Update on Papaw

{Again for some reason this will only show as one big paragraph. Makes it seem so long. }

Papaw is still hanging in there. He has been in the hospital for a week tomorrow (Friday). We were pretty aggressive on his treatments (treating his pneumonia, UTI, all his normal home meds, IV fluids) until Tuesday. On Tuesday the Doctor talked with my Dad and Aunt about what all we wanted to do for his care as a 98 year old since his kidneys were shutting down and his infection wasn't responding to any treatment. We decided for Hospice to then take over his care. At that point we got him off all his meds, including home meds and stopped IV fluids. Just comfort measures. Keeping him on 5 L of oxygen NC and keeping his pain under control. Oral Morphine was schedule every 4 hours as needed. He then starting taking a turn for the worse. Yelling out like he was in pain. Then we would ask what was hurting and he couldn't tell us. We decided to go ahead and start giving him the pain meds. Not 2 hours later he would start shouting out and yelling again like he was in pain. We asked the Doctor if he could have it every 2 hours. So starting Wednesday we stayed on top of his pain meds trying to remember to ask for it every two hours if he was not resting well or acting like he was hurting. Wednesday they also put his Oxygen to 4L. We decided to stop having his Vitals signs taken. He would get so bothered by anyone touching him and also when he would have his blood pressure taken. Since a lot of nurses in the family we of course are keeping and eye on his resp. rate, it was average about 12 breaths a min most of the day. This is the day we also all talked about saying good-bye. We have heard and read that you should tell your loved one it is ok to let go. So they know it is ok. My Dad was saying he didn't know how to bring it up. While everyone went home to rest and i was working night shift i would come to see him on all my breaks. Around 3 am i came to see him and his eyes were open i started talking to him and i really think he understood what i was saying. I decided to take this moment to tell him good-bye and told it was ok to go to heaven to be with Meme. I just sat in his bed and watched as those sweet blue eyes stared at me. I just held his hand and cried. This was probably the first time i really really cried about the entire thing. I don't know if it was because i was tired working all night and sleeping a few hours in his room or what. Thursday morning a nurse let me get off early so i could be in the room when the Doctor came to see him. My mom was already in the room reading the bible to Papaw. She had tears just running down her face. She said she told Papaw good-bye and she loved him. Then he went back to sleep. His resp. rate was around 8 breaths/min this am. Dad got here and Mom had to leave to go to work. Basically everyone told Papaw today that is was ok to leave us and go be with all his family in heaven. His color is still good and you can see his heart beating good. We then noticed his RR 4 breaths/min. At one point he did let out a gasp, My Aunt, mom, sister and I just stared at him. It seemed like forever before he took his next breath. Papaw has a hymnal that he has his favorite songs writen down in. Aunt Margie, Dad, Mom, Ashley and I thought of our favorite hymn and had them playing for papaw on our computer. Kind of an emotional moment. Papaw has a pacemaker (this is device that helps control your heartbeat) so his Heart rate is still obviously good. We can't remember what it is set at but basically if your heartbeat drops under a certain number it will pick up, making your heart rate normal. So his color (another way to tell if his end of life is close) will most likely be good since his heart is beating and circulating blood throughout his body. The only thing we can go off of is his resp rate. Tonight it was down to 2-3 breaths/min. Having a pacemaker during end of life issues could prolong the process of dieing but we haven't even thought about turning it off. That would be a VERY HARD decision to make. Not one that i look forward to my family making at all. Tonight i am off work but still continuing my night shift duties and spending the night with him. I couldn't imagine him being here alone. Everyone just left for the night to get some rest. He is sound to sleep. Everyone now and then he will start to snore. If you look at him he seems like nothing is wrong. The respiratory therapist just came to check on us. His 02 sat is 99% on 4L of Oxygen and his Heart rate was 60. Man makes you wonder if it is his pacemaker doing the job or his heart. {My brother and his family aren't able to come in town yet. It is such a hard thing to plan and figure out. He did get to talk to him on the phone tonight and we tell Papaw all the time that Jason, Sarah and Hollis love him and said hello. Papaw thinks the world of Jason...his only Grandson and to have a great-grandson Hollis name after him. Gives me chills. Well night night going to try to rest and visit with Papaw!}
As a Nurse, I know how nice it is to get surprises! This is what my family gave our wonderful crew on 6 North..a huge cookie cake....Everyone has been great with Papaw.