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Thursday, August 22, 2013

Grandpa's Passing

Sunday the 18th was the hardest day of my life.  That evening, Grandpa left us to be with Jesus.  It was an emotional roller coaster and it all happened so suddenly.

Grandpa had undergone a lot recently with his surgery, recovery, then the strokes.  He was having difficulties eating and was recently put on feeding tube only feedings.  Nothing by mouth. He had underwent one round of chemo and was doing fairly well.  August 8th he had his second round of chemo and that one seemed to knock him down pretty badly.  But that's to be expected as it builds up in you.  With each additional chemo treatment, I remember feeling just as crappy.  But Grandpa seemed to be doing pretty badly.  At first we just figured it was the chemo mixed with his older age and body.  He had started to get really down, wondering if this "shitty" way of life was really worth it all.  Sometimes he'd say it wasn't and other times he'd tell you he wasn't ready to give up.  He wanted to fight.  He told me he wanted to fight.  I was over at my Grandparents' house every second I could be while I was home.  I took over doing his tube feedings, something that made me feel honored knowing he trusted me to do so (he didn't trust many to do this.)  But I could see him weakening.  He was having more and more of the side effects.  One in particular seemed too frequent.  We asked the home nurse that came on Wednesday and she said it was normal.  We still weren't sure so on Thursday, they called the oncologists nurse.  The "side effect card" said 3 episodes in 48 hours was cause to call the doctor.  Grandpa had had 5 in just 20 hours.  But they still told us to wait the 48 hours.  (Why?  Clearly if he's at 5 now, he's already surpassed the 3 in 48 hours.)
On Friday afternoon, things were not any better so my Grandmother called a neighbor who happened to be a nurse.  She came over and told Grandma that he needed to go to the emergency room.  They called 911 and while enroute to his hospital, Mercy, he began vomiting.  This marked him as "unstable" so they had to go to the nearest hospital, St. Anthony's, which was only 3 minutes from their house.
The entire family (minus those out of town, but on their way in town after this call) was there.  Thank goodness our neighbor didn't listen to Grandpa's doctor's nurses and told him to go immediately.  After quite a few tests, while giving Grandpa oxygen and IV hydration and medication, it was discovered that Grandpa had c-diff and sepsis.  He was being moved to the ICU so we all headed up to the third floor ICU waiting room.

While in the waiting room, we were able to visit Grandpa, two at a time.  Eventually the ICU doctor sat us all down, pretty late that night, to tell us that Grandpa was incredibly sick and might not live.  It was not at all what any of us suspected.  The c-diff had taken over his colon.  Grandma, with all of us in agreement, had decided this was it.  He has been through too much, he's ready to give up.
Then the surgeon came to talk to us.  Grandma had pretty much made up her mind about just letting Grandpa go.  But this surgeon said if we remove his colon, he has a 60% chance of survival.  Without surgery, he will die.  There's no doubt about that.  When he learned we weren't sure if we wanted to do the surgery, he asked why. "You've already put him through the mouth surgery and the chemo.  Why put him through all of that to just give up now?"  He was kind of an ass but he seemed very confident so we all sat down to discuss it again and realized he was right.  We were going to go ahead with the surgery because he seemed so confident and 60% was a great chance.  We gave the okay and they began to prep him (getting all his levels where they needed to be) for surgery.
Not too long after, the anesthesiologist came to talk to us.  He had a much different outlook on this all.  He informed us that the surgeon wasn't necessarily looking at the large picture.  That Grandpa "is a very, very sick man."  He told us that the odds of him actually living through the surgery and making it off the table were very slim.  We were crushed.  We had just given the okay and they were prepping him.  Now we're told this was the wrong decision and he won't make it?   We all decided to take turns walking back to his room (where he was now fully sedated and we could not talk to him.  Well, we could talk but he did not respond) and saying goodbye.  However, they called us ALL back at once and they seemed to be rushing.  We knew something was wrong.  He wasn't scheduled for surgery until 1:00pm-2:00pm and now it was 11am and they were rushing to get him in the OR.  After we all left, we stood in the hallway, waiting for them to wheel Grandpa down to the elevator.  We wanted one last look, to say one last goodbye.  We learned that Grandpa's kidneys were failing and his systems were shutting down so he needed to get into surgery immediately if there was any chance he'd survive.  As he was wheeled by, we all told him how much we loved him and cried together.
Thankfully, the surgeon came to see us about an hour later.  He said that Grandpa had made it through surgery but that things didn't look good.  He admitted he was wrong and he should have given us a much smaller percentage of Grandpa making it.  He didn't realize just how sick Grandpa was.  We were told he was moved to the Surgical ICU so we all moved down one floor and waited to see him.

