Wednesday, March 14, 2012

David Lee Jongeling Nov 12, 1951 - Nov 27, 2011



I let go of this blog at the beginning of January 2009. It is now March 2012. I'm back to tell you about the last 3 years of my Dads life.

February 2009, my Dad had been living with me since he got out of the hospital. He was doing really well keeping up with projects around our house. Richards family gets together annually in Park City for skiing and it was time for us to leave Dad for the first time. I wasn't really worried about it. He had a list of chores to do and the animals to care for. However, the first evening away, I called him from the airport and I could tell he had already had a drink. It was heartbreaking. Without going into all the details, we supported him through several relapses until finally we had to ask him to leave. We just couldn't have him around our children in that condition. We moved him to an RV park in Bastrop. He didn't do well by himself and on Fathers day weekend of 2009 I asked him if I could look into Salvation Army rehab for him. He agreed to go!
He was in the Salvation Army program for the full 6 months. He did very well there. He helped run the front desk and made some sober friends. He moved back into his house after rehab and unfortunately he relapsed that very week. I believe it was his very first night home. He said to us that he slipped and was going to get back on the wagon and he went ahead with his plan to have other members of Salvation Army rent rooms from him. This was his attempt at a "sober living" house. However, I don't think he ever got sober again. That was all of 2009.
In 2010 and 2011 he was distant about the details of his house situation. He stopped denying it when we asked if he was drinking and eventually we quit asking. I asked him about every 6 months if he wanted my help finding a different way of life (rehab again, new house, etc.) He always said he would think about it and let me know. What can a family do but show love and pray for him? We never really went to his house but he would show up to all the family functions. He called us all, his friends and family, regularly. I had some really wonderful talks with him over the phone. I would say we all had the best relationship we could with him these last few years.
November 17th 2011 he called my sister from the emergency room and said he had fallen and broken his hip. When I got to the hospital I warned the doctors of his poor health and alcoholism. They monitored a medical detox for several days. This was very painful to watch because Dad became extremely confused mentally and pumping his body with fluids, minerals and vitamins was actually a shock to his system. However, since we had been through this before, it was a little easier to watch this time. After detox, they monitored him for many days, waiting for his body to be strong enough to handle surgery. We all knew this surgery would be extremely hard on him but our bigger concern was the recovery process it takes after hip replacement.
My brother and Grandma (Dad's Mom) came into town on November 22nd. It was Thanksgiving week so my Uncle Ken and his family all came into town to wait together for surgery time and to visit with Dad. It was great that he got to see everyone before passing away.
He finally went into surgery on November 23rd. He went to Cardiac ICU after surgery because his blood pressure and oxygen levels were very low. They told us he could be out of ICU by the following morning and that sometimes it just takes the body awhile to regulate after major surgery. The following day the doctors called with a list of new problems. Retaining too much fluid in his body, possible embolism in the lung, lung infection (could be pneumonia). He was somewhat alert and able to visit on the 24th. But with every visit he was looking weaker instead of stronger. I had expressed his desire to not ever be kept alive by machines. I had power of medical attorney since the 2009 hospital stay. Because of his past health problems, I had talked with dad extensively about his medical wishes. The doctors assured me that all that was being done at that point was helping him stay strong and not actually keeping him alive.
By November 27th, he was still in Cardiac ICU and not getting any stronger. Some good family friends of ours, that are in the medical profession, asked us if we were still sure that the hospital was helping or keeping him alive? I went to the hospital and asked the head nurse that had been with him for several days, what his opinion was. He sullenly said he thought it was keeping him alive. He said if I wanted to, we could turn down the oxygen level machine and see how long it takes for his body to fall to a lower number. When we did this, his oxygen level dropped immediately. He said that was a strong sign to confirm his opinion. My Grandma, sister and brother came up to the hospital right away. We had a hospital chaplain go in and ask him if he understood his medical situation and what he wanted to do. We didn't want to be in the room with him when asked this because we knew he would look at us and not be honest if what he wanted to do was to let go. And sure enough, that is what he wanted. It was very certain, and we were right out side the door to witness this.  When we walked back into the room, Jeff walked over to him and Dad reached out his hand, took Jeff in close to him, looked right into his eyes and said "I'm done."  From that moment Jeff knew what needed to be done.
I know there will be more difficult moments in my life, but this thus far has been my worst moment. I had to tell the nurse our decision to turn the machines off. We (Grandma, Rachelle, Jeff and I) stood around Dads bed with him and I asked if he had anything to say. He said "You all are good kids. You will do good." I think he also said, if you want to have more kids, have more kids. But I'm not sure as his breathing heavy made it very hard to understand him. We all knew for certain that he knew what was happening. We called the chaplain in again and we held a circle of hands and said a prayer. We turned the machines off.
I asked the head nurse how long we should expect the wait. He said from several hours to a couple of days. I'm told the morphine going in feels cold and a little painful.  Dad started moving around, reaching for blankets, our hands, to get up?  I'm not sure what he wanted.  Jeff and I were on the same side of the bed, I was up closer to his head.  We each held one of his hands.  I really didn't know what to do, so I just started talking.... I told him it was all going to be painless soon, I told him to imagine sitting by Lake Poinsett watching the sunset.  Then I described our backyard while growing up.  I described him sitting on the patio at sunset watching us kids play in the pool.  He calmed down after a few moments.  Rachelle and I left the room because our friends had come to support us in the waiting room. My Uncle Dick had just arrived. We had left Grandma and Jeff in the room with Dad and told Dick to go see Dad. He was back in the waiting room moments later to tell us my Dad had already passed away. It had only been about 45 minutes.
My Dad knew there was a better place waiting for him. He had been near death in his twenties and remembered a bright white peaceful light and no pain. I know that is what met him again this time. Rest in Peace my Father. You were deeply loved. You will be missed by all who knew you. I still think my phone should ring and I will get to tell you all the details of my crazy life. I loved running things by you and always having your verbal support in my decisions. I know you are watching us now and smiling because you raised some really great kids!

