It is finally been enough time that I can try to discuss what happened to your last week or so.
Sadly, it all started on your birthday, September 19. In the late afternoon, we started you dialysis treatment here at home. I tried to connect to your fistula and get a working access to no avail. After a couple of unsuccessful tries, I whipped out the old stethoscope to see if I could find a heartbeat on your fistula. I could not. Your fistula was blocked. We rather knew it was coming as it was about in the period to have to flush the fistula to clear clots. My comment to your was to sing “Happy Crappy Birthday to You!” The only result that we foresaw was that you had to go into the hospital and have it fixed – same-o, same-o.
You made the calls, and sure enough I dropped you off at OHSU on Tuesday, the 21st. I gave a quick kiss and drove off. With Covid-19 protocols, I could not go with you.
The next morning you called at said that they had a problem fixing the fistula. That there was a tear of something in it. That later that day, they were going to take you into vascular surgery to fix the fistula. They didn’t know when it would happen, so I waited to hear from your or the hospital.
About 6:00pm, I got a call from a Dr. who was doing the surgery (apparently they had decided to put in a new fistula) and told me they had a problem. Your heart stopped and they had to do CPR for 8 minutes to get your heart started again and that you were in ICU. I started to pray and worry.
A little after 9:00pm I got a call from a Dr. in ICU that said your Blood Pressure was not rising to a sustainable level and was being supported by drugs. They suggested a few options. One was a “balloon” intervention, which had only a 5% chance of success; which with our discussions on “no heroic measures” I dismissed. The other was to remove the drugs that were keeping you BP up and let you pass away. I could not do that either; not right away. I told them to keep them on the medications until the morning so to see if there was any changes. If not, then I would make the decision.
The next morning you were awake, cognizant, and seemed to be recovering; albeit still not the meds to keep you BP up. That is where it stood until the 29th. During that time the put a drain on your lungs to drain the fluids because of your being bedridden and put some kind of monitor in your heart to better measure your BP numbers. Other than that, every day I called your nurses (only once because I knew how busy they were) they said you were doing well. Your BP still needed assistance but you were doing well.
Then on the morning of the 29th, a doctor called. They wanted me to come in to discuss a possible catheter department surgery to try to fix you up. I was in as soon as I could get there (once I got clearance to be admitted because of Covid protocols). Their plan was to use a catheter to go you’re your heart and fix what they though was causing you BP to keep dropping and, if possible, also try to fix one of your heart valves. This was about 11:00am. At first, they talked to me as if you were not right there in the bed and I insisted that they talk to you. I told them you were awake and cognizant. I said I knew you were on medications and could not make the decision but I would only approve what you said. They may have thought that I was possibly passing the buck, but I wanted them to treat you with respect – especially now. You and I approved. After all, this was it. This was for all of the marbles.
A few hours later, these doctors and a few more came back. They said that they could not do the surgery. That your BP was so bad without the medication and that they could not last on the table enough for the surgery to be completed. It was over.
Therefore, they had the talk. There was only one “solution”. That was to remove the medications to keep you BP up and for you to just pass away (sounds so benign, do it not). Even then, I made them keep you in the loop. You were needed more and more medications to keep your BP up. So the decision was made to keep you on the medication at the current levels and when you went into a coma (low BP), they would remove the medications and you would pass.
But you did not go into a coma. You kept going. You and I talked. Then you and I held each other’s hands. Then you slept and I sat beside you, dozing. But we didn’t need to talk. I needed to be with you every moment we had left. I finally had to leave to take care of the dogs. I slept for a couple of hours so that I wasn’t a danger driving back. When I returned they were surprised that you were still lucid. You could no longer talk but you were lucid. The doctor on duty asked if it was time. I told them once again. You nodded. Not long after, the nurse let me know you had passed. I kissed your forehead.
My life as I knew it was over.