One year ago...

It's been a full year now since Nana's passing.  Things around the house have settled into a new normal, but there's an awful empty place. It's getting easier to go through the mail that Nana still gets from the different charities that she used to give to.  I guess this is a sign of being able to move on.

We still need to go through Nana's things, and my wife is almost ready.  But not quite.  For me personally, a day doesn't go by that I don't think of Nana.

We know that she is rejoicing with the Lord.  No more oxygen tubes, no more walkers, no more difficulty swallowing.  She is at peace. We're at peace with it, but there's still an empty feeling.  I wonder if that will always be with us.

Remembering Nana

Here's a slideshow that I put together for Nana's memorial service.



I hope you enjoy it. Please feel free to comment and post any memories of Nana that you wish to share.

Blog winding down

It's getting close to the time to wind down this blog, as there really isn't much more to add, other than Nana's memorial is this Saturday.  She was quietly and peacefully interred last Thursday at Forest Lawn in Cypress.  Laura put together several pages for a guest book that I sent off to a printer earlier today (and hopefully it arrives without any problems).  We are currently working out how the program for the memorial will go, as we'll be meeting with our pastor this week to go over the arrangements for the memorial.

In thinking over the past nearly two weeks since Nana's passing, I'm grateful that she was on hospice care.  The hospice people were so incredibly helpful.  Nana was able to be at home with her family and have her needs met and exceeded in many cases.  Laura and I are both thankful that Nana wasn't bedridden.  Had she been, her care would have been especially difficult for Laura.  The Lord saw fit to take Nana when the timing was right according to His purposes and not ours.  We're all thankful that Nana is rejoicing in Heaven with her Savior.

1 Corinithians 2:9
But as it is written, Eye hath not seen, nor ear heard,

neither have entered into the heart of man, 

the things which God hath prepared for them that love him.

It's been a week...

It's been a week and a day since Nana passed away.  The house is quiet.  Feeling is slowly starting to creep back in, but time still feels like it's standing still.  We're trying to plan Nana's memorial service, and things just seem to take too long to do.  Things that should take a few minutes drag into hours.  Everyone has been so gracious and understanding during this time.  I'm truly amazed.  We're in a valley right now, but we'll get out of it.

Since Nana didn't want a funeral, just what they call a "direct burial," that should be happening sometime today.  I hope they'll let us know when, but I kind of doubt it as the burial is at their convenience.  Her memorial will be June 4th at 2pm at our church.  More info later...

Thursday...

A representative from Forest Lawn called later in the day on Wednesday and wanted Laura and I to come up on Thursday and make Nana's final arrangements.  Nana had requested no viewing, no funeral, no graveside ceremony...just a simple burial.

We made the long drive from our home to Cypress to meet with them, and they were the very model of professional.  The person we worked with was efficient, very cordial and respectful, and answered all of our questions.  Laura was doing pretty good until it got to the part where he wanted us to go with him upstairs to select a casket.

I told him "That's where I come in..."  He then turned to me, and I'd mentioned that I'd found a casket on Costco, and could they match the price.  He said they couldn't, and that many people go that route.  I went in completely expecting a scrap over the casket, and they're fine with it.

We finished our business with them, and paid for everything.  We then went and visited Papa's grave, and Laura's grandparents' grave.  We made note of how things were engraved on Papa's memorial plate so we could make sure that Nana's will match.  After visiting for a little bit, we made our way back to my truck and started on the long drive home in heavy traffic.  It was a very tiring and draining day.

One thing that was very interesting happened.  When the representative came into the little meeting room, he produced some sort of hand filled out document from his leather dayrunner.  I couldn't see it clearly, but it had all sorts of information written on it.  My guess was that it was the document that the people from Forest Lawn brought out the day before when they collected Nana's body.  Boy, was I wrong.  It was the original information sheet that Nana filled out in June of 1966 when she and Papa had bought their plot!  As we were wrapping up, the representative said that we could keep the information sheet.  I was (and still am) amazed by their document and filing system that can make a nearly 45 year old document look and feel like it was filled out just the day before.

Just the day before...

