Wednesday, December 28, 2011

Finding Hope and Comfort in Death

There are good reasons for my complete lack of blogging since this past summer. Some of which include a busy schedule, other priorities, and a void of anything really worth posting about. But on December 2, 2011, my Grandpa Jim passed away after battling pulmonary fibrosis for about a year. I wanted to use this blog post to reflect upon the journey that we all experienced and to also remember those final conversations I had with Grandpa.

To briefly recap, Grandpa didn't really let the fibrosis bother him or his lifestyle until he was admitted to the ICU early Thanksgiving morning. Just this past year, Grandpa went to a Twins game at Target Field (Easter weekend), spent a weekend in Okoboji with my uncle Kelly and his family, and even took a trip to Las Vegas and the Grand Canyon with Grandma in September! He carried oxygen on and off with him from June on...but he hated it. He hated the stress of not knowing if he was filling his portable tank correctly, and he hated how it tied him down and limited his activity. Throughout his entire adulthood, Grandpa struggled with depression. It's not an easy topic to talk about, but I think it's even more difficult to understand what exactly he was struggling with and how that was affecting his outlook on life. So when Grandpa started to lose a lot of weight, fixate on why he couldn't breathe, and sleep all of the time, we started to worry about his mental health as well.

My first "hands-on" experience with Grandpa and his struggles was in June when my Grandma had a total knee replaced. Dad was in Canada fishing with Nick and Josh (a trip that Grandpa would normally go on...but he wasn't feeling well at this point), so it was up to Mom and I to make sure everything was taken care of. The morning of Grandma's surgery, I sat with Grandpa in the waiting room. He constantly asked questions about his portable oxygen tank and when we should go out to their van to refill it, questions about how to refill the tank, and when Grandma's surgery was going to be done. The questions themselves didn't bother me, but it was the repetition of these questions that made me wonder what was going on with him. It was almost reflective of an attention-deficit disorder. No matter what I told him ("Your portable tank is full...there's no need to refill it at this point" "When Grandma's done with surgery, it'll show up on this screen. The doctor said it will probably take 1.5-2 hours"), it didn't seem to give him any peace of mind. So I decided just to walk down with Grandpa to refill his tank. I had no idea how to do this, and Grandpa was quite flustered and probably embarrassed that he didn't really know what to do (even though the doctors and technicians had explained this to him many times over). He also judged whether or not the oxygen was working based on the pulsating noise of the tank itself. He had a difficult time understanding that constant oxygen flow, instead of oxygen pulses, also meant that he was getting oxygen. As our luck would have it, the level that it was supposed to be at, 4 I believe, wasn't pulsating. Clearly I had no idea what to do and I just wanted Grandpa to feel comfortable, so we walked to the ER to have a nurse look at it there. Unfortunately, they didn't really understand what was wrong either, but provided us with a different portable tank for Grandpa to use in the meantime. This was great, except it only prompted more questions from Grandpa, and more questions I couldn't answer ("Why can't I breathe, Courtney?" "I don't understand what's wrong with me." " I hate the way this makes me feel.") It was truly an overwhelming experience, and from that moment on, I knew things weren't looking good.

But the doctors insisted that his pulmonary fibrosis was under control. They were primarily concerned with his mental fixation on not being able to breathe. Because of this and a series of panic attacks, Grandpa was admitted to Avera's Mental Health hospital to undergo treatments, including rounds of ECT treatments. Looking back, this breaks my heart. All along, Grandpa was trying to tell us that he couldn't breathe, but instead of actually listening to what he was saying, we all chalked it up to his depression and mental history and tried to give him somewhat condescending advice of "just relax," "take deep breaths," "try to distract your mind with something else." Although ECT treatments are obviously much safer than they used to be and are nothing like the stigma of the scenes depicted in movies like "One Flew over the Cuckoo's Nest," they are still extreme and difficult. I feel like we were telling Grandpa that we didn't believe him, so we were going to shock the depression out of him.

