In loving, living memory, John Melançon 1928 – 2007
This morning Grandpa is lucid and *not* wanting to die.
Instead he is saying, "if they aren't doing anything for me, why do i have to stay around here?"
And: "I can afford a private nurse at home." (This is a very good attitude: as positive as he started out, and practical.)
15 minutes late on the pain medication-- nurse Wayne was waiting in vain for an increase in the dose.
"Why do they do this to me? Why don't they let me die?"
Finally gets the medicine at about 10:30am.
And the goddamn jerks saying he was refusing oral medication.
He will take pain medication any bloody way it's offered if he's told it's pain medication, and i was there for over twelve hours with nothing even being offered.
"His kidney function is markedly worse."
[Duh-- he hasn't drunk anything substantial in a couple days.]
"I think what we have to do is -- get his pain under control with a stronger dose of IV, then be able to [build up his strength"
"he looks not well, so i'm concerned
Now talking to Grandpa:
"How is your breathing?"
Grandpa: "Breathing, comparable to the pain, is perfect."
In reply to my saying that the problem has been when the dose comes late, that they're not giving the .5 mg every two hours because they say it is only to be done up to that "as needed", she said:
"giving a standing dose of pain medication kills people"
Grandpa: "I wish it would kill me."
"We cannot do that"
"Pain medication, IV fluids-- do you have a catheter in?"
"Have you been able to pee?"
"Yes. Not recently but i will be able to." And soon after he asked for the bottle, which i brought, but he had not gotten enough fluid in his at most two sips of juice, water, or ginger ale at a time to actually pee.
"When you came into the hospital, did anyone ask you questions like what you want to happen if
"You are not supposed to revive me. I have that signed with Doctor Newman."
"I have muscular dystrophy, and pulmonary fibrosis"
"Having suffered this fall, and several days of poor intake, your kidneys are in poor shape from not taking in very [much fluid]"
"I'm going to try to turn things around with fluid and aggressive pain management"
"I'm not so worried about my status," Grandpa said with humor in his voice. "I am going to die anyhow. I ask that it be without pain."
"I'm hopeful you will be able to take the longer lasting oral medication, Oxy—"
"That doesn't work for me—"
"Oxycotin works different from Oxycodin", she said firmly, knowing we didn't catch the difference [(or whatever these spellings are)].
And than Dr. regular pain medication can kill you is talking on the phone while her orders are carried out -- which she didn't tell us directly or talk over with us -- to add 1 mg of Hydromorphone (Dilaudid) on top of Oxycodin and whatever he got that morning and the .5 mg he got before that-- WITHOUT ASKING IF THE PAIN HAD FINALLY GOT UNDER CONTROL FROM THE GODDAMN ***LATE*** ADMINISTRATION OF THAT FIRST .5 mg. (Which i feel it finally had, what with the pill he took that morning finally kicking in by then.
This would be about 11:30am.
And they tell us to leave the room? Because they are doing such a bang-up job.
He was bloody backing off his wish to die, lady. Talking about getting out of this hospital alive.
Anyway. Blood pressure back up.
She has the explanation, at least.
To the person on the phone: "Shortly after i got off with you, Mr. Natkin became unresponsive. I think a combination of dehydration and the extra Dilaudid did it. As soon as i put his legs in the air, he came around."
[The IV had come long after the bone scan doctor had ordered it ("had trouble finding tubes" the one-woman IV team said), and then the nurse came and snuck the increased Dilaudid dose in right before the IV was attached.]
Who would have thought that giving an extra dose of Dilaudid to a severely dehydrated person could possibly have bad effects?
Oh, maybe a medical doctor.
God damn this system.