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Keep in mind, no one in this story, which is true, ever contracted COVID-19. But this story is about COVID and its impact on real people. I write this with some reluctance as this story is highly personal and involves people dear to me. But it is an important story, so I am sharing it.
My Dad, about whom I’ve written before, lives in The Villages in Florida. When he retired, he bought his first place there, splitting his time between a southern New Hampshire townhome and Florida. He retired a vigorous man, enjoyed bad golf, and all the other activities offered at his winter homestead. He and his girlfriend were serial travelers and traversed the world, two or three trips a year, often with their Villages friends. They traveled so often they actually returned to places that they especially loved. I know that they cruised to Alaska at least three times. The British Isles were also a favorite as was Italy.
At 75, he sold his townhome, purchased a larger home in the Villages, and moved to Florida to live year-round.
As he approached 8O, time’s health toll started to come due. Setbacks piled up; conditions that were difficult to dial in, like low blood pressure and a slow heart rate. Little things, like getting up from the easy chair or getting into his SUV, became difficult. He napped all the time but could not sleep through the night. His cardiologist suggested a pacemaker, but that idea was abandoned when he had no issues whatever with a stress test. The problem, it seems, was inactivity. He needed exercise. So he started walking. And walking. Then, on a particularly vigorous walk, he lost his balance, fell, smacked his head shockingly on a curb, and knocked himself out.
He woke in the hospital, stitched and bandaged. The MRI showed no bones broken and he suffered a concussion, but there was this shadow at the base of his brain, next to his pituitary gland. This was not good: a tumor.
Chemotherapy treatment was a long-term ordeal and hardly ideal for an 80-year-old man. Another option was surgery. There was a specialist in Jacksonville who’d developed a method of removal through the nasal cavity. So on to Jacksonville, another MRI. The tumor was on the move so there was no time to waste. The tumor had to go.
But recovery was elusive. His pituitary gland refused to come back online; Dad’s entire endocrine system shut down. No thyroid function, no adrenal function, no testes production. The shuffle of an artificial replacement began. They gave him two emergency bracelets; one for Addison’s Disease and one for Grave’s Disease (insufficient adrenal and thyroid function.) He did two tours in rehab. Finally, they sent him home, but within a couple of weeks, he suffered a setback that sent him back to emergency: a sudden electrolyte imbalance often associated with pituitary insufficiency. Miraculously, he did not die, but he did end up back in Jacksonville and then back in rehab.
After a few months, things stabilized. That is until he had an “episode.” Back in the hospital, it was determined that he’d suffered from a transient ischemic attack (TSA); that is a mild stroke caused by a blood clot. MRI’s showed no damage, but the stress kicked hard, so back he went to rehab. Now the blood thinner Plavix was added to his prodigious pill consumption. A type of monitor was wired to his heart to detect fibrillation. Every night he had to hook himself up to a modem that transmitted his heart data to his cardiologist.
Out of rehab and back home, he was happy. That was when I last visited, about a year ago, and Dad was doing pretty well. There were some heartbreaking moments for me, but he was progressing and trying. We talked about the future; assisted living? Coming to live with me in Arizona? (I have plenty of room; he could even bring his girlfriend, an accommodation he never allowed me, by the way.) I left Florida sad, but optimistic. The man had spirit, but cats like him do eventually run out of lives.
After I left, he thought he was well enough to take a trip back to New England to visit my brother in Massachusetts and my sister in New Hampshire. My brother was shocked at just how my father had declined, but it was in Laconia with my sister that my Dad once again suffered a TSA. She took him to emergency where, once again, the symptoms declined on their own with no discernable damage. However, he was diagnosed with severe carotid arterial blockage. He elected immediate surgery and in two days, he was back in rehab, this time in New Hampshire. After four weeks, he was discharged. Despite my sister’s admonitions, he was determined to get back to the Villages. He booked the earliest flight he could find; it required a change along the way. Bad plan. There was a delay and he spent hours, hungry, thirsty and alone in some airport in a wheelchair unable to move or even get up. He did eventually make it to Orlando early the following morning, but the trip was a disaster and set him back.
The next few months in the Villages were difficult. He was prescribed outpatient rehab but it was curtailed after a month when, as I’ve now learned, he failed to make progress. His cardiologist kept him on Plavix and scheduled a “Watchman” defibrillation implant so that he could be weaned of toxic anti-coagulants. His testosterone therapy had been discontinued after his carotid surgery and was restarted. His thyroid and adrenal medications were adjusted.
At some point though, he lost control of his medications, stopped taking some, dropped testosterone altogether, and took others incorrectly. That’s about when COVID arrived. Day by day, he declined. Then, he collapsed. His girlfriend and a neighbor put him back into bed. He was unable to do anything. Of course, my siblings and I were desperately trying to get the measure of things. I called a cousin who lives in the Villages and he made a visit. After getting his input, my sister told him to call an ambulance. She wanted Dad transported to Leesburg Hospital, not the Villages Medical center. There he was diagnosed with critically low platelet levels and problems associated with a failed pituitary (adrenal and thyroid insufficiency.) Plavix!
The previously scheduled Watchman procedure was delayed indefinitely. The care in Leesburg was exemplary and within two weeks, his medications were controlled and he was transferred back to a rehab facility in the Villages. My Dad has nearly no memory of his time in Leesburg nor of the problems leading up to it.
I wanted to be there with him, but my siblings were frightened I might pick up COVID on the plane. I could drive, I said. That was better, however, Leesburg allowed only co-habitant visitors. All others had to be tested and quarantined. His rehab facility is even more restrictive. They allow no visitors at all.
So my Dad is essentially in jail, isolated and left to his own melancholy, wheelchair-bound and alone. We await the decision to insert the Watchman. I call him daily, and honestly, he is losing spirit. I try to give him hope. Once he breaks out, I’ve told him, I’m on my way. It will take me two very long days to drive, but I’ll be there.
In the meantime, the Villages rehab suffers from a chronic lack of qualified personnel. The facility is new and beautiful, but like all services in the Villages, demand far outweighs the local labor market’s ability to respond. And the overarching complications of elder care in the days of COVID-19 make everything exponentially more difficult.
It breaks my heart.Published in