on the back). We got him to Dr Trang's office and unfortunately had to wait about an hour to see. We did weigh Dad in before seeing him and he weighed 166 lbs. Dr Trang asked Dad how he was doing and Dad said he was doing better. Dr Trang looked in Dad's ear and said that it was the best that he has seen with Dad. He asked about what Dr Nguyen was doing and we told him about the pet scan and possible chemo treatment. He told Dad that he would call Dr Nguyen and Dr Heidari to make sure all three were on the same page. He said he wants to see a minimum of another two weeks of antibiotics and would probably bet his house that Dad would need at least another month past the 25th. He wants Dad to have a gallium scan around the 25th of Sept. He said the gallium scan would highlight any infection that Dad has in the bone area of his skull. He mentioned that he would prefer holding off of chemo until he is sure they have eradicated the infection, he is concerned that infection may come back.
After Dr Trang's visit, we took Dad to the Garden Spot for lunch where Dad had soup for lunch. He also enjoyed chocolate pudding, but not much more. We then took Dad back to Rosewood, getting back about 1:30. He wanted to take a nap.
At about 2:30 we met with the staff at Rosewood, with representatives from therapy, food services, social services, nursing and activities. We first discussed how happy Dad was with Rosewood and we were too, but did have a few ideas that would make it better for Dad. Most of the items were from Jim's list, great job Jim. We went through Dad's ailments, which included the SBO, Cancer, facial paralysis and stomach issues due to the antibiotics. We talked about the food that Dad was being served and they are going to move Dad to mechanically processed soft foods. They are going to start checking with Dad more to see if he is having diarhea and if so suggest the Imodium AD. They are going to have evaluated by a Speech Therapist, to see if they can help with his speech due to the facial paralysis. Also the OT will already had reviewed how he gets out of bed and told Dad that he was doing good. They are going to observe him brushing his teeth and give him a routine that he can follow for brushing his teeth. We also reminded all of them that Dad cannot hear out of his left ear and cannot see out of his right eye. That Dad may not always fully understand them even when he says ok or nods in confirmation. I talked about the importance of having Dad repeat back any important instructions or information.
OT will review Dad to see how he does dressing himself and the nursing staff will provide assistance to Dad in putting on clean clothes every morning. We also let them know that Dad prefers to get up at 7:00 am so that he can participate in breakfast and all meals in the main dining room. We reviewed all of Dad's medication and we questioned the stool softener and talked about the lacri lube and eye drops. They said that Dad was getting eye drops every two hours, but when we asked when he got his last eyedrops, they said it was 1:06 pm. We told them that he was at the doctors at that time and she said, oh sorry it was 11:06 am. We said he was still not here and she said she will have to get back to us on when he had the last eye drops.
The meeting was very helpful in clearing up misunderstandings and the staff was very responsive and eager to help, often suggesting what they could do when an issue was brought up. We did forget to mention the issue around response time when Dad needs to use the bathroom. We will talk with the head of the nursing staff tomorrow.
He did walk to the car with the aide of the walker (this is an older style walker with wheels on the back). We got him to Dr Trang's office and unfortunately had to wait about an hour to see. We did weigh Dad in before seeing him and he weighed 166 lbs. Dr Trang asked Dad how he was doing and Dad said he was doing better. Dr Trang looked in Dad's ear and said that it was the best that he has seen with Dad. He asked about what Dr Nguyen was doing and we told him about the pet scan and possible chemo treatment. He told Dad that he would call Dr Nguyen and Dr Heidari to make sure all three were on the same page. He said he wants to see a minimum of another two weeks of antibiotics and would probably bet his house that Dad would need at least another month past the 25th. He wants Dad to have a gallium scan around the 25th of Sept. He said the gallium scan would highlight any infection that Dad has in the bone area of his skull. He mentioned that he would prefer holding off of chemo until he is sure they have eradicated the infection, he is concerned that infection may come back.
After Dr Trang's visit, we took Dad to the Garden Spot for lunch where Dad had soup for lunch. He also enjoyed chocolate pudding, but not much more. We then took Dad back to Rosewood, getting back about 1:30. He wanted to take a nap.