When we saw him, he looked pretty weak.  He was pretty much on life support.  His body was too weak to breathe on his own so he had a breathing tube.  He was on various medicines to regulate so many things...his pH levels were off, his lactic acid was off, his blood pressure was too low, etc.  When one thing would improve, another would decline.  We were told this recovery, or loss, would be an emotional roller coaster.  And it was.  Shit, it already HAD been!
We were ready to let him go.  Had accepted that.  Then the surgeon gave us hope.  So we were optimistic.  Then the anesthesiologist crushed that hope and we were back to tears and mourning.  Then he made it through surgery and we thought "That's the strong Grandpa we know!"  Then we're told he's very weak and still very sick.  Back down again.

Saturday night Grandma was ready to give up.  She knew Grandpa had given up.  She knew this was no way for him to live.  His kidney's still weren't functioning.  Things looked so grim. The doctor, Dr. Pritz, talked to us and said it doesn't look good.  Rock bottom and many tears.  Again.
Then Dr. Stein comes on the night shift and talks to us around midnight, just after Grandma says we are going to let him go.  He says that 24 hours was too soon to give up and there's still hope.  He was starting to regulate his own blood pressure and his pH levels were looking good.  So we decided to keep fighting.
Quite a few of us stayed the night in the ICU waiting room that night.
Early Sunday morning we get word that he's still doing well with his blood pressure and pH levels.  That's the longest he's held steady for something so we were so hopeful!  He'd also produced a small amount of urine so we thought the kidneys might be reversing.

Around 2pm, Dr. Pritz and a lung specialist come to talk to us.  We went from hopeful to this is it.  We needed to make a decision.  Although some things were looking good, it wasn't the right things.  His lactic acid was too high.  The doctor has never seen someone with this high of a level ever live.  Grandpa was in complete kidney failure.  He was still on too many medicines that were keeping him alive.  It was an incredibly hard decision, but we all decided it was time to let Grandpa go.  He had suffered long enough.  He had fought a good fight.  But there was no hope.  He deserved to go with dignity.  He wouldn't recover from this and it wasn't fair to keep him here on earth with us for selfish reasons.  It was the hardest decision we ever made.  But we knew this was what Grandpa would want.  His wishes were to fight as long as he had a fighting chance.  But there was no chance anymore.  His time had come.

We then took turns going into his room to say goodbye.

As I awaited my turn, I was sick to my stomach.  How do I do this?  How do you say goodbye?  How do you say goodbye to your Superhero?  To the greatest man you've ever know?  I couldn't accept that I would never see him again.  Never hear his voice again.  Never hear his corny jokes.  Never hug him again.  This was it.  It was over.
When it was my turn, I went in, held his hand, and just sobbed.  Uncontrollable sobbing, with my head on his chest.  (Mind you, I'm also in a gown, gloves, and a mask because his c-diff is contagious).  I just talked to him.  I thanked him for everything I could think of.  I told him what all I was going to miss about him in my life.  I spoke about the future.  I relived old memories.  I wanted him to squeeze my hand.  Let me know he could hear me.  But nothing.  I realized I needed to stop talking.  It was time to say my final goodbye.  I leaned over, kissed his forehead, and told him how much I loved him and how badly I would miss him.  As I walked down the hallway to the waiting room, sobbing, I thought of a million things I should have said.  I wanted to run back down that hallway, suit up, and sit there again. I wanted more time.  This couldn't really be happening.  Just 6 months ago he was the healthiest man ever!  Not a care in the world.  How did this happen so quickly?!

