Tribute to Karen

April 2010

• Apr. 1 – Extremely tired. Average heart beat 130. Blood pressure low (85/38). Mucus attack. I had feed Karen four 8oz Ensures during the day. At 9:30pm Karen started coughing uncontrollably. To weak to cough up the mucus. Heart rate race up to 150ppm and blood pressure dropped. Took 4 hours to stabilize Karen by giving her Oxygen with nebulizer.
• Apr. 2 – Low blood count. Start another 2 units of blood transfusion
• Apr. 2 – Tried to removed fluids, however, there were to many pockets of small fluids and therefore could not do a paracentesis. Will try Monday April 5. Between now and April 5, will work with Karen to setup and move around and to see if gravity and medications can help create large pockets of fluids for draining.
• Apr. 5 – Paracentesis 2 liters
• Apr. 5 – Cat Scan
• Apr. 6 – Plan (on Apr. 7) drain fluids on both lungs and test for cancer cells. (Thoracostomy)
• Could not drain fluids from lungs due to lack of amount and the proximity to lung
• Apr. 7 – Low Hemoglobin. Blood Transfusion 2 liters. Blood pressure 112/65 Heart rate 125ppm
• Apr. 8 – For 5 hours, every hour on the hour, had Karen setup on the side of the bed for 15 mins and do breathing exercise. 
• Concern – Due to Karen’s weakness, swallowing some foods is extremely hard (e.g. fish, bread, fries, etc.) 
• Karen can not eat dairy products due to mucus build up. Things to think about. The rehabilitation facility does not have immediate access to certain medications. We need to develop food for Karen that is high in protein and electrolytes.
• Apr. 9 – Tried level 3 – All intravenous (IV) and medications completed and removed in morning. Moved to Oakwood Rehabilitation and Skilled Nursing Center at 4:30pm.
• If I had to do this over again, I would have had Karen stay at the main hospital over the weekend so she could received the proper foods. Still having Karen doing breathing exercises.
• Apr. 10-11 My concerns have become a reality. Oakwood Rehabilitation and Skilled Nursing Center (ORSNC) is unable to provide food that Karen is able to eat (pureed meals). Therefore, Karen has not eaten well these past two days. I have asked for fresh fruits and smoothies; However, until a nutrition specialist meets us, these foods can not be provided to Karen. Go figure, Sunday Morning for Breakfast they offer Karen biscuits and gravy. Met Physical Therapists Saturday. Have yet to meet Dr. Belal F. Abdallah. First impression – not a great facility for our needs, but Karen will get through it.
• Apr. 12 – Today was much better than over the weekend. Met with two different therapists (one for lower body and one for upper body). Met the Geriatric Nurse Practitioner. Only medication being used is sleeping pill and blood thinner. Only sore is the on the right calf. Exercises – Today Karen did two sets (20 rotations forward and backward) of arm bike. Three pound weight box reached forward and backward than left to right. This is for the back muscles. Next Karen did leg exercises. Leg lifts, ball between knees and leg extension. Was able to get food ground up so Karen can eat solids. Throat muscles very weak.
• Apr. 14 – 13 Sweating uncontrollably. Due to lack of strength in Karen’s throat muscles, she is only able to eat ground up foods at this point. Also very little fat and muscles on her back, so laying down on her back bones (spinal) is starting to hurt. For the first time ever, Karen has asked for a pain killer. I rotate her about every two hours. At night, I place pillows under her entire body to help reduce the amount of pain.
• Apr. 15 – Blood test – Tests showed white cells count extremely high. Possible infection. Karen taken back to hospital to emergency room 4:30pm.
• Apr. 16 – Karen given fluids and antibiotics
• Apr. 17 – Continue fluids, antibiotics. I continue to work with Karen with her eating and exercising. Lesson learned – Had I not been with Karen during the day/night she would not have been exercising or eating. There is not enough help available. E.g. to eat a bowl of oatmeal takes about 1.5 hours. Also, she needs encouragement to exercise and eat.
• Apr. 18 – The infection is from pneumonia
• Apr. 19 – Chemo#2 moved to April 21
• Apr. 20 – Continue fluids, antibiotics, eating, exercising. A week ago, Karen could only left her hand 6-8 inches of the bed. Today, above her head. We exercise every 2-3 hours from 9am to 9pm. Objective – Get her strong so she can stand, sit and walk. Exercises are for fingers, arms, toes, legs and lungs.
• Apr. 21 – Waiting for bowel movement. Last bowel movement was Sunday. Continue eating pureed meals (meals ground up to help swallowing).
• Apr. 21 – 13:00 hours – Paracentesis removed 2.2 liters. Weight before paracentesis 198lb, weight after 196lb. During the evening, fluids continue to drain. By at 10pm an aliitional one (1) liter had drained. Hopefully by morning 90% of the fluids will have drained.
• Apr. 21 19:30 hours – Chemo#2
• Apr. 21 – Showed Karen a bill from a self storage unit that I did not know existed. She smiled. What else has she done that I do not know about? 🙂
• Apr. 22 – Karen doing good. Paracentesis still draining. Let’s hope this chemo works.
• Apr. 23 – Ultra sound on the heart. Karen may be fighting another infection. 
• Apr. 24- Karen’s breathing hard. Not eating and has pain in her lower stomach. Seems to be in pain while having her legs massaged.
• Apr. 25 – Morning Karen not doing go. Infection and cancer has spread. The chemo seems not to have worked. She fought a good battle. The doctors and nurses have done a great job. Karen is approaching a new life. We’re No ‘Awa’ Tae Bide Awa’. – We are not away to stay away.

During the 6 months, I would ask Karen “did I say I love you” and every time she would nod her head no. I would than say “I love you” and give her a kiss on the lips. Sometimes I would do this every 15 mins. Today, people did not think Karen was responding so to show they were wrong, I would say “did I say I love you”, Karen was to weak to nod so I would put my lips against hers and she would slow pucker up and we would kiss.

• Apr. 25-26 – John Berger (friend for 30 years), Gary Leemaster (from California using SMS) and I stayed with Karen through the entire night.
• At 6:00am Dr. Peter enters the room and then states “Karen can you hear me?” Karen can not response because she is weak. Dr. Peters gestures to me to come out in the hallway. I leaned over to Karen and said “Did I say I love you today?”, put my lips on hers, she pucker up and we kiss. I told her I would be right back. I agreed to have hospice care. At 10am John and I decided to thank the people who had helped us. When we got back at 10:10am, Karen had taken her last breath. My brother Dean, son William (age 20), daughter Emily (age 23) and Maura (age 17) had all arrived at about 10:15am. Emily and Maura gave their mother a final kiss. It was interesting on what William did. Instead of a kiss William left the room. When I asked William if he wanted to see his mother he stated “That’s is not my mother, it’s just the shell. Her spirit has left the shell.” Karen has stated a new and wonderful journey.
• City of Dearborn tickets one of my vehicles because it is parked in the street on a service day. Called the City of Dearborn to ask for a waiver. They request that I put in writing the circumstances.
• Apr. 26 – Went to funeral home to make arrangements. Requested 15 death notices. Things needed: Karen’s Social Security Number. Her “real” name. I say this because Karen used both Karen Cawthon and Karen Leemaster Cawthon on records.
• Apr. 27 – Dean and I write the letter to have the ticket dismiss. I had to actually go to court and explain the circumstances. Here is the copy of the ticket and letter.
• Apr. 28 – 30 Continue to make arrangements and contacting Karen’s relatives.

Ticket from City of Dearborn while vehicle was parked in front of my house. Reason – Abandoned Vehicle. Go Figure. Only in Dearborn Day Karen passed away