At about 2:30 we met with the staff at Rosewood, with representatives from therapy, food services, social services, nursing and activities. We first discussed how happy Dad was with Rosewood and we were too, but did have a few ideas that would make it better for Dad. Most of the items were from Jim's list, great job Jim. We went through Dad's ailments, which included the SBO, Cancer, facial paralysis and stomach issues due to the antibiotics. We talked about the food that Dad was being served and they are going to move Dad to mechanically processed soft foods. They are going to start checking with Dad more to see if he is having diarhea and if so suggest the Imodium AD. They are going to have evaluated by a Speech Therapist, to see if they can help with his speech due to the facial paralysis. Also the OT will already had reviewed how he gets out of bed and told Dad that he was doing good. They are going to observe him brushing his teeth and give him a routine that he can follow for brushing his teeth. We also reminded all of them that Dad cannot hear out of his left ear and cannot see out of his right eye. That Dad may not always fully understand them even when he says ok or nods in confirmation. I talked about the importance of having Dad repeat back any important instructions or information.
OT will review Dad to see how he does dressing himself and the nursing staff will provide assistance to Dad in putting on clean clothes every morning. We also let them know that Dad prefers to get up at 7:00 am so that he can participate in breakfast and all meals in the main dining room. We reviewed all of Dad's medication and we questioned the stool softener and talked about the lacri lube and eye drops. They said that Dad was getting eye drops every two hours, but when we asked when he got his last eyedrops, they said it was 1:06 pm. We told them that he was at the doctors at that time and she said, oh sorry it was 11:06 am. We said he was still not here and she said she will have to get back to us on when he had the last eye drops.
The meeting was very helpful in clearing up misunderstandings and the staff was very responsive and eager to help, often suggesting what they could do when an issue was brought up. We did forget to mention the issue around response time when Dad needs to use the bathroom. We will talk with the head of the nursing staff tomorrow.
Sunday, September 9, 2012
PT and OT
One of the very positive things about Rosewood is the fact dad receives Physical Therapy and Occupational Therapy every weekday. OT focuses on function and coordination. PT focuses on strength and elevation of his heart rate. Dad really seems to enjoy it and looks forward to spending time with the staff. They are very kind and encouraging.
Here dad stands, holding a rail and practices kicking a small ball against the wall, alternating feet.
Here dad uses 2lb weights for upper body strength. This is after he practiced standing from that bench without the use of his arms. He did it 15 times in about 20 minutes.
Each session is 30-45 minutes.
Here are two short videos to give you a better idea of what they have Dad doing.
...Jim
Here dad stands, holding a rail and practices kicking a small ball against the wall, alternating feet.
Here dad uses 2lb weights for upper body strength. This is after he practiced standing from that bench without the use of his arms. He did it 15 times in about 20 minutes.
Each session is 30-45 minutes.
Here are two short videos to give you a better idea of what they have Dad doing.
https://docs.google.com/open?id=0B_B-QKBHRzApZ21hdGhQLUpFMGs
Enjoy,
...Jim
Saturday, September 8, 2012
Jim's Rosewood Playing the Cards Your Dealt
I thought it might be helpful to write up a couple notes to pass on to the team.
Things to talk to Rosewood about:
- Diet, high protein meals if possible.
- Regular eye drops throughout the day.
- Better response when he presses the button.
- Imodium AD every 8 hours to control his diarrhea, until we see improvement. Ask Dr. Heidari on Thursday for advice if it's not improved by then.
- Make sure every member of the nurse staff and PT/OT understands he only hears in his right ear.
- Ditto, he only sees out of his left eye and he can only see shapes.
- Have PT/OT help teach him how to get in/out of bed by himself. Lifting his legs up on the bed is getting harder for him. Have them teach him how to put the toothpaste on the toothbrush with his vision challenges.
- He would like to change his undershirt every morning and put on a clean golf shirt. Can we direct the morning shift to do this before breakfast.
- Make sure the staff doesn't allow him to sleep through a meal. He did not eat lunch on Tuesday because he was sleeping and they didn't think to wake him. He can't read the clock.
Observations:
Dad likes to sleep in his undershirt and grey Depends. When I get here, I check to make sure he has a clean undershirt and new golf shirt on. He wanted a couple "white" golf shirts, so I grabbed two from his closet. I didn't get a chance to write his name on the tags.
I check to see of he brushed his teeth after breakfast, he usually says no and ask me to help him, which means I move this toothpaste and brush to the sink and put the toothpaste on the brush.
Getting out of bed is a strain for him, so I've been helping him sit-up out of bed by letting him grab each of my hands and pull himself to the edge of the bed. I get his slippers on and then he can do the rest on his own.
The heart hospital asked for dad to take protein shakes, 2 per day. I don't know exactly which doctor requested it. They asked me to go to wal-mart and buy a case of Nepro. The problem is he never drinks more than a sip and it sits next to the window, near the sun. I asked John to see if we can substitute the Nepro, that he doesn't drink, for two tablespoons of a Twin Lab's liquid protein instead. I spoke to the nurse about it tonight and she said the doctor will have to ok it and she can't give it to him. She can't stop us from giving it to him though.
