Dad’s Heart Attack
The last time I wrote that dad had just had a heart attack. In this post, I will tell about the events at that time. I had arranged for some companions to visit dad 4 days a week while I flew south for a winter respite. But as my departure date came closer, I began to get nervous about leaving. I knew that dad had done well with his companions each year for the last 3 years. And I knew he could just as easily die in his sleep even while I was just a few miles away in my home.
Our last visit though, I became concerned when he went in the bathroom and literally didn’t come out for 2 hours. I asked my son to go in after him, but he was embarrassed so I went in myself and asked dad if he had gastrointestinal problems. He insisted he was “fine” but nevertheless didn’t come out. Finally he did, and I spoke with the staff. Since it was Sunday neither the nurse nor the director were there.
I asked the Aides to keep an eye on dad and I emailed the director when I got home. The ALF had just hired a new nurse after a month without one. I requested that they have dad checked for a UTI and have his doctor’s office NP check him the next day.
The director called me before I flew out of town telling me that the nurse practitioner would see him that afternoon. She said dad had come to the dining room for his breakfast and lunch and seemed fine. But that evening after I arrived at my destination, she emailed to say the NP had ordered some tests including an ultrasound and a blood test.
By Tuesday they were saying he had congestive heart failure. His Monday companion had called to tell me he had shoulder pain and his ALF just gave him Tylenol for it. She felt it could be more serious than that.
His Tuesday companion was a retired NP. I asked her if she thought I should just go home. She said she could be there with him as needed and suggested I wait for the results of the tests just ordered.
Wednesday none of the companions were scheduled to be there and dad seemed stable. But early on Thursday the new ALF nurse called to say dad told her he was not feeling well and wanted to go to the hospital. I said if he wants to go to the hospital send him NOW as he never was willing to go before, even during his gall bladder attack. They called 911 for an ambulance to take him to the ER.
I called the nurse companion and asked if she could be there with dad when he gets to the hospital. Somehow she managed to get there and brought the MOLST form from the ALF. I had called my daughter and son, and they managed to get to the hospital shortly thereafter.
The nurse companion called me and said they thought the congestive heart failure was the result of a recent heart attack. Blood tests indicated that. Then by the time the nurse companion had to leave, my daughter arrived and stayed with dad in the ER. Soon my son arrived.
My daughter called me but she was crying so hard I couldn’t understand her. The doctor was asking her questions and she needed to know if he had a DNR. I said yes, don’t they have the form there? She was incoherent. I told her to calm down. I said I know dad recently had a heart attack and now he is in the ER. Somehow she managed to tell me that dad was in the process of having another heart attack right there in the ER and the doctors and nurses were treating dad while she was on the phone with me.
Somehow dad survived that and the doctor took the phone from my daughter and talked to me. He said the situation was serious and I should come immediately. I said I thought it was too late in the day to get a flight and it would be morning before I got there. He indicated dad might not make it through the night.
I contacted friends at my vacation rental condo as I don’t have a car when I am on vacation. Friends take me shopping and to or from the airport. Most other destinations are within walking distance. I was in a panic. I couldn’t focus on what to pack. How long would dad survive?
I bought last minute tickets at a reasonable price and packed very few things. I decided to leave everything in my vacation condo – suitcase, clothing, everything except my carry on. I was to be moved into a different rental while I was gone, so I just put everything in my suitcase and left it there.
I didn’t sleep well knowing dad could be gone by the time I got there. My daughter and son said they didn’t sleep well either.
Friends took me to the airport Friday morning after just 3 days in my vacation condo. I arrived just before noon and my son picked me up. We went straight to the hospital.
Dad was awake and aware of what was going on. My son said dad looked better that day than he had the day before. The PA explained that since dad had survived the night, his chances were looking better than they had the day before. Still, after 2 heart attacks within a week, dad’s heart was badly damaged and his long term survival prospects were poor. They estimated he had about 3 months to live.
The PA wanted to talk to me about hospice. That was good as I wanted to talk to her about hospice too. I signed the papers and by the next day, after getting the necessary signatures from the doctors in charge, dad was put on inpatient hospice. That meant he would remain in the hospital for the time being but instead of curative care, he would get comfort care.
At that point, they removed the IV lines giving him fluids and medications. He had 3 or 4 needles in his arms and they were removed too. Now dad could eat whatever he wanted and drink whatever he wanted. They stopped all his medications except those that might relieve the pain or improve his breathing.
For the next week, I spent mornings making phone calls as I was trying to determine where he would go for hospice – probably a nursing home. I called my care manager for help in getting him into a good one and avoid the bad experiences of the past. I had to arrange rides to the hospital for myself as the roads were covered with snow and I don’t drive on snow. I was very lucky my regular driver was willing to squeeze me into his already busy schedule. Usually I had to give him a week’s notice. But this time he fit me in every day for the time I needed rides. Thank goodness I already had that relationship!
I spent afternoons in the hospital with dad. After a few days it became clear that they were soon going to pressure me to choose a care facility so dad could be discharged. It looked impossible to get him into a free-standing hospice as they had an estimated survival time of 3 months for him and the local free-standing hospices only took inpatients with 2 weeks or less to live.
I will continue this next time….