The passing of my father-in-law

Papa has been in the hospital since he was admitted a week ago. Through the week, the staff continued to work on this sodium levels. They were hovering around 119, and the normal range is 135-145.

This sodium deficiency has been confounding. Tests indicated that his kidneys were ok, and his thyroid levels were ok too. So no one was sure why the sodium was so low or why it was not increasing.

Throughout the week, we would visit before and after work, and Mama would stay all day. She helped feed him and clean him, as he lost the use of his hands more than a year ago (rheumatoid arthritis). Each day, we would check if there was an estimate when he could come home. Each day, we were told it would be many days minimum.

Today, his condition deteriorated rapidly. He was scheduled for an MRI around 10:45AM. His nurse called Rosa at 10:30AM and said his condition was serious and that she should come in. She called me and we agreed that she would go to see him and call me if I was needed. About 20 minutes later, she called me and told me to come in immediately.

Papa surrounded by family
Papa surrounded by family

When I arrived, Papa was partly on his side, propped into a comfortable position with extra pillows. This position helped his breathing – he had been having difficulties over the past week. He was on an oxygen tube. He had been given some pain medication and some medication to calm and relax him. It was clear that it was very serious.

We talked with the nurses and they gave us a booklet on preparing for a family loss. Rosa and I went through part of the booklet and made some agreements on our course of action. I called the Tubman funeral home next door to the Queensway Carleton Hospital and made an appointment for 3:00pm.

And we waited.

Rosa needed to go back to the office to gather a few things, so she left for a little while. The nurse came in around 1:45pm to bring a warmer blanket. When the sheets were pulled back, she said that it would not be much longer, based on the mottled colour of his skin. I immediately called Rosa and said she needed to hurry back.

His breathing was averaging once every 8 to 9 seconds. But with the medications and oxygen therapy, he was actually sleeping much better than he had in a long time. At some point in the afternoon, he closed his eyes, or perhaps Mama closed them for him. He looked more peaceful than he had been in a long time.

Nothing seemed to change for the next hour, so I went to my short appointment with the funeral home. I wrote some notes, and gave the background information to the consultant, but I was anxious being away from the hospital room for any length of time. I hurried back to the hospital after 20 minutes.

Papa’s condition did not change for the rest of the afternoon. Rosa and I discussed what to do. No one could guess how much longer it might be. It could be soon, or it could be the next day. Mama wanted to stay all night if she could.

As the sun set, Rosa and I prepared to leave for supper. She went to the washroom. Mama and I were sitting by the bedside.

Suddenly, Papa’s breathing changed. It increased to 25-30 seconds between breaths. When Rosa returned, I motioned for her to come immediately.

We didn’t know what do to. Every pause in his breathing was an eternity. Papa had a thin chain around his neck holding an icon of the Virgin Mary. His pulse would cause it to flicker in the light.

In about 3 minutes, with Mama, Rosa and I around him, Papa passed away. He took his final breath after 75 years; the chain around his neck stopped its flicker.

I leaned in and whispered to Rosa, “He just passed.”

And then we all started crying.

I went out of the room and told the nurse. She and another nurse each confirmed there was no heartbeat, which is the standard procedure. They comforted us and we comforted each other.

We were very sad, but there was also a sense of release, not for us, but for Papa. He has lived in such terrible pain for years and years. He was free from that now.

Jinduo Wu (Jul 14, 1935 - Nov 26, 2010)
Jinduo Wu (Jul 14, 1935 - Nov 26, 2010)

Two acquaintances from the Institute where Papa and Mama worked in Lanzhou arrived, too late to see Papa before he passed away. They looked shocked and sad too. They talked with Mama for some time, and were near tears. I called the funeral home and let them know about the death.

We asked the nurse if there was anything else we needed to do. She said that the funeral home will contact the hospital and will take possession of the body overnight or in the morning. There was nothing else for us to do. We gathered all our belongings.

And then Mama, Rosa and I left.

Papa's not quite a stroke

On Friday, Rosa called me around noon to tell me that there was a problem at home. Mama had called her and said that Papa was behaving strangely and was confused. He was not able to answer any questions. It had started on Tuesday, and even though Rosa asked Mama twice since then if everything was ok, Mama said yes it was ok until out-of-the-blue this morning it’s not ok. This is one of the fundamental challenges to sanity in the household – the continuously changing story about what’s going on.

I told Rosa I would leave work as soon as I could, which was later in the afternoon. If the problem started on Tuesday and has not changed since Tuesday, then it was not an emergency situation yet.

When I arrived, Papa seemed ok physically. Mama said he was sleeping more than usual (he already sleeps about 18 hours a day), but that’s not a cause for concern (yet). She said he gave strange answers to questions. My problem is that I do not speak Mandarin, and even if I did, I would not be able to interpret his mumblings. He mumbles because his jaw joint has changed due to the advanced rheumatoid arthritis.

I watched him through the evening, but I could not see any issues and I felt I could not make a good assessment on his mental cognition because communication was nearly impossible. I had to wait until Rosa returned home in order to make a better assessment.

When she arrived home, we spoke with Mama and Papa. It seemed that Papa was very confused. We debated if we should take him to the hospital. Rosa had the brilliant idea about calling TeleHealth Ontario and talk with a nurse. It was nearly midnight when we reached a nurse. After about 10 minutes of discussions, the nurse said that an ambulance would be called to bring him into the hospital.

We ran around to get a few things packed for what might be a long night. The ambulance arrived and they also assessed Papa. Asking, through Rosa and then Mama, if Papa knew where he was or where he was born. His answers kept changing and were confused. They bundled him up and took him downstairs to the ambulance.

Papa in the emergency room
Papa in the emergency room

We arrived at Queensway Carleton Hospital close to 1:00am. Rosa came in her car separately. We planned that she would help with the check-in and assessment, and then go home to get sleep and relieve me in the morning.

We waited a long time – there were other patients who needed more urgent attention, including a car accident victim and a girl who had had a severe food allergy. Around 2:00am, we decided that Rosa would leave as I was feeling better equipped to deal with Papa, now that I understood what questions needed to be asked to evaluate his cognition (where are you, where were you born, what is your wife’s name). I can do this with Mama’s help.

As shifts changed and specialists were called, we saw 3 doctors in total. We agreed that he had symptoms of a stroke, so he was X-Rayed and had a CT Scan. The results came a few hours later – nothing was visible. This means that it was not a stroke. The blood work indicated a severe sodium imbalance, which might also cause the results we were seeing. So he was hooked up to an IV drip – 2 litres in the first 2 hours, which is a lot considering he weighs less than 90 pounds. More IVs were given later, but at a much lower rate. His demeanour changed and he was able to understand much better. Everyone could see the difference in his face after even the first IV.

Papa in the CT scanner
Papa in the CT scanner

However, it was decided to check him in to a hospital room for further observation. The doctors were concerned about his weight – he is literally (not figuratively) a bag of skin and bones. He also seemed to have a sleep problem like sleep apnea – he breathing would appear to stop. They wanted to take some CT Scans of his chest, as they were concerned about his persistent cough. The cough started in both Mama and Papa about 4 years ago after they returned from 3 months in China.

In the morning, Rosa and I decided that she would go to the Les Petits Ballets rehearsals – her performance is only 3 weeks away. She would come in the afternoon to relieve me at the hospital and help with any further paperwork for the check-in.

She arrived just after 1:00pm. We grabbed a quick lunch and went to see Papa. There was no room upstairs for him yet, so he was still in the emergency area. We checked with the nurses, and there was nothing we could do and there was nothing left to be done to check him in. I left the hospital to get some sleep and Rosa went back to rehearsals, leaving Mama to watch over Papa.

I got about 4 hours of sleep before they both arrived home in the evening. Rosa and I went to the NAC to see the Toronto Symphony Orchestra present an evening in celebration of Slavic composers (Dvořák, etc). I left my cell phone number with the nurses, should something come up.

Last night, I got over 10 hours of much needed sleep.

This morning, Rosa called the hospital and found that Papa would not be discharged today. I’ll go to the hospital in about 30 minutes to check in on him.