In addition to ECT treatments, doctors recommended that he see a counselor to talk about his issues. Dad attended many of these sessions and he did mention that he saw improvement in Grandpa's attitude, especially after the counselor recommended that he go to Active Generations a couple times a week as part of his therapy regime. Grandpa went a couple times and often remarked that AG was a place for "old people," and that he didn't fit in there. We also saw sides of Grandpa's humor when he talked about playing "kickball" with a bunch of senior citizens. We thought we were getting Grandpa back.

But the disease was winning. We just didn't know how close Grandpa's body was to surrendering.

It was November 17th and I was traveling for work doing some outreach. I was just leaving Lake Andes and was on my way to Fort Thompson when I received a call from my dad informing me that Grandpa was going to have a stent put in that Friday morning. In the weeks prior, Grandpa went in for a second opinion at Sanford to see what was causing his breathing difficulty. The doctors noticed that two of his main arteries were almost completely clogged and that with the placement of a stent, he may experience some reprieve from having to work so hard to breathe. (I should note, it's very possible and likely that some of my recollection of these events is inaccurate, but the general picture should be the same). That Thursday (the 17th), the doctors noted that they were very surprised that Grandpa hadn't experienced a severe heart attack, but due to his great physical condition before he fell ill, Grandpa's heart continued to function normally. So Dad told me that if I wanted to see Grandpa before his surgery, I should think about coming back to Sioux Falls that evening and stopping at the hospital. He didn't need to say anymore. I finished my afternoon meetings and started driving back to Sioux Falls.

I knew that the procedure was pretty simple, due to my mom's experience working in Sanford's CVOR. But I knew Grandpa would be worried and stressed about it, so I knew it was important for all of us to visit if we were able in order to reassure him that everything would be okay. To be perfectly honest, I don't remember too much about this visit. I don't believe I stayed too long, but all of these hospital visits start running together. We probably talked about my recent trip to Austin, TX and Grandpa was always asking about my job. I just remember him being really, really tired.

The surgery went well and there were no complications. I had to hit the road early that Friday morning again for work, but my dad called with an update to say that Grandpa was in good spirits and was getting some of his color back. He was released from the hospital later that weekend to recover at home.

Everything seemed to be going well until early Thanksgiving morning. Due to panic attacks and Grandpa's inability to catch his breath, he was taken via ambulance to Avera's ICU. The first diagnosis was that he had pneumonia, which was affecting his ability to catch his breath and was also causing him to cough so hard. My dad spent these early morning hours with Grandpa...which was hard especially because Dad also had pneumonia! Grandma came over for Thanksgiving lunch while Grandpa continued to rest at the hospital. Later on that afternoon, I went up to visit Grandpa. This was my first experience in the ICU and holy cow, that place is depressing. I distinctly remember wondering why Grandpa was here, because this seems like a place where people come to die. You hear and see families crying, empty Kleenex boxes are strewn about, and an endless supply of surgical masks and antibacterial hand sanitizer is everywhere you look. I pulled up a chair and Grandpa asked me what I thought about Thune endorsing Romney for president. This had just happened the day before, so I was astonished and very happy that Grandpa was still "with it" and understood what was going on in the world around him. But perhaps the hardest thing for Grandpa to deal with was the fact that he wasn't going to get a Thanksgiving dinner. If you knew my Grandpa at all, you knew that he could eat. This is the guy that would order the endless soup and salad at Olive Garden and would legitimately eat 8-9 bowls of soup. He would only stop once we paid the check and everyone else was standing up to leave. He also had an unbelievable sweet tooth, which only made him long for pumpkin pie and some vanilla ice cream. He kept asking my grandma, Dad, and I what time it was. We couldn't figure out why he was asking, but later on realized that he was awaiting the Thanksgiving dinner that he would never get. Dad managed to convince a nurse to let him have some pumpkin pie later that night, which made Grandpa light up like you can't even imagine.