Friday, January 9, 2009

Sorry it has been so long again.

Hello All
It has been hard to keep up with this blog as things are starting to calm down. Not a lot of new information coming in anymore. So this may be the last entry for a long, long time.
Dad is celebrating being released from his doctors care for 6 months. His monthly visits have shown to be progress at every appointment. The doctor said he is very pleased with how well Dad pulled out of such an ordeal.
His leg pain is being managed with a script for nerve pain. (Lyrica) Seems to be doing the trick, so he will stay on that until we can get him some better medical insurance to cover further options. The insurance struggle is our only stress now.
We keep Dad very busy helping Richard (my husband) build an apartment on Uncle Jim's property. (Richard's uncle) It helps dad to keep busy. His memory is almost normal. He has some difficulty with getting too much information at one time and being able to retain it. But hey, who doesn't have that problem!!
I hope everyone is doing well. Have a happy 2009. Thanks for all of your support through our tough 2008.
If you want, please contact Dad directly or email me directly and I will give you his contact information. He would love to be social again.

Thursday, November 20, 2008

Results...

Dad went back for his results of all the blood work last week. Everything looks remarkably well! The doctor was very impressed with how good Dad looked. He has gotten so much stronger in these last few weeks. He hasn't used his walker at all in the last 2 weeks. His only ongoing complaint is the pain he still gets every night in his lower legs. He is now on medication to see if we can ease the pain.

We also went to get an MRI this past Monday. We are waiting for the results of that. The doctor is guessing he has lumbar spinal stenosis. That is a narrowing of the nerve opening in the lower back that could be the cause of the leg pain. We will see.

His balance is a little off still. He can't move and turn to quickly as he gets dizzy.
His memory is getting much better. We keep him fairly busy with things around the house. Just getting through all the new life changes and decisions is forcing him to work out some of his memory confusion.

All in all however, he is doing very well.

Saturday, November 1, 2008

Getting better everyday

Dad went to his first follow up visit this week to his new primary doctor. They gave him a round of test (EKG, blood work) to see what his new base line is. We have a follow up appointment for two weeks to talk about the results. Dad was pleased with the doctor we picked for him. I'm happy he has someone he likes to help us continue with his recovery.

He is usually walking without the walker now days. However, he slows down a bit in the evenings. He is doing a good job of not pushing himself too hard later in the day. He is continuing his leg and arm exercises daily.

His memory is doing much better. He remembers all people we discuss. He will definitely know who you are now if you call or come by to visit him. He really only has a hard time with details of recent thoughts and conversations. A lot like we all can be sometimes when we feel we are having a "brain fart" kind of day! He is getting good about writing lists and referring to them rather than stressing over forgetting the little things.

I will let you all know how the results come in at his next doctors visit on Nov. 11th. The day before his birthday!

Please feel free to call him if you would like. He is getting a little bored out here sometimes. Not working is hard for him.

Saturday, October 25, 2008

Sorry for the delay

I know it has been awhile, but we have been very busy getting things set up here for Dad.

He is here and doing very well. He is, of course, pushing himself too much during the day and having some swollen ankle and leg pain at night. I have put him on bed rest for today! There are enough sports on TV today to keep him entertained.

