Hello again (said sheepishly after a long absence from the blogosphere). I didn't actually drop off the face of the earth; I am still here. Thank you so much for all of your lovely, kind comments and prayers in response to the last few posts. I appreciate them more than I can say, especially the prayers. I believe it is people's prayers on my behalf and the grace of God that have enabled me to keep my head above water emotionally for the past several weeks, and I apologize for not updating or expressing my gratitude sooner.
For the first few weeks after my dad's death and my latest miscarriage (the seventh, in case you're counting), I didn't post because I just didn't have the extra emotional or physical energy for non-necessities like blogging. At first there was so much to do to get ready for my dad's funeral and to help my mom out, and then when I came back to my own home my time between crying jags was spent taking care of the basics of life, like doing laundry and starting back to work.
Grief is so draining, and I am dealing with a double dose of it after losing my baby and my dad in the same weekend.
Slowly, I have regained some of my energy. I am starting to find it a bit easier to concentrate and focus at my job and at home I have been doing a lot of cooking, which is something that I enjoy. Still, I when I have considered what to write about the miscarriage and losing my dad, I have found myself at a loss for words. It reminds me of a quote I once read that said, "Life's small sorrows are loud, but its biggest sorrows are silent."
So I guess I'll start by just telling you the facts regarding what happened, chronologically. I think I left off at the point where I was on my way to my hometown to visit my dad in the hospital after receiving news from my doctor that our baby was measuring small and its heartbeat was slow. The doctor said it was possible that things could turn around for the better--she has seen it happen--but that it was more likely that I would miscarry.
I arrived at my dad's bedside on January 11, the Thursday of his first week in the community hospital in my hometown. The previous Sunday he had gone to the emergency room because he was experiencing shortness of breath that he attributed to an allergic reaction to a new medication that his doctor had prescribed for him for hip pain. Unfortunately, at the ER an X-ray revealed that his lungs were 50% filled with nodules, and he was told that it was probably lung cancer; he was admitted to the hospital for tests in the hopes of securing a definite diagnosis.
At this point I should mention that prior to his trip to the ER, Dad had been living a normal life: he had just gone grocery shopping on Friday, and other than a few aches and pains that were worsening, he seemed fine. None of us suspected anything was wrong. We were blown out of the water by the news about his lungs. How could he have lung cancer? He never even smoked!
We still had some hope that it wasn't cancer. Without a tissue sample that shows cancer cells, cancer cannot be diagnosed with certainty. The doctors said that there was still a slim possibility that it wasn't cancer and perhaps was something else like a fungal infection.
The doctors suspected that the cancer in Dad's lungs had spread from somewhere else. They didn't want to start with a lung biopsy because there are significant risks of collapsing a lung, which could be very dangerous to a patient who already only has 50% lung capacity. So my dad had test after test, and none of them revealed cancer anywhere else.
During that first week in the hospital, he was on oxygen and breathing treatments and was in stable condition. He still was able to carry on conversations, even though he got a bit breathless. The nurses were still getting him up to walk and move around. On Friday morning the nurse walked him all the way down the hall to the family waiting room, and we enthusiastically said, "Wow, look at you go!"
It's the last time I ever saw Dad walking.
That same day, despite the fact that we still didn't have a definite cancer diagnosis and that multiple doctors were giving us differing levels of hope (or hopelessness, actually), one of the doctors was straightforward and let us know that Dad's condition was almost certainly cancer that almost certainly was terminal and that he probably would only live a few months at most. None of the other doctors would venture any guess as to how much time Dad had and were evasive when I asked.
My mom, sister, and I had to meet with a hospice nurse to discuss his care after he was released from the hospital to die at home. We planned to set up a hospital bed in my parents' dining room. A hospice nurse would visit periodically, but we would be the main ones responsible for his care. Hospice wouldn't do anything for Dad but make him comfortable, and once he was under hospice care he never could go back to the hospital again. The nurse explained the stages of dying and how Dad probably would withdraw from us, how dying people usually remember their spouse but sometimes don't even know their own children at the end. She explained that when someone dies of lung cancer, they basically suffocate to the point that the lungs put so much stress on the heart that the heart gives out and that's it.
It was horrible. I wanted to clamp my hands over my ears and yell, "LA LA LA, I'M NOT LISTENING TO YOU."
