Taking Care of Daddy  The Last Seven Months of His Battle With COPD Cathy B. Bridges   � Copyright 2020 by Cathy B. Bridges

        In December 2007, my dad's quality of life started going downhill rapidly. He had very unhealthy lungs, and his body was growing steadily tired from fighting to breathe. Daddy had gone to the ER complaining of chest pains and shortness of breath, ending up spending several days in ICU due to his damaged lungs. Years of smoking had left him with COPD, which is a long-term lung disease that is not curable. COPD is treatable with medicine, and of course, quitting smoking can slow the progression. Chronic obstructive pulmonary disease is a combination of emphysema and chronic bronchitis. Emphysema damages the air sacs in the lungs, causing them to lose elasticity. Chronic bronchitis is inflammation in the lining of the bronchial tubes, causing massive mucus production.

        The hospital released daddy after four or five days because they had done all they could do. He was still so frail and could hardly get his clothes on by himself, or stand up without getting dizzy. The doctor advised him of the need for rehabilitation and physical therapy. Daddy refused, and it greatly affected his improvement. I had noticed a few years back that daddy had become more and more anti-social and preferred not to interact with others if he could keep from it. This time it costed him.

        I worried about him because he lived alone in an apartment in town, and I lived about 15-20 minutes away. He did not want to leave his cozy apartment, but his condition was growing steadily worse, and the damage to his lungs was irreparable. He was on so many medications. Prednisone helped to keep the infection down in his lungs but made him bloat, with a distended belly. That was not good because he needed enough room to breathe. He had a nebulizer that he already depended on way too much to help him breathe better.

His COPD continued to advance. Added to the chronic cough, wheezing, shortness of breath and fatigue were swollen feet and ankles, and cardiovascular disease. He already had high blood pressure, and several years before, he had suffered a light heart attack, so his heart was having more stress heaped upon it day by day. Also, his skin was paper-thin and would tear easily. He had purple bruises on his arms and other parts of his body, where the small blood vessels underneath the surface would break at the slightest touch. His feet and ankles would swell because of an increase in pressure in the blood vessels of the lungs.

         Daddy watched Christmas 2007 go by through his hospital room window. He had Turkey and Dressing but was not eating much, partly because he just did not seem to have room for food. I am sure daddy was also thinking of mama's great Southern Turkey and Dressing that we had every Thanksgiving. That was the good old days, and he was missing mama. We lost her in 1995 from cardiac arrest. It can be so hard to get through the holidays after losing a loved one.

It was almost a brand-new year, and the misery was ramping up because he also had two hernias causing him much pain. The surgeon refused to fix the hernias for fear that daddy would not make it through surgery. He was requesting more and more pain medicine, which was causing other problems. Mainly, he was getting very constipated and impacted, which made the hernias hurt worse. Then he wanted even more pain medicine, which he could not have every time, and that made him mad.

Well, he made it to 2008, but I could tell he was giving up. Home Health was coming to his apartment now, and that made me feel a little better. I just could not be with him 24/7. I had a family, worked part-time, and did not live close to him. Daddy had lived with us previously, but acted up, made my family uncomfortable, and just plain miserable at times. You would have to know how daddy was. He always said or did what he wanted. Thus, the apartment in town. Although I hated for him to live alone, he needed to be closer to the hospital anyway, since his condition had begun worsening.

Always overdoing things, he was not supposed to depend on his oxygen so much, but he had started doing so. Tripping over the oxygen tubing that trailed around behind him, he fell and bruised his elbow, which eventually caused Cellulitis. He overcame that, thanks to Home Health and the doctor. Not long after that, he got Shingles on his back and waist. Of course, he already had a bad case of it, before I even knew about it. Home Health did not know about it, because he did not tell them, and would not let them help him with a bath. He never totally overcame the nerve pain it caused, and he started having sleeping problems. I wondered how much more he could take.

In February 2008, the hospital admitted him after he ended up in the ER again. His body was getting exhausted, and breathing was getting so hard, that it kept the hernia pain flared up. He was not eating well, and could not urinate on his own, so they catheterized him. Eventually, he started feeling a little better again but had a terrible rattling in his chest. Sleeping when I walked in, daddy was looking so old and sickly. I just sat down and watched him.

