Because nothing is perfect this side of heaven, and because everyone is human and makes mistakes, there were things about Ronnie’s stay at the VA that could have and should have been better. There were questions I should not have had to ask, and things he should not have had to endure.
When Ronnie’s lymphedema became so severe that the swelling in his feet broke into wounds, he contracted MRSA, which is a difficult to treat infection that is highly contagious and easily transmitted. Once he was infected, he had to endure excruciatingly painful treatments several times a day. He then couldn’t leave his room, and saw only medical staff when they came to care for him. I had to wear a mask, gloves, shoe covers, and gown when I came for a visit. It was difficult, and it never went away. Ronnie kept the MRSA infection till the day he died.
The thing I began to notice was that there were isolation signs on several doors up and down the hall. A new patient would come and a couple of weeks or a month later, a sign would be on his door as well.
I believe that MRSA is embedded on that floor. I know the staff took precautions. I saw them. I don’t think the cleaning staff did as good a job as they could have. That is just my opinion. All I know for sure is that Ronnie did not have MRSA when he arrived on that floor, and a few months later he did.
Within a few weeks of entering hospice care at our local VA hospital, Ronnie became increasingly difficult for him. He began to rely on his wheelchair more and more. When I came to visit, we went outside so he could smoke, and I pushed him part of the way. As he gained more weight from the lymphedema, pushing him became more difficult.
I’m not sure who made the arrangements, whether it was his social worker, a doctor, or a nurse, but before long Ronnie had a motorized wheelchair. It was such a blessing.
Yes. There were many good things that were part of Ronnie’s last months.
There is no shortage of news reports about the care our veterans receive when they are patients in VA facilities. Most of the media coverage is negative and well deserved. Ronnie’s stay at our local VA hospital had its share of negative aspects, and I plan to devote a post to that topic.
However, for this post I want to write about some of the positive aspects of Ronnie’s care, most of which are centered around the people who were part of his daily world for the almost eight months of his care.
People are not perfect, and what I found at the VA was not even close to perfection, but most of the doctors, nurses, and aides were caring and competent. They made sure that Ronnie was as emotionally and physically comfortable as possible.
The doctors were attentive to his needs and my unending questions. They kept up with his changing medical needs and quickly adapted his medication to meet those needs. Because I wanted to be closely involved in Ronnie’s care, I researched every decision the doctors made, and almost every medication they prescribed. I’m sure I drove them nuts, but they never made me feel that way. Instead they treated me as an essential part of Ronnie’s treatment team.
To be continued.
It was 4:30 a.m., Sunday morning. My husband and I were at the VA hospice unit in my Uncle Ronnie’s room. He was lying on the bed, finally resting from his months long illness.
Within a few minutes the hospice chaplain joined us. It was good to see him. I appreciated his presence. Together we waited for the funeral home. When they arrived, the security guard also became part of our group.
We waited outside Ronnie’s room while his body was loaded on the funeral home gurney. The door opened and Ronnie’s body was rolled out, draped with an American flag. They paused at the door as the security guard signaled someone somewhere to start the music. From nowhere. From everywhere we begin to hear “Taps” being played. Everyone on the floor saluted Ronnie Patton as his body was rolled down the hall, down the elevator, and out the door.
It was a special moment in my life. It was a send off fit for a hero.
The doctors were kind of concerned when we told them that we were going to be out of town for a few days. Ronnie was fading fast. I felt bad about leaving, but it couldn’t be helped. We got back into town late one evening and I was up to see him the next morning.
I was shocked to see the difference in how Ronnie looked. His eye were almost completely closed and his words were just a whisper. I gently sat down on the edge of his bed. When he saw me he reached up and pulled me close. He put his arms around me as best he could and whispered, “I love you.” Those were his last words to me.
i stayed almost all day with him, and left late in the afternoon. I regretted leaving, because my phone rang about 3:30 am. It was the nurse telling me that I needed to come to the hospital. By the time I arrived, he was gone. Ronnie stepped into heaven.
Next post: the VA send off.
i remember clearly the last day that he was able to go outside to smoke. It was a beautiful cool Saturday morning in November just before Thanksgiving. I took Ronnie outside to an enclosed smoking area, and placed his wheelchair in front of a large window. The sun was shining directly into the window, enabling him to feel it’s warmth. He smoked and talked and laughed. I sat beside my uncle Ronnie, enjoying the specialness of the moment.
When at last I took him back in the building to his room, the nurses and I knew this was it. He was getting weaker and in more and more pain. The decision was made that he needed to go to bed to stay.
His last week began.
Life gradually gets more difficult for Ronnie. The lymphedema gradually gets worse, and MERSA sets in. The treatments for the infection are painful and gross. I can no longer take him on outings because his swollen bandaged feel no longer fit into shoes.
I found myself buying cigarettes for Uncle Ronnie, which was something I never thought I would do. However, since he had a short time to live, I felt it was important for him to be as happy as possible.
Through all of this Ronnie maintained his sense of humor, and his positive attitude. No matter how bad his day was physically, I never saw him have a bad day emotionally. What a man.
It began in his feet. Ronnie could no longer wear his cowboy boots. Then soon he needed larger shirts and jeans. I erroneously thought that he was probably just enjoying the food served to the veterans.
However, one day the doctor informed me that the increase in Ronnie’s size was due to lymphedema which is swelling due to damage to the lymph node system. News to me. I had never heard of lymphedema and had to to some research to learn how this was going to effect Ronnie. Before he passed away I was ordering shirts and pants for him in size 4X. Being this size was one of the things that made him miserable.
I know he understood the consequences of smoking. I know he had been told that lung cancer was a possible result of decades of breathing in the toxins in cigarettes. I don’t know if he did not care, or if he refused to mentally acknowledge that it could be reality for him.
Whatever his thinking, a diagnosis of lung cancer was not enough to make him stop smoking. Nope. He smoked through his entire illness, up until about a week before his death when he was too sick to smoke.
I had such mixed emotions when he bought cigarettes on one of our first Walmart trips. Part of me wanted to yell at him for continuing a nasty habit that was going to be the cause of his death. Another part of me wanted to just acquiesce to the fact that his man did not have long to live and deserved to live his last days doing what made him happy.
Well, stuffing the former urges into my heart, I did the latter. I even bought cigarettes for him once he was too sick to by them for himself. I never thought I would do that.
There are no regrets in what I did or didn’t do here. He needed to be as happy and satisfied as possible, and smoking helped accomplish that. I would do it again.
Hospice Care is primarily comfort care.Ronnie was not going to beat this cancer so he had no therapeutic treatment. Mild pain meds were all he needed to keep him comfortable initially.
The growth of the tumors in his brain were causing confusion and memory issues for Ronnie which were evident at his original diagnosis. The doctors in the first hospital prescribed dexamethasone, a steroid which helped with inflammation and slowed the growth of his brain cancer. The hospice doctors decided to continue this treatment and it made a huge difference in his ability to think, reason, and remember for several months.
All things considered Ronnie’s care was adequate for his needs for about 3 months. We were rocking along.