The expected is always unexpected
Frank Booth, RGN (retired)
...there's going to be one heck of a fight coming deaths way...
The expected is always unexpected
It is fairly normal for me to write within these pages in a responsible yet light hearted manner, using knowledge gained through my past nursing history and commenting upon things medical or/and nursing from the 'other side' of the bed. From a care giver and care receiver prospective, I have opined at length. But even I was surprised at how different recent events seemed.
This piece is certainly the most difficult and even traumatic piece that I have written as I again draw from personal experience from a bank of current illnesses.
I have quite a long history; a catastrophic heart attack some years ago developed into a 'Bundle branch Block', then various types of AF (atrial fibrillation) and VF (ventricular fibrillation), necessitated the insertion of a pacemaker/defibrillator device. However, perhaps inevitably, Heart Failure followed. If this wasn't enough, add into the equation Type 2 Diabetes (on tablet and silly amounts of insulin) and Stage 4 renal failure. Am I being greedy here?!
Yet I still get along and am fairly flippant about my health. Of course my mobility is now poor, my breathing problematic and periodically need hospitalisation for cardiac decompensation, I simply fill up to much with fluid somewhere in the region to the tune of an additional 14Kilos. I'm cheerful enough, and people tell me that I look well. All of which sort of lulls you into a false sense of 'it will be all right in the night'
Very recently, once again I was admitted in somewhat of a hurry to my local Cardiac Unit. Although I was very ill, there were no beds available until the next day. I was admitted and my usual regimen of 4-7 days on IV Furosemide - 480mg/24hours (yes that's right) was started. All of that went well as usual, care excellent, doctors fine, consultants pleasant. However, things didn't progress as expected and after 3 weeks and 'weight on, weight off' in true Karate Kid style, I finaly 'progressed' to oral frusemide.
Of course the heart tablets harm the kidneys and the diuretics harm both the heart and kidneys, and while my blood ranges are on a scale that would make the path-lab raise enough alarms to wake the dead, they are 'normal for me'. But, a heart to heart (see what I did there?!) with the registrar left me with the knowledge that my normal medication to keep my fluids down (high doses of Bumetanide, Bendroflumethiazide and Eplerone) have basically stopped working.
So, the next stage was the discussion with my family about end of life choices and the matter of resuscitation, and a referral to the Palliative Care Team.
Now I am a buoyant character, so in the past while I may have hit the floor, I have always bounced back to my normal. But this time the floor opened up beneath me and I fell through it. The best way that I can describe it was numbness, emptiness and total loss and devastation. I have never experienced such a reaction before.
The saving grace of this situation I believe was a young staff nurse who must have heard what was said or was aware of what was going to be said, as within minutes she approached me, quietly held my hand and spoke softly. Somehow, and I still don't understand it, she gave me my life back. Naturally I was embarrassed as I struggled to hold back a tear, I certainly was shocked by the news. That one person in that one action gave me a chink of light in a dark world.
When the nurse from the hospice arrived a day later I was once again bouyant, my flippant old self, telling her that she had come about 10 years too early for me as I didn't want to play her game at this particular time. That flippancy, that awkwardness (ask those who know me) is second nature. We did talk, and she left telling me that I could call the hospice anytime. I thanked her and decided that I had so much to do in the next 2-3 years that I didn't have time to consider dying.
Now I'm home; not everything is perfect, but with the bag of goodies (half the local Pharmacy stock) I have to swallow, it's hardly surprising really. Of course I tried to return to normal but have found that I can't do things that I could just a month or two ago.
Maybe they're right? If so then there's going to be one heck of a fight coming deaths way.
So why write this down now? perhaps that as a former nurse (you're never an ex) to a current nurse I can counsel you to take care in the way to tell people bad news. What shocked me most of all is that I didn't think that I would have reacted in the way I did. I thought that as I had already settled my affairs, had the conversation with my daughter that no father ever wants to have that my future (or lack of it) had been put into a box for others on another day.
Somehow it didn't quite work out that way.
So a keep reading these snippets, there's a fight coming down the track and I thank goodness for that staff nurse and all of her colleagues on that Cardiology ward who got me through that tough time and I'm sure that "I'll be back" with them soon to fly the flag for dead people who simply won't lay down.
I thank goodness for that staff nurse and all of her colleagues on the Cardiology ward who got me through that tough time; I'm sure that "I'll be back" soon to fly the flag for dead people who simply won't lay down.
The saving grace of this situation I believe was a young staff nurse who must have heard what was said or was aware of what was going to be said, as within minutes she approached me, quietly held my hand and spoke softly. Somehow, and I still don't understand it, she gave me my life back.