We found a steal of a deal on an RV this week and Dad bought it. In a couple of weeks, when I feel he is strong enough, we will move him out to the RV. We feel it will do him good to have his own place. We don't want him to worry about putting us out for letting him stay here.

Long term plan: If this continues to work out, we will move the RV further from the house and let him stay here and help us run the property. If he decides he wants to go back to his old drinking lifestyle then we will send him back to his house or move him and his RV to another location. We are planning on renting out his house. If anyone knows someone looking for a 3 bedroom house in South Austin let me know.

Monday, October 20, 2008

Trial Run

Dad got a pass to leave the center today. I picked him up at 12pm and he went back at 7pm. What a great day! He did very well. His balance is great. He is really coming along. We first came to my house and Dick brought over food and my sister and her family came over for lunch. We hung out here for awhile, then I brought dad to his house. Gathered a few things, then back to rehab.

He has had some visitors at the Rehab center. (Thank you) I heard those visits have been enjoyable. Everyone I have spoken to say it is nice to see Dad have some color and looking healthier.

Waiting for Tuesday. I'll keep you all up to date on his future recovery.

If anyone wants to visit him at our home, you are welcome to do so. Give us a call.

Saturday, October 18, 2008

I'm going to have a house guest

We have looked into some options and have decided to let dad come stay with us at our house. His care needs are decreasing everyday. I would rather take him in and keep an eye on him myself than to have him put out the kind of money required for an in house "aid" or assisted living facility. We will see in the next coming weeks how he progresses outside of rehab.

Thanks to everyone. If anyone is interested in coming to visit him at our place, you are welcome. Just call his cell phone (after Tuesday) or email me.

Thursday, October 16, 2008

We have a discharge date!

They are letting him out next Tuesday Oct. 21st. Our family has a lot of brainstorming ahead of us this weekend.

He will still need 24hr care. They are releasing him because he is making great physical progress and they have decided that the referred doctor can continue to help him with outpatient sessions regarding his memory issues. The 24hr care is needed because he still has some balance issues and could fall at any time. I don't know how long that will be a problem for him.

I have just realized today that I never posted the actual diagnosis of his condition. I only learned it myself recently. It is called Wernicke's Encephalopathy. Below is a link that explains what that means. With the information that I have read and been told by his doctors, his mental disorder may be permanent.

http://www.nlm.nih.gov/medlineplus/ency/article/000771.htm

I believe that if he stays dedicated to recovery that he will continue to get stronger physically. That would be great.

I am going to ask all of you to help my family...If anyone has any thoughts, ideas, advice on where he should be placed (short and/or long term) please post a comment or email me directly. I am researching for short term care either at a nursing home or a full time live in care taker. Long term...who knows! Any referrals or opinions are welcome. We want to make the best decision for his care, but we don't have many days for thorough research.

I have started the process the get him Social Security Disability. Is that all I should be doing? Any legal/government advice from anyone?

Thank you to everyone for all of your help and support.

Tuesday, October 14, 2008

We have to wait a little longer

The meeting was pushed until Thursday morning.

Hope we get some good useful information after this long wait!

Monday, October 13, 2008

Waiting for Wednesday

The case worker told me today that they will be reviewing dad's case this Wednesday.

He seems to be physically improving more and more everyday.

I will let you all know as soon as I find out anything.

Thursday, October 9, 2008

He will be there a little longer

I was told today that he will be at the rehab center for 1 to 2 more weeks. They will re-evaluate his case next Tuesday or Wednesday. I spoke to the speech therapist and she said he is doing very well in their sessions. Much improvement everyday. She is also working with him on the memory stuff. She says he does really well with visual cues but not as well with verbal cues. However, she says as well as he is doing, she thinks he will come a long way in the coming week.

He is also seeing a medical psychologist. That is the person who is talking him through keeping his spirits up during the rehab process and also slowing talking to him about his drinking and what he plans to do when he leaves the center. His primary goal is to keep dads attitude positive. He says dad is a pleasure to work with and thinks he is doing great.

We will now wait and see for another week.

My brother Jeff is coming into town tomorrow. We are all very happy about that!

I will post again when something new happens.

Wednesday, October 8, 2008

Swallowing test

He passed! The swallowing test went great. He is now able to eat and drink everything.

Tomorrow morning is the "team conference" about dads condition. So, I should hopefully know a lot more by tomorrow evening. This should tell us roughly how long he will be in the rehab center and what his needs might be when they release him.

I hope to give you all more information tomorrