8-4-2012
I’m not even really sure how to write this post, or if I should write it… all I know is that it replays in my mind constantly and I feel like I need to get it off of my chest.

It is roughly one year to the day that we found out my Dad has cancer. It is also about 4 months since we were told that it had come back and is now stage IV. What a year it has been… I often talk about the hellish nightmare it is, nothing’s changed there. We should have a frequent flyer card for the hospital, even my 2 year old knows how to manuever through the rat maze that is Swedish Hospital, he’ll tell you exactly where to go to see “Grampa and his big owie”

A few days ago was another trek to the hospital. I got a phone call early in the morning from my step mom, clearly panicked, that my Dad had just left the house in an ambulance. He had gone to the bathroom and just as she went to check on him she caught him as he fell to the floor and proceeded to bleed out all over the bathroom floor.

I jumped in the car and headed to the ER. It was one of many of these drives, blurry tear filled eyes, arriving at my destination with no memory of getting there, wondering if one of these times would be the last time. A million things running through my mind… and then pulling myself together in time to walk in and see what disaster we would be dealing with this go round’.

I knew the bleeding would be a relatively quick fix pending any other complications, I knew exactly what had happened and I knew that the docs/nurses had screwed up. I had spoken with them the night prior about my very serious concerns that needed prompt attention only to be dismissed as usual. I warned them about the exact scenario that I was now watching play out.

A little background, my Dad has a blood clot in his lungs and they had just found two more in each leg the previous day. Earlier in the week the docs had put him on some intense blood thinners (oral meds and injections), a standard practice with blood clots, but I knew the dosing and combination was a bad idea. Without getting technical for all the non medical folks out there, there were too many variables in his situation that made the “standard course of treatment” a BAD idea for him. The morning prior to his ambulance ride I spoke with the oncology nurses about his recent INR lab work (a measure, simply put, of how thin your blood is) only to be told it was 4.5.

Aka VERY HIGH = VERY dangerous.

They were laissez faire about this and didn’t see need for urgent concern to be dealt with that moment or even that day. I pleaded with the nurses to treat his situation more acutely and to bring my concerns to the oncologist immediately. They continued to reassure me, “we stopped his Coumadin and we’ll just monitor him and adjust his Lovenox injections tomorrow when he comes in.”

My response was “IF he makes it to then.”

Per the usual, they didn’t listen, and at 7:00 am the next morning he arrived in the ER via ambulance due to bleeding complications.

They addressed the bleeding and shortly after we arrived he was headed up to a room. They were already admitting him no more than 2 hours after getting there. I thought this was odd, usually we spend 8+ hours in the ER and FINALLY get a room at the end of the day. I could only guess that they figured he would be staying since we’ve been through this rodeo a few million times before? So they sent him up.

I know I kept thinking this was odd… I had no idea that I should’ve said something… that I was about to witness the most traumatic experience of my entire life.

It turns out he was much too critical to be sent up to the floor, he should’ve stayed in the ER where they could deliver immediate care.

Once we arrived to his room on heme/onc things started moving very quickly downhill. My Dad was having considerable trouble breathing and I felt an overall sense of uneasiness that I couldn’t shake. I called the nurse to tell her we needed oxygen and that someone needed to reassess his bleeding because he was saturating more and more towels, both of which were issues needing immediate attention.

The feeling in the room was escalating and yet there was no reciprocal sense of urgency from the nursing staff. The nurse had still not come in to address the oxygen or bleeding from my phone call 5 minutes prior. My Dad was also in a LOT of pain, it was growing quite suddenly. He asked my brother and I  to help him sit up in bed so I had him swing his legs to the side of the bed and he grabbed a hold of my brother’s neck.

What happened next is a complete blur yet so vivid I will not forget as long as I live.

He stood up with our help and immediately went limp, I couldn’t see his face because I was behind him reaching over the bed. He started to almost convulse as we sat him back down, his head began to flop violently backward, I caught his head and laid him down flat in the bed and I could hear him sucking for air….