These last few days seem like they've all been merged together into one long blur.  Here's some more on what happened Wednesday.

Nana managed to poke herself in her left eye last week, and Laura had fitted her with an eye patch the day before.  Nana was saying "Arrr" like a good pirate while wearing that eyepatch.  Just the day before.

The hospice nurse got here very quickly on Wednesday.  She was very shocked about Nana, as she had just been out to check on her.  Just the day before.  The hospice nurse was so very helpful on Wednesday.  She had to check Nana's body, then repositioned her in her bed and covered her.  Then she started making phone calls.  Laura and I were in no real shape to do more than just call people and inform them.  Nana seemed to be doing so well just the day before.

It seemed to take a long time for the people from Forest Lawn to come to collect Nana.  I suspect the underestimated the traffic on the freeways, as the mortuary is quite a ways away.  The gentlemen who came were consummate professionals--very understanding, polite, gracious and did their work quickly and efficiently.

Hospice came later in the day to pick up their bed, the oxygen enricher, and some other stuff.  This left us with a nearly empty room and silence.  We'd gotten used to the hum and puff of the oxygen enricher running.  It was a normal noise in the house, and now it's just so quiet in the house.

After the equipment left, our cat was wandering around downstairs making these strange, sad little meows.  Nana's rooms seem so empty, even though they sill contain her stuff.  Quite a change from just the day before.

Nana passed away last night...

Nana usually gets up around 8am.  Laura didn't hear anything in Nana's room like she normally does.  Laura went in to check on Nana and found she had passed away last night.

I'll post more when I'm up to it... It's a pretty difficult right now.

A night on the floor

I'm going through my normal morning routine, reading the paper, eating a bowl of cereal and having a cup of coffee.  There are normal noises in the house for this time: Nana's oxygen enricher, coffee pot making noises, refrigerator running, that kind of stuff.  I hear a noise coming from down the hall leading to Nana's room.  Our cat gets put to bed in our downstairs bathroom at night, so it could just be her starting to make her "let me out" noises.  But it doesn't sound right.

I went upstairs to get Laura, and encounter my daughter who's getting ready for work. "I think I heard Nana" she says with a nervous voice.  Okay, that confirms it..something happened.  I get Laura and she goes in to investigate.

She finds Nana sitting on the floor between her bed and her bookcase.  Nana had gotten up sometime during the night to use the bedside commode and stumbled.  She couldn't reach her cell phone which was on the other side of her bed.  She couldn't call out loud enough for us to hear.  So she pulled the covers off her bed and made a little nest out of it.

Needless to say, she's been pretty sore today and moving slowly having sat on the floor for who knows how long.

And the odd thing?  Her oxygen cannula was off and placed by a box of tissues on the other side of the bed.  She spent the night on the floor, wrapped up in blankets without oxygen.

I sure hope this doesn't happen again.

Disaster Averted....for now

Laura started calling Dr. M's office yesterday about Nana's midodrine prescription.  They called her back today, and, after speaking with Laura, Dr. M. called the prescription into The Pharmacy.  The Pharmacy at first said "No," but Dr. M can be very persuasive when necessary.

Laura went over about 5:45pm to pick up the prescription!  And we can get this prescription refilled twice!  Praise God!  This will allow Nana's blood pressure to be at a level where her kidneys will function (albeit at a lower-than-normal efficiency).

Now we won't have to fight this battle again for 90 days.  Sorry for the lousy cell phone shot...it was the quickest way to get a photo online.

All in all, Nana had a good day.  She had a visit from the nurse's aid, some friends came by to visit, and even our Pastor stopped by.  We're currently playing musical beds in prep for the hospice to deliver a hospital bed tomorrow.

A punch in the gut...

Well...more like a body blow followed by an upper-cut to the chin...

So the hospice doctor came out on Monday with a nurse to check up on Nana.  The visit went pretty well, and they discussed some options with Laura.  What Laura found out yesterday was not encouraging at all...