Dad more comfortable using the Depends instead of underwear. He still has Diarehha, I have tried to teach the staff to ask dad if he still has diarrhea, but they don't. So I have been asking for the Imodem AD every 6/8 hours for him and they have been great getting it for him when I ask.
He's having trouble chewing food on his right side. That is why he likes soup for lunch and dinner. Breakfast seems to be his favorite meal. He doesn't like eating all the bread and breaded meals (ham on toast, cheeseburgers, etc...) or things that are hard to cut up. I made friends with Simone and asked her if she could help dad cut up his food during her shifts and she said, "of course" and dad was very appreciative when she cut-up the cooked ham tonight. She even made a comment how hard it was for her to do it with a butter knife.
Dad is wearing suspenders and likes them, however they are a challenge to manipulate when using the restroom. I think elastic shorts might be easier if they'll stay up.
I got dad to sit in his chair instead of going straight back to bed several times. He's a good sport, but he gets bored in the chair because he really can't see well enough to watch TV or play a game. We also said outside on his patio a couple times for 10 minutes or so and he seemed to enjoy getting a few minutes on sun. We also went to the shaded area across from the PT room and he enjoyed that as well.
This afternoon we visited with John and Ranae and decided to walk over to the dining room for more space. I thought the change of location really helped Dad, he was more alert and attentive. He also got to meet some other people staying there, like Charles (81) - the country music singer who invited dad to a sing along tomorrow at 4pm.
I'm going to post one more message about PT and OT next and see if I can include some photos and video I shot.
In closing, I share everyone's observations in terms of Dad's strong will and amazing spirit. I'm blessed I was able to share the last couple of days with him. A lot of the time, I would just sit with him on the his right side of the bed and give him play-by-play on the US Open or read him headlines from the news.
I got to watch him do all of his PT and OT sessions and got to see first hand how nice the staff are to "Mr. Bill" or "Mr. William". Are they perfect, no way. However, I never once witnessed any staff member being "short" with anyone. Dad had two accidents while I was there with his diarrhea and each time two staff members came to his aid, took him in the restroom, shut the door and cleaned him up, and did it cheerfully without judgement.
I believe dad likes the variety of people and personalities and being on a set schedule. He's fighting using the wheelchair with all his might because he firmly believes if he allows people to start pushing him around in it, his legs will just weaken more.
I share the heartache and emotion of seeing dad like this, as all of you have. This week I got a lesson in "Playing the cards I have, instead of complaining how crappy they are." He continues to be an amazing role model to me every minute I'm around him.
Love to all,
...Jim
Things to talk to Rosewood about:
- Diet, high protein meals if possible.
- Regular eye drops throughout the day.
- Better response when he presses the button.
- Imodium AD every 8 hours to control his diarrhea, until we see improvement. Ask Dr. Heidari on Thursday for advice if it's not improved by then.
- Make sure every member of the nurse staff and PT/OT understands he only hears in his right ear.
- Ditto, he only sees out of his left eye and he can only see shapes.
- Have PT/OT help teach him how to get in/out of bed by himself. Lifting his legs up on the bed is getting harder for him. Have them teach him how to put the toothpaste on the toothbrush with his vision challenges.
- He would like to change his undershirt every morning and put on a clean golf shirt. Can we direct the morning shift to do this before breakfast.
- Make sure the staff doesn't allow him to sleep through a meal. He did not eat lunch on Tuesday because he was sleeping and they didn't think to wake him. He can't read the clock.
Observations:
Dad likes to sleep in his undershirt and grey Depends. When I get here, I check to make sure he has a clean undershirt and new golf shirt on. He wanted a couple "white" golf shirts, so I grabbed two from his closet. I didn't get a chance to write his name on the tags.
I check to see of he brushed his teeth after breakfast, he usually says no and ask me to help him, which means I move this toothpaste and brush to the sink and put the toothpaste on the brush.
Getting out of bed is a strain for him, so I've been helping him sit-up out of bed by letting him grab each of my hands and pull himself to the edge of the bed. I get his slippers on and then he can do the rest on his own.
The heart hospital asked for dad to take protein shakes, 2 per day. I don't know exactly which doctor requested it. They asked me to go to wal-mart and buy a case of Nepro. The problem is he never drinks more than a sip and it sits next to the window, near the sun. I asked John to see if we can substitute the Nepro, that he doesn't drink, for two tablespoons of a Twin Lab's liquid protein instead. I spoke to the nurse about it tonight and she said the doctor will have to ok it and she can't give it to him. She can't stop us from giving it to him though.
