Matters Concerning the General Health of Raymond Ernest Dickins, paterfamilias.

The Roller Coaster
Raymond Ernest Dickins
July 9th., 1919 - March 2nd., 2009

March 1st., 2009 plus

Episodic Diary (start) : or, latest entry
Blood pressure readings : or, go straight to latest reading
page edited: Friday, October 16, 2009

(2008 Diary and table)

Medications, etc., will be entered here and changes noted when applicable.
Specifically, I want to find out what they are (see George's comment of Jan 1st.., 2008).

Antibiotic, for ear infection, twice daily, twenty doses, Clarithromycin, since Friday, December 28th. Produced side effects. Ear infection yet present mid February, 2008. By early April, seemingly gone.

Constant pharmacological intake, daily:
Blood pressure, blood thinning, anti-cholesterol, etc.:
a) Diovan, 160mg/25mg
b) Fosinopril 40mg (20mg morning and night)
c) Aspirin, full size, uncoated (ceased when Plavix kicked in)
NB: after one week, Aspirin intake to cease (DONE). The Ranitidine is for easing possible stomach upsets.
d) Multi-vitamin, especially E.
Above daily, morning.

e) Sandoz-Felodipine (Felodipine XR) 10mg, one at night.
f) added, 2008/02/15: one 20mg Fosinopril to be taken evenings.

New additions, expected from February 22nd., 2008:
h) Plavix, 75mg
i) Ranitidine, 75mg
j) Lipitor, 20mg

Added, March 3rd., 2008 by Dr David M Halliday (613-235-8146).
k) Novo-Metoprol film coated (Metoprolol Tart) 50mg., twice daily

Added, by Lynn's request:
l) Lecithin, granular, for sprinkling over food, or mixing with juices, two tablespoons daily. Currently not taken, if ever after the first time!

m) Aggrenox 200/25mg, added by Dr Stotts (2008/03/26) in lieu of Plavix. Immediate, twice daily.

n) Aggrenox to be stopped on Friday, May 2nd., and Plavix to be reinstated immediately, Monday, April 28th.

Note that there are blocked (sclerotic) arteries in his neck, and that he has had at least one small TIA, and maybe, late 2007, a somewhat larger one. This caused us to use Appletree, and later obtain a family doctor, Dr David Halliday (who prefers to be addressed as doctor: does not like familiarity.

Phone numbers, where known:
Dr David Halliday (GP): 613-235-8146 (locum: Dr J. W. Maloley (613) 594-2831))
Dr Piney Pollock: 613-234-4807
Dr Grant J Stotts: 613-761-5353 ext 3
Dr Hakim: 613-737-8899 ext 74518 (extension not in use)
Dr Lu


Thursday, January 1st., 2009: I took the readings a little after Dad had got up for the second time this morning. He had, like yesterday, taken the meds and gone back to bed for a while. The readings are lower, but need to be retaken to check in later days.

Dad has what appears to be a black eye, which is fading somewhat. This just appeared and the cause is unknown, but probably linked to the meds. He does look old nowadays, as he occasionally staggers around the apartment. Staggering is not a euphemism.

My elder daughter, Sarah, phoned whilst Dad was in bed. Her husband, Prasannavira, has been going up each weekend to Nottingham, where his mother has been laid up in hospital. They were all there for Christmas, but I doubt it was the happiest of times. Sarah will phone again, later today, to talk to Dad.

Last night, I tested Skype by phoning their home, but they were out, or asleep. At least I know that Skype will work, and also with mobile phones as well as fixed land lines. The best method is, of course, to use a computer attached to a broadband internet connection. My sister, Lynn, only has dial-up, so that may not allow decent quality calls. However, something is better than nothing, and it's very inexpensive.

My latest ex-wife had brought up pies. I have found that the instructions are faulty: cooking for longer, at higher temperature has fixed that. I had thought it was my cooking skills at fault. That was true, in that I couldn't figure out why the pies were always undercooked. Rats!

Friday, January 2nd., 2009: Well, I waited to see what happened, and Dad went back to sleeping in his chair when, after breakfast and his meds, he fell foul of the side effects.

Not that I feel well, after the snow, the footing has been more treacherous than I expected. My back hurts, but it won't prevent me from cooking. To everyone's disgust!

