Bev's Final Days

It's difficult to know where to begin this story. As most of you know Bev had a stroke & cerebral hemorrhage in November 2008. Thanks to the heroic efforts of Dr. Arlo Brakel, she miraculously recovered and come home in January 2009. Though she recovered the vast majority of her capability, she still struggled with chronic knee degeneration and COPD. She had a second miraculous recovery when she impaled her thigh on a piece of rebar while "investigating" a neighbor's construction project.

Since September 2011, she was hospitalized five times for pneumonia, fluid in her lungs, cellulitis, low blood pressure and swelling of her legs. She managed to fight her way back through all of it, but swore she "never wanted to wake up in a bed with rails again." There was never any indication of heart problems.

On Weds May 9, 2012 she went in to see her PCP. Her edema was under control, BP looked good, and except for low potassium levels, the PCP said she was in the best shape she'd been in for 6 months. She felt good, was up and sewing, and was making plans for a summer trip that got cancelled at Christmas.

On Thursday, I woke up about 7 AM and found her on the floor with a bruised hip. She had fallen sometime during the night, but was unable to wake me. I helped her to the bed and asked if I should call for help. She said she wanted to sleep a bit, and then would decide. Around 10 AM, I called her orthopedic surgeon and he asked her a few questions and told her she needed to go to the ER. She reluctantly agreed. I left to make arrangements and returned in about 10 minutes. I found her in full cardiac arrest.

I called 911, started CPR on the bed, and the paramedics arrived in less than 10 minutes. The first EMT thought she was gone. His supervisor did not. They did CPR and were able to shock her back to normal sinus rhythm with good BP. She was taken to NorthWest hospital.

The admitting physician said her outlook was pretty bleak, but that 80% of the patients never made it to the ER. She was moved the cardiac ICU around 2PM. The attending nurse Ligita (Lithuanian) was an absolute gem, she explained all the measures that were being taken. They put Bev under sedation and chilled her body temperature to 94 degrees. The doctors felt this would give her brain the best chance to recover. After 24 hours, they slowly warmed her up. At this point (Friday afternoon) things looked pretty positive. Good BP, eyes were equal and responsive, she was at least partially breathing on her own.

On Saturday afternoon she crashed again. They were again able to restore her heartbeat, but she was very unstable. They had confirmed her hip was fractured, but felt she was too fragile for an MRI of her brain. After a few hours, it became clear that there were signs of brain damage. Rehab of the hip would have meant weeks in traction as they probably could not surgically repair things. (Remember "beds with rails"?) We consulted as a family, and I ordered them to withdraw life support. As per Bev's wishes, she will be harvested for any usable eyes, bones and tissue. She also wished to be donated for research purposes. Some young neurosurgeon needs to study Dr. Brakel's work. I signed all of the consent forms.

By Sunday afternoon, she was in obvious distress, with virtually no hope of improvement. We agreed to move her to the inpatient ward at the Casa de la Luz hospice. They kept her very comfortable, and relaxed. She finally was ready to pass on in the early morning on May 17, 2012.