October 24

I (Barb) spent 6 hours at Dobie Road yesterday–Thursdays are the day that Betty goes to  Senior Citizens and she comes later–this time at 3:30 pm.  By then we had had quite a day.  Dad was quite alert in the morning and told me a couple things that I later verified.  He told me they had to use a catheter (in and out) to drain his bladder.  He also told me that he had gotten a very nice letter from Mark Eifert telling him how Dad had been helpful to Mark over the years.  Betty told me that both of those things were true.  I pulled the puzzle table in from the hall and worked on that and conversed on and off until he dozed off.  Shortly his doctor poked his head in and said he would be in to see Dad.  He brought his latest labs from Monday which were not much different/some slightly better and his hemoglobin was stable.  Dr. Ensberg and I started to talk about the massive amount of edema (swelling in his legs,left arm and abdomen), and how it seemed unlikely that this is all being caused by congestive heart failure alone.  He then pulled another physician in who is going to spend more time reviewing Dad’s chart.  The two of them decided to get an ultrasound of the legs, abdomen and L arm to rule out any blood clots.  By the time all this was over, it was noonish, but Dad refused to go to the dining room.  I asked him if he wanted an Arbys roast beef sandwich and shake and he did.  So I left briefly to go fetch those.  When I got back Erin and Beth Leonard were there and he was really not arousable–his food went into the refrig.  Erin and Beth said that he had greeted them briefly but had not conversed at all.  They left shortly and the aide came in and said that the Ultrasound tech was on her way and she needed Dad in bed.  So they were able to get him to transfer from the wheelchair to the bed with one person assisting.  Ten minutes later, they came in and said the tech wanted him undressed–so back up to get his pants off, shirt off, etc.  And the lady came and did the studies–probably took about 1/2 hour.  Every movement, transfer, etc, is so laborious!!  She would not give me any preliminary report but said she would talk to the nurse.  About 3 pm the nurse came in and confirmed that they had found ascites (fluid inside the abdominal cavity)–there are just not a lot of good or correctable reasons that some one starts accumulating this massive amount of fluid that he has on board.  He looks so uncomfortable, but he does NOT complain.  There is no way he can even begin to swing his own legs upon to the bed by himself.  The nurse also scanned his bladder and confirmed that he had over 700 cc of urine and did another in-and-out catheterization, this time draining 900+ cc.  The night before they had gotten 1200 cc!!  That must have felt better.  I think the fluid in his abdomen must be obstructing his bladder outlet.  In-and-out cathing is not particularly uncomfortable but is inconvenient for staff–but on the other hand, they don’t have to assist him to the bathroom every two hours.  Though he doesn’t seem to be suffering in the sense that I would describe it–it is very hard to watch this whole thing drag on.  Haven’t heard from anyone today about whether they plan to sample the abdominal fluid–which would be the next step ordinarily.  Sometimes persons with this much fluid have it drained just to provide some relief from the pressure on the diaphragm (and thus the lungs).

I get by by compartmentalizing my head.  Tomorrow at 3:30, my head compartment will be Go Green!!

Monday October 20

Spent about four hours with Gpa yesterday afternoon.  He wanted to be pushed around outside and so we bundled him up and went for a walk.  We went around the whole facility and then extended and went around the original building to the north.  That is the facility where Mom donated hundreds of hours doing people’s hair and where Grandma Neifert died.  It is now a senior apartment facility.  He stayed awake and was obviously observing but does not start any conversations.  He gives simple answers to questions.  I asked him if he had gone to the “Jeopardy” activity the night before and he said yes.  I asked him if he won and he said “it was too confusing”.  Debbie verified that he and Rick had taken him down to that.  When we got back it was time for supper but he didn’t want to go to the dining room.  I asked him if he would like a Frosty and he said yes (vanilla–which surprised me).  So I went to Wendy’s and brought back a vanilla Frosty which he ate.  He had also apparently asked for a tray because when I got back his tech was bringing a P&B sandwich and soup which she said he asked for.  He ate the whole sandwich.  His face remains almost expressionless which is sad to me.  He continually denies pain.  I told him I was so happy I am retired and can spend so much time with him because I did not get that privilege with Mom.  He told me, “and I really appreciate it too!”  I might add that I learned that he has gained another 10 pounds (of water), now up around 260 and the doctor is adjusting his water pills again.  Nothing seems to help.

Thursday 16 Oct

Barb was with Dad last night about 7:30 and he woofed down a chocolate Frosty I brought.  He then stayed awake for almost 1/2 hour conversing–meaning I would start a subject and he would add bits.  He doesn’t initiate any conversation on his own.  Carol reports this AM that he talked in a normal voice to her and asked to be pushed outside.  Judy sang to him again today.  I forgot to mention in an earlier post that his doctor told me “Your family is amazing”.  I think he is impressed at how much time we spend with Dad.  He sees other families visit rarely or not at all, especially in the long term care end.  Dad is still technically in the rehab end, so patients are coming and going at more frequent intervals than long term.

Carol and Ron took Grandpa for a ride to the farm and to Mason on Sunday afternoon and by the time they returned to the nursing home he was “unresponsive” and seemed to be having trouble (more trouble than usual) breathing.  Morphine was given.  By the time I got there, he was in the recliner chair and breathing steadily.  Amazingly, he did ask to go to the bathroom and used a walker to get there.  Later he was in bed and both Rick and Don sat by his bed and had small conversations.  All five siblings were there, thinking this was the night we needed to start a 24 hour vigil, but he stabilized and all spent the night in their own beds or in the case of Carol, in Karley’s bed.  (Thanks Karley)  Monday Carol and I were there in the AM and again, he was in his usual position in his wheelchair dosing–acknowledging persons when they come in but no real conversation.  He really is too weak to take out of the facility again in a private car.