Saturday, January 3rd., 2009:  The bus strike persists, the parties idiotically stranded in mutual accusations. Meanwhile, the rest of us suffer: and the city saves the money by not paying wages. The mayor, a charlatan, maintains his stance as a capitalist hero. Rubbish, given the state of the world at this time. We need compassionate governments, with a mix of privatised and state run sectors. Nothing else works.

Dad is just under half-way in reaching his actual 90. Just over six months to go. The error in the reading today, indicative of erratic heart beat.

Monday, January 5th., 2009: The bus strike continues; and as father retires he states 'I'm getting weaker'. No wonder, no exercise. What does staying within a foetid area imply, minimal air changes when the weather is inclement, with no real stretching of his limbs. I saw him standing behind his chair, stretching out. He can't possibly be having enough exercise to keep him in any reasonable condition. The idiots on either side of the strike still prattle around: pride rules.

Friday, January 9th., 2009: An odd day for Dad: he told me that he fell down in the bathroom earlier after his right side went weak. Then, when I took his readings, they revealed odd numbers. This made me state that the machine was giving an error so we'll leave it until tomorrow to retest. I did not want to give him anything to worry about.

I also did his laundry, that he normally does on Thursdays, but was too tired. He remade his bed and put the other stuff away when I was out during the middle of the day. He admitted that he hasn't felt at all well today. The anomalous readings agree with that sentiment.

Monday, January 12th., 2009: I took the readings and mentioned to Dad that they were high again. To which he responded that he knew, because his right side had been playing up. At any rate, the dust mites should not affect him since I did a total vacuuming job this morning. Bloody housework!

Wednesday, January 14th., 2009: What is going on? These three readings are worrisome. The bus strike pervades many people's health and welfare. The anger that I hear from many people about the lack of movement by either set of idiots is based on the fact that no one cares about what is happening to so many citizens in ill health, or having disability. Apart from that, the expense of using cabs is exorbitant. Dad has not been out for some time, and the current frigid spell can't help, either. He needs to leave the apartment for at least a little time.

Monday, January 19th., 2009: I returned home early this afternoon (to see Liverpool draw with Everton) to notice two shoes on the drip tray just inside the front door. Good grief! Dad had been out, via taxi, to his bank, the branch on Bank Street, but not his home branch on Wellington. When I asked why he had not gone there, because there is a bookstore close by, he remarked that it was too expensive to do that. Would maybe have cost him three more dollars. What comment should I make? His UK pension has gone down by $200 CA in recent times. Mine, a pittance, has dropped commensurately. His loss equals my monthly intake!! What a joke.

But, at least he had some fresh, frigid air, and a chat with strangers (Sarah phoned last night, and Lynn phones each Friday).

Tuesday, January 20th., 2009: The only reading similar to today's is one on January 10th. All of the others seem to be consistently high. No clue why.

Wednesday, January 21st., 2009: Dad told me that he had fallen down in his bedroom this morning. He said that he thought he would recover. I don't know what he actually damaged. David, his grandson, phoned in the evening: Dad was happy to hear from him. He has a new job, and that is amazing in this economic climate, effective worldwide.

Saturday, January 24th., 2009: Visit from the ex with our daughter Katharine. Dad, as is now usual, did not accompany us to the restaurant. Other than that, he had an odd day, going to bed looking poorly and stating that his right side has been acting up again. He looks a little scruffy because he has not had his usual short top and sides at his barber's shop. That is too far away, without the bus to use.

I did not take his bp readings today, because no time seemed appropriate.

Monday, January 26th., 2009: The parties are to meet this morning, following a decision by the mayor and his acolytes to modify their stance. The response from the head of the bargaining committee was the usual belittling aside. Would that there was some common sense.

I have been having mild consistent migraine attacks for the past three days: mild headaches but allied to vision problems, that are more serious. Can't help Dad if I'm like this. I wrote this using only my left eye: so, it's the left side of my brain causing problems, hein?

Tuesday, January 27th., 2009: I had another migraine attack, but still made dinner, since by then all I had affecting me was a headache. I made salmon for dinner, and afterwards Dad told me he was feeling somewhat poorly, just like me. But, when I asked him what was actually wrong, he stated that he can't think straight. Whatever that really means. I recommended that he just watch the telly, just like he did for the soccer game this afternoon.

And, the OCTranspo strike persists.

