March 16, 2009

We waited all day today.

When I arrived to be with our dad this morning, he explained that he had not slept last night...maybe it was the pain or maybe he was overstimulated from the previous day. He looked so tired, but had already had cardiac rehabilitation and physical therapy, as well as his daily chest Xray. He needed to rest, at least a little bit, before his next walk. In addition, we were anxious today; I am certain the fear of test result reports had impacted his restlessness.

He tried to sleep throughout the day, but the interruptions were endless: housekeeping, vitals, a visit from the surgical team, the nurses, nurse assistants, pulmonologist, and respiratory therapists all made their required visits with our dad. From the moment I saw him this morning, I knew he was drained. It was difficult to balance the need he had to rest with the necessity of activity for him. Clearly, he needs his rest to manifest the strength and endurance for activity. Without the activity, he slips physically--his lungs are weakened and his recovery period takes longer. He became frustrated with me pushing him to use his Incentives Barometer and his "Flutter Puffer" every 15 minutes. He just wanted me to give him a break--let him rest. He did not want to sit today. He did not have the energy for the walking. He was so tired. It was difficult to push him, as his pain is incomprehensible; but the consequences of not expanding and working the lungs, constantly, seem more dire.

Dr. Krishnan orders the removal of the chest tube, the epidural block, and the catheter. These tube removals are promised to be acts that will make him, ultimately, more comfortable and more willing to engage in activity. But the lack of sleep from the previous night has made him weakened physically and in spirit. His chest tube removal came first. The removal and sutures seemed to go smoothly. As our dad held my hand and my arm, I watched Dr. Krishnan's nurse remove the thick tube and stitch the area. This sight was bearable. What was unbearable was the sight of our dad's pain during this procedure. Equally painful was watching him in such excruciating pain as the nurses ripped the tape from his back and removed the epidural line. For both separate procedures, he was in agony. It took all of his energy to sit up, even bend forward toward me, and remain there as the procedures took place. I told him to clench my hand and arm as much as he needed to, and as he did so, I tried to lean into him to kiss his forehead and encourage him to hold on. These tasks left him completely exhausted.

He slept for a time following all of his tube removals and I waited for word of his surgical pathology reports. The lung cancer nurse coordinator came in and gave me a care binder for our dad. Seeing he was asleep, she offered to return again tomorrow to introduce herself to him. Dr. Krishnan's nurse returned later and I asked whether Dr. Krishnan would be back again today with any pathology report. Doubtful. She talked to me a bit more about the chest Xray and the hopes for more deep breathing, exercising, sitting, walking, and expanding the lungs to loosen the secretions and avoid infection.

As I waited for my brothers and mom to arrive to take the "night shift" with our dad, I watched him rest. This day was a struggle for us. I welled-up as I thought about how much loving someone so much really hurts. The more you love someone, the more painful it feels to watch him in so much pain. We all just want to be able to do something to take some of the pain away.

Minutes after I left, Dr. Krishnan arrived to see our dad. He had the surgical pathology report on the ribs. Free of cancer. In spite of our dad's exhaustion and pain, he sheds tears of joy.