Wednesday, January 5, 2011

Loss: my Dad died ... .and another miscarriage.

The night following the transfer I was bed-resting on an Amtrak train in the middle of Nevada on my way home from Colorado, when at 2AM my brother called me in a panic asking me what sort of measures he should take with my Dad in the emergency room.

What I have withheld from you for the last five months is that my Dad was diagnosed with stage 4 pancreatic cancer in August of this year. It was such heartbreaking news. I knew what it meant, my Dad, however, was much more optimistic about his illness. He didn't want me blogging about it because he didn't tell his family until just recently and a few of them follow my blog. So I couldn't share anything on here - which was hard. These last five months my Dad endured bi-weekly chemo treatments, moved in with us, quitting smoking, lost 50 lbs easy (and he was only 150 to start), stopped eating, slowed down quite a bit ... but that didn't stop his spirit. Two days prior to going into the ER he baked 12 dozen Christmas cookies. My Dad was a very functional dying man.

Back to that night, December 22nd. My brother and my Dad were in town, because my brother was taking care of my Dad while we were in Denver cycling. Late that night my Dad attempted to swallow one of his morph.ine pills with some water and instead slipped and choked on the water and the pill - they went right into his lungs. Almost immediately he started with shortness of breath - and he was frightened. My brother called 911, the Fire Department and an ambulance was dispatched and he was taken to the local hospital. Upon arrival the ER docs were grilling my brother on whether or not they should treat my terminal father (most stage 4 cancer patients have DNR - do not resuscitate - directions) they gave my father an hour to live, so he had 10 minutes to make up his mind about treatment - so my brother called me, as I was my father's durable power of attorney and we had discussed and signed his advanced directive ... I knew all of my father's wishes so I immediately told my brother to resuscitate, resuscitate!!! There I was woken at 2AM, trying to stay calm and receptive for these embryos - all the while stressing out about not being able to see my Dad before he died. I was going through scenarios of getting off the train in Reno or Sacramento and flying home to be able to say good bye ... even when I was on the train because I can't fly due to the stress it causes me and these little embryos. Thankfully by 5AM, before the next train stop, my Dad was put on a Bi-PAP and given antibiotics and his diagnosis of aspiration pneumonia was already looking better - according to the x-rays they had run.

I made it home and to the hospital by 8PM on 12/22. I found my Dad admitted to the ICU, hooked up to the Bi-PAP (a partial ventilator) and a glucose/saline IV, very weak, unable to breath on his own, unable to speak, and sleeping. I didn't realize the end was coming. You see this "incident" occurred 7 days after his most recent chemo treatment and most times he hit his physical low 7-10 days following chemo - so we all thought this was a set back for him and not the end. It wasn't until the late evening of the 23rd that I realized that we'd be spending Christmas in the hospital. On Christmas eve morning my Dad had graduated from the Bi-PAP and he was breathing room air - something, I found out later, the doctors didn't think would happen again for him. Then we learned that my Dad had blood clots in his legs, he couldn't move his body except for his arms so we had to worry about bed sores and more clots at this point. But his blood was WAY too thin for his condition (having clots, being a cancer patient, being a chemo patient - it didn't make sense) so we couldn't even give him blood thinner to help him, we just had to wait them out, hoping they'd go away ... and the next day, they did. We snuck the kids into the ICU and had them open up gifts from "Grandpa" in front of him - but he was so out of it with pain meds, I'm not sure he'd say he remembered the occasion. We decorated the room with pictures from our family photo shoot in September (right after we learned of his diagnosis, we took pictures to remember him by - I'm so glad we did this). We put up a tree and lights, stockings, garland, and family photo ornaments to decorate a gift wrap cutout tree taped to the wall. The best part was the santa hat placed on my Dad's cute balding head. That man was loved.

By this time it was the weekend, between me, my husband, and my brother, we took turns watching the kids (Dru and Laila our 6 year old niece) while the other two went to the hospital to visit my Dad. I was there in the early mornings to meet with the staff, strategizing about treatment options, then I'd take an afternoon break to relieve someone watching the kids, then I'd be back to the hospital for the dinner and late night timeframe because my Dad was most alert between 10P-2A. He would use that time to write messages to us on a white board or point letters out to us spelling messages - like "I want to eat" and "let me decide". So he had recovered his ability to breath and his blood levels stabilized, but he had gone 5 days without eating. It was time to start eating or time to start dying. The problem was - he had lost his ability to swallow (something we later learned had landed him in the hospital with aspiration pneumonia to begin with). When I asked our new doctor (let's call her Dr. Kavor.kian) about placing a feeding tube - kick starting him back to nutrition she told me she didn't recommend it and suggested it was time to comfort him into death. I knew my Dad was not ready for that - though I asked him EVERY night - "Dad, are you suffering? Is it time? Are you ready to say goodbye? Because we will support whatever you need to do. Always being answered ... no, I want to eat. So the doctor and I did not get along. As an infertility patient, I have learned to be an advocate - and that's what I was for my Dad until the end. That doctor didn't intimidate me. I held my ground and we followed my Dad's direction.

This was how I spent the first week of my two week wait.