Less than two weeks prior to this, I had been sitting at my parent's house on New Year's Eve eating pork and sauerkraut with Mom and Dad while Dad expressed how much he hoped that 2007 would be a great year for all of us.
Emotionally during the first week that my dad was in the hospital, I think I was shell shocked. Yes, Dad had talked to me from his hospital bed and told me that he probably would die soon, and that he was as ready as he probably could be at that point. He felt that he had a good life and had been blessed with a good family. He told me that I had always been a good daughter and that he loved me. He talked about what he wanted for his funeral and asked how I felt about what he wanted.
But it all seemed surreal. The constant, ubiquitous Muzak piped through the hospital halls didn't help the feeling of unreality. When I left the hospital at night, Dad would be sitting up reading his newspaper as usual, just as he had done almost every evening that I could remember. How could he be dying? I still was praying for a miracle and hoping against hope that the tests would reveal that Dad's problems were treatable.
It seemed real enough to me, though, that I often was overwhelmed with sadness, for the suffering that he would endure and for myself at the prospect of life without him. Down the hall from my dad's room, there was a small, one-stall bathroom that I could lock and have some privacy. I closed myself in there and cried every time that I had to go to the bathroom (which was a lot due to being pregnant and having to pee or heave or throw up all the time; I had morning sickness worse than I had ever had it before and was constantly nauseated).
When I was at my parent's house, I often used the bathroom in their finished basement, which was my dad's domain. He kept all of his clothes there. I can't tell you how many times I wrapped my arms around his hanging pants and shirts and dampened them with desperate tears, whispering "Don't go, Dad!"
You have to understand how it was between me and my dad. We were always close. I was born when my parents were in their 40s and my sister and brother were in their late teens. Dad didn't have as much time to spend with them as he would have liked when they were little because he was in his 20s and trying to make his way in the world (serving in the Marines, going to college, and starting a small trucking company). By the time I came along, he was more settled professionally and he relished having another chance to parent a small child.
When I was a baby, Dad gave me most of my night feedings and still often would say that those times were some of his favorite memories. He was the one who was with me at the park near my parents' house when I took my first steps. During my pre-school years, I would eagerly await his return from work in the evening, watching out the front window for his car, then tearing through the house to the door to greet him yelling, "Daddy, Daddy, Daddy!" We spent a lot of time together when I was a kid, and I have great memories of bike rides, sled rides, and playing games with Dad. Each Saturday morning for years I would go grocery shopping with him and he would buy me a smiley face cookie as a treat.
As I grew up, we stayed close. He always was my biggest cheerleader and my biggest fan; he always was interested in my life. I was embarrassed at how he sometimes would brag about me to other people; he often introduced me as "his daughter, the attorney;" he was so proud of that. He was a family man first and foremost and loved his wife and kids (he and my mom would have celebrated their 60th wedding anniversary this October). He put us first. I could count on him not only for practical help but to always be in my corner from an emotional standpoint. We often had long, meandering phone conversations that always ended with an exchange of "I love you" at the end. He and my husband became great friends.
As my sister so aptly put it, Dad was the heart of our family. We all love Mom, too, of course, and she is great in her own way, but her way is more quiet, more reserved. Dad was outgoing, active, talkative and loud, expressive, affectionate, rarely critical, and had a child-like sense of fun. He had an attitude of gratitude and tons of vitality.
How could that vitality fail? How could he be dying? Instead of a grown-up woman, I felt like that toddler who had pressed her face up against the window watching for Daddy to come home...except that this time he was never going to come home again.
The weekend after Dad was admitted to the hospital, he had to have a colonoscopy to determine if he had colon cancer. I don't know if you are familiar with the procedures that one has to go through with a colonoscopy, but it's hard on someone who is in the best of health. He had to drink about a gallon of horrible tasting liquid laxative called "Go Lightly" (which, believe me, is a misnomer). My poor, sick dad had to sit on the toilet for hours. The colonoscopy, which didn't reveal any cancer in his colon, is the turning point at which he started to go downhill very fast.
The night after the colonoscopy, one week after he originally was admitted to the hospital, Dad was moved to intensive care because his breathing was deteriorating rapidly. They told him that if his oxygen level stayed above 90% (with an oxygen mask on, of course), then they finally would do a lung biopsy the following afternoon. Test after test had failed to give us any definite diagnosis, and the lung biopsy was our last hope. My dad desperately wanted to get a diagnosis. He wanted a diagnosis so badly that he stayed awake all night, deep breathing and watching the oxygen monitor to make sure that he was doing everything possible to keep it above 90.
