HIS missing dentures had nothing to do with it. There was something else troubling my Dad, but I couldn’t fully explain it to my US-based siblings, especially my sister, who insisted regardless of our father’s current state that I bring him to the dentist pronto.
Having undergone an operation herself years ago, which left her unable to chew her food for several weeks, my sister understood the importance of having a full set of teeth in boosting one’s appetite.
Stuff that went through the blender, she said, is guaranteed to dampen even the heartiest eater’s gusto. I wish she was right, but looking at my Dad who grew weaker by the day, getting a new set of false teeth would have probably amounted to nothing.
Distaste for food
Once my sister saw our Dad at home soon after she arrived from Virginia, she began to understand what I meant. His dentures, which got lost during his previous hospitalization, had nothing to do with his chaffing lips, dry tongue and odd distaste for food.
Friends and media colleagues know by now that my dear Dad, Vicente B. Vergara, 83, the subject of my two previous blog posts didn’t make it from his latest hospitalization—the third in less than two months—since going through the knife in an emergency operation on New Year’s Day.
On his third and final visit to the hospital, my Dad was diagnosed with pneumonia, which partly explained why he felt “like jelly” for more than a week prior to his admission.
Just the day before, we went to his neurologist for a checkup. All the while, we thought his weakness stemmed from his recent stroke.
(His cardiologist-slash-diabetologist, whom we saw almost a week before didn’t suspect anything wrong with him despite Dad’s obvious loss of weight, dryness in the mouth and overall pananamlay. Imagine the time he lost. He could have been diagnosed earlier. My Dad liked the fellow, but hell, I’m not taking my mother to that doctor again!)
Instead of examining him, the neurologist ended up ordering a workup—chest X-ray, blood exam and urinalysis—when he saw my Dad lying on a stretcher instead of sitting on a wheelchair while waiting for his turn outside his clinic.
He was too weak that he himself insisted that I get him a stretcher. When the family doctor, an expert in infectious diseases, saw the workup’s results the next day, she ordered that Dad be admitted immediately to the hospital.
Judging from his cloudy chest X-ray and elevated white blood count, he was suffering from a classic case of pneumonia. By then, his tongue was already covered with whitish fungus, a direct result of the infection that was already ravaging his frail body.
Two swab tests also revealed the presence of a sinister-sounding bacteria called pseudomonas. A quick check on webMD made me realize how serious his condition was: pseudomonas happens to be one of the primary causes of “hospital-acquired” pneumonia.
Enemy from within
He probably got it during one of his two previous hospital stays. The enemy that was attacking my Dad lurked on the very walls and floors of the building we were in!
With the discovery and formulation of new and more powerful antibiotics, contracting pneumonia isn’t as dreadful as it once was. But not when you’re already elderly like my Dad, whose immune system was also compromised by diabetes.
After an 11-day stay at the hospital, two days of which were spent later in the ICU, my Dad eventually succumbed on February 22 to multiple organ failure as a direct result of severe infection.
Also known as sepsis—the sound of it is enough to make me cringe—the massive infection rendered even the most expensive intravenous-administered antibiotics powerless.
It was a Catch 22 situation, as his team of doctors (apart from the infectious diseases expert, he was attended to by a diabetologist, nephrologist, pulmonologist and that, hmmm, cardiologist) couldn’t give him a full dose of the supposedly targeted antibiotics to treat his pneumonia, as it was sure to create further havoc on his already malfunctioning kidneys.
And as long as the infection continued to thrive, it not only managed to destroy his kidneys, but also his liver and lungs. Because of pulmonary embolism, a direct result of infection while he was lying flat on his back and sides for too long, my Dad soon found himself gasping for breath.
As the days wore on, he was also beginning to experience difficulty in swallowing his blended food and oral medications.
As if the NGT they placed through his nose the other day to help provide him with adequate nutrition wasn’t enough, they had to attach something else to him less than two days later to help him breathe.
The very thing his lead doctor, the infectious diseases expert, dreaded just a day ago was happening. Since he could no longer breathe on his own, he had to be intubated.
