Mom, Dad, and I were enjoying our annual ward (congregation) picnic on Labor Day this past Monday when my Dad got a phone call from my Grandpa Bere. He said that my Grandma Bere had fallen down and gotten hurt. We gathered everything up and rushed to Northwest Hospital in Randallstown, Maryland - about an hour drive from our house.
When we got there we met my Grandpa and he said that she had broken her ankle. My Dad and I went into her room to visit with her. The nurse explained that she had broken her ankle in two places and would need orthopaedic surgery to repair it. As the various general ER tests started coming back the emergency room nurses and doctors became increasingly concerned and freaked out about her oxygen levels and blood pressure. I was confused by this. She was diagnosed over two years ago with advanced stage COPD Chronic Obstructive Pulmonary Disease. It is a lung disease in which the lungs are damaged, making it hard to breathe. In COPD, the airways—the tubes that carry air in and out of your lungs—are partly obstructed, making it difficult to get air in and out. Cigarette smoking is the most common cause of COPD. Most people with COPD are smokers or former smokers. My Grandmother Bere smoked 3 packs of cigarettes a day for over 50 years and up until the minute she broke her ankle. She refused to use her oxygen and nebulizer machines and the accompanying medications.
Later we found out that when she came into the ER and they had asked her if she had any other conditions she responded, "No, everything else is just fine." When the panic set in the nurse moved her to an ER room equipped for someone with her unique health concerns. Very quickly her other health concerns started to become the major problems. She became increasingly agitated and lost understanding of what was going on and why. Her blood pressure dropped to 60/40 which is deathly low. They were concerned that she had a blood clot and rushed her for an emergency CAT scan. While in radiology she coded - stopped breathing. At that point they bagged and intubated her. She was now on life support to keep her alive.
They moved her to the Intensive Care Unit. They felt very strongly that she would not pull through this. Each afternoon we would all go to visit her. At the 72 hour mark it is recommended that it be decided if the patient will be removed from life support or have a tracheotomy put in. My Grandma Bere did not have any type of advanced directives, living will, or power of attorney. We were having to make decisions without knowing exactly what she would want done. This is an emotionally grueling thing to do. A horrible burden to leave for your family. I suggest that anyone reading this take the time to make these arrangements regardless of your age! It was so painful to make these life or death decisions without knowing exactly what she would have wanted. Grandpa felt very strongly that she would not want to be living off of tubes and machines.
Grandpa asked that she be removed the life support on Thursday afternoon. We all gathered at the hospital. The nurses and doctors were so absolutely certain that she would pass away immediately. I will try to explain how bad her situation was. She was getting 75% of her oxygen from the machines. Technically, they do not attempt to wean patients off of a machine until that number is at 50 or less. We waited for them to remove the life support (a somewhat gruesome procedure) then they came and got us. A very uncommon thing happened. Actually, an unprecedented thing occurred. In less than 8 minutes from extubation Grandma Bere was smiling, laughing, and talking to us. She was happy and even chatty. She had a significant presence of mind. We do not think that she understood that she was dying and Dad and Grandpa were reluctant to ruin such nice moments with such sorrowful news. We spent about 90 minutes with her in this happy state. The nursing staff recommended that we all go get some rest as the week had been grueling and sapped our strength.
Friday we went back to the hospital and she was in the condition that everyone had expected the previous night. That span of time the night before was a special gift that no one can possibly have expected and we were very lucky to have had it. The staff at the hospital called us and asked that we come in to sign paperwork to move her from ICU to the Hospice. We went in and we stayed all day. Later in the afternoon my Mom had to leave for an appointment, Dad had gone to work, and Grandpa was home resting. I stayed with Grandma. I spoke to her. I told her how much I appreciate her son and the joy he has brought into my life. The way he has taken care of our family. That he is a strong and honorable man. I promised I would help Mom take care of him. I let her know that it was okay to relax and let go. That everything would be okay.
Around 5 PM I had the distinct feeling that my father and grandfather needed to get to the hospital. So, I called and left a voice mail for him on his cell phone. Apparently while I was leaving the voice mail he was on the phone with my Mom telling her that he had the strongest feeling that he needed to leave work and come to the hospital. When he hung up with my Mom he got my message. Dad went to pick up Grandpa. The social worker came into the room and told me that grandma was doing very badly. They were going to move Grandma, but they are so concerned that she would pass away when they moved her they decided to wait until Dad and Grandpa arrived.
They moved her and we all gathered in her new room. We waited several hours together. Grandpa got very tired. Dad went and drove Grandpa home. My Mom and I sat with Grandma. When Dad came back he told Mom and I that we needed to go home. That grandma was waiting for it to be just the two of them together like it always was. Sure enough, Mom and I left and less than 90 minutes later at 11:23 PM she passed away.
Dad and Grandpa are going to go on Sunday to make the arrangements at the funeral home. She will be buried at St. John's Cemetery in Ellicott City, Maryland. We knew with all of her health issues that she would get sick, but we did not expect it so soon and for it to happen so suddenly.
