medical equipment for life support

In this short story, as Annie’s loving husband and caregiver, I got caught between the ebb and flow of two different worlds…Wanting to do the right thing, and learning to let go. In life there are consequences for everything we do. This two part story will take you on a journey where Annie is struggling to live her cancerous life to its fullest, while creating an event that will lead to an courageous battle for her very survival.

Inspiring Story

Annie raises a glass

Annie raises a glass

August 10, 2009: Annie received a call today from her sister Lesley in California. While they were talking, Annie held the phone away from her mouth, and asked me if she could go to California for ten days.

I told her that with her immunity problems, it probably wouldn’t be a good idea. It upset Annie, as she wanted to go. She felt it could be the last time she’d ever be able to make the trip. Annie had three very distinct issues she was dealing with. She had limited mobility (wheelchair bound), was very frail, and her immunity to germs was very low.

Over the years of traveling to Los Angeles, Annie made many friends. There would be lots of hugs and direct contact with germs. Every fiber in my body told me the trip could easily end up in a disaster.

Leslie got me on the phone and told me that she and some friends were hiring a large hall and having a big surprise party in Annie’s honor. That made me even more apprehensive. However, as it was a surprise party, I wasn’t allowed to speak to Annie about my concerns, knowing the last thing she needed was being around bunch of people contagious with who knows what.

I stood my ground for a few days, but the pressure was building from our daughter Melissa, some close friends, and a couple of the doctors. They felt Annie had been living on the edge long enough, and deserved a short vacation. I was told I couldn’t protect her forever. Their thoughts were, when the cancer came back and knowing that it would, she wouldn’t survive again. I knew they were probably right, but I still disagreed.

Annie was currently enjoying a small window of stability, and no one knew just how long it would last.

August 14, 2009: This morning Annie and I were sitting at the dining room table having some breakfast.

Without much warning she started crying, saying “Please, let me go.”

I told her the risk of infection was just too great. I said, “Annie, I love you and don’t want to lose you.”

She countered by saying, “I know you love me, so be happy for me. This could be my last chance.”

Looking back, we all knew Annie had a death sentence, at least based on science, so really what was the worst that could happen from this trip. I suppose from her perspective it would simply speed up the process. Annie didn’t want to die, but she didn’t fear death. She was surrounded by it every day of her life. In her world, people were dying.

She manipulated me into saying okay. She promised me she wouldn’t let people get too close to her, which I knew wasn’t true. When Annie’s white count was down to one and she had almost no immunity, if someone got near her, she’d hold her little arms out for a hug. She never really understood the risks she was taking, or maybe in her own way, knew her survival was limited and just didn’t care. I could have gone with her, but knew if I was there I’d spend my whole time pushing people away from her and make her “special event” miserable. Annie was still not aware of the party.

Later on in the day I called her sister Leslie, and told her I was going to let Annie come out. I told her about my concerns and I got the same promise Annie made me. I didn’t believe her either. I guess in some way it made me feel better by at least discussing the issues.

Annie was on several different medications, to include different narcotics for pain. I had to make a detailed list with instructions and put it in her bag of pills. I knew Lesley would make sure Annie got her medication on time.

This was one of the toughest and most difficult decisions I’d made so far. I think what influenced me the most was reflecting back on all the difficulties Annie had with the cancer, and knowing it would be back. I had to stop being selfish and thinking of myself. She deserved a chance to have some fun and get out of this world of cancer she’d been living in. I knew the trip would be good for her, if she didn’t catch some sort of germ.

Annie usually flew with US Airways. It always flew out of Wichita, made a stop at Phoenix, and then onto Ontario, California where her sister met her.

I got in touch with US Airways and started working on the logistics of getting Annie there and back safely. I discussed my concerns in detail, and they assured me they would take good care of her.

August 20, 2009: Annie and I went to see Dr. Farhat today for an EKG. He wanted to make sure her heart was still functioning properly after the high-dose chemotherapy. Some of the effects from the chemotherapy don’t show up for quite awhile after the patient receives it. Her heart was functioning normally, with no signs of swelling. Her weight was 106.8 pounds; and from a cardiac standpoint she was doing reasonably well.

August 24, 2009: I took Annie to the airport and parked in front of the US Airways terminal. The baggage handler came over to the car to assist us. Annie knew him well, as she traveled often. I got her in the wheelchair and wheeled her inside, while the baggage hander brought the bags in. He gave me his word he’d stay with her until I got back from parking the car. When we checked in, I was given a pass so I could push her through security to her gate.