Tinubuhan, in local parlance, meant that my Dad had to be attached to a ventilator through a tube connected to his lungs to help him breathe. After nine days in a regular hospital room, he had to be wheeled ASAP to the ICU where, apart from the ventilator, he would be strapped to other contraptions to perpetually monitor his blood pressure, pulse rate, hydration level and even urine discharge.
Just a few days earlier, my sister and I were very hopeful. Now that the problem had been identified, said my optimistic and can-do sister, she told our Dad in typical American fashion that the next step was to find a solution. That was all there is to it, Daddy, she said.
Unfortunately, she had to fly back to the US because of pressing work- and family-related commitments even before a solution could be found. Like me, she probably thought the problem could be licked in less than a week.
Being more of a pessimist, I had no heart to tell her when we parted ways Wednesday afternoon that I hardly saw any improvement in our Dad’s condition.
She must have seen it herself, too, in his appearance—red patches on the back, yellowish skin and bloating were beginning to show—but instead she chose to be brave about it. I tried to be brave as well despite the nagging feeling I felt that Dad seemed to be losing his battle.
Just two days ago, my dad, his voice now weak but still audible, was already telling us a list of wishes. Nagbibilin na! My sister tried to shush him through her tears, assuring him that everything would be all right.
I just stood there stoically unable to summon the “right” reaction to a situation that was so alien to me. A ham actress like Kris Aquino would have probably done a better job. I realized later that I was in denial.
The big, strong Daddy whom I depended on almost all my life, the guy who seemed to know the answer and the solution to every problem under the sun, was now on his deathbed. And I simply couldn’t accept it.
No turning point
The endgame happened early Friday morning, February 20. With my phone on, I hardly slept that night at home until I received a frantic call from Belle, one of Dad’s caregivers, sometime after 2 a.m.
“Sir, Daddy is having difficulty breathing. He’s been calling your name—Alex, Alex, Alex,” said a distraught Belle.
“Then call the nurses,” I told Belle as calmly as I could. “I’ll be there ASAP!”
Dad, who had always been fair in dealing with his children, wasn’t playing favorites when he singled me out. (I wish he were.) It only goes to show how lucid he still was in spite of being bogged down by his labored breathing and other issues.
Something to say
I believe he knew fully well that his two other children, including our bunso brother, were in the States. He probably had something to tell me, but was unable to because he was already gasping for breath when I arrived.
Nurses and the emergency room doctor were frantically trying to alleviate his condition. From a normal level of 100 plus, his oxygen intake was down to 47.
“He needs to be immediately wheeled to the ICU so we could attach him to a ventilator,” said the attending doctor.
“Is that necessary, doc,” I said, fear and anxiety evident in my voice. He nodded.
I knew it was crucial both in terms of addressing Daddy’s critical condition and mustering enough resources to pay for his stay in ICU—a bed in a typical ICU unit costs between P1,500 to P3,000 a day. Chicken feed, as they say in the old days.
But once they start putting all those life-saving contraptions and tests, the rate could jack up to anywhere between P20,000 to P30,000 per day.
I had to quickly call my two siblings to update them and get their consent. I immediately got an unqualified yes. My poor siblings despite already spending quite a fortune on my parents’ health were willing to give their last dollar to the very end.
Living with elderly parents is both a gift and a curse, you know. Unlike my US-based siblings, I got to spend more time with them, which got more precious and few by the day. Now, that’s a privilege my brother and sister didn’t get to experience often.
But at the same time, I have also witnessed my parents’ gradual and sometimes abrupt decline through the years, and nothing could be more painful than seeing loved ones fade away right before your eyes.
And when I heard the nervous edge in Belle’s voice over the phone earlier, I knew that the turnaround my sister and I had been praying for all week hadn’t happened.
Much as I tried to remain positive, as I drove to the hospital during the wee hours, I couldn’t help thinking that my Dad’s condition had now turned from bad to worse. (To be continued)