One of the medications that Nana receives to keep her blood pressure up (so that her kidneys are able to do their job) is midodrine.  Her supply runs out Thursday morning.  The nurse called the pharmacy and found out it's been pulled off the market, and that there are no meds to take its place.  We're going to do a bit of research in this, as it looks like the FDA called for it's withdrawal from the market in August 2010, and relented from this in September 2010.

If we aren't able to get in a supply of midodrine, Nana's blood pressure will drop.  The doctor said that a pacemaker would help, and possibly extend her life several extra months.  When Nana heard the cost of such a device (around $20K), she said she didn't want it.  :-(

Laura was saying that she thinks it might be time to start making some phone calls...

Home Hospice Care

The other day when the visiting nurse was checking out Nana, she suggested hospice care as an alternative to having to continually take Nana in to see different doctors.  This would provide a means by which a doctor and nurses could continue to come to Nana to evaluate her.  So Nana decided to go with it.  This started last Thursday...

My big problem with this is that it's hospice care.  EOJ  EOT  exit(0);  halt -q  margin :0,:1  That's it. Your done. End of the road.

In talking it over with Laura, they (Laura and Nana) felt it would be best for Nana to be able to receive care at home instead of having to go through all of the stuff they need to do when taking Nana out.

So far, we've gotten a new oxygen enricher, new oxygen tanks, new transport chair, and I think they'll be trying to deliver a hospital bed next week.  She'll be getting a visiting nurse coming by twice a week, and some sort of assistant two other days of the week.  And a doctor will be stopping by from time to time to check up on her.

The good news is that Nana can go off hospice at any time.  I first thought that it was a one-way street, or like a roach motel--once you check in you can never check out. Until you Check Out.  I'm still not entirely certain about whether or not this is a good thing, but Laura has spoken with several of the people who have come out and she's much more at peace with it now.

I'm really hoping that she can build up enough stamina that she doesn't need all this support, and I certainly hope I'm not disappointed.  Things are so crazy hectic in the house right now, we just need to get to some form of stability going.  I'm glad that the kids are old enough to mostly take care of themselves, but school work seems to be coming less and less of a priority.  Especially as Laura has to spend more and more time daily helping Nana with just simple little things.

Good Friday, Good Dr. Visit

Today is Good Friday, and it really is a good Friday.

Things have been going pretty well this past week.  Although Nana's surgery recovery seems to be taking a very long time, we're having more good days than bad ones.  It is taking a long time for her to build up her stamina.

We had started looking into how much transport chairs cost, and requested one from the insurance company on Apr 18th. The transport chairs are small wheelchairs, so they are much lighter and easier to get in and out the trunk.This will be very useful for when Nana has to go visit Dr. M, Dr. W, or just going out in general.

When the company delivered the wheelchair on the 20th, it was a full size one. It's heavy and doesn't fit in Nana's trunk without taking off the feet pedals. It was quite a workout manipulating the thing, but it let Nana ride instead of walking for her doctors appointment!

Nana went to see Dr. M yesterday, and saw Dr. W today.  Both trips went very well.

Dr. M removed most of the bandaging on the hand Nana hurt when she fell in her bedroom.  Her poor hand looks like it's quite painful, but it doesn't seem to bother Nana.  It could still be a while before it fully heals up.

Dr. W is reducing the amount of sotalol from 2 pills to 1.5 pills a day.  He said it should help Nana with more energy since the medicine slows down her heart. Her next appointment with Dr. W will be in a couple of months, and it's likely that she'll go down to just one a day.

It was also a busy day for phone calls, with different care providers wanting to schedule a time to come out.  The visiting nurse, occupational therapist and physical therapist called, and even someone from Nana's insurance company.  The only one who managed to get time in today was the physical therapist, so I'm expecting Nana to be tired tonight.

Have a happy Easter!  Don't forget the real Reason for it.

He is not here: for he is risen, as he said.

Come, see the place where the Lord lay.

Matthew 28:6

A little forward, a little backwards

Wednesday was such a good day for Nana.  She was feeling better, had an appetite, and could taste her food.