When we got to the gate, the US Airways agent came over and discussed her trip with me. She told me what their plans were, and reassured me that her trip would be smooth. I was still very anxious, but went with the flow, as I could see the excitement building in Annie’s eyes. We transferred her into one of their wheelchairs, and they took her to the plane before anyone else was allowed to board.

Annie at the party. Leslie is in the white top.

Annie at the party. Leslie is in the white top.

Leslie had contacted some of her friends, and had a beautiful hospital bed delivered and waiting for Annie at her home. Leslie also had a nice wheelchair with comfortable pillows waiting at the airport. In addition to all that, there was a new portable potty sitting near the hospital bed. Leslie loved her sister and it really showed in the effort she made a to insure Annie was comfortable while at her home.

Annie called me from her cell phone after the airline agents got her comfortable in her seat. She said she loved me and thanked me for letting her go visit her family and friends. At that moment Annie’s spirit was very elevated. I was still at the gate and not going to move until the plane was flying safely in the air. I was really sad and knew I’d be a nervous wreck while she was gone, and miss her terribly. I couldn’t wait for her to get back so I could get my hands on her, and she hadn’t even left yet. For the past fourteen months we were almost always together; this was going to be a long ten days.

Eventually the US Airways flight took off, filling my mind with so many emotions. I knew I needed to let her go, but at the moment it was very hard for me. One of the thoughts that troubled me was; “What if they had an in-flight emergency, or worse? Who would care for her?” It was starting to feel like my mind was playing head games with me. Eventually I turned my focus to the sky and watched her airplane until it disappeared from sight. Now all I could do was wait until I received the call telling me she was safe. Within five hours of departure, I received that long-awaited phone call from Annie. She said the flight was marvelous, and that US Airways flight attendants took great care of her. She seemed really happy, and I was happy for her. While she was in Los Angeles, I spoke to her every morning, for at least an hour.

It was now becoming obvious to me that I was addicted to Annie and our extraordinary way of life. I wasn’t just missing her, I had a craving for her soft touch, her smile and beautiful laughter.

August 31, 2009: I called Annie this morning as usual, and as soon as she started talking, I knew we were in trouble. She couldn’t say more than a couple of words without taking in more air.

“Annie, you’re getting sick.”

She replied in a soft voice, “I know it.”

Photos from Annie's trip

Photos from Annie’s trip

My first concern was that she had a buildup of fluid in her lungs which would account for the sharp short bursts of taking in air, possible pneumonia, or fluid retention from possible congestive heart failure. I’d seen it many times before, and felt so helpless! Over the period of the illness, I became exceptionally good at seeing potential problems in their early stages and taking the appropriate action. This was my biggest fear, slapping me in the face.

I asked Annie to put Leslie on the phone. I told Leslie to have a close look at Annie’s legs, check for any swelling, and to take her temperature. While Lesley checked Annie out, I held the phone to my ear listening for any sounds or conversation between them, and as I did I could feel my heart pounding in my chest as I waited with anxious anticipation.

Leslie got back on the phone and said her legs looked okay, and her temperature was normal.

I gave Leslie the following instructions: check her temperature and legs for swelling every hour or so, and if her temperature starts to elevate or her legs swell, take her to the hospital emergency room immediately. Lesley was to tell them she has symptomatic multiple myeloma, and may be experiencing a fluid overload or have pneumonia.

The nearest hospital, Loma Linda, was very close to Lesley’s home. On this issue, I knew I could trust her. Lesley and I usually spoke daily over the phone, and she knew how quickly Annie condition could deteriorate when she gets ill.
Annie didn’t progress any further with her illness, but my suspicions were that she was ill, and it just hadn’t reared its ugly head yet.

September 2, 2009: Annie arrived home this afternoon and she seemed well, but I was still worried. The symptoms Annie had in California were typical of the way an illness starts when you have multiple myeloma. My instincts told me there was something else going on.

September 3rd, 2009: When we woke up this morning, Annie seemed okay. As I gave her morning medications to her, she told me how Leslie made her take her medications on time, every time. That pleased me, but I wasn’t surprised.

To be on the safe side, I contacted Melissa at Family Medicine East and set up an appointment for Annie to have a complete checkup tomorrow afternoon.

September 4, 2009: I took Annie over for her appointment at 2:00 PM. Her blood work was basically okay, with low platelets which was nothing new. She had a chest X-ray, which was within normal range for her, so we went home and decided to have a good weekend together.

Annie's photo album

Annie’s photo album

September 5, 2009: Today was a good day as we relaxed, and for the third time I got to listen to Annie’s stories again. She was so proud of herself for making that trip, and I was very proud of her too. She said she had a wonderful time and made lots of good memories. She told me around fifty to sixty people attended the surprise party in her honor. Annie said she didn’t know many of the people, but made many new friends and had many pictures taken with them. I loved the picture of her with short blonde hair, which was still growing after her treatment with high-dose chemotherapy. She was holding a glass of purple juice, saluting the camera. I loved the picture even more, after I told her it’s not a good idea to have a glass of wine when on morphine. That was one of the things I warned her and Leslie about when she went there.