I continued to visit Grandpa throughout the weekend and he asked about my Black Friday shopping experiences and also kept asking when he was gonna get out of there. He was moved out of Intensive Care on Sunday, but was still on a high level of oxygen and we were awaiting the results of his bronchoscopy, which would determine if his breathing difficulty was the result of infection, or his pulmonary fibrosis. At this point, he had this giant oxygen mask on which was strapped to his head. It seemed very uncomfortable and he often tried to pull it off. But the medical staff insisted that although it may be hard to adjust to, this mask would give his lungs an opportunity to rest a little bit. I ran into Nick in the hallway on my way up to the hospital room, and Josh also came up to the room while I was there. They were heading back to school, since it was the end of Thanksgiving break, and wanted to stop by and see Grandpa before they left. Although Grandpa wasn't able to talk too much, both Nick and Josh were able to have great conversations with Grandpa and were able to tell him that they loved him. Nick and Grandpa were even making plans for Grandpa to come down for the Nebraska vs. Wisconsin basketball game. And I'm sure Grandpa was excited to see Josh run at an indoor track meet. Unfortunately, this would be the last time Nick and Josh would be able to talk to Grandpa.

That Monday morning, Grandpa was re-admitted to the ICU unit and was placed on a ventilator. My mom called me that afternoon to let me know. If you know my mom, you know that she wouldn't call unless she thought it was absolutely necessary. And she also wouldn't say that I should think about leaving work to come up to the hospital. I'll never forget getting off the elevator and seeing my dad stand at the end of the hallway with tears in his eyes. My uncle and his family had just arrived, and my mom, her sister Denise, and my grandpa's sister Doreen were in the waiting room. Dad asked if I wanted to go in and see grandpa and I said yes, but I had no idea what to expect.

Grandpa was hooked up to the ventilator, but was awake and relatively alert. Due to the position of the ventilator, Grandpa's head leaned to the right so I walked over to that side of the bed and held his hand. He squeezed it. He knew I was there. We truly didn't know when Grandpa would pass, so many of us ended up saying our good-byes multiple times. This was my first. Dad was in the room with me and I just told Grandpa how amazing he had been and how grateful I was that he was my grandpa. I told him that I was sad that he wouldn't be able to be at my wedding or see his future great-grandchildren, but also told him how happy I was that he was going home to spend eternity with Jesus Christ. There were a lot of tears and I'm sure I was a blubbering mess, but I just wanted Grandpa to know how much I loved him and how it was okay for him to let go because nobody wanted him to be in any more pain. Seeing a couple tears roll down Grandpa's cheek was gut-wrenching. He kept reaching for the ventilator, his sign to us that he wanted the ventilator out. He wanted to speak to us. I will always wonder what he was thinking when I was saying good-bye to him. I can't even imagine what it's like to be alive, conscious, and hearing people tell you how much they care for you and just sobbing over you.

When I left Grandpa's room to let other people talk to Grandpa before he fell asleep, I honestly thought that was the last time I would see him alive. But I didn't know how much of a fighter he truly was.

The decision was made to remove the ventilator at 1:30PM that Tuesday, Nov. 29th. We were all able to visit with Grandpa again that morning to let him know what was going to happen and he conveyed to Rev. LaRue Jundt (the Chaplain at Avera and a close family friend) that that is what he wanted. Rev. Jundt reassured Grandpa of his faith and his commitment to God and also shared some Scripture with him that morning. I spent most of the morning holding Grandpa's hand and visiting with other family members who were there to spend time with Grandpa. Shortly before they removed the ventilator, I told Grandpa again and again how much I loved him.

Then they removed the ventilator.

We all stood around Grandpa's bed, holding his hands, arms, legs. His breaths were quite shallow for the first 20 minutes after they removed the ventilator, so amongst tears and runny noses, we let Grandma and Grandpa have some final moments together. Standing outside of the room, we could hear Grandma say, "Go to the light, Jim, go to the light." And then Grandpa responded, "I don't see a light. Am I supposed to?"