Dad more comfortable using the Depends instead of underwear. He still has Diarehha, I have tried to teach the staff to ask dad if he still has diarrhea, but they don't. So I have been asking for the Imodem AD every 6/8 hours for him and they have been great getting it for him when I ask.
He's having trouble chewing food on his right side. That is why he likes soup for lunch and dinner. Breakfast seems to be his favorite meal. He doesn't like eating all the bread and breaded meals (ham on toast, cheeseburgers, etc...) or things that are hard to cut up. I made friends with Simone and asked her if she could help dad cut up his food during her shifts and she said, "of course" and dad was very appreciative when she cut-up the cooked ham tonight. She even made a comment how hard it was for her to do it with a butter knife.
Dad is wearing suspenders and likes them, however they are a challenge to manipulate when using the restroom. I think elastic shorts might be easier if they'll stay up.
I got dad to sit in his chair instead of going straight back to bed several times. He's a good sport, but he gets bored in the chair because he really can't see well enough to watch TV or play a game. We also said outside on his patio a couple times for 10 minutes or so and he seemed to enjoy getting a few minutes on sun. We also went to the shaded area across from the PT room and he enjoyed that as well.
This afternoon we visited with John and Ranae and decided to walk over to the dining room for more space. I thought the change of location really helped Dad, he was more alert and attentive. He also got to meet some other people staying there, like Charles (81) - the country music singer who invited dad to a sing along tomorrow at 4pm.
I'm going to post one more message about PT and OT next and see if I can include some photos and video I shot.
In closing, I share everyone's observations in terms of Dad's strong will and amazing spirit. I'm blessed I was able to share the last couple of days with him. A lot of the time, I would just sit with him on the his right side of the bed and give him play-by-play on the US Open or read him headlines from the news.
I got to watch him do all of his PT and OT sessions and got to see first hand how nice the staff are to "Mr. Bill" or "Mr. William". Are they perfect, no way. However, I never once witnessed any staff member being "short" with anyone. Dad had two accidents while I was there with his diarrhea and each time two staff members came to his aid, took him in the restroom, shut the door and cleaned him up, and did it cheerfully without judgement.
I believe dad likes the variety of people and personalities and being on a set schedule. He's fighting using the wheelchair with all his might because he firmly believes if he allows people to start pushing him around in it, his legs will just weaken more.
I share the heartache and emotion of seeing dad like this, as all of you have. This week I got a lesson in "Playing the cards I have, instead of complaining how crappy they are." He continues to be an amazing role model to me every minute I'm around him.
Love to all,
...Jim
Friday, September 7, 2012
Dental Information
I called my dentist, Dr. John Wilson. The office runs on a minimal staff on Fridays but Stephanie was kind enough to track down the doctor and get back to me.
Dr. Wilson would have to examine Dad and that would be about $60. He may insist on x-rays, however, I think my realtionship with him is good enough that I may persuade him otherwise. If I can't, then x-rays are about $150.
Cleaning can run from $90 - $200 and that depends on the severity of Dad's teeth. The exam and cleaning would take about 90 minutes (with 30 minutes for the exam and 60 minutes for the cleaning)and we split it up if Dad is not strong enough.
Dr. Wilson's office is modern and up-to-date and I consider him to be an excellent dentist. His office is in the same center as CBCC, right across from Truxtun Lake. I will add contact info on our contact page.
I have a call in to Dr. Hedari to double check that there is no danger to the dental hygenist who would work on Dad. I am waiting for someone to call me back.
Let me know your thoughts and I will move forward or not to make the necessary appointments.
Update: Just got the call from Dr. Hedari that it is safe to perform a cleaning.
Dr. Wilson would have to examine Dad and that would be about $60. He may insist on x-rays, however, I think my realtionship with him is good enough that I may persuade him otherwise. If I can't, then x-rays are about $150.
Cleaning can run from $90 - $200 and that depends on the severity of Dad's teeth. The exam and cleaning would take about 90 minutes (with 30 minutes for the exam and 60 minutes for the cleaning)and we split it up if Dad is not strong enough.
Dr. Wilson's office is modern and up-to-date and I consider him to be an excellent dentist. His office is in the same center as CBCC, right across from Truxtun Lake. I will add contact info on our contact page.
I have a call in to Dr. Hedari to double check that there is no danger to the dental hygenist who would work on Dad. I am waiting for someone to call me back.
Let me know your thoughts and I will move forward or not to make the necessary appointments.
Update: Just got the call from Dr. Hedari that it is safe to perform a cleaning.
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