Not according to plan

The idea was for all the siblings to convene to celebrate my father's 95th birthday. His chronically healthy body had a different idea, though. We still gathered but in his hospital room instead of his favorite restaurant. And there was no cake since he could not yet eat anything post-surgery.

For the generally healthy, we are perfectly fine until we are not. In this case, for unknown reasons, an adhesion put a twist in Dad's small intestine, causing a blockage. The surgeon called it a "best case scenario" because she did not need to resect the intestine, just snip the adhesion to release the twist.

This kind of surgery might leave someone in their 30's, even 60's, unfazed. But in the 90's? Recovering from the anesthesia takes days, mostly spent sleeping. As we age, the skin becomes more fragile, speeding the possible development of bed sores. Pneumonia is a potentially lethal complication.

And then there is the mental confusion. Lahey Hospital has a program whereby new nursing assistants spend six months serving as one-on-one "sitters" - they simply stay with the patient to make sure no tubes or IVs are pulled out and the patient stays in bed. This usually prevents the need for restraints, plus the newbie learns how to interact with patients and their families while also getting some on-the-job training when assisting in patient care. Dad required one of these aides for a few days post-op.

All was going reasonably well. I was particularly surprised Dad had no pain because after my abdominal surgery, I held the plunger for my morphine drip in a death grip. But then the oxygen level in his blood dropped. The first sign was a sudden lack of cooperation with the nurses. He became more and more incoherent as they tried to determine exactly what was going on and what to do about it. At first, this downturn was heartbreaking, but once he became more docile, the ensuing conversations grew highly entertaining.

Most of his babbling centered around the voices telling him to find the paper with the instructions about what our next steps were regarding the two bodies on the table; I used this fantasy to tell him his job was to cough up the phlegm in his throat. At one point, he lost track of who I was ("Do you have a sister?"), then he confused me with his second wife ("Time for our tea and a cookie"), and then with my mother ("We have a baby now. We need to take care of him.") And yet, when distracted by the construction of his bed, the plastics engineer in him spoke quite lucidly about the process and materials used to make it.

This story has a happy ending. The staff managed to short circuit the fluid gathering in Dad's lungs, gave him Nebulizer treatments to break up the mucus, and put him on oxygen. After a subsequent day spent with him thinking he was in Chicago, he became his old self again. He is eating solid food, the tubes and IVs are gone, and he should be released today from the hospital for a several week stay in the rehab unit of his retirement community. Then it will be back home to his apartment.

Of course, while witnessing all this, I couldn't help but think, This is my future. We like to ignore the fact we will get old and sick and someday die; that is something that happens to other people, not us. The getting old part is annoying and the dying part incomprehensible. The getting sick part, though, is scary. If we are lucky, we get appropriate care. But even the best facility, the brightest medical staff, a bevy of caring relatives cannot guarantee anything, not even a peaceful passing.

Dementia and Alzheimers are the scariest of all. Confusion in the elderly can be mistakenly attributed to either of these when the problem may be fixable, like low blood oxygen. Unruly dementia patients are often treated with psychotropics when frequently the actual problem is pain that can be relieved with ibuprofen were the patient able to communicate. My nightmare is to be bedridden and suffer excruciating leg cramps and be unable to ask for help. And then there are the well-meaning efforts to drag Alzheimer patients back to reality when the kinder thing may be to just let them go into the void.

Anyway, blah, blah, blah. The future is unknowable. All we can do is mitigate the risks - sign a will, designate a health care proxy, set an example to our kids of how to treat aging parents. Hope for the best but prepare for the worst. Nothing goes according to plan.