After he had been in the hospital a week, things got worse again. The fluid was building up so fast that the doctor said daddy was "swimming in it." He sounded awful, and of course, had congestive heart failure. One side of his heart was not working very well, and fluid was leaking from his skin, which was so paper-thin that the nurses could hardly get a needle in him anymore. He had so many purple bruises all over his arms. We thought we would lose him at that time because he also had MRSA, the nasty staph infection that is so resistant to antibiotics, and he was not responding well to any of those antibiotics either.

Daddy spent 14 days in the hospital, and the doctor told him this time he absolutely could not go home. This time, he had to go to rehab. After that, he was in and out of the hospital and rehab quite a few times. Daddy received a fracture to his left lower leg at the very first nursing home he was in for rehab. No one knew what could have happened. Sure. No one at that nursing home even mentioned or acted as if they cared. I had a pretty good idea about what had happened to his leg, though, because one day, a physical therapist spoke up a little too fast in defense of himself. Once while there, his vitals dipped so low, the nurse called me at home because they thought he would need to go to the ER. He improved, but I made sure that he would not go to that nursing home again. That was in March 2008. Although daddy did not make much of an effort at physical therapy anyway, he never walked again. His legs were so tiny and weak, and he was just giving up. He did not want to walk anymore, and no one would succeed in changing his mind.

Eventually, I moved daddy's things out of his apartment for good, after he finally realized that he could not move back, and live alone ever gain. From then on, daddy would be residing at the hospital or a nursing home. He was miserable, which made him in a bad mood more often; he refused a bath and complained a lot. He continued to get better, then worse, and time was just ticking away, but I knew his old heart could stop ticking at any time. I was preparing myself for the inevitable.

In June, daddy had his 77^th birthday at the last nursing home where he would ever reside. It would be his last birthday also. Hospice took over not long after he had his birthday. Daddy was in so much pain; they started giving him liquid morphine. It wasn't long before he started having a sore throat, fever, and elevated heart rate. The MRSA staph infection had been dormant in his body, just waiting to flare up again. It was spreading through his weak body, drowning the life right out of him. Daddy had told me before he left the nursing home the last time, he would never be back, and he was right.

On July 10^th, he was back in ICU. He was very contagious, so we had to wear a mask, gloves, and a gown each time we came to visit, and of course, daddy never understood why we had to wear all the garb each time we visited him. I just told him it was so that we would not make him sick, because his immunity was down. I was always telling him not to try to talk because he was so congested and rattling. It honestly did sound like he was drowning in his very own fluids, and I could not understand what he was saying, which frustrated both of us.

Later they put him back in a regular room, but he could not swallow, and although he was starving after having nothing to eat for several days, he was only getting his nourishment from glucose. They finally put a tube in his stomach and fed him Ensure. Fluid continued to build up faster than they could keep it pumped out. The clock was ticking now, and I knew it was just a matter of time. Daddy had some good-looking suits, and he had chosen a navy pinstripe for winter or a lightweight beige suit for summer. He always cared a great deal about how he looked. I had both suits dry-cleaned.

He wanted to either get better or die and was having a hard time dealing with this kind of slow demise. Anybody would. A suffering kind of death must be one of the worst. I remember feeling of his hands, and they were so cold it made me shiver as if I had a chill. He slept fitfully on that day, and when he woke up, he seemed to be so relieved that I was still there with him.

        On the night of July 20^th, the doctor called me at home and said that daddy was not going to get any better. I wish the doctor had told me that daddy would not make it through the night, but there was no way of knowing that. On top of everything else, he did have pneumonia, which is what finally got him. The doctor put him on a more substantial morphine drip to make him comfortable, and at 2:00 am on July 21^st, daddy slipped away. They called me at home, and I felt terrible that I was not there, but he was out of it, and would not have known anyway. At least that is what they told me. I was glad that he was not suffering anymore. His body was finally at rest, and I thanked God for that.