Mar 04, 2012 - 12:47 am
I know I haven't posted much of my journey along the way with my father over this past year but I have been visiting this site and reading from time to time. I think I spent so much time worrying about my father's condition that when I was finally home, I didn't want to get on the computer and think about it anymore. I hope that what I share here doesn’t offend anyone. What I am about to share is my personal experience about the final stage of my dad's journey and maybe it may help someone in some way.
My father was diagnosed with Stage III Esophageal/Stomach Cancer in early October of 2011. He passed away at home on February 26th 2012. It is so hard to believe how fast this year went by with him and it is even harder to believe that I will be speaking of my father in past tense from here on. I can't wrap my head around his permanent absence from my life. We both share birthdays in April; he would have been 64 next month as I turn 33.
His only PET scan was at the time of diagnosis and it revealed that there was no apparent lymph node involvement and that his tumor was 12 cm stemming up the esophagus and down the stomach at the junction. From the beginning, we were told that even though he was stage III that his tumor was inoperable based on his state of nutrition. His weight was just barely over 100 lbs. The doctors also feared that his lungs would not be able to handle the surgery. He was experiencing a severe cough early on and that cough only worsened in the end. He eventually was treated with antibiotics for pneumonia and when it didn't clear a month later, I had to have him rushed to the ER for shortness of breath. Everything went so quickly from there. His oxygen levels were low but stabilized when he was put on oxygen. He had fluid drained from his left lung and then a chest tube had to be inserted because the fluid kept coming. The doctors discussed a chest tube for fluid that had also developed on the right side but my dad didn't think he could handle the pain of two tubes. Next he required a blood transfusion and it was mentioned to me that the cancer may have spread to not only his lungs but possibly his bones. They suspected it had spread to the lungs because there was no other probable cause detected in the fluid.
13 Days after being admitted to the hospital, the fluid subsided on the left side and they were able to remove the chest tube. I saw this as a promising sign. The doctors also informed me that they would be able to remove the fluid from his right side via parenthesis rather than inserting a chest tube in on that side too. I also saw this as promising. But the very next day things took a turn for the worse. His breathing became labored and his blood pressure and oxygen levels dropped. I was informed that his chest x-rays now showed an obstruction in one of his bronchial tubes on the left side. They weren't sure if it was a mucus plug or a tumor but they wouldn't be able to do anything about it without sedating him and placing him on a ventilator, at which point they feared that he probably wouldn't survive the procedure. We were basically told right then and there that either he "goes the natural way" or he "goes out the hard way". We had to explain this to him and he chose the natural way and it was then arranged for him to be brought home just an hour later under the care of hospice. By 8:30 pm Saturday he was home in his own bed and by 10:30 am Sunday morning February 26th my dad took his last breath with my sister and I by his side.
When he was admitted into the ICU, I forced myself to have the "talk" with him. I had to know what his wishes would be for his remains and so we discussed cremation. I also told him I had a special request for him, I asked him to please visit me or give me a sign that he is in a better place and of course he agreed to try if it was at all possible. And then he said he also had a request for me and the family, that we didn't mourn him long. That was a tough conversation and of course I was in tears. But at that point we still hadn't come to terms with the fact that the fight was truly over. No matter how bad things seemed, he and I always held out hope that things would turn around for the better. He wasn't ready for his life to end. Even in his final moments he clung to life so tightly.
He was brought home around 8:30 pm on Saturday evening and the nurse suggested that he take morphine and Ativan a couple hours later to help him relax since he was so anxious and was having a terrible time breathing. In my heart I knew that the meds were going to take his life because his blood pressure was already so low but another part of me hoped that it would just allow him to breath a little better and get some rest. I just didn't want to see him suffer another minute. I could tell he was fearful of letting himself relax because I think even he knew it was the end for him. In one hand he clutched my hand and in the other he clutched the remote to his bed. We told each other how much we loved one another. I kissed his cheek and stroked his face and told him it was okay to go and not to be afraid. He said he wasn't afraid and that he would try to visit me like he promised. It wasn't long before he was no longer responding to my presence. He was just breathing hard and intermittent throughout the night from there on out. I stayed up with my dad through the night holding his hand and watching him breath, afraid that every breath he took would be his last. The nurse informed me around 1:30 am that his time was approaching and I cried and cried but he still continued to breath. It was around that time that I felt a tap on my shoulder and turned around to see if it was the nurse. She was still sitting in the corner of the room and nobody else was there. I can't explain what it was and I am not one to have those types of sensations or experiences and I was left questioning myself and the possibilities of what I may have really felt. I will never know I guess.
When the morning came, around 8 am, the nurse said she had never seen someone enter that breathing pattern and hang on for so long. She felt he was hanging on for someone. Sometime around 10 am my sister called and said she was on her way. I told him to hold on for her, that she would be by his side soon. I remember telling him I loved him again and I watched his face for any sign that he could hear me. I saw his tongue move like he wanted to say something but couldn't. He wasn't able to respond but it was not long after my sister arrived that he passed on at 10:38 am. The image of my father passing away will forever be engrained in my mind. I watched him take his last breath and then I saw the blood stop pulsing through his veins as his heart stopped beating. All I can say is that I am so grateful that I was able to be there in that moment for him. I know he found peace and relief from his suffering. Even though he was unresponsive to his surroundings throughout the night, I watched his face closely for signs of life and he often raised his eyebrows in amazement and smirked like he was happy about something. I would like to believe that he saw something amazing in those hours and that he was happy about what he saw. Reflecting back on those final moments, I realize that I have lost an amazing man and yet I gained a greater faith through this experience. I will see him again.
In closing, I would just like to share my advice to caregivers. I cannot express enough how important is to really cherish every moment and make sure to have those “end of life” conversations, no matter how tough it is. I am glad my dad and I discussed his wishes and shared plenty of “I love you’s”. I think I will always feel like there was more to be shared but at least I know that he knew how much he meant to me. My sister passed up opportunities to have those moments with him. She will probably regret it her whole life.
If I could do it over again, I would have spent even more time with him going through his personal effects so that I could understand what every one of his keepsakes meant to him. I would have asked him what some of his favorite songs were. And I would have asked him what it was that he would have liked others to remember about him, and if there were any important things that he would have wanted me to have shared with specific people. We were just never ready to face the reality that was right in front of us. Talk to your loved ones and hang on to their every last word. Maybe even keep a journal to remember all that you can because once they are gone, you will try to recall every last word and every last memory and wish you wrote it down.
Much love to all!
God, give us grace to accept with serenity
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