This sound is unique, anyone in healthcare who has worked a respiratory arrest code will know the sound, anyone who has sat beside someone during their final moments may know the sound. For the medical folk it’s called agonal gasps.

This is something I can’t really explain, it is not like the movies. It was a sound that clearly indicated to me that he was not “there” that his brain stem had just taken over to sustain vital functioning, it’s a barbaric sound. And it wasn’t coming from a random patient it was coming from my father.

In the nanoseconds that passed while this was happening it was as if time stopped. I stood there and watched him stare blankly into the ceiling as his body continued to gasp for air. My Dad was not in that body at that moment and I knew it. I could not believe this was happening right in front of me. I will never forget that expression on his face as he laid there contorted in the bed. Felt like the whole room was spinning around and I was just locked onto his face thinking

this…..

is…..

it….

In the short time that this occurred a tech had run to his nurse and she had finally run in with the oxygen and a couple of other nurses. I felt the trauma switch flip in my brain as it had many times before when I was caring for my own patients and immediately went into nurse panic mode.

I started screaming at the people in the room who appeared to have never worked a day on the floor. I shouted at one to GET THE OXYGEN!!!!! and pulled the code cord to activate the rapid response team as my brother nearly tossed the tech out of the room to get help and to get the fuck out of the way. It was absolute chaos. I had one or two nurses behind me flailing around trying to get him hooked up to get a blood pressure reading and I turned to them and told them to stop with a look on my face like are you fucking kidding me right now?? as I yelled to them to FIND A PULSE! I yanked the oxygen tubing from the charge nurse and struggled to get it on his face.

All the while he continued to suck for air with his eyes wide open… no one was home.

The nurse behind me kept saying “Max are you ok, are you there, are you ok” as my step mom yelled at her “NO he’s NOT ok!! He can’t even respond!!?”

As I was literally about to climb on top of my Dad’s chest to start CPR while we waited for the code team the awful sound started to improve by some miracle and I screamed DAD?!!! DAD?!! And he finally uttered “yeah”.

My Dad had coded in my brother’s and my arms.

He almost died on the bed right before me.

There’s no describing that feeling when it is someone you love. No words could ever explain the horror. I have never felt anything like it in my life, not in my nursing career, never.

This was as close as it possibly gets. Cancer. It rears it’s ugly head in more ways than you can imagine. You don’t think of someone having sudden respiratory arrest from cancer. You don’t think of someone bleeding out on the bathroom floor from cancer. Unless you’ve lived it, then you get to see the whole spectrum. Short term issues, long term issues, acute issues, chronic issues. Every day is something new. Most people think of someone dying from cancer by getting progressively more sick until they slip away in a bed surrounded by their loved ones. There are many more exit points along the way painted with a much more horrific picture. The lucky ones slip away peacefully in a bed.

Traumatizing is the only word that comes close to describing that day. I had spent countless other days at that hospital on the cancer rollercoaster. None like that. It took me 2 days to even tell anyone what had happened in his room. It is a memory forever seared into my brain. I won’t forget that experience, that sound, that look on his face for as long as I live. I felt like it lasted 10 hours when in reality it was only a matter of a few minutes.

I say a miracle, because it was, he came back to us. He was moved appropriately to the ICU, several units of blood, plasma, platelets, surgery to place a pulmonary vein filter for the clots. No telling when he’ll finally get out of the hospital again but we’ve certainly done a 180 from three days ago. It’s just another day on the cancer journey….

This is exactly why I’ll be Stepping UP on Sunday.

For you Dad, for all of our family in heaven taken by this awful disease, and for all of the families whose lives are forever altered by their experience with a family member’s cancer.

I had a nurse ask me yesterday about my tattoo, I said it reads “Get up and fight another round” and she looked at me confused and said “fight? for what?” I pointed to my Dad and I said, for him, for this, for life. She smiled and said she had never thought about it like that before 🙂