The anatomy of an emergency.

March 28, 2012

Terence on the up-swing: Eric showing him a hunting video

I am creating this post a little differently. You'll hear from  both Terence and I......I'll be typing for Terence since he's not up to it, and his post will be short........

Sherry:

"Terence is on the up-swing.....he was moved from ICU to a regular room and is doing well. Thanks for everyone's prayers, it got him through the "dark hour" of death. Whew.

The diagnoses (DX) came back confirming that the kidney we thought was "dead" was functioning somewhat but it didn't have the ability to drain since his kidney ureter is completely blocked by cancer-----they needed to drain the kidney by putting a by-pass in. The stagnant kidney created a perfect storm for an infection to brew- which it did. The ER and ICU docs and nurses worked aggressively for 3 days to stay ahead of the infection, which was life threatening.

Three days after he entered the ER the medical staff felt confident that they got a grip on it. Now they are following up on his cultures to be sure he goes home 100% clean- no infection left, or cultures re-growing, post draining.

Now he has 2 kidney by-passes which he was hoping not to have.  In the midst of all the chaos, Terence was barely cognitive and had difficulty understanding the need for the nephrostomy (kidney by-pass)- so he wouldn't give his consent.  He kept insisting that he came in with a fever so why wouldn't they just give him some Tylenol and send him home. At one point there were 3 doctors, his nurse, Nadine (our daughter) and I trying to explain it to him. Mike (our son-in law who is an internalist whom Terence trusts very much),  had to explain in simple terms that he is very sick and needs medical intervention.

Our grand daughter Annie waiting outside to see "Papi"

At this point, Terence was so overwhelmed and exhausted (his blood pressure was dropping)... he laid his head back, closed his eyes and deferred to me; "Sherry, I'm going to sleep.....get my back"....I.e.- "You make the decision, I trust you".  They rushed in with the consent form while he was still somewhat cognizant (which reminded me to check into his medical directive on file....lots to think about....).

Terence:  "When all this happened, I was shocked.  I didn't expect to get this sick. I thought 'why can’t I take a couple a couple Tylenol and go home?'…..I guess sometimes I am naïve to the depth of this illness. An infection for any chemo patient can be deadly, I keep forgetting that. I guess at this point, I’ve resolved myself to say,  'OK- I have physical limitations.' I hate that”.

Sherry-  "I had been in prayer from the onset of his fever on Saturday.... we needed wisdom from above to navigate through everything that was being thrown at us.  I knew he needed the surgery to get to the source of the infection (for starters)- so that was no question in my mind. But I also understand that even a clear cut decision like this has long lasting emotional results- it is hard for you and I to understand, we are not terminal patients....but every time cancer strikes, it feels like a low blow and one more step toward the grave.  Terence needs to process  all of that information and come out strong in spirit. He never wants to feel like he is giving up. The "process" he takes is usually a sense of mourning and sadness that cancer is evidently progressing, then a sense of anger.  Only then is he usually willing to make a decision, any decision.  Typically those of us standing by (medical staff and family) don't understand the delay, but I've realized that it's an important step for Terence; I find myself balancing the urgency of medical intervention and being sure that Terence exercises his right as a patient.

Not being completely aware of the urgency, I needed to encourage him to submit to the healing ministry of the medical staff. I reminded him that they are in the medical field because they were compelled to help others heal- and it was God who designed them that way------so he could release himself to the their hands knowing that ultimately  Jesus is the Great Physician".

Mike, helping Pop understand the seriousness & Callie keeping it light

Terence: " I knew when I started to loose my ability to think clearly.....I was loopy it was necessary to rely on the wisdom of my wife-I had 4 doctors asking to me to make life changing decisions on the fly------my wife….my best friend….whom I trust to make decisions in my behalf……..I trust in her wisdom as I know she’s relies on the Lord…….this is another example of how much I love my wife. I know she knows what’s best for me in times when I cannot articulate…she’s there.  I pray that all my friends would have a wife like this".

 Sherry: "I think that's the 'power of two'- it was important that Terence have an advocate. At a crucial point (once we had made the decision to have the procedure done), the next question was whether or not to make the transfer to UW medicine where he receives all of his cancer care- the continuity of care is important to us and the hospital he ended up in didn't have his records on file- so I was constantly fighting an uphill battle- trying to bring them up to date on all of his care.  Terence initially wanted to transfer to our hospital in Seattle, but they didn't want him to....

Negotiating our thoughts through this, I  reached a point  where I said to my daughter "Well....maybe we should just stay here....it's easier".  Her reply was "mom, you need to be your own advocate and we need to find out what's best for Pop, if it's staying here, then  stay because it's whats best. Don't let them make the decision for you".

Well said daughter.

Terence:  "Throughout this difficult time, my son Eric and son-in law Mike (a naval ICU nurse and and Internalist)  were there questioning what needed to be questioned- things that Sherry wouldn't know to ask. I felt great peace in that."

Advocacy is important.

Praying for Terence before he went into emergency surgery.

Sherry:   Long days.....I never really left Terence alone in the ICU because they didn't have his history................Our grown children stayed by our sides and helped relieve burdens and pressure.  

Prayer was most important. At one point, Terence awoke and saw Carmen and Donna in room quietly praying. It was 1:00 Am. He saw them and was able to rest knowing that intersession was being made".

Terence: I cannot express in words  how much we feel loved. Our children, family and friends have been here.....and even our friends  from the other side of the world are praying.....this is all huge and we never take any of this for granted".

Sherry:   Day 5- things are looking good for Terence- reports came back today that no new bacteria is growing in his most recent culture, so he may be able to come home tomorrow (Thursday). He is in a little more pain today........

 I don't understand the anatomy of this illness. It takes sudden twists and turns in the blink of an eye usually catching us off guard. But we we take everything on a day to day basis living life simplified-----

1. trusting in our Heavenly Father who is sovereign and loving,

2. enjoying each other and our family and friends,

3. giving God glory in all things,

4. facing each day knowing that His  grace is sufficient for what every it is that we will be facing that day.

In closing, I'll leave you with Terence's quote for the day: 

"Sherry, be sure to listen to the rain....it's like God is playing symphony just for you. I think you'll find a variety of simple pleasures in it to help you through this".

 

Terence & Sherry