However....  Laura and I were startled out of a deep sleep at 3am with Nana calling Laura's cell phone to say that she fell.  We got downstairs to find Nana sitting next to her bed, and daubing the back of her hand with some sort of gauze.  We got her on the edge of the bed easily enough, and were able to get a better look at her hand.  She managed to whack something while she was on her way down, and cut the back of her hand pretty badly.  Laura and Nana just left to go to the ER to get her hand checked out.

Edited to add:

Laura and Nana got home from the ER around 6am, so this was a quick trip.  The doctor decided that since Nana's skin is so thin on her hands, he wouldn't be able to use sutures.  So he used some skin tape to get things back together.  Nana's poor hand is just one massive bruise.  The doctor said that it will take a few weeks for her hand to heal.

Nana was on her way back to bed, and was within two steps of getting back in bed when she fell.  The problem was that her legs became wobbly.  She described it as she was staggering like a drunkard.  Laura reminded her again that when she feels this way, either lean up against the wall or sit down for a few minutes to catch her breath.  We might just have to locate another chair in Nana's hallway so she has a landing space between her bathroom and her bedroom.

It's the little things

One of the things that has been a bit of a downer is that all food seems to taste mushy and bland to Nana whenever her lungs are affected with the fluid retention.  Part of this might be attributed to her low salt diet, but even with fruit?

Yesterday was a busy day for Nana.  Both the home nurse and the physical therapist stopped by.  She did fine with both, but her pulse always seems to be on the low side and the nurse was worried about the increased swelling in the legs. She called Dr M. to tell him about the changes and he changed Nana's medicine.

Today, Nana's weight was down about 6 pounds from yesterday, and she's breathing a bit easier. We're thankful for that!  Laura says that her legs are still swollen, but when Nana ate a banana for breakfast, she was able to taste it!  For the first time in a long while, it didn't taste like mush. We're hoping that means her lungs are clearing up!

Long days

It seems that with the time change, the days truly are getting longer.  A feeling of ennui is starting to set in, and this isn't a particularly good thing.  Laura's days are a flutter of activity between school for the boys, running Mom's Taxi Service, the routine household chores and now caring for Nana, coordinating doctor and in-home health care visits, doling out medications, and a new one: working with the insurance company.  Laura really does deserve a gold star for doing all this, but I think she'd just settle for a good long nap.

One piece of good news is that the catheter incision on Nana's leg has stopped seeping, and has been dry for the last couple of days.  We had just gotten enough supplies to deal with this and that's when it stopped.  Even though that's a bit ironic, I'm happy that her leg healed up.

The down side is that Nana is having a harder time breathing, she's still swelling, and it's getting progressively more and more difficult for her to get around the house.  We've had to put one of our sturdy kitchen chairs in the hall way leading to Nana's room so that she has a good place to grab or sit if she starts feeling weak while moving in our out of her room.  Also, one of her medications has a side effect that causes her to feel itchy, and this is making it difficult for Nana to sleep at night.

A fairly rough night

Last night / this morning was pretty rough.  Nana was using her little walker to get into her bedroom when her legs decided to no longer support her.  She had a slow speed fall just at the door to her room.  Laura was there to keep her from hitting the sharp corner on a book case.  Nothing was broken, but she did bruise herself on her arm.  This all happened about midnight.

With some help from my son, we got Nana sitting on the seat of her larger walker.  She was pretty tired, and not terribly pleased that she fell.  Laura and I were very puzzled about why her legs gave out.  Laura thought of several culprits: a side effect from one of her medications, her low blood pressure, or a sodium imbalance due to the fluid that's still seeping from the dialysis catheter incision in her leg.

Laura and I were discussing what to do given that Nana has an appointment with Dr. M later today.  I thought that if it were an imbalance or side effect, that might clear up (or change) by the time the appointment rolls around.  Laura went to talk to Nana about going to the ER, and they decided to go.  So about 1:30 or so in the morning, Laura drove Nana over to the ER.

I haven't had much of a chance to speak with Laura about what transpired at the ER as they got home a little after 7am.  When I got downstairs today, Nana was sleeping and Laura was ready to go take a nap as she'd been up all night.  She did tell me they didn't find anything.