We couldn't believe it. I was truly stunned. And part of me wanted to believe that maybe a recovery was in sight.

My dad, Uncle Kelly, and I were around Grandpa's bed when he asked my dad and Kelly if he was dying. They told Grandpa that yes, his body was failing and the fibrosis was just too powerful. Then Grandpa started to cry. I don't even know how to explain the feelings I was experiencing at this point. Part of me wanted to run away and forget that this entire situation was even happening, but I knew that this pain was just a part of the process. Dad and Grandpa were able to talk about faith and placing all of our worries into God's hands and Grandpa was able to verbalize that he knew that God was preparing a place for him. Those words are powerful enough when you read them in the Bible, but they come to life when you hear your dying, yet incredibly strong Grandpa say them out loud and to feel comfort in that. We asked him if he was scared and he said no. What a blessing. My grandpa, the biggest worrier I know, wasn't scared about what was coming next. He knew that there was no need to be scared when he knew that God was waiting for him.

Since Grandpa was doing okay, relatively speaking, he was moved to Dougherty Hospice House to rest comfortably during these final moments, away from all of the noise and chaos of the ICU ward. I found so much peace at this facility. Not only was it beautiful and the staff incredible, but it just felt like this was all a part of God's plan. Grandpa slept most of that Tuesday evening, but when he woke up, he had questions as to where he was and who was paying for it, which was typical Grandpa. We were all emotionally and physically exhausted and ended up saying good-bye, again, and left to try to catch some sleep.

Sure enough, Grandpa was awake the next morning. My grandma had spent the night with Grandpa and said that he had been awake since the early morning hours. You could tell he was so tired, but wanted to talk to everyone. He told us that he was worried that if he would close his eyes, he would never wake up again. It was very hard to hear, but it was so accurate. I tried to imagine what he was feeling and thinking, but it was impossible. We continued to share Scripture together and pray with one another. Perhaps my "favorite" and most powerful moments involved Grandpa telling Kelly and I that he kept seeing a big house with lots of rooms. He kept looking up at the ceiling and looked like he was experiencing a completely different world. I'll also always remember standing at the foot of Grandpa's bed with him looking at me. My dad said, "Do you see Courtney?" Grandpa nodded. Dad: "Is there anything you want to tell her?" Grandpa: "That I love her." Even as I type that, tears fill my eyes because I can still hear his voice and see his eyes looking at mine. It was incredibly powerful, sincere and overwhelming. Before we let my grandparents spend some more time alone before Grandpa fell asleep, my dad gave Grandpa a hug. But Grandpa was so weak, he was unable to lift up his arms. As my dad walked away, I saw Grandpa lift up his arms so I said, "Dad. Turn around." Dad gave Grandpa another hug and Grandpa was able to hug him back. Dad said, "I'll miss these hugs," and Grandpa responded, "I'll miss them too."

Those were the final conversations we had with Grandpa.

He fell asleep later on that afternoon and didn't wake up. He died in peace and comfort at 2:05 AM, December 2nd, 2011.

The days leading up to the funeral were filled with people bringing over tons of food, looking through endless pictures and reading all of the incredibly thoughtful cards that people sent. It was truly amazing to see how many people Grandpa touched throughout his life.

During the family visitation, I cried when I saw Grandpa's body in the casket. I thought my tears had dried up, but the body always has a way of finding more! It was just very shocking. During his final days, the wrinkles disappeared from his face and he looked 20 years younger! It was amazing to see him look so good for his funeral. Grandpa was very particular about his appearance, so I'm sure he was pleased :) Miller Funeral Home was very great and gracious throughout the entire experience...and they were all very professional and understanding.

The visitation was a unique opportunity to see how many people loved Grandpa. I'm sure a part of Grandpa Jim always wondered if anyone would show up to his funeral, but goodness, I'm sure he never expected a packed house! It was comforting to be around so many friends and family, and even people I didn't know.