After everyone had said their individual goodbye, we went in as families.  My Dad, Mom, brother, sister and I went in together.  We laughed about memories, we cried over how badly we'll miss him, and then we prayed together over him.  I cannot begin to explain the heartache I felt watching my mother cry over her father.  Listening to her call him Daddy...telling him she's going to miss him.  Telling him she loves him so much.  I was hurting so badly and here was my mother, losing her father...the most important man in her life.  They were so close.  She was his "Linny-Loo".

After each family had said their goodbyes, we informed the staff we were ready.  All 18 of us gathered outside of his room, putting on gowns, masks, and gloves as the nurses and doctors began taking him off all his medications and taking his breathing tube out.  They would leave him on the pain medications and heavy sedatives.  We wanted him to be completely comfortable and pain-free (he had been feeling zero pain this entire time thanks to the medicine).  When it was all removed and turned off, they left the room and we all surrounded his bedside, hand-in-hand.  Being the Catholic family we are, we prayed together.  We started with the Our Father, then the Hail Mary, then a Glory Be.  We ended with the Eternal Rest prayer.  Afterwards, we all talked to him.  We shared memories and laughs.  We told him what we would miss.  We told him we'd take care of each other, especially Grandma.  The room was filled with so much love and so much laughter.  Even during this time, my family was laughing, thinking of the amazing memories of him.  For instance, every single day, at 5pm, Grandpa has a Manhattan.  (Even when Grandma had knee surgery, he had his Manhattan makings in the car in a cooler!)  We joked that it was 4:55pm and he needed to go meet his sister, his Manhattan buddy, who passed away a little over a year ago, for a drink.
The feeling in the room, the intense love was overwhelming; in a good way.  But the hardest thing was hearing Grandma talk to him.  Their love....it is unlike anything you have ever seen.  I promise you that.  It absolutely breaks my heart to know their physical love has ceased.  Hearing her talk to him, seeing her caress his face.  Letting him know it's time for him to go.  That she'll be okay.  That she'll never stop loving him.  Or missing him.  I could not hold myself together.  No one could.  I could barely even stand.  I have never felt sadness and pain as deeply as I did when watching her by his bedside.
Grandpa didn't last long.  Not even 5 minutes.  And then he passed.  He passed with his entire family surrounding his bedside, engaged in prayer, laughter, and love.  Just the way he would have wanted it.  There truly is no better way to pass into Heaven than with your family by your side, holding your hand.  I think Grandpa knew his time was here.  I think he held out for this weekend, when he knew everyone would be here.  Even Nick was able to say goodbye that morning before he headed back to Florida (although when he left things were looking up but he still said goodbye.)
We each took a turn walking up to him, kissing him, and saying one last final goodbye.  Then we gathered in a private consult room and cried and cried.  And laughed and laughed.  I've always known this, but on August 18th, it was reinforced more than it ever has been, just how truly amazing my family is.  The bond and closeness we all have to each other as cousins, aunts, uncles, grandkids, etc is unique.  It's rare.  I can honestly say I have not witnessed another family like mine.  I will forever be grateful for my family and how we have helped each other get through this together.

After we were composed, we gathered our things from the waiting room and gathered at my Uncle and Aunt's house.  No one wanted to be "alone".  We all gathered together and started to discuss Grandpa's funeral and wake.  We all just wanted to get it going and over with.  We didn't want to drag out the pain and heartache.  And we know Grandma didn't either.  So we sat around, planning that, and again sharing memories of Grandpa.




This post was incredibly hard for me to write.  It took me a few days.  I don't really know how to end it.  So I'm just going to end it by saying that my Grandpa is honestly the most amazing man I have ever met.  I love him so deeply and miss him more than I could ever express.  I have never felt so empty or lost and I don't know how to go on in life without him.  I'm just trying to take things one day at a time.

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