Wednesday, January 28th., 2009: The strike continues after the latest meetings collapsed: I do think that they should be set up in the middle of a road, with just their skivvies on and told they can't leave until they've made an agreement. Dad said, after taking the reading, that he didn't feel so bad today. But, look at the pulse.

Friday, January 30th., 2009: The government threat of back-to-work for OCTranspo has resulted in an agreement to go to binding arbitration. Given that both sides approve the tentative agreement, the operations to restart the bus service will begin. This means that Dad might be able to travel somewhere within a week.

He has not been feeling well, especially yesterday for whatever reasons. Today's readings imply the meds are working, although I am doing his laundry each Friday, so his exercise is limited.

He also told me he is going blind, because he can't see the falling snow. It is very fine, but is quite obvious if one looks at it with a dark background.

Tuesday, February 10th., 2009: I waited until just after 09:00 to see if Dad was alright. I could not, prior to that, see if he was breathing, because of poor light. At my call to him, he did reply that he had had a bad night. After I had showered, he arose to go to the toilet, and returned to bed. He is obviously either tired or remains sick. His readings have been unstable lately.

Dad is up now, and asked me to look at one of his big toes. The lady who gave him a pedicure yesterday obviously cut the skin and perhaps damaged the nail. This is one of the reasons that he had a poor night; it was aching all of the time.

On top of that, I have noticed that his hernia gives him problems each morning, until he has settled down.

Wednesday, February 25th., 2009: Dad has been  in bed all day so far: not feeling at all well. I came back to watch the soccer, and he was on the toilet with the door open but no light on. I had looked everywhere but there, and couldn't find him!

I heard the toilet flush and he disappeared back into his bedroom. I really don't know what to make of this.

Neither do I know if he has eaten so far today.

I have spoken to him and he says he feels incredibly tired. He doesn't want me to cook a meal. He doesn't want to eat. All he is doing is going for a pee. If I call for an ambulance he probably won't come out again: I'd rather he was here.

He has refused the offer of chicken soup; simply wants to go to bed. What to do?

He is yo-yoing out of bed to pee: what is the cause? The light is on in his room, and I keep on checking. I see him move, and he is lying on his back, but I can't tell how he actually feels.

It is 08:15hrs: he has just asked me to put the light out. I asked him if he expected to get up at all today. Note that he wants no food, his bowels are in a bad way.

What responsibility do I have about being required to call an ambulance? Or, do I wait until the morning. Hobson's Choice.

19:00hrs: Dad is standing by the counter in the kitchen, in his Depends, imbibing his meds. After another waterfall. So, he can do that, at least. Better than I expected.

Now, he goes for yet another pee. There is something really untoward going on in that particular extremity

I noticed that the light was on at 22:40hrs, and he was doing something in the kitchen and then went to the can. He never approached me in any way. Presumably, he will be up tomorrow?

Thursday, February 26th., 2009: The light came on, so I saw him coming out of the bathroom. He said he was feeling a little better, but his toe (the one damaged by the pedicurist) is still hurting him. He asked me to look at it later, when he eventually got up. He went back to bed. Was this a bug? Is it something to do with an infection in his foot?

At around 10:00hrs he came out for breakfast. I asked him if he felt any better, to which there was a positive response. He went back to bed, of course. Not quite out of the woods, but the crisis, that I thought was here, has lessened.

I returned around 14:40hrs. Dad is still in bed, but I can see him breathe in the dim lit room. However, I do not think that he has been out of his room into the living area since I went out on errands. Thinking whether to phone the doctor/call for an ambulance.

I called for an ambulance at 15:55hrs: a result of not being able to speak to anyone at the Ottawa City Paramedic phone numbers. I spoke with Dad and told him that I would, and that I had spoken to Lynn, and that I was told that he wouldn't have to go to hospital, as far as I know. They will check him out. We shall see.

The paramedics have taken him to the General: I have stayed here, and will go and pick him up when required, probably after I have eaten and informed family. They found nothing obvious, but insisted it would be better to have him seen by a doctor.

Info: I phoned Sarah (who, I discovered, is on a retreat) to talk to Prasannavira, and Lynn was not in, twice.

In the event, it took several hours, blood tests and an x-ray, for them to determine that he has an urinary infection, which, with him not eating properly, has damaged his kidneys. That's the main reason for having him there, (and they did mention the problems with bacteria in most hospitals. That was not unexpected, the staff were excellent.)

I shall return tomorrow, after doing the laundry, with his teeth and glasses and the Guardian Weekly.

Friday, February 27th., 2009: As it rains, and the temperature rises, to fall rapidly this evening, I ponder what has gone, lost for ever: doctors who visited their patients. This was the commonplace in England, at least until I left there. Nowadays, here come your friendly paramedics, who check one out and take the sick to the emergency where, usually, they wait and wait and wait. The fault is not with the doctors in the hospitals, its with the idiots who govern us: if one thing should not be forgotten, it is that local care, preventative care would remove much of the pressure. Lots of people end up in emergency areas because they simply do not have a doctor. This is not too difficult to fix. Pity the NHS in the UK: soon to be totally overwhelmed by the fat.

The visit to the General today determined that Dad has not been moved out of Emergency; no bed available. That to happen during the afternoon/evening. The doctors informed us that he has a sensitive prostate as well as the urinary infection. There is, as I mentioned, damage to his kidneys.

There will also be physiotherapy done to help him recover, since the normal physical signs that he transmits are good. He is fit, except for his excessive hypertension, and the deleterious effect his meds have on him every day. So, tomorrow will see the Montréalers come in and visit him, because they want to. That is nice.

The doctor told me that physiotherapy can be continued at home, should they think it helpful. That's good news. The doctors think that with the antibiotics, and the anaesthetic for his urinary tract, he should rapidly show an improvement.

Saturday, February 28th., 2009: Dad was pleased to see the three who came up from Montréal and also interested in the football scores, especially that Liverpool lost.

I came home to find a message from the General. I phoned back and heard that Dad may be discharged tomorrow, and that he will probably become a urology outpatient. That is to be confirmed.

Sunday, March 1st., 2009: I went out because I wanted to see whether he was to be sent home, and with odds and sods for him.

When I arrived at the ward, the bed was surrounded. My first reaction was these were interns, it's a teaching hospital. When I saw the doctor who had been on duty last night was there I nodded and he came out and told me that what had happened was totally unexpected.

Dad was found on the floor. They do not know whether he had fallen or passed out and landed hard on the floor. He was checked and found to be breathing. When the team came, he stopped breathing and they resuscitated him. They ran an ABG (blood gas levels) which was really bad.

He was shortly taken to ICU, and I saw him again after a talk with a Dr Hibbert regarding what to do in the circumstances. I decided not to stay, because there was to be a considerable time spent following his vital signs, and I could do nothing but sit.

If he is likely to be damaged or debilitated to the level where he is unresponsive then I advised the doctor that I would prefer that he was allowed to die. Dr Hibbert was of the opinion that the overall prognosis is poor. I told him about some of what Dad has been through in the past year, including the TIA, and how the bus strike affected him.

I phoned Lynn, and she was agreeable, as far as I can recall, with allowing him to pass in peace, should that be preferable under the conditions that transpire. This was after I had phoned Sarah and Michelle/Katherine.

Phoned the General, using the incorrect number that I was given. Now, I have the correct one, and was told he was slowly deteriorating.

Phone call: the nurse phoned at 15:07 to tell me they are weaning him off the machine, so there is now the onset of determining if he can fend for himself, or if he slowly disappears.

I was out at the General again. I saw a nurse replace his breathing equipment. Whilst it was disconnected, he could breathe on his own, if with difficulty. Then Dr Hibbert saw me there and told me that Dad's blood pressure was very low, and lessening.

In his opinion, Dad might not last the night. When I returned home, taking a little time off for a coffee, there was no phone call. Presumably, the regimen he is under, with the gradual removal of props, has not, so far, resulted in death.

Please forgive me, but I cannot stay there. He is inanimate, he is unaware of his surroundings, he is not who he was when the four of us saw him on Saturday, in the early afternoon. When, or if, he dies, it could come at any time, according to the doctor. It is likely to be swift, I was told. That is better for him, than perpetual cosseting and invasive medicine would be.

Phone call, 23:00hrs.: Dad is comfortable, has just been turned. The details are that his heart has been damaged by the cardiac arrest. The oxygen levels being pushed around are simply not high enough to maintain him. His blood pressure has improved a little, but that's his basic strength. However, something went wrong.

He will, therefore, slowly weaken over the next while. So, this is clearly the end, according to what they are telling me.

Sorry to have to advise you all of this. However, given what I have seen of his deterioration in the past couple of months, I could not see him lasting very long in any event.

The nurse in ICU told me she would call if anything happened.

Monday, March 2nd., 2009:

Phone call: Dr Hibbert called roughly 07:30hrs. Dad still there, but slowly sinking, the doctor surprised that he is so strong.

The idea is that the "team" will look at him today, also the palliative care group. It is likely that he will be returned to the ward where he was, which is understandable. There, he will be cared for until the end. There is no doubt that it is coming now, his blood pressure and oxygen levels, for example, are much too low to support him. There are no resurgent signals coming from him. Dr Hibbert said something else, but I forgot what it was. Will ask about things when I visit today.

I went out again late morning, to find that he is still in the ICU. The doctors have decided that, rather than take him up to a ward, they will keep him here as he slowly fades away. I am thankful for that show of compassion. They said he is comfortable with the sedation, and is showing no signs of pain. He looks a fragment of what he was, with his mouth open. He is breathing on his own, and his body is simply working without him knowing. He is deeply unconscious.

The nurses, doctors I spoke with have all said that he has a very strong heart. The extremities of his body are becoming colder, as it slowly shuts down. There are signs that his pulse and respiratory rate are slowing little by little.

I stood there and gave him all our love and best wishes, from everybody in the family. Not that he would have heard, but I felt that this was necessary for me to state.

I am expecting some news within a day or so. That he was to have died last night and did not is an expression of his innate strength. After all, he lasted this long, with all of that medication that had adverse effects.

On a personal note, I had my hair cut today, it has been rather scruffy: this to show respect, in actual fact. I found myself bowing in front of him: I really don't know where that comes from. I thank you all for your wishes, and signs of respect for him.

Phone Call: Dad died at approximately 21:20hrs. ICU, General Hospital, Ottawa, ON

Latest entry above

Ongoing, almost daily, blood pressure readings:
Date   Time Blood pressure
Heart Rate
January 1st 10:30 137/82 51
January 3rd 09:35 140/72 error
January 4th 10:50 158/83 49
January 5th 11:05 122/66 49
January 7th 15:45 152/100 50 erratic
January 8th 11:25 134/74 48
January 9th 17:45 89/52 see this day error
January 10th 09:40 115/65 53
January 11th 09:40 145/118 56
January 12th 16:50 176/94 45
January 13th 11:05 134/77 45 erratic
January 14th a 17:00 159/97 100 erratic
January 14th b 17:05 207/98 47
January 14th c 17:08 191/101 see this day 43
January 15th 09:50 162/73 48
January 16th 11:20 171/78 43
January 17th 09:45 139/60 55
January 18th 10:40 186/98 error
January 19th 17:25 153/79 52
January 20th 09:55 110/68 50
January 21st 20:35 144/77 53
January 22nd 10:45 133/85 51 erratic
January 23rd 06:45 170/110 53 erratic
January 25th 11:50 142/77 45
January 26th 10:20 147/76 47
January 27th 16:10 174/96 47
January 28th 10:40 142/68 85 erratic
January 30th 11:00 133/78 53
January 31st 11:55 118/71 48 erratic
February 1st 10:55 121/67 55
February 3rd 11:25 127/68 43
February 4th 17:05 177/87 43
February 5th 09:50 110/62 53
February 6th 11:15 149/75 50 erratic
February 7th 09:55 122/74 48 erratic
February 8th 10:35 143/83 52 erratic
February 9th 15:40 130/50 Error/erratic
February 11th 10:45 141/83 50 erratic
February 12th a 11:10 100/62 51 erratic
February 12th b 11:12 142/66 45
February 13th 11:10 135/73 47 erratic
February 14th 11:00 171/84 46
February 15th 11:25 137/67 52 erratic
February 16th 11:35 165/70 44
February 18th 15:45 181/90 50 erratic
February 19th 10:05 136/66 45
February 20th 10:30 125/64 49
February 21st 10:50 138/68 54
February 22nd a 18:35 197/86 50 erratic
February 22nd b 18:40 204/82 48 erratic
February 23rd 11:30 158/94 46
February 24th 16:45 198/79 53 erratic
Date Time Blood pressure

Latest reading is immediately above. Note that erratic is the particular symbol, a heart, that flashes on the reader. Error is shown if the machine fails for some reason, probably human. Click the link below if you wish to email me.

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