Tuesday, July 15, 2008


Yesterday was the day from hell.

Dad had his annual VA physical, I took him. We got the wheelchair van to pick us up, which was a relief, as I had to make about a dozen phone calls to have him hooked up with that Service. It was next to impossible to get him into my little Hyundai. The primary care doctor is an asshole, no other word for it. We've tangled a few times.

So he's shocked at the condition dad is in since last year, asks me what's new, I tell him that he's up most of the night, incontinent etc all the typical dementia stuff. First he infers that maybe the home I have him in isn't adequate. Uh, no, I explain that they are great. He latches on to this incontinence thing (which has been a natural progression from occasionally to constantly, it's not like it just showed up overnight) and he says it could be prostate issues, which is easily treatable with meds. I'm cool with that treatment. Asks if he can do a quick bladder scan. I agree, am in the room with dad, talking to him while it's happening, it's quick and non-invasive. He's confused but he gets through it ok.

That comes back and he says he wants to do a quick rectal exam to make sure it's not the prostate. I hesitate, say I don't know if he can handle it, he says some BS like "oh, it will be fine."
I leave the room at this point for some privacy, then come back in, doc says prostate is fine. Says it could be a bladder infection causing the incontinence and he wants him to see a urologist.

I point out he has no other signs of bladder infection (like fever, abdominal pain), and if it is a bladder infection we are not going to treat it anyway. At this point he's absolutely horrified and says "You mean you are willing to let him die over a bladder infection?" I say "Yes, because that's what he wanted. Look at his DNR order. It says quality of life meds only." "Well a bladder infection causing incontinence is a quality of life issue." "The caregiver reports that he isn't even aware when he's being changed for the most part." My dad is nodding off in his wheelchair at this point. So we go back and forth and he puts through a referral to urology anyway. I tell him I'm not taking him. He essentially ignores me and is really rude at this point, infers I'm basically going to kill my dad, or I want to kill my dad. I get my dad out of there as fast as I can. He is very agitated at this point.

The thing also is about 2 years ago the neurologist (who I like) showed me his brain scans, and there was so little healthy brain material left, he was amazed how well he was doing, so it seems that that string essentially broke and his condition is matching the scans now. This isn't surprising. It's sad, but not surprising at all.

The second we get back to the home he loses it and starts crying, he's saying a bunch of stuff I can't understand, then he starts asking for pills, for ALL the pills and says "I'm dead… I am just dead…can't do anything anymore…I'm dead… I'll sign…" so basically he was begging me to give him all the pills so he could off himself. I told him I was sorry but I couldn't do that. I basically bailed at that point, because then I was crying, and the caregivers took over, and I told him I'd see him this weekend.

The main caregiver, who has become a friend of mine, asks me what the hell happened, I told her, and obviously even being poked/prodded that much set him off, as he's been very docile and happy for the last month or so. We both agreed Dr. Asshole should witness what we just did and then he could tell me that treating a bladder infection was quality of life.

When I get the letter about the urology appointment in the mail I'm canceling it, asking to talk to a social worker, and complaining about that idiot doctor. I had already put in for a change of provider but it's about 6 more months on the waiting list. I hate the VA.

I just completely lost it last night. I haven't cried like that in years. I don't think Dave knew what to do with me. I don't want to kill my dad. I hate that doctor for how he made me feel. I don't want my dad to die. But he is going to die. He is already dying, slowly. And who the hell am I to refuse let a natural process happen, when it's what he's wanted, and has vocalized many times before he couldn't communicate? Today I'm totally just wiped out, like I'm in a haze, and I'm on autopilot. I was happy to go to work. I just wanted something "normal" to happen today.

I am going to do my damndest to keep him out of as many doctor appointments as possible.

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