Her reply was, “I didn’t have very much, and unless you have cancer with a death sentence, you’ll never understand.”

She was right! Physically, I usually had an accurate impression of how she was feeling, but mentally, I didn’t have a clue. Annie was on “death row,” but hadn’t done anything wrong.

September 6, 2009: This day started out as most, and she seemed to be feeling pretty good throughout the day. Melissa came over in the afternoon and we played around and made Annie laugh. Around 6:00 P.M. when Melissa checked Annie’s temperature, it had spiked to 102 degrees Fahrenheit. We both told her she needed to be transported to the hospital, and I was going to call 911. She begged me to give her something for the temperature and give it a little time. Annie could be a handful at times, but I respected her wishes, and gave her two Percocet tablets which contained 500 milligrams of Tylenol each. I told her I’d wait until 8:00 P.M. for a response, and not a minute longer.

At 8 P.M. her fever was gone, so I got her out of bed, wheeled her to the dining room table, and fixed her some macaroni and cheese. She seemed fine, so Melissa left for home. Around 10:00 PM, I helped her into the hospital bed, checked her over, all was still well. At 12:30 A.M., I gave her nighttime medications to her, checked her over thoroughly, and she still seemed okay.

When I laid down, it was around 2:00 A.M. My mind was focused on the two events that happened over the past week, of Annie feeling unwell. This time we added a high fever and I knew something was wrong, but for whatever reason, the underlying cause of the two events hadn’t revealed itself. I’d been through this sort of event several times; it always took some sort of intervention to get it under control. It never just faded away!

September 7, 2009: We got up this morning, did our usual routine of getting her washed, her medications, and breakfast. She had a snack for lunch, and laid down on her hospital bed around 2:00 P.M. for a nap. I did my usual chores, the dishes, cleaning, and sanitizing while she was resting.

Around 5:00 P.M., I walked over to her bed and put my hand on the back of her neck to make sure it wasn’t radiating heat, which I’d been doing throughout the afternoon. As soon as my hand got close to the back of her neck, I could feel the heat. I hustled to the medicine cabinet, grabbed the thermometer and took her temperature. It was 102.5 degrees, but the heat from the back of her neck was so intense I knew it would be getting higher. I ran next door, and luckily Sarah and Janet were home. They were both nurses with 70 years experience between them. They ran over to our house with a kit to check Annie’s oxygen saturation. Essentially, the oxygen saturation measures the level of concentrated oxygen in your blood. Annie was very low at 84 percent. Her breathing was labored and she was in obvious distress. Normal oxygen saturation for Annie was 95 to 96 percent on room air. When Sarah got the reading, she didn’t say anything to me, just simply showed me the number. I saw the number and said, “I’m moving,” meaning I was calling 911.

The fire department and paramedics arrived about fifteen minutes later. By that time her temperature was approaching 104 degrees. She was in respiratory distress, and I knew it. They took her vitals and noted that her fever was still around 104 degrees, and her oxygen saturation was unchanged. They put her on oxygen and transported her to Wesley Medical Center. When we arrived, they didn’t waste any time getting her in the hospital.

Once we got inside, and into a bed, they hooked her up to an IV for aggressive administration of fluids. Her temperature was 102.9 degrees, and her blood pressure was 120/76.

Dr. Womack was the attending physician at the emergency room. After they drew her blood and did all the things they needed to do, he probably made a decision that saved her life.

He walked over to me and said he’d be treating her with broad-spectrum antibiotics with Vancomycin and Zosyn for probable sepsis, which is blood poisoning.

When a person is in Annie’s condition, with her underlying immunity compromised gets sepsis, there can be as little as a three-hour turnaround period. Anything outside that window usually results in death. The vital organs are poisoned, and simply stop functioning. It can be a very painful death, and does happen, although rarely, with multiple myeloma patients.

By this time, my tears were flowing. I didn’t cry; they just ran down my face. I’d been so traumatized from all the pain and suffering I’d witnessed to this point in her journey and it was getting more and more difficult with each event. The only thing I had going for me at the moment, was the strong sense that Annie had a higher power on her side. I understood the desperate situation she was in and that she was going to need some help.

