Since being checked into the hospital, Larry was on a rapid decline as far as his condition. His kidneys and pancreas had completely shut down prior to entering his hospital and his lungs were under attack as cancer cells replaced healthy tissue. The main thing that lead to his final decline was his liver had completely shut down.
What happens when one goes into liver failure is the blood is no longer filtered and the body floods with all the toxins that would normally be cleaned. One of the earliest signs of liver failure is confusion and lack of ability to communicate. By this time, the best treatment for liver failure (the laxative lactulose) was no longer working and it was determined to keep him comfortable and take no drastic measures to prolong his suffering.
At this point, all that was left of Larry was instinct and the pain as cancer ravaged his internal organs. As his liver was no longer processing his blood, intravenous pain medication no longer would work, so he was on a regime of three medications administered under his skin in 20 minute intervals: a sedative to relax him, morphine to ease his pain, and a muscle relaxant to prevent him from fighting the catheter and the restraints and prevent further injury. These injections occurred around the clock to prevent his suffering and I thank the doctor and staff of Juravinski Surgical Ward in ensuring that he was well taken care of.
The last coherent conversation with Larry confirmed that he was ready to let go and we asked him to, however he kept saying he was afraid and wanted to say goodbye one last time. When asked who he wanted to say goodbye, he could never explain fully. However I suspected who it was.
As I left the hospital to take care of the dogs, I ran into the palliative care doctor and he said the first words he said to me since he told me “seven to ten days.” This isn’t a complaint as the doctor did most of his work through gesture and facial expression – which I found incredibly helpful. There is little that can be said to a dying man and the family who is processing their pain and grief as they watch their loved one fade away. What he asked me was “Is there any more I can do at this time?”
Yes, there was.
During the entire time Larry was in the hospital, I was working with the nurses and social worker in getting permission to bring the dogs in for one last time and I was constantly running into roadblocks, despite bringing in immunization and medical records. Finally I asked the doctor whether it were possible to bring in at least one of the dogs to have one last visit with Larry.
He was with the charge nurse and his flock of interns at this time and his response was quick: “Who am I to deny a dying man his last wish.” He turned to the nurse and confirmed that all staff were to be in a meeting with him at 7pm that evening and turned to me and said, what happens between 7:00 and 7:30 that evening was up to me. Point taken.
I swallowed the lump in my throat and rushed home to confirm my ride up to the hospital to be there just at 7pm. Thankfully, incredible neighbours Jeff and Michele were on the case and I was able to arrange for a drop off and pick up 30 minutes later. I had purchased a simple carry duffel for Sunny and prepared him to go in it, I put his towel in the bottom of it and he seemed to understand what it was for. I did my chores around the house
At 6:45 Jeff and Michele honked their horns and I convinced Sunny to get in the carry bag, while keeping the zipper opened so he could see. Sunny knew that something big was up and he actually settled down and relaxed. When we got to the hospital, I tucked Sunny’s head in the case and proceded to lug this bag with 16 lbs of Sunny over my shoulder, trying to be as low key as possible as we walked to the elevator. We got on the elevator and made our way to Larry’s room, I pulled the curtains tight as I announced myself to Larry.
I said to Larry quietly that I had someone special to see him and he opened his eyes. I put the case on the bed and opened the zipper. Sunny cautiously stuck his head out and Larry’s eyes widened when he saw him. Larry moved his right arm away from his body and Sunny cautiously got out of the bag and sniffed around, carefully creeping up the side of the bed and lying down to rest with his head on Larry’s shoulder and chest.
“Hi Sunny,” Larry moved his left hand across his body and laid it to rest on Sunny’s back. No mean feat as Larry had been non responsive beyond reflexes for over a day at this point. We sat quietly as Larry and Sunny had what was likely to be one final snuggle. I sat in silence watching them together until twenty minutes passed and Sunny began to visibly shake and whimper.
I told Larry that we really needed to go as Sunny was getting nervous and we had to be out of there by 7:30. Larry moved his left hand off Sunny and said “Goodbye Myke. Goodbye Sunny. I love you, thank you” and went back to sleep. I put Sunny back in the bag, zipped it up and kissed my husband goodbye one final time.
Jeff and Michele were at the entrance when we came down and drove us home. I walked Sunny and Chloe as I was too uneasy and didn’t want to be in the house. Finally at 10pm I collapsed in a heap on my bed and went into a troubled rest.