He was fighting, and he succeeded. During the night and early morning his oxygen level stayed consistently just above 90 and his lung biopsy was scheduled for 1:00. Even though we knew there were risks, we all desperately wanted that lung biopsy to be done. Dad's condition was worsening, time was ticking, and we still didn't have a definite diagnosis. If he had something other than lung cancer or if the type of lung cancer he had was amenable to treatment, we wanted to know and to start treatment as soon as possible. For a week we had been spinning our wheels with no answer, no treatment, and time was running out.
Late that morning, I stood by Dad's bedside for hours, holding his hand. We reminisced about many good, fun, and funny times that we had shared together over the years. It was a great conversation, and the last time he had enough breath to speak with me at any length.
1:00 p.m. rolled around, and nobody had come to get Dad for his biopsy...then 2:00 rolled around. A nurse came in to explain that the radiologist had refused to do Dad's biopsy because his blood clotting time had been too slow and they were worried about bleeding in the lung. The radiologist said that we could take Dad off the aspirin that he was on for his heart, wait 10 days, and try again for the biopsy.
We all knew, then, that Dad wasn't going to get the biopsy. His lungs were deteriorating too quickly; each day he required more and more oxygen. Even if his clotting time improved, there was no way that in 10 days his oxygen level would be where it needed to be, barring a miracle.
Dad was deflated. We all were deflated.
After that, Dad continued to go downhill fast. His breathing deteriorated again, and the next day, Tuesday, one and one-half liters of fluid were drained from the tissue surrounding his lungs (they tested the fluid for cancer cells, but none were found). Draining the fluid helped.
On the following day, Wednesday, Dad seemed to improve enough that they moved him out of intensive care to a regular room. However, that did not go well and did not last. I was alone with him that afternoon, and after he ate a few bites of his lunch he got nauseated. The anti-nausea medication that they subsequently gave him seemed to make him disoriented. He kept moaning in pain, constantly shifting positions (his hip hurt), speaking loudly and unintelligibly, slurring words. He kept taking off his oxygen mask and trying to get up out of bed. His heart rate increased. I called the nurse for help a few times and did my best to keep putting his mask on and to keep in safe in bed, but it was hard, physically and emotionally. It broke my heart to see my Dad like that. I began to pray for mercy for him.
Meanwhile, I was exhausted and nauseated from my pregnancy, and weak. I was so sick to my stomach that all I had been able to eat for days were a few crackers and some homemade yogurt/fruit smoothies, except for a brief reprieve every afternoon when I was able to keep down part of a plain hamburger. Everything else made me sick. I gagged and heaved in the hospital bathroom, in the parking lot, at my parents' house. Secretly, hope for my baby was growing in my heart. Everyone always said that nausea was a good sign of a healthy pregnancy, and my nausea was getting worse and worse. Surely that was a sign that the baby could still be alive. I prayed and prayed for a miracle.
That Wednesday night, Dad was transferred back to intensive care because they couldn't get his heart rate below 140. He was agitated, his hair was soaked in sweat. When I had to leave his room around 10 p.m., his heart rate still hadn't dropped at all.
The following morning, Thursday, I had an ultrasound appointment at 11:30 with my OB/GYN back in my own city three hours away. Before leaving, I got up early and went to the hospital to see my dad. His heart rate was stable, but his oxygen level wasn't good. Despite his obvious suffering, Dad smiled and his gauze-swathed hand reached for my hand when I walked up to his bedside. His hair was still matted with sweat and his shortness of breath was making it harder and harder for him to talk, but the disorientation of the day before was totally gone. My Dad was back. He knew about my pregnancy and my appointment. He told me that I should get on the road because he was worried about me and didn't want me to have to hurry and to speed on my drive. As I left, he waved, saying, "Take good care of yourself and get some rest. Love you."
That's my dad: thinking of others despite his own suffering. He was so brave when he was in the hospital, rarely complaining, always thanking the hospital staff for the care he was receiving, thanking me and the rest of the family for being there with him, trying to make the best of a bad situation.
I wondered if I would ever see him alive again. I prayed that I would.
