h2g2 The Hitchhiker's Guide to the Galaxy: Earth Edition

I would like to share this story with the people of Hitchhiker's Guide to the Galaxy. It may seem depressing in places but in the end it's in my view inspiring and uplifting – a tale about endurance, survival and hope.

As many of you will be aware, my father has been diagnosed with cancer in November 2008 and has been receiving chemotherapy until recently - for a total of about 9 months, in fact. He responded very well to the treatment, but at the end of it, still had some problems with his prostate. For that reason it was decided that he should have a prostatectomy, and went in for the operation on Thursday 1 October. This was here in Pietersburg, at our private clinic, which is quite well equipped. It was expected he should stay in hospital for five days. My mom and I would visit him tree times a day during this period.

He had a full examination before the operation, including ECG's (electrocardiographs) which indicated no problem. But he had been complaining of chest pains for some time ... I remember, my dad had been experiencing them for years. But all ECG's he had, showed no problem. So ... he was operated early the morning that Thursday, and we visited him later the day. He was groggy and uncomfortable from the operation ... it was quite stressful to him, since his whole system was 'down' as a result of all the chemotherapy he's had. On Friday he had the chest pains again and had difficulty breathing. Also, one of the nurses whom he asked to help him to the bathroom (he was weak and had tubes and stuff inside and going out of him) actually dropped him and he 'awoke' (must have lost consciousness) on the floor! Later his knees and parts of his shins to his feet were red and swollen.

Anyways all that was a stress on him also, and somewhere Friday evening or night he had the first heart attack. His internist saw him and said that there was a narrowed or blocked vein somewhere but the facilities in Pietersburg were not such that he could do an angiogram, but the internist gave him some medication. He was transferred to the intensive care unit in the Pietersburg clinic. He phoned us early Saturday morning; we came and he told us he had a heart attack.

The problem then was that the medication that would treat the heart problem worked by thinning the blood … whereas he had to take medication for the prostate operation that worked the opposite way, stimulating the blood to clot more easily so the wounds would heal faster. So his heart medication delayed their healing.

And during the day it became clear to the internist that my dad was not responding to the heart medication. We saw it too during our visits … my dad was extremely uncomfortable and breathed with difficulty.

That evening my sister Maryke and her boy Christiaan (5 years old) came through from Pretoria to be with my dad.

The next morning (Sunday) we got the call informing us my dad was going to Pretoria by ambulance. His internist was concerned because he wasn’t responding to the medication and thought there might be more than one blocked artery. He thought they’d be able to help my dad in the Cardiac Intensive Care Unit of the Wilgers Hospital in Pretoria – which is one of the top 3 cardiac units in South Africa. So my dad was put in the ambulance with specialist emergency treatment folks watching him every second and they set off for Pretoria. Normally, this is a drive of two and a half to three hours. But an ambulance has special privileges.

At home, we made our preparations as well and left for Pretoria somewhat later. My mom and I initially prepared to stay at my sister’s. We packed our things in haste, not knowing how long we’d be staying in Pretoria. Anyways, we set off then, with Maryke and Christiaan leading in their car, my mom and I following.

The drive was harrowing and we thought of my father … he looked really bad and we just hoped he would arrive at the hospital alive! We thought back of a friend of ours, who had for some years lived with a replaced valve in his heart and then got trouble with it … his doctor had his wife, not an ambulance, drive him to a specialist hospital – and he died halfway on the way there.

When we came to the Wilgers hospital, my dad had been there for about an hour and a half. They had already given him the angiogram and also put a little spring device in the blocked artery to open it! They showed us photos taken by the angiogram, showing that a rather large artery on the outside of the heart was completely blocked. With the spring in, it was open and the blood got through freely – this was clear from the photo. We were very encouraged by how professional the hospital folks were!

But my dad was still in bad shape. He was still breathing with difficulty. During the time when his heart wasn’t working properly, fluid had accumulated in his lungs.

Well after visiting with him, we went and made ourselves at home at my sister’s. They don’t have a big house, and my mom and I slept in Christiaan’s room while Christiaan slept on the floor in another room. Their house is about 25 km from Wilgers Hospital, and it was rather hard to drive that distance three times a day. Also, we were discomfiting my sister because she and her husband have very busy lives. So my mom and I decided, after two days at my sister’s, to book into a guest house closer to the hospital. First guest house we found was about 5 km from the hospital, called the Janri guest house, just a couple who were renting out some of the rooms in their house. They had quite a nice garden. I’d have loved to take my mom for a tour of the garden, but she just didn’t have the energy for it … it was harrowing for both of us.

Back to my dad. With his breathing problems, we were worried. Then on Monday we were told he had pneumonia! And pneumonia caught in the intensive care unit of a hospital is a big problem – it would be a very resistant kind, and would necessitate my dad staying in hospital for about six weeks or more!

But then later they told us no, it wasn’t pneumonia, but some other kind of infection, somewhere. They couldn’t find out more than that … in fact we still don’t know what or where it was. They simply picked it up in his blood tests. It was a severe infection … there was a count of something like 480 that had to be reduced to less than 15 before he’d be considered all right. He was put on 4 different antibiotics.

At this point he was also on adrenalin and a bunch of stuff. I was concerned because it made his heart race very fast. So I was routinely watching his heart rate on the large flat-screen display beside his bed.

When we got in the Wednesday evening (8 October) I saw his heart rate was at 120 to 140 beats per minute which was very fast. We had to go in to visit him by twos, and while my mother and sister were with him, I was outside in the waiting area entertaining Christiaan.

Then my mom and sister suddenly came out in tears, saying something happened to my dad!

My mom later told she had looked at the heart monitor and saw it go up to 187 beats per minute … she turned to ask my sister (she’s a medical doctor) if that was not too high … my sister looked and the heart rate was over 200! Next thing personell from all over the ward came running up … there was a serious emergency … my sister and mom were asked to leave … emergency medics came running up with shock-equipment … we were told to wait outside, they pulled the curtains around his bed and we could see considerable activity going on behind it …

And my mom and sis and I just had to wait out there … for how long? … I think it must have been half an hour at least, maybe even more, but it felt interminable … not knowing what was happening, not knowing if my dad was even still alive …

But mercifully, at some point, they’d managed to stabilize him. His doctor … the one treating him in Wilgers Hospital, called Dr. Michele Guera (a young doctor, but very good) came over to us and explained.

My dad’s heart had gone into ventricular fibrillation. This means the heart completely loses its rhythm, and instead of beating, it just ‘flutters’. The doctor was sure there wasn’t an underlying problem with the heart itself – the problem was apparently with the medication he was using, which was disrupting his heart’s beat. Dr. Guera said he had stopped all medication that might have contributed, and assured us it would not happen again … an assurance that turned out to be somewhat premature.

But for then, my dad was stable again. They had to shock him to get his heart beating again – the shock he described as being one of the most painful and traumatic things he’d experienced in his life; in fact he could hardly believe he survived that intense a shock. But survive, he did … you can imagine how relieved my mom, sis and I were when after it we were allowed back in, and could look at and speak with him again.

The shock had weakened him even more. The next day he seemed to be slowly improving. He still breathed difficultly, and he was very hoarse. He could hardly speak … whether this was due to the infection, or the tubes he had in his throat during the operations (prostate and angiogram) we couldn’t tell … maybe all these played a role.

People came to visit him … I don’t recall in what order, but they included his two sisters, Lydia and Lettie, his brother Nick (his other brother Willie is currently living in New Zealand), his local preacher, and even the preacher who used to be his preacher several years ago; and our art teacher Kathryn and her father-in-law. My mom and I visited him three times a day; my sister also came to visit quite frequently; she took a couple of days off from her work.

Well … as I said, on Thursday he seemed to be doing well … then on Friday morning, very early … just after six, I think … the hospital phoned us and said he was doing very badly and we’d better come! Talk about a scary message! Once again my mom and I prepared and set off for the hospital. My sister also came.

We found him again curtained off, and again had to wait before we had any idea what was going on.

Again they finally told us … his heard had stopped again (fibrillation) and again they had to shock him. They also had to perform ‘heart massage’ which is a nice way of saying they pounded him very violently on the chest. Later it turned out some of his ribs were broken and even now his chest has a ‘dented-in’ look. BUT … once again, the good thing was he survived! And again, afterwards, they let us go in to see him.

That was probably the worst we saw him. He couldn’t breathe on his own … they had a tube down his windpipe connecting him to a machine helping him breathe. So, he couldn’t even speak with us! He also had another tube through his nose into his stomach, so that if he vomited, it would suck it all up and prevent it from getting into his lungs.

He seemed profoundly uncomfortable. The hospital folks had tied his hands to the bed so he wouldn’t try and pull out the tubes. We asked that his hands be untied so he could at least write messages to us. He had a hard time doing even that … first he merely said the tube was making him nauseous, then he asked that his hands would be tied up again! He couldn’t prevent himself from trying to pull at the tubes.

Later, he told us it wasn’t the tubes as such that bothered him, but the mouth tube wasn’t positioned comfortably … it was in the corner of his mouth and he was even compulsively chewing at it. He had developed, as we noticed, a number of different kind of nervous ‘ticks’ involving his face, his hands as well as his feet, going into regular, stereotyped movements and twitches. This must have been some of the medication since he’d never done such a type of thing before. He later told us, he was aware of these ‘tics’ but couldn’t control them.

But he could tell us nothing yet. My mom and sis and I spent that whole day sitting with him. It seemed like a very long time until they finally removed the tube in his windpipe, but they did, and he could speak again … just barely.

That was the low point, actually. From there he started recovering … but very slowly. For a few days we were still in constant fear and expectation that he would have another heart stoppage, or that some other very bad thing might happen. At the same time I was also getting very worried about affairs back home. We had left our house in Pietersburg and our cats and my plants just like that … we simply asked some friends to come and feed the cats and the birds (we throw seed out for them in the back yard) but no instructions for other potential problems. On Monday the 13th my mom and I came back to Pietersburg to see if things were OK. At that point my father had stabilized but still I worried about him constantly while my mom and I were away from him. But in any case … we drove here, and it was great to see the house still standing and the plants in the garden still alive! Even better was when our little cat Kadoefie came to greet us … we had been away more than a week! Obviously, she could survive just fine without our attention.

But I was worried about our other cat, Poplap. The people watching our house had told me they hadn’t seen her recently … and when we arrived, Poplap didn’t come. I went around the house and yard, calling her. At last I decided to tend my plants, and while busy in the garden, I heard the most heartbreakingly plaintive mewing! It was Poplap! She came to me … she spent the whole time I was watering my plants, near me, and didn’t stop mewing! She must have felt we had totally betrayed her, abandoning her like that! But she, too, was at least still alive (although very dusty).

I managed to rescue the plants that were wilting … it is very hot and dry in Pietersburg up till now. Then I went inside the house and connected my computer and modems and sent some messages over the ‘net.

Later that evening we discovered just how fortunate it was that we took the day to get back to Pietersburg. By some miracle of chance, my mom discovered that the large freezer in the kitchen had just stopped working! The meat in it was thawing and a puddle of bloody water had formed at the bottom. It must have happened very recently. So my mom and I packed all the thawing meat out of the freezer. We threw it all away … packed it into plastic bags and the next day I loaded them all in my wheelbarrow and put them out for the garbage-removal people. I helped my mom clean out all the smelly bloody water … YUK! (Again I realize the benefits of being vegetarian.) But imagine what a hideous mess it would have been if we had NOT cleaned it out then and it had thawed and decomposed for another week!

So seeing that everyting back home was OK, we could head back to Pretoria, still worrying about my dad, but at least with less worry about the house, the cats and the plants.

But my dad was still in a serious situation. His infection count was still high, though slowly coming down. Every day when we got in, I asked the nurse on duty what the infection count was.

Speaking of nurses … during this period, we got to know the nurses fairly well. They really took excellent care of my dad – and many times went quite above and beyond the call of duty in what they did for him. There were many encouraging words, even hugs, and special gestures. One nurse, Lynette, moved and turned my dad’s bed when there was a bit of rainy weather outside … so that my father could see the rainbow! And another, Theresa, gave him a deep red long-stemmed rose near the end of his stay!

The Wilgers Cardiac Intensive Care Unit is one of the top 3 in South Africa and it shows. They display every patient’s ‘vital statistics’ on large, crisp flat screens, and there are many smaller LCD screens showing what’s happening with administered medications, oxygen and so forth. Nurses work in 12-hour shifts and each nurse tends to a single patient, constantly, looking at and documenting everything. Like I said before, when the emergency happened to my dad, about 10 members of the staff were with him within seconds. His doctor saw him daily, and spoke to us as well to clarify things.

Still, a hospital stay – even with the best of care – is a very stressful and frustrating affair. It’s tough feeling low and sick and not being in one’s own bed! Now my dad, was recovering from chemotherapy … recovering from a prostate operation … recovering from the angiogram … in bed with so many tubes going in and out of him (my sister calls it ‘Spaghetti syndrome’) … because of all the wires and monitors and stuff, he can’t turn and lie or sleep on his side … he is too weak to sit up in bed or get out of it … his eyes are weak as well so he can’t even read … all he can do is lie on his back! Imagine how slowly time passes under such circumstances! And … he doesn’t sleep well. He is not comfortable … often, he is cold (they keep the ward rather cold so that microbes won’t be breeding and multiplying too fast) … he is not properly covered by the sheets … his feet hurt (we still don’t know why) … there is too much noise and commotion around him … even in the middle of the night, if he’s been lucky enough to sleep, a nurse will wake him to draw blood or administer medication …

My dad was getting thoroughly fed up by this situation … and we too. You can imagine how badly we wanted him to be better and out of there and back home with us. I wondered just how long he would take to recover … if he would ever recover?

But he DID recover. Oh so slowly … but, the infection count kept going down; his throat improved and he could speak to us fairly clearly again; he was able to read a bit in the newspaper; he was able to sit up in bed; the physiotherapy girls helped him get out of bed, and finally, took him for a few brief walks in the ward; the recovery, though slow, gave us hope. And after the last heart fibrillation – there were no further incidents.

And on Saturday he got the news that he would be released on Sunday! That evening they rolled his bed into a ward with a TV set along with two other patients, so that they could watch the rugby matches! The one guy – much younger than my dad, and in there for a heart bypass operation – got so excited during the match (his team pulled off a last-minute victory) that he said if the hospital staff knew how the game would go, they wouldn’t have allowed him to watch! But my dad was fine.

On Sunday – the day of his release – there was just one last hurdle to be cleared. My dad had a low potassium count in his blood. Potassium is vital for the regulation of the heartbeat. So they gave him some pills and also fed potassium into him by drip … we came and sat there with him and waited until the final blood test came in. It had to be over 3.5 … and when it came in as being 3.6 we all cheered! There were hugs and handshakes and so on exchanged … and then finally they put him into a wheelchair and rolled him out!

My dad was in hospital from the 1st to the 19th of October, and spent two full weeks in the cardiac intensive care unit. It was a harrowing time for us all.

We decided to not go home just yet. Instead, my dad stayed with my mom and me in the guest house, slept there that night, and came back to Pietersburg the next morning. The trip was a bit of a stress for my dad – but it was so good to be back home again – and with him as well! And again, to see the cats were still well … the garden too … no other emergencies in the house, except for a few messes made by the cats!

As I’ve said elsewhere, my dad has also since Monday been getting steadily better. First, I had to help him walk … then, he was able to walk with a stick … and today, he managed quite a walk through the house, all on his own and without the stick! The numerous nervous ticks are abating. The various bruises (my sister calls it Leopard Syndrome) are fading. He’s received a few visits as well and held up OK during them. He’s also becoming capable of reading again … so much to be thankful for! That people can be strong even while being frail … that there’s always hope.

Your father has been through so much. I'm glad he's back at home. And I'm glad your cats were okay. The trauma of all this must really be affecting you and your whole family. Sending thoughts of peace and equilibrium and wellness.

I am so pleased he is making progress. The human body and spirit is so much stronger than we imagine.

Take care, and long may it continue.

Websailor

My very dear Willem,

What an ordeal your darling Pa has been through. Supported all through by his family who have probably suffered just as much as he has.

How fortunate you were to find that marvellous internist. And also to have found that marvellous Wilgers Intensive Care Unit.

With love, and attention and prayer I am sure that he will be continuing his recoveruy. I know that I had to take six months out to get over my double by pass. We South Africans are made of stern stuff.

Thank you for your ever s sensitive wonderful account of his ordeal and the marvellous support which you all gave to your much loved Pa.


With a great deal of affection


~Christiane and Keith.
Saturday 23rd October, 2009 13.30 BST

Hello JEllen, Websailor, Christiane and Keith, and thank you so much for reading the story!

Yes people can be very tough when they need to. My dad is getting better by the day. His vision is improving and today he finished reading the latest chapters of my story - something I feared, when he was in hospital, he might never do! And today I took him for a little walk through the garden!

Thanks again for your concern and your friendship!

With affection,

Willem

Where did I leave my brain??!! Kathryn was there with her *father*, Peter Hunt, not father-in-law!