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    GJ has passed

    It has been a difficult couple weeks.

    On Friday, (July 19) morning, GJ awoke with an extremely bloated and rigid belly. As the day progressed he became more and more uncomfortable. He was transported to the ER about 4:00PM, and diagnosed with a volvulus, a twisted sigmoid colon, which created a blockage.. Something like this happened in November just before Thanksgiving, but went undiagnosed because it resolved itself before a CT scan was done and was not evident at the time of the scan given in ER.

    Since admission, he had three procedures, the last one (July 26) resulted in a colostomy.

    I stayed at the hospital, in GJ's room on a roll away bed for these many days. We expected he would be released vey soon, but his condition deteriorated rapidly during the afternoon.

    About 4:30 PM, July 29, GJ had a swallow evaluation to help decide the best way to administer nutrition. The evaluation took about a half hour. It is thought that he aspirated fluid into the lungs. He was having a great deal of trouble keeping the oxygen levels up even though he was on oxygen supplementation. Try as he may be could not get up phlegm without severe coughing and a lot of suctioning. The hospitalist was still on duty and called in a rapid response team to deal with the breathing issues. They were unable to do what GJ needed in the hospital room and took him to ICU.

    In ICU they set him up on a BiPAP which operates as a positive pressure breathing machine, much like a C-PAP that people use for sleep apnea.

    Friday, July 30 the BiPAP breathing system was removed and replaced with a high pressure cannula breathing system. The change released GJ from the BiPAP mask, a medieval instrument of torture. We could resume taking to each other and I could see his grizzly beard. Hard to imagine GJ with a 15 day growth of facial hair.

    The absolute high point of the day was that his medical team decided how to get nutrition into him. An NG (nasogastric) feeding tube was placed that would deliver some high protein, high carbohydrates nutrition. I?m just hazarding a guess, but I?d say he had lost 10-15 pounds, existing on Dextrose and Sodium Chloride IV. Quite a crash diet. Nutrition was delivered 24 hours a day.

    As time passed in the ICU his blood pressure, oxygen and general physical condition were very unpredictable.
    On August 4, he started the day doing pretty well, but that didn?t last long. Eventually, the oxygen delivery systems weren?t sustaining enough oxygen in body tissues and air flow in his lungs was almost imperceptible. Doctors wanted to intubate and place a trach. GJ said absolutely not, the only way he could then communicate, by lifting his head from the pillow and vehemently shaking his head "no." There was a discussion between me, his doctors and GJ shaking his head in either positive or negative gestures. In labored words, he told the medical staff he was dying, he couldn?t live on ventilators, he was tired and didn?t have the physical reserves to continue the fight to get well. He told them he was ready to die, no further life sustaining measures and medical heroics.

    Doctors started morphine and anti anxiety medications. In the middle of the afternoon he was transferred out of ICU into a quiet, private room and placed on Comfort Care. Morphine and comfort medications were administered and when he was sedated enough the breathing machines were removed and he was placed on regular hospital oxygen. After about 30 minutes, there were no more signs of respiration and no vital signs. He was pronounced dead at 10:20 PM, August 4.

    He died four days short of his injury day, nearly 37 years ago at age 74.

    Written by NL, GJ's wife of 50 years and loving caregiver for almost 37 years. He died 4 days before his injury day of 8/8/82.
    Last edited by gjnl; 08-09-2019 at 01:40 AM.

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