Annie’s chest X-ray came back positive to left upper lobe pneumonia. Once they saw the X-ray, Annie was immediately taken up to the Cardiac Intensive Care Unit and put in isolation. Annie was now relatively safe from getting germs or transferring germs to others. She was placed in a room, off of a smaller entry room. Being a military retiree, I called the entry room her first line of defense, which is essentially what it was, as the rooms were separated by glass sliding doors.

Annie was experiencing major breathing problems, and struggling to get enough air. She had two tubes, one in each nostril, pushing air into the passageway. About every thirty minutes they turned the volume up a bit, but it didn’t seem to help. I was starting to get anxious, as I’d been through some traumatic events, but seeing Annie struggling for air took things to a whole new level. Thankfully, Annie was sedated at the moment. When she knew the paramedics were coming she started getting anxious, so I gave her a Xanax to keep her calm. But, I suspected her anxiety was more due to her labored breathing than the paramedics.

September 8, 2009: In an effort to administer aggressive fluids, antibiotics and other medications a PICC line was installed this morning. Annie was approaching the maximum amount of oxygen she could receive from the wall-mounted device. I could feel panic creeping through me, as I knew if the lungs are not taking in the appropriate amount of air, over time the vital organs and tissue will be affected. There was urgency in her care; and they still didn’t know what was causing this event.

By the afternoon, it became apparent she had reached the maximum amount of oxygen the apparatus could provide. It stated in one of the progress reports, “even with the antibiotics and aggressive treatment, her condition was deteriorating rapidly.”

Dr. Troung, a pulmonologist, was called in to evaluate Annie. He realized quickly that Annie was in respiratory failure and needed immediate intervention. He decided to try her on the BiPAP, which is basically a mask, connected by tubing to a BiPAP ventilator. It delivers noninvasive positive pressure for impending respiratory failure. After several long-agonizing minutes, Annie’s rapid breathing was quickly turning into an emergency. Her breathing was so rapid it seemed as if she was exhaling and inhaling at the same time. I was standing beside her, with my eyes locked to hers, while she was sitting up on the bed struggling for air. I could see the fear in her eyes, questioning me, looking for some sort of reassurance, or telling her everything was going to be okay. All I could say was, “Hang in there, Annie.”

Melissa had the Bible out and was reading Psalms 23 to her momma. As soon as she read it, she’d say to her mom, “Do you want me to read it again?”

Annie would nod her head yes.

The situation was very intense, and Melissa kept reading until Dr. Troung recognized that the BiPAP was failing.

He walked over into the first line of defense room and motioned for us to come in. We quickly started walking his way and while in mid stride he looked at us and said, “We need to put your wife on the ventilator now, or she is going to code.”

I asked him if he needed our permission, and he said, “No.” Then I asked him if it would help her?

He replied that it will breathe for her, provide life-supporting care and maybe give us time to find out what’s going on. He said her illness is progressing very rapidly and we still don’t know what the underlying cause is.

Melissa told him her mom was a DNR, and he acknowledged her by saying, “If her heart stops beating, we will not resuscitate.” As he was moving back to Annie, he told Melissa and me to go to the waiting room.

Melissa and I went out into the hallway and just started hugging each other and crying. We were both very fearful, and knew life-supporting measures were a good thing, but the outlook for Annie was obviously in question or she wouldn’t be on the ventilator.

What we went through since Annie arrived at the hospital was very fluid, and intense. Melissa and I adored Annie, and watching her suffer as she had the past fourteen months, was starting to wear us down. The truth was, it was only going to get worse.

In part two, you will witness a courageous battle from a lady with a very strong will to live. And hear these words from Dr. Tom Moore, Annie’s oncologist’s son and future assistant director of the CDC. Bob, the odds of Annie surviving this event would be incalculable. Further, a healthy person would have trouble surviving what’s going on here. Dr Moore was Annie’s infectious disease control doctor. Brilliant man.

Written by Bob Harrison
Bob Harrison was raised in the heart of the Redwoods in the far northwest comer of northern California. The little town of Crescent City, California was located near some of the world’s tallest trees, with the west shoreline being the Pacific Ocean. Bob spent most of his time fishing the two local rivers where some of the finest Steelhead and Salmon fishing is located. He was also well known up and down the north coast as an avid motorcycle racer, winning several hundred trophies, and one Oregon State title. Bob graduated from Del Norte High School with the class of 1966, then spent a one year stint at the College of the Redwoods, before having a strong sense of patriotism and joining the United States Air Force. After three years of service, Bob met Annie, the love of his life, and they got married in England in 1972. Bob’s love of country pushed him on to what turned out to be a very successful career, retiring in 1991. Bob’s last military assignment was Wichita, Kansas, a place he and Annie decided to call home. Together they developed and ran two very successful antique businesses until the stranger knocked on their door and changed their lives forever; “Because of Annie.”

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