Then came Monday and my Dad was determined to pass a swallow test - so that we could stop talking about feeding tubes or dying and he could get back to living. The swallow therapist came for a visit and my Dad, try as he might, could NOT swallow like he used to. He failed the test and his eyes showed so much disappointment. He had gone 6 days without food and I knew that we'd need to use the feeding tube if he had a chance - otherwise, if he wanted to keep trying the swallow test every day - even to fail - at least he felt like he was still fighting - not just waiting for death to come. That night we delayed in placing the Fente.nyl patch - because we wanted to keep my Dad alert the next morning to pass his swallow test. He agreed and endured the pain all night long, just getting boosts of 1 and 2 mg of Mor.phine while he waited for dawn to break. I met the swallow therapist at the hospital that morning and she brought him vanilla yogurt though he didn't look as excited as the day prior. She gave him a teaspoon of yogurt and he resistantly swallowed it. Somehow, on that day, Tuesday 12/28 he passed his swallow test - we were all in shock. And my Dad whom I thought would be beaming from ear to ear just gazed right passed me, as if I didn't exist. Something had changed.

My entire family was there (my mom and my two brothers - my mom and dad divorced in 2000) - I had invited them down to say good bye because I assumed he'd fail the swallow test and we'd place the feeding tube and because it was a procedure with general anesthetic - I thought there was a chance we could lose him during the process. However, he passed the swallow test so we didn't need to worry about the feeding tube. So the four of us sat together in a nearby waiting room discussing policies, paperwork, funeral wishes, etc. While we were meeting, our Pall.iative Care consult team came and visited my Dad and they had a rare opportunity to talk with my Dad without us there. The doctor saw that my Dad was not doing well. She told him that she's seen this before and that he was a dying man. She asked him about his plans to try to swallow things and recuperate from this illness but she thought he looked like he was in a lot of pain and basically she asked him if he was being honest with his family about wanting to hold on versus being ready to let go and he confided in her that he was not being honest with us - my Dad was ready to go. When this doctor told us this, we broke down into tears ... the LAST thing we wanted was to drag this out. We wanted what he wanted! They recommended the mor.phine drip and my Dad wanted it. We were told my Dad had anywhere between 1 and 48 hours (with 48 hours being very generous) this was at 2PM on Tuesday 12/28 (11dpo for our cycle).

There was about 30 minutes between being told he was ready for the drip and having it actually placed and starting to work. After I got a chance to love on my Dad and tell him that we support whatever HE wants - and kissing him and hugging him and crying with him. I was able to call and reach by speaker phone all five of his siblings, his mother, some cousins, and a handful of nieces and nephews who were all able to say their last good byes to my Dad. It was such a precious and beautiful time. I cherish those words, those acknowledging nods my Dad gave, and the tears running down his cheek. I can't imagine what was going on in his mind. And because he couldn't talk, I'll never really know. But I hope he was glad to have some closure with his family.

For the next 9 hours we sat around my Dad, playing music he enjoys, singing to him, talking to him, kissing him, hugging him, keeping him warm, crying with him. It was beautiful. My favorite part was being able to tell him that I had so much peace about his departure - that we had left nothing unsaid. My Dad and I had the best relationship. He wasn't the greatest Dad from 0 to 18, but he really turned things around and made up for it from 18-33. I couldn't have asked for more. My Dad and I were close, we forgave each other, we were and are kindred spirits. My Dad was such a good man. The things that people kept repeating about him were that he was their favorite ______ (fill in the blank) uncle/cousin/son/etc. and that he would drop everything to help someone in need. He had that giving servant's heart.

I went home to sleep around 10:30 that night, I was very reluctant ... but we knew that I had 3 embryos cooking inside of me and I needed to protect them - it's what my Dad would have wanted for sure. And so I left. At 5:15AM I woke up and looked at the clock, I wondered if my Dad was still alive. My brother called and woke us at 5:19 and told us that Dad's breathing had dropped off ... by the time we got to the hospital at 5:40, he was gone. My brother was there with him, holding him, kissing him, affirming him as a Dad and as a person. It couldn't have been any better. Yes, I would have liked to have been there - but that wasn't meant to be. My brother will forever have that time and that moment and for that I'm grateful.

Barrie Eugene Wadman
August 11, 1941 to December 29, 2010
May you rest in peace

That day my brother, my husband, and I went to my Dad's house to find the important paperwork. Amazingly we found everything we needed - the burial policy and a good amount of the pink slips to his vehicles. I found his living will and learned that he had never submitted the paperwork to make me the Executor nor the beneficiary (which is fine, there's nothing really to benefit). I spoke with his attorney and learned that because my Dad liquidated two years ago - there's really nothing to do except tell his landlord, stop his accounts, and follow through on the burial and memorial service arrangements. There will be no probate process. That and the fact that I'm not the executor makes my life a lot less crazy, so I'm glad for that.

The next morning was 10dp3dt and our time to pee on a stick. Since 6dp3dt I had been peeing on sticks and putting them away without looking at them. I wanted to know if my trigger ever left but I didn't want the emotional roller coaster of seeing BFN's prior to a hopeful BFP ... especially given all we were going through. So the morning following my Dad's death we looked. And the stick was VERY positive. I looked back at all the other sticks and the second line was there the whole time - the trigger never left. We were both subtly excited. The excitement was hard to share with the events of the previous day.

I went in for a 11dp3dt beta (on 12/31) and learned that it was 67. They wanted it above 50, so it was fine, it's just that Dru was 108 and I got a BFN at 7dp3dt with his cycle. So things weren't adding up. Then I went through beta limbo:

11dp3dt: 67
14dp3dt: 114
16dp3dt: 129 (today)

So I'm waiting on a call from CCRM. I'm pretty sure they'll instruct me to stop all medication and wait for AF.

I'm numb. I'm back at work and I'm overwhelmed.

I picked up my Dad's remains today (he wanted to be cremated). We're shooting for a service on 1/23 and 1/29 - one is out of state for his family. We'll see.

So now it's back to the drawing board, with my heart broken wide open.