I guess they now have something to talk about with Dr. M...

Nana is Home!

Nana was released from the hospital today.  Laura brought her home this afternoon, and it was so much easier than the last time.  Nana had no trouble walking from her car to the house, as we still have the oxygen concentrator.  We had a good evening together.

Laura still has to get some of Nana's medication from The Pharmacy.  The pharmacy called because some of the medications were tagged as allergic, so we still have to figure that out.  The pharmacy spoke with Dr. M, and Nana will be seeing him next week.  There's a bit of confusion about when the appointment is, but that'll be easy to figure out Monday morning.

One thing that's a bit of a concern is one of Nana's incisions is seeping clear fluid.  It seems like walking around encourages this.  It's more of an annoyance than anything, but Laura's keeping an eye on things.

Nana's heart rhythm is still normal.  We're hoping that the a-fib rhythm is a thing of the past.

Last two days

Monday was a good day.  Nana got moved from ICU to PCU in the morning.  She had another (and much shorter) dialysis session sometime before Laura went to see her.  Some of Nana's friends visited for about an hour, which is always a good thing.  The biggest good news yesterday was when Nana called around 9pm to say that one of her doctors confirmed that her heart went into a normal heartbeat rhythm (not a-fib)!

Tuesday was good then turned kind of so-so. Nana had a busy day--some more friends visited.  She's able to get up and out of bed when she needs.  She had a really good lunch today and ate just about everything.

Dr. C came by and said that Nana's kidneys are doing much better.  Nana's heart doctor came by and listened to her heartbeat, and everything seemed to be in order.  Her heart is still in normal heartbeat rhythm.  Dr. M - thinks she might get out in 2-3 days.

This afternoon, they took out Nana's PICC line.  The area on her arm was starting to turn red and puffy, and an infection is suspected.  If she didn't pick up this infection, she might have been released tomorrow.

The IV to dialysis catheter connection is leaking, which is a bit concerning.  Laura said the nurses were going to change the bandages and see if that helps.  They are trying to avoid putting in an IV line in her arm since they just took the PICC line out (and her left arm is sort of reserved for a more permanent dialysis connection).

A good day for Nana

Nana had a good day today.  Laura spoke with her this morning, and she'd lost 15 pounds of fluid!  This is very good news, as her body will now have an easier time recovering.

Laura spent the afternoon with Nana.  One of Nana's friends was there visiting when Laura arrived.  Nana was a little bit sleepy, but nothing like yesterday.

The dialysis machine & operator

The hospital staff also performed another dialysis session this afternoon, and got another 3.5 liters (about a gallon) of fluid off of her.  Nana took a nap towards the end of the dialysis session, so it was Laura, Nana, Nana's friend and the dialysis machine operator in the room for several hours -- a full house in that small ICU room.

She's doing well enough that they're moving her out of the ICU into a PCU room sometime tonight.

Recovery Day

Nana had a good day today.  Laura found out that the dialysis they did last night got three liters of fluid off of her.  There's still plenty of fluid left, and they'll be performing another dialysis on her tomorrow.  One of the things they need to do is fix the electrolytes.  Laura was trying to find out if it was too high or too low, but it's something they need to keep an eye on while doing her dialysis.

Nana's breathing was much easier today, but her blood pressure is still low.  We went to visit her around 3:30 this afternoon.  Since only two people can visit at any one time in the ICU, Laura and our youngest son went in first.  I waited in a nearby waiting room with our other son.  We were in there for 30 minutes or so when Laura came out, and we went in.

Nana was awake when we went in, but fell asleep seemingly mid sentence.  She woke up a few minutes later, and apologized for falling asleep.  We spoke a little more, and then she was out like a light.  After we left, Nana was telling Laura that she's very tired of being in the hospital.

Nana's monitor in the ICU

The graphic here is a cell-phone photo of Nana's monitor.  The number in green is her pulse, the number in light blue is oxygen, and the number in white is breaths per minute.  Her blood pressure is at the bottom left with her pulse in ( ).  Laura says that the 107 is pretty good for her, but the 57 is low.