Daddy’s biggest and final battle (first of three parts)

MY parents during my 50th birthday celebration last February 3. After being released from the hospital after suffering from a stroke 12 days ago, Dad still appears weak and far from regaining his appetite. In less than eight days, he is back in the hospital. In 10 days, he is dead. It's as if he only waited for his first born to turn 50. Thank you, Daddy, for the love and the memories. We were lucky to have a good and upright father like you.

MY parents during my 50th birthday celebration in February 3. After being released from the hospital 12 days ago, Dad still appears weak and far from regaining his appetite. In less than eight days, he is back in the hospital. In 10 days, February 22 to be exact, he is dead. It’s as if he only waited for his first born to turn 50. Thank you, Daddy, for the love and the memories. We were lucky to have had a good and upright father like you.

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.

THE upper number is Dad's pulse rate, and the lower set of red numbers are his blood pressure. Without the BP-boosting medicine he is given in the ICU, Dad's blood pressure will plummet to an alarmingly low level.

THE upper number is Dad’s pulse rate, and the lower set of red numbers are his blood pressure. Without the BP-boosting medicine he is given in the ICU, Dad’s blood pressure will plummet to an alarmingly low level.

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.

THE ventilator responsible for helping ease Daddy's labored breathing.

THE ventilator responsible for helping ease Daddy’s labored breathing.

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!)

Workup

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.

DAD less than 30 minutes before the medical team's second and unsuccessful attempt to resuscitate him. It was an privilege and honor to have served such a wonder and loving father like you. I love you, Daddy. I hope we see each other again.

DAD less than 30 minutes before the medical team’s second and unsuccessful attempt to resuscitate him. It was a privilege and an honor to have served such a wonderful and loving father like you. I love you, Daddy. I’m looking forward to the day when we see each other again.

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.

THIS bag contains a gown and mask for patient Vergara's guest in ICU. Now I regret not spending more time with him during his final days at ICU. I'm sure I could charm the nurses to let me stay awhile longer. Visiting hours are limited to one hour each in the morning and evening.

THIS bag contains a gown and mask for patient Vergara’s guest in ICU. Now I regret not spending more time with him during his final days at ICU. I’m sure I could have charmed the nurses to let me stay a little longer. Visiting hours are limited to one hour each in the morning and evening.

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.

Intubated

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 lunchtime meal for the ICU patient's bantay, which I didn't touch. Ten minutes later after meal arrives, a medical team begins rushing to the ICU department and into my Dad's unit. All the while, I'm outside with this boxed lunch to keep me company.

THE lunchtime meal for the ICU patient’s bantay, which I didn’t touch. Ten minutes after meal arrives, a medical team begins rushing to the ICU department and into my Dad’s unit. All the while, I’m outside with this untouched boxed lunch keeping me company.

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.

Losing battle

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.

DRIP, drop, drip, drop, tic, tac, tic, tac

DRIP, drop, drip, drop, tic, tac, tic, tac

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.

DURING Daddy's final moments, only his pulse rate is being measured. His medically-induced BP has probably become too low and irrelevant to help save him.

DURING Daddy’s final moments, only his pulse rate is being measured. His medically-induced BP has probably become too low and irrelevant to help save him.

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)

On the morning Dad died, his favorite dog Dexter seems to be feeling his pain. He seems agitated and refuses to leave Dad's old technician's table. My Dad, an animal lover (he also loved cats, too) had a hand in helping Pipay, Dexter's mom, give birth to him. This dog was literally born in our living room with Dad as the OB-Gyne.

On the morning Dad died, his favorite dog Dexter seems to be feeling his pain. He seems agitated and refuses to leave Dad’s old technician’s table. My Dad, an animal lover (he also loved cats) had a hand in helping Pipay, Dexter’s mom, give birth to him. This dog was literally born in our living room with Dad as the OB-Gyne.

7 thoughts on “Daddy’s biggest and final battle (first of three parts)

  1. I cried while reading this, Alex. I thought you might write about this but even after two deaths in my own family, nothing still prepares you for the shock and pain of loss. With your recent Facebook updates about your dad, I see more and more similarities between him and my own Tatay (both Lay Ministers). And now I read that your dad expired after 10 days (his last hospital stay), just like my Nanay. We have both lost the very people who were the pillars of strength in our lives.

    I feel your grief very much and I can tell you to hang in there.

    • Ever since this happened to me, May, all the cliches, which I tried to avoid like the plague as a writer, resurfaced one by one from the baul: God has a greater plan; Everything happens for a reason; My Dad is now in a better place, etc. etc. Of course, all of them are true and are not to be taken lightly. But one truism I really experienced in my life is the one you mentioned in your letter: no matter how prepared you say you are about the death of a loved one, especially those who are getting on in years, you’re never truly prepared for it when it actually happens. But I also hold on to what they say that I would feel my late Dad’s presence/influence wherever I go. He is now virtually everywhere watching and guiding me I hope with the wisdom and good example he imparted on us.

  2. You were such a good and supportive son, Alex. Any elderly parent going through this would be so very lucky to have a son or daughter like you.

    • Thanks, Bob, but it was a team effort. There were times when I really felt tired. But, in the end, love and a sense of duty and decency prevailed. It wasn’t as difficult as you imagine it to be because my folks were such good parents. They have always been there for us. Now, it’s our turn to be there for them.

  3. Alex,your dad was lucky to have you as his son, as much as you feel so blessed to have him as your father. Ronnie and Farida too, to have you as their older brothers. I never knew my parents and when my grandfather, who raised me, died, I felt as devastated. Time will come when you all will be talking about your dad without that much pain, but with a lot good feelings over the memories. Chin up and hang in there.

    • Thanks, Tanya. I can’t wait for that day to come. But you only get to appreciate happy memories when you contrast them with not-so-happy ones. Yes, I believe animals, especially domesticated animals raised by a particular person in pain or in trouble, feel our pain, too. They have certain gifts that we don’t have and will never fully be able to understand. See you, guys, this weekend.

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