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She’s gone

My aunt died last week.

She was 69.

That’s it.  69.

She called me around 10 am on Thursday the 3rd.  Her nurse didn’t like the way she looked and the blood work they’d taken the day before (and rushed) came back with a low hemoglobin and her blood pressure was low.

I ran home, called an ambulance and we took her to the hospital.  I followed the ambulance in my car, so wound up about 10 minutes behind them.  She was already in an ER room, on monitors and hooked to oxygen by the time I got in there.

They did some blood tests (and tried FOREVER) to get in touch with her nurse. 

Her hemoglobin was 5 (I think they said normal is 14) and her blood pressure was the lowest I’ve seen (for her) 100/44.

This is a woman who was on high blood pressure meds, pain meds galore, anti-seizure meds, iron pills and stool softeners.

She would take all but the iron pills.

After they did the tests, she was hooked up to her first blood transfusion.  We were both joking around saying that SHE got to be the vampire this time (normally we call the phlebotomists the vampires).  She even asked the ER nurse for some nail polish to paint fangs on her.  She was in good spirits.

I stayed with her until about 7:30.  She was on her way to a room (it was pretty inevitable that she’d be admitted) and I had to go rescue my neighbors and friends (they had taken turns watching my son throughout the day, after he got home from school).

We did our thing, went to bed and made plans for the next day.  I wasn’t even sure if I’d be able to go see my aunt the next day because Jake was supposed to go to his dad’s, right after a doctor’s appointment, and I didn’t think the hospital would allow visitors after 7:30 (which was about the earliest I could get there).

After getting to work on Friday and doing the necessary "just got in" routine, I called to see how she was doing.  She was very winded and said she had a rough night because they kept waking her up to take more blood.  I put in a page to her doctor to see what was going on.  Thankfully, he did call back pretty quickly.  Because she was so anemic, her blood had become acidotic and they figured she was either bleeding internally [yet no blood in stool or urine and no vomiting of blood] or that her body had ceased making RBCs.  She developed some breathing issues and was being transfered to ICU.  "For monitoring".

Well shit.  I HAD to get in to see her, but if she was in ICU, Jake would not be going.

I took jake to his doc appointment, then to meet his dad, canceled some Friday night plans with friends and went to the hospital.  I got there about 7:30 and walked in to see my aunt intubated and tied to the bed.  Yet she was conscious.  As shocking as that scene was, I took it as a positive that she was awake.

She seemed to be more upset that they’d tied her to the bed than anything else.  The nurses untied her, since I was there and she and I were able to communicate through writing.  She still got frustrated because she couldn’t actually SPEAK, but we were getting somewhere.

One of the residents came in to give me an update that she had developed a "pneumonia-like" infection in her right lung and had some fluid in the lung and around her heart.

WTF happened to "a blood transfusion to get her numbers up" and she’d be fine?

Her lack of iron was systematically shutting her down.

The night nurse was angry that they’d left her conscious while intubated.  She said they don’t normally do that unless they’re getting ready to extubate.  So she was going to try to get the doc to prescribe a mild sedative so she could sleep through the indignity.

Inny was upset and afraid she was going to die.  To be honest, I didn’t see this as dire.  She’d had 3 units of blood and her numbers were up (however, her bp was still pretty low and now the pneumonia and beginnings of heart failure).  I assured her that I didn’t think things were that far gone yet, but asked what she wanted, should the time arise.  She told me "no" as in nothing.  Let her go.  😦  She did admit that she was scared and all I could do was hold her hand.  With the tubing and such, you couldn’t even really hug her.  😦  (and knowing my aunt, that’s what she truly wanted.  To be held and reassured).

Shortly afterward, the nurse came in and said that they’d prescribed her some atavan (sp) and added it to her IV.  She tried to fight it, but I told her I was staying until they threw me out.  (visiting hours were over at 8:30 and she was sedated about 9:30).  I got "tossed" about a half hour later.

Went home and crashed.

Saturday I woke up with a nasty freakin cold, but since it was just a cold, wanted to go visit.  Hours didn’t start until 12:30, so I drugged myself, did some laundry and got ready.

When I got there, she was still sedated, but I was told that she was rousable and that they all thought she was very sweet (everyone kept thinking she was my grandmother).

I stayed until hours were over (they chunk 1230-230, 430-630, 730-830) and went home and slept some more.  My sister went to visit during the 430 chunk.  I was planning to go back during the 730 chunk, but was told to just stay home and rest.

Sunday, I did the same routine as Saturday.  When I went in her TV was on, so I’m assuming she was awake for a bit and watching TV, but she was still out when I got there.  Again, all kinds of IVs (for infections, nourishment, bicarbs, pain) and she was status quo.  I stayed until I had to leave to go pick up Jake.

Once I got Jake, we got home and did our normal routines and went to bed.

I got a phone call at 1 am letting me know that my aunt had gone into v-tach and they had shocked her to fix the rhythm.  I asked them if I should come in and they said it would probably be a good idea.  I texted/called family and friends to let them know what was up and started to get dressed.  They called again about 30 mins later to say she had gone into v-tach again and that she had been shocked again.  Jacob was just inconsolable.  I got him calmed down (and myself too!), called my mom and wound up getting a text response from my friend,  .  Holy crap!  She’s awake!  I called her to see if she could take Jake for me (because I *really* did not want him to see Inny in ICU.  She was basically medical spaghetti with all the wires, IVs and intubation.  That would have scarred him for life) 😦  She readily agreed and I dropped him off on my way to the hospital (OMG thank goodness for friends.  I really don’t know what I would have done…all of my family members live at least an hour in any direction).

By the time I got there, she was pretty stable.  I sat there holding her hand, smoothing her hair, talking to doctors and nurses and breathing specialists for a few hours.  Around 5 am, she went into v-tach again.  It finally dawned on me that she was originally DNR and now they were shocking and doing CPR.  I was a tad confused. 

Apparently, sometime Saturday, she roused enough to change from DNR to Full Code.  Stupidly, I thought full code meant do absolutely nothing (I’m pretty sure, with DNR they can do something medically, but not physically…I’m now more confused than I originally was). 

They rushed me out of the room and then every doctor, nurse, resident, etc. on the floor poured into her room.  The nursing supervisor came out to ask me about the DNR/Full Code confusion.  I told her the last time Inny and I had spoken, which was Friday Night, she was DNR.  As I’m not the next of kin (my mother is), I couldn’t make a decision for her, so we had to call my mother.  My mother than referred back to me.  In the meantime, they did get Inny’s heart back into a rhythm again, but not a very good one.

The heart doctor came in and checked on her and then pulled me out of the room.  He said, we can continue to shock her and put her heart back into a rhythm (every time she hits v-tach), but she’s going to continue to go into v-tach, her heart just can’t do it anymore.  😦

So, they stopped the IVs (except for her pain meds, because I didn’t want her to hurt as she was passing) and left in her intubation (because she would have suffocated and it would have been hard/painful for her and awful to watch).  I held her hand, told her I loved her (that everyone loved her), smoothed her hair, and asked her to say hi to my uncle, my dad, my grandmother and a few others when she made it to the other side.

Told her that we would miss her, but she shouldn’t hang on and suffer if she had a chance to find peace.

She finally passed around 9:13.  No one else had made it in time (my mom and older brother were on their way) and my sister hadn’t even made it out of her neighborhood.

She drove me nuts, and there were times I resented her, but she was a great nanny for Jake and we both loved her despite her faults (and she us, despite ours).

Happiness and Light and Peaceful Journeys, Inny.  You are very missed and loved.

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