Saturday, April 19, 2014

April 19 – “The News”

Barely able to catch our breath after Uncle Jerry’s funeral, we received some news about Mom yesterday.  Her white blood cell count that points to infection had jumped to 31 and then dropped to 29, basically hovering around the same thing.  The docs next step was to check for an infection known as C-DIFF (Clostridium difficile - a bacterium that can cause symptoms ranging from diarrhea to life-threatening inflammation of the colon.  Illness from C. difficile most commonly affects older adults in hospitals or in long-term care facilities and typically occurs after use of antibiotic medications).  That definition is from a textbook somewhere.  Chris explained it to me as the extended antibiotics use killing off too much of the “good” bacteria in the intestines, allowing the “bad guys” that sneak past the antibiotic explosions to thrive.  Until the test came back, she would still be taking zocin and levoquin, but not vancomyacin.  Seems the level of that one in her system had reached the point beyond which it would become toxic rather than helpful to her body.  Oh, and her kidney functions were off as well, so they stopped the naprocen she was receiving for pain.  The CT scan of her abdomen showed “some opaque areas,” but there was initially not much further explanation related to that.  The gerontologist had called in some infectious disease doctors to look at the scan and see what their opinion was and what other treatment courses they would recommend.  He said they probably wouldn’t be by until the next day.

Whew.  That was a mouthful, I know, and most of it medical jargon, but it should give an idea of the mass of information we were dealing with.  It was hard to stay completely focused after a point.  One thing was obviously piling on top of another and on top of another and so on and so on.  I had to leave the hospital for a while to lead a wedding rehearsal for the wedding I am officiating this afternoon.  I stopped by Office Depot to pick up the programs for the Easter sunrise service and by WalMart to grab some Easter candy and stuff for our grandkids.  They were supposed to come over this morning to dye some eggs and do an egg hunt.  And just as I got to the house to change clothes, Chris called and asked if I had a second to talk.  Never a good sign.  I plugged my phone in to recharge and sat down on the couch.  The infectious disease team had just left.  Yep.  The ones who weren’t supposed to come until later on today.  And their news was not good at all.  Those “opaque spots” were pockets of air in the abdomen that shouldn’t be there.  They suspected a rupture of some sort in the colon.  From their perspective, the next step would be surgery, but they didn’t think Mom was a good candidate for the surgery.  They asked Chris how many kids Mom had, then said “The brothers, then need to get together and make sure everyone is on the same page as to what is going on here.  They and maybe any grandkids might want to make a trip up here to see Grandma.  Best case scenario, they get to see grandma over the weekend.  Worst case, they get to say their goodbyes.”  Needless to say, that news hit Chris pretty hard.  And I was frustrated that I wasn’t there to hear it with her.  I assured her I would be back up as soon as I could.  And I called my two brothers to make sure they were in the loop and that we were indeed still on the same page.  We all agreed that it was Mom’s wish not to have any sort of invasive procedure done that would extend her life at the expensive of quality of life.  We were thankful that she had made this decision time easier for us. 

As soon as the rehearsal ended I headed back to the hospital.  Chris filled me in on some more of the details, and we just sat and talked quietly for a while.  She finally convinced me to go on back to the house and try to get some sleep.  I agreed, knowing that likewise, she would never sleep as long as I was there.  We decided that with things in this upheaval of sorts, it would probably be better to call off the family Easter egg party for the time being.  I made it back to the house and after working a few crossword puzzles, I finally drifted off to sleep around eleven.

My phone rang right at 1:45 a.m.  It was Chris.  The surgical team had just left the room.  They were wanting to do a surgery right then.  She tried to explain the family’s wishes, but she knew they wouldn’t be satisfied until they talked in person to whoever had medical power of attorney.  So back to the hospital again.  The picture of what had happened to Mom over the past ten days or so was slowly beginning to take shape.  The doc had started out by saying “We know she had diverticulitis.”  That was news to us.  The urinary tract infection was probably caused by a small leak in the colon, which was compromised by the diverticulitis.  Over a period of days the leak has gotten larger, and now the CT shows that she has the air in her abdomen.  We were left with two options.  One, surgery.  That would clean out the infection, but would leave her with a colostomy bag and considerable post-operative pain.  The downside was that she was a very poor candidate to survive the surgery because of her age and the event back in the ER that had compromised / weakened her heart.  Two, no surgery.  There is a very remote chance that the problem will correct itself.  In the meantime she would be treated with antibiotics and medication to control the pain.  Once again, bolstered by the knowledge that Mom knew she was right with God and was headed to heaven when she died, and by the confidence of her having stated her wishes much earlier in life, and by the solidarity of the brothers, I thanked the surgery team and assured them that we had made an informed decision.  They accepted it, and assured us that they would be there to answer any questions or to be available if we changed our minds. 

OK.  Double whew.  Once again I sat quietly with Chris for a long time before finally coming back to the house somewhere around four a.m.  I dozed kind of fitfully until around six, my usual time to wake up.  I called the brothers again to keep them updated.  Pretty soon I’ll head back up to the hospital to see if the results of that C-DIFF test have come back.  The reason that’s a big deal?  If it is positive, then that is an infectious disease and the little guys shouldn’t come up to see MeeMaw.  That’s an awful lot of bad news to handle over the course of one 24 hour period that just happened to also be Good Friday.  Not any worse than the rampant bad news that swept the world on the first Good Friday, though.  But the incomprehensible pain and agony of that day resulted in the most incredible joy and long-lasting benefit that the universe has ever known.  Easter ... So much more than just bunnies and candy and colored eggs.  And for Mom?  Won’t be long before she’ll be dancing the dance of ultimate joy with Jesus and Jesse.  I know she’d happily take the trade-off. 

In John 14:27 Jesus said, “Peace I leave with you; my peace I give you. I do not give to you as the world gives. Do not let your hearts be troubled and do not be afraid.”

Father, it is really hard not to give in to those troubled hearts you talked about, and the unknown always has that all-too familiar taste of fear in it.  So thank you for that peace, for your peace.  Amen. 

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