Always have and always will

NewFNP has the raddest grandparents -- all of them.

When her paternal grandfather died while newFNP was in nursing school 3000 miles away, newFNP asked her brother to help take care of their grandmother. BroFNP moved in and cared for her for four years. When her care exceeded what could be done at home, newFNP moved her grandma to her urban jungle. She had been faring rather well for a 94-year old lady with dementia until this week. She had cough, she was tachypneic, and she had unilateral lower extremity edema. (But she always has edema because she's got the ole Norvasc and she's in a wheelchair.)

Now, newFNP and broFNP have power of attorney, DNR, advance directives -- the whole nine. But having all that is all well & good until one needs to use them.

NewFNP's grandma was admitted to the hospital and had a thoracentesis which drained 700cc of fluid from her right lung. Her duplex ultrasound showed extensive DVTs in her left thigh.

NewFNP opted not to treat. Anticoagulation is not the move for a 94-year old woman and won't improve her quality of life at all. Plus, just last week, her grandma told newFNP that she was "ready to hang it up." NewFNP knew that deciding against treatment could mean deciding for a pulmonary embolism. That's just kind of the beauty and the bitch of being in health care -- one understands the implications of one's decisions. And, frankly, a massive PE is not a bad way to go.

Her decision weighed heavily on her as she watched her grandma doze off in the hospital bed. As she waited for the ambulance to transport her back home, she crawled into her grandma's hospital bed and sobbed. Her grandma reached her hand out to hold newFNP's hand.

"Honey," she said, eyes closed,"I hope you're not getting sick. It sounds like you're stuffed up."

"Yeah Grandma," newFNP replied, "I'm a little stuffy." All the memories of summers and swim lessons and shopping for ESPRIT and lunches at I. Magnin and how her grandma consoled her the evening that her mom died were playing in newFNP's mind as she laid next to her.

NewFNP remained in bed with her Gram sniffling and soaking the sleeve of her James Perse t-shirt until the ambulance arrived. Every once in a while as newFNP and her Grandma snuggled, her Grandma would reach her hand up to scratch her head and then slip it back into newFNP's and give her a little squeeze.

"I love you so much, honey," her grandma told newFNP. "Always have and always will."

When she was leaving, newFNP gave her grandma a kiss goodbye. She turned to get her purse when her grandma said, "I want another kiss."

You got it, Gram. Whatever you want.