I made it to my appointment on time. My husband, Bill, was with me. He had been with me most of the time at my parents' house and at the hospital. He had been great the whole time. I am so grateful for his support. Early each morning, when I was too nauseated to get up and out of the house quickly and my mom was still sleeping from exhaustion (she was still recovering from her cardiac bypass surgery), he would get up at the crack of dawn and rush to the hospital so that my dad wouldn't be alone and so that Bill could talk to the doctors as they made their rounds. Late each night he held me as I sobbed into his shoulder.
At my appointment the doctor I saw was very kind. His own father had died of lung cancer, and he was empathetic. He asked me how I was feeling, and I told him that I was exhausted and very nauseated. "Great! That's what I want to hear; severe symptoms can be a good sign." I hoped and waited with bated breath as I clutched my husband's hand and the wanding began. However, the image on the ultrasound screen was motionless. The slow flicker of the heartbeat that I had seen over a week before was gone. I was at 9 weeks, and the gestational sac looked great and measured a little over 9 weeks, which explains why my symptoms were so strong. The baby, however, was small, measuring at slightly over 7 weeks. Dead. It seemed like a cruel joke. I felt numb.
My doctor advised a D & C, and I agreed. He said it could take days or weeks before I miscarried naturally; the timing of it would be unpredictable. Given the size of the sac, I would have a lot of tissue to pass, and the bleeding could be heavy. I wanted to have a D & C and get it over with; I didn't want the specter of a natural miscarriage hovering over me. I wanted to put the physical part of the loss of my baby behind me so that I could get back to my dad's bedside.
Thankfully, the hospital operating room was able to schedule my D&C for the first thing the next morning (I think my doctor may have pulled some strings). I went home and picked out clothes to take back to my parents' house with me, including clothes to wear to calling hours and a funeral. I also went through photos and picked out good ones of my dad to take back with me, in case we needed them for display at calling hours. My husband went to work. I cried some, but mostly felt numb.
In the afternoon, my sister called to tell me that my dad was being transferred to a hospital in a larger city where a radiologist had agreed to do the lung biopsy (why they didn't transfer him sooner is beyond me). The procedure was scheduled for late the next day, a Friday, the same day as my D&C. That evening I talked with my brother, who said that the doctors at the bigger hospital had not given up hope that my dad's condition was treatable; they still thought that there was a possibility that the nodules could be due to a fungal infection and not cancer, or that the cancer could be of a type that is more amenable to treatment. Hope for my dad sprang up in my heart. Maybe I wouldn't have to lose my baby AND my dad right now after all.
My husband and I arose very early the next morning. It was still dark outside as we drove to the hospital and checked in. My D&C was delayed because the doctor who was performing it got called to deliver a baby (that was like salt in my wound, but I guess it makes sense that women having live babies take precedence over those carrying dead ones). I laid there in pre-op wearing my hospital gown and paper cap for over two hours. Strangely, I mainly was calm. It had to be the grace of God.
The doctor who did my D&C is a part of the group practice of OB/GYNs that I go to, but I had never met her before. After she had finished delivering the other woman's live baby, she finally was able to come in and speak with me briefly before my procedure. She was 8 months pregnant. I didn't exactly feel like seeing her big belly at that particular time, but she seemed nice enough.
After the procedure, when I woke up in the recovery room, I was crying. I couldn't stop. The nurse asked me what was wrong, and I told her that I had just lost my baby--my seventh miscarriage--and my dad might be dying. It was hard for me to believe everything that was happening all at once.
Thankfully, I did not get nauseated from the anesthesia. My husband got me dressed, took me home, and tucked me in bed. I slept deeply. Later he got me some delicious soup from my favorite restaurant and brought it to me in bed on a tray (he's a keeper). After being nauseated for weeks from the pregnancy, I was grateful to be able to eat again, and the soup tasted good to me.
In the evening, friends of ours from church brought us dinner and prayed with us. They were very comforting, and I was so glad to see them. While they were there, the phone rang. My dad's biopsy, which he had wanted so much, was over, and it had gone well. Dad was stable and his lungs had neither collapsed nor filled with blood, thank God. The pathologist had been right there during the procedure to make sure they got a good tissue sample.
Later that night, we got another call from my brother: the nodules in Dad's lungs definitely were cancer; he said that the pathologist should be able to tell what kind of cancer within a day or two. I prayed for mercy for my dad.
Somehow, I was able to sleep that night, but was awakened the next morning by the phone ringing. It was my sister. The hospital had just called and said that the family should gather quickly at the hospital because it didn't look like Dad was going to make it through the day.
