C. diff

April 25, 2008

Dear family and friends,

Over the last 72 hours I have done what our son John told me a couple of weeks ago that I needed to do - I have grown up. Surprisingly, it wasn't as difficult or painful as I thought it might be and I am thankful for that.

You know that my dad has been unwell since April first. We thought that he was suffering from a viral illness, but it just wouldn't go away. This past Monday, Tuesday and Wednesday he completely stopped eating and drinking. Finally on Wednesday (the start of my growing up) I said to Arend that Daddy should go to the hospital "emerge" (ER in the States). Daddy really didn't want to go, so I just told him that I had called for an ambulance and he was going. If he had been well he would have fought me "tooth and nail", but that certainly didn't happen this time.

Because he arrived by ambulance he avoided that 6-8 hour wait one usually experiences when going to "emerge". Within two hours of his arrival they had made arrangements for him to be admitted to the surgical floor of the Chatham hospital. The whole time that he was in "emerge" he kept calling me "Dot" and I would just tell him that she wasn't there. I couldn't tell him that my mother had died nearly two years ago. It just wouldn't have helped things at all. I told him that it was Willa Dale with him. Then he kept telling me that he was going to die and I replied every time that he wasn't going to die especially since he wanted to see the two new babies and visit with Noah as well as talk to him on the phone.

The "emerge" physician told me that he felt fairly certain that Daddy had C. diff (see http://www.mayoclinic.com/health/c-difficile/DS00736 ) and possibly an abscessed diverticulum.

I went up with him to the fourth floor and stayed with him for quite some time. I was surprised to see a very dear friend appear at the door of his room about 10:15 with a large cup of Earl Grey tea in her hand! She stayed with me until I was ready to leave and was a great comfort, probably more than she can imagine. How did she get up to the fourth floor when all the doors were locked? She went through "emerge", told them that her granddaddy had been admitted to the hospital, got the room number from them and then the security guard unlocked the door and let her through! I would call that pretty resourceful!

The next morning I had some school board duties that had to be attended to at the school and that same friend took my place by my dad's bedside and made sure that he drank the contrast liquid he needed for one of the tests. Amazing - he wouldn't drink it for the nurse, but he drank it for Marlene! After he was taken down for the test, she came to the school and told me everything that had transpired at the hospital, then took me out for lunch. Wow! Unfortunately, I didn't have much appetite at that point.

When I got back to the hospital, I found him pretty much the way Marlene described - sleepy and kind of "out of it". (I didn't realize how "out of it" he was till today - more on that later). Matt arrived about 2:30. We knew that he might come because he had to be down in this area of Ontario on business, but we didn't tell Daddy because we thought he would be disappointed if something happened and Matt couldn't get there. Considering how "out of it" he was, I don't suppose it would have made a difference if we had told him that Matt was coming.

It was time for Daddy to have some barium solution for his CT scan. Matt got him to drink it all! Daddy's nurse said that Matt had missed his calling - he should have been a nurse. She really liked his bedside manner. That's something I have been saying for the last two years. I saw how he worked with my mother in the hours just before she died and he was fantastic with her!

Matt left about four o'clock because he had work that needed to be done in Guelph before dark. I went down with Daddy for the CT scan, but Arend (who had arrived while Matt was there) stayed in Daddy's room. Not too long after we got back to his room, the surgeon came to talk to us. The news wasn't very good. The diagnosis of C. diff had been confirmed through blood tests and the sigmoidoscopy and CT scan. However, there was no diverticular abscess. She told us that in 5% of the cases of C. diff a colostomy had to be performed and in people of my dad's age, that percentage was ever greater. She also wondered whether he would survive the surgery if he indeed had to have it.

That generated a whole new set of concerns, of course. Finally (the next step in my growing up) I told her that we would like to have him transferred to the U.S. if he were to be hospitalized for a long period of time and have to undergo surgery. He has no medical or hospital coverage here in Canada but is covered in the U.S. That doctor moved mountains to get him admitted to a hospital in Port Huron, Michigan! She even made arrangements for an ambulance to come from Michigan to pick him up! Unbelievable!

Arend and I rushed back to Ridgetown to pick up all of the documents the three of us would need to cross the border then hurried back to Chatham to be there before the American ambulance arrived. As it turned out, we needn't have rushed. We ended up waiting for it for 90 minutes!

We followed the ambulance to Port Huron then went up to the floor he was to be on - the fourth floor again! We had to wait until they had assessed him before we could see him. He was so "out of it" that we just told him that we were there and that we were going to stay overnight in Port Huron and would see him this morning. He didn't really grasp what we were saying at all.

After a short night's sleep we were back at the hospital. Before we went to see him, we stopped at the nurses' station and were able to talk with three of the doctors who had seen him. Imagine my surprise when one of them said that Daddy had told him that he was immigrating to Canada because his daughter lived there! Compare that to 12 hours earlier when he didn't understand that he had been moved from Chatham to Port Huron or even that he was in a hospital! Incredible!

When we went in to see him, we were very happy to see how much better he was. Sure, he was still in pain, still a very sick man, but dramatically improved from when we had left only 10 hours before. He didn't remember anything at all about Thursday - no Marlene, no Matt, no tests, no bumpy ambulance ride - nothing, but throughout today he continued to improve. He reminded us of some things that needed to be done - some of which he hadn't discussed in months! He even "ate" about half of his clear liquid lunch and the same of his clear liquid dinner. Clear liquid diets, we learned, include popsicles and Jell-o in addition to the usual broth, juice and tea. Not overly appetizing but good for you when you are so dehydrated.

We talked to more health care professionals today then we could count (well, not really, but there were a lot) and they all said that Chatham had done a very good job of "working him up" and that their (Port Huron's) findings concurred with those of Chatham. Now they are treating him with the antibiotic Flagyl by mouth and an IV GGG which is a specialized bunch of antibodies that will go directly to the colon and destroy the C. diff that is there. Of course he is still getting a saline or potassium IV drip to re-hydrate him. It appears that they are alternating between the NaCl and the KCl drips for some reason.

The doctors are extremely positive about his recovery and we are encouraged by that. But most of all we thank the LORD for hearing our prayers and answering them in such a way. Once again we have been reminded that we can place all of our burdens on Him and He will carry them. What a wonderful promise and comfort that is!