Our Journey Together Part 1: Tap Tap Tap

The moment I knew my wife was never coming home.

It was a Monday. Nice enough for the beginning of March. A few large snowflakes slowly fell but melted as soon as they landed. I pulled up to the Royal Victoria Regional Health Center, put the SUV in park and hurried out. 

We were not late, but Ivana always needed lab work before an appointment, so it was important to be early. I ran inside and grabbed a wheelchair with an oxygen tank holder. I had to help Ivana with her legs as she was just too weak to lift them over the footrests as we got her seated. 

Ivana had a small blue backpack on her lap with her medications and some papers. The pile of medications she had packed was enough to make you cry. Lately, the medications had not changed, but the doctors were trying different levels of each to get the most benefit with the least complications. 

An impossible juggling act. 

Also, a nightmare for our pharmacy, but they are awesome people, always patient and understanding. 

Ivana always smiled when we were going to her cardiologist appointments. Her favorite of the doctor’s offices we visited. The doctors and nurses were always so patient. At Christmas, we had taken them a box of Merci chocolates to thank them in appreciation for their hard work and wonderful attitudes. We delivered several boxes of chocolates for the same reason.

I wheeled Ivana into the office and up to the desk. Friendly greetings were exchanged. As always, Ivana needed bloodwork, so we set off for the lab. Not far. Just far enough for me to crack a couple jokes and go around a corner on 2 wheels. Which brought on the very predictable responses from Ivana about my trying to finish her off. Which was always good by me. No matter how brave her face, I knew these appointments were hard for her. 

Ivana’s heart and lungs were badly damaged, and she knew that was nothing that could be done. And she knew the appointments were hard for me. It had been a long time since we received any good news from her cardiologist, so the more we could laugh the better.

The lab was not busy, so we wheeled right in. Ivana praised the technician for finding her vein in one attempt, something that was proving to be increasingly difficult as her arms had shrunk to nothing but skin and bones. 

In the last while, Ivana had taken to saying, “Enjoy your journey!” This she repeated to the lab technician as we left, turning into the hallway, passed a suddenly-filling waiting area. I pushed her back to the waiting area at a normal, cautious, wheelchair pace. The hospital was getting busier.

We only had a brief wait before being shown into Nicole’s office. Nicole is a thin but strong woman of regular height. She was wicked smart and used to finding solutions. She could have been anything, and I have thanked her for choosing to be a doctor.

Nicole began with the usual questions about Ivana’s health and strength and medications. Checking her all over for water retention. Listening to her heart and lungs. She went through the blue bag one green pill bottle at a time, reading the label and checking her notes, as Ivana told her about her current dosage.

I always hated watching this. In the last months the number of pill bottles had increased to an alarming amount. How can a person be taking so many medications? No wonder there were inevitable complications. Nicole knew this. She would be careful to explain the need for each and the dosing to keep Ivana and I relaxed. More for me, I am certain. Perhaps for herself as well.

She would often try to cut a pill from the list, but then the next bloodwork would confirm that no, Ivana’s magnesium level was very low, or that the water build-up was simply too dangerous, or her liver count was too low, so that pill would be back next visit. The juggling act continued.

This visit, Nicole made no changes to Ivana’s medication. Nicole was clearly agitated. She would look at Ivana’s bloodwork, comparing it to past results. More feeling Ivana’s body for water. Nicole wrote in pencil, and the pencil began to get the brunt of her frustration.

Tap tap tap.

Always the eraser end. Tap tap tap.

A check of Ivana’s pulse. A deeper listen to her lungs. Back to the screen. Nicole’s computer mouse was the type with a ball on top to roll with your fingers, and it was getting a workout. Back to the pencil. 

Tap tap tap.

That was when I knew that Ivana was never leaving the hospital.

Up until now, Nicole could see a path. A path to a better, healthier life for Ivana, for however long it lasted. It was clear that there was no path this time. 

Tap tap tap.

I looked at Ivana, whose expression had barely changed. My eyes filled with tears.

“There is no answer.” I held her hand as tears rolled down my cheeks.

“It’s OK, Boo. It’s OK.” In retrospect, I believe Ivana already knew. She knew in her heart. Perhaps before the appointment began. She packed more than usual into the blue medication bag. Ivana had expected to be admitted.

I felt that Nicole wanted to give Ivana a big hug. But no, she turned to the phone and asked for her collegue to join us. Nicole was visibly upset as she apprised him of the situation. The cardiologist arrived in a couple minutes. His name escapes me right now, even though I met him a few times. (While posting this story, I remember his name as Dr. Yasdan. 95 % sure.) 

I remember his shoes needed a shining. They always did. He had seen Ivana before and knew her story well. Ivana liked him, he did not sugar-coat her situation. Her heart was in bad shape and would not last much longer. Her lungs and liver were not in good shape, either. Time was not on our side.

Ivana was going to be admitted, and medication adjusted. The gravest concern was the water build-up around her hips. If the water reached her chest cavity, it was game over. Obviously, it was a tough walk to Emergency for admittance. Nicole pushed Ivana in the wheelchair. I followed, I think there was small talk, but I don’t know. I just followed the coloured lines on the floor. 

Nicole arranged things with the triage nurse. I sat with Ivana, our hands squeezing each other’s. The 2 women shared a hug before Nicole had to return to the busy Cardio clinic, reminding Ivana that she would see her the next day.

I waited with Ivana through the various stages of admittance, neither of us saying much. Most of the time, our hands were together, always touching in some way. I went to the hospital auxiliary and picked up a couple muffins, coffee for me, and a tea for her. After several hours I left Ivana sleeping in an examination room, to get a nap and a list of things from home. 

When I returned, Ivana had been moved to the Cardiac and Renal Inpatient unit. She had been there before. I ascended a flight of stairs, and followed through a similar corridor as in the past. 

The corridor is long, some 150 feet, and usually silent. Monochrome paint in a strange pastel-beige covers the walls. There were windows, but they looked out onto a rooftop and exterior hospital walls, very dark at night. Foreboding, like from a movie scene. Certain shoes would echo wonderfully.

I stopped at the nurses’ station to say hello, sign in, and find out which room she was in. Her nurse told me that she had just taken Ivana’s vitals, but she promptly went back to sleep before the nurse had even left the room.

Ivana was sleeping soundly, and looked comfortable. I grimaced at the cords attached to her. The monitor they were attached to show her heart rate and oxygen saturation, among other things I didn’t understand. I knew Ivana would not like that. They frustrated her, making every movement a chore, even just going to the washroom. At this point, were they necessary? 

I unpacked a couple things from the small duffle bag I had brought from home. Most importantly, I placed Pandie in the space between her arm and body. Pandie was a stuffed Panda bear that I bought to keep Ivana company during her last hospital stay. She loved to cuddle with Pandie at night. He helped her sleep. A light kiss as not to wake her, and I settled into the chair beside her bed. 

Pandie continues to provide comfort. Sleeps on Ivana’s pillow.