His lung cancer was Stage IV (the worst), primary (meaning that it had not originated somewhere else), non-small cell, very aggressive. It seemed as if Dad had been holding on until he got a diagnosis, and then when he learned that his cancer was untreatable, he was letting go.
My husband and I quickly packed, including our funeral clothes, and drove to the hospital almost three hours away.
Tears flowed down my cheeks. Would Dad die before I got there? Would I never get to see him alive again? I fervently prayed that I would get to say good-bye to him. My entire family already was at the hospital, except for my husband and me.
We arrived at the hospital around noon and hurried to the intensive care unit. My poor Dad was suffering greatly. His chest heaved violently with the struggle of taking each breath. He had not taken the larger dose of morphine that would have eased him because he wanted to be awake and lucid to see me. For the same reason, he was wearing a powerful oxygen mask that forced air into his lungs, which was very painful but kept his blood oxygen level high enough for him to be mentally alert. He had kept the mask on for hours and eschewed more morphine the whole morning while I packed and traveled. He wanted to see me one last time, and he knew how heartbroken I would be if I never got to say one last good-bye.
This loving sacrifice was so characteristic of the kind of person he was, the kind of dad he always was to me. Every time I think about him hanging on, suffering, but waiting for me to get there, I can't help sobbing (tears are flowing as I type this).
The rest of my family left the room as my husband and I said good-bye to Dad. I told him how much I loved him, what a wonderful father he had been and how blessed I felt that he was my dad, how much I will miss him. I asked him, for my own reassurance, whether he believed that he would have eternal life due to Jesus' saving grace. He nodded emphatically and, despite his breathless, almost complete inability to speak, forced out "Yes!" I cried and said, "I will see you in heaven, Dad, and it will be wonderful. Take care of my babies until I get there." I leaned over and hugged him, and he smiled and managed to say "Love you."
Then my mom had some time alone with Dad before the whole family came in and surrounded his bedside: his wife, all his kids and their spouses, and all his grandchildren. We held his hands, caressed him, hugged him, spoke loving words as the nurse came in and swapped the oxygen mask that forced air for an easier, more comfortable one, and then put more morphine in Dad's IV. His family surrounding his bedside was the last thing that he saw on this earth.
I felt God's presence there in Dad's last conscious moments. What a blessing that I was able to get there in time to say good-bye, what a blessing that the whole family happened to be there on that particular day (my brother and his family live out of state and, due to work and school commitments, weren't able to come that week until two days prior).
God hadn't answered my prayers for a miracle, but he did answer my prayers for mercy for my dad. Yes, Dad was suffering a lot, but he had not suffered long. Dad had always been an active, independent person who would have hated a long period of disability more than anything, and he was spared from having to face that. Dying is inevitable for each and every one of us, and there could have been many worse, more drawn out ways for my dad to go.
It's strange, given the circumstances, but in Dad's last conscious moments I was filled with peace and gratitude to God: gratitude that I had a dad who loved me, that we had always been close, that I had had him as long as I had, that--even though I was going to miss him terribly--his suffering was about to end and he was about to start his new life in heaven.
Dad's last words were "Love you" then "morphine....hurry." As the morphine eased his pain, he became unconscious shortly after 1 p.m. The next several hours were filled with sounds of his tortured, shallow breathing while our eyes intently shifted between him and the monitor showing his oxygen levels and heart rate. They gradually decreased but stayed relatively stable throughout most of the afternoon. Around 4:00, I started holding his hand and didn't let go. I prayed for mercy.
I had strange, random thoughts. I looked down at my shoes and thought about how I had bought them to go on vacation last fall. When I got them I had no idea that I would be wearing them at my father's deathbed a few months later. I kept staring at Dad's face, his hands, trying to soak them in, to memorize them and imprint them on my brain, knowing that soon I wouldn't see him anymore.
Shortly after 5:00 p.m., Dad's oxygen level started dropping more quickly, as did his heart rate. Shortly before 6:00 p.m., his heart rate plummeted and he slipped away without ever regaining consciousness. He took one last breath, and then the only sound in the room was the white noise of his (now unnecessary) oxygen mask. It was a Saturday, January 20, fewer than 2 weeks after he had gone to the emergency room with shortness of breath, fewer than 3 weeks after we had optimistically celebrated the New Year together.
I put my head down on his chest and wept onto his hospital gown. I was still holding his hand.
It's so hard to let go.