I was a pallbearer with my brothers, cousin Spencer, and Grandpa's godchildren Corey and Chad. This was my first experience carrying a casket, but it was an incredible honor. Grandpa served 10 years in the Minnesota National Guard, so he received a military burial. Carrying a casket is a sobering experience regardless, but carrying one with an American flag on top of it was even more special. Although it was a sunny day, it was freezing so I was shaking uncontrollably due to not being able to feel my legs and from the tears. Watching the Honor Guard fold up the flag and hearing Taps in the background was one of the most beautiful experiences. I was so proud of my grandpa in that moment. At the end of the burial service, we released purple and gold balloons (for the Vikings of course...Grandpa was a big fan) into the sky. It makes me wonder if anybody saw the balloons and wondered what they were for. But like the balloons which traveled a long distance, Grandpa also traveled a long distance to get to where he is now.

His life was never easy. He fought and beat cancer, only to fall victim to another disease. But in 1995, Grandpa gave his life to Christ when my dad took him to a Promise Keepers event. We didn't know this until after Grandpa died, but Grandpa kept his admissions bracelet to that Promise Keepers event and kept it in his jewelry box. Written on the back was the date when he gave his life to Christ. Grandpa was a man of few words, so the fact that he kept this bracelet (and his Promise Keepers t-shirt) were physical reminders of Grandpa's decision to follow Christ. I can't imagine how much this means to my dad since he shared that moment with Grandpa, but it meant the world to me that we can rest easy in knowing with 100% certainty that Grandpa's faith carried him through and God's promise of an eternity with Him was fulfilled.

I know this was a long post, but it was important for me to share this experience. I continue to have good and bad days. I continue to have dreams about Grandpa on a frequent basis and occasionally, I'll spend time scouring my room looking for reminders of Grandpa. I've found a couple that mean a lot to me.

1) My high school graduation guest book. My mom purchased "Oh the Places You'll Go!" by Dr. Seuss and Grandpa wrote, "Courtney, I'll always remember the good times we had together. Grandpa Jim."
2) A Christmas ornament I received from Grandpa. It's a gold quartet of angels playing trumpets. Although I haven't found the card that was included with the ornament, Grandpa wrote that I would always be his angel.
3) A card I received from Grandpa while I was in college. It says something along the lines of, "Courtney, Just wanted to write you a little note to thank you for being so kind, calling me on my birthday. It was nice of you to remember...We're counting down the days until you're home again. It's always nice having you home. Love you, Grandpa"

It's no secret that people grieve in different ways, but I will continue to grieve by furthering my relationship with God and praise Him for guiding my grandpa to eternity. My grandpa was a great man and I consider myself to be truly lucky to call him Grandpa.

John 14:1-4 "Do not let your hearts be troubled. You believe in God; believe also in me. My Father's house has many rooms; if that were not so, would I have told you that I am going there to prepare a place for you. And if I go and prepare a place for you, I will come back and take you to be with me that you also may be where I am. You know the way to the place where I am going."

3 comments:

Doreen said...

Courtney, thank you for sharing this beautiful blog about Grandpa. Your words are amazing, your expressions are so well stated, truly Grandpa was an amazing person. I as one of his sister's could tell of so memories we had growing up. However; you have said it all, there are no other words that need to be said. May Our Lord give you and all the strength to get through this week. Prayers for all!

Courtney Heitkamp said...

Thanks Doreen! Thanks for the prayers - I'll be praying for you as well. I can't imagine what it's like to lose a brother.

Grandma Alice said...

Courtney it is soo hard to read this again. It's like Grandpa is still here until u get to the end. I am having a hard time finishing, in fact I couldn't. I can't see the lines with all the tears but "thank You" Courtney you will always be close to my heart as u were to grandpaa. After you and Erin were born we always said God sent us our girls that we nefver had and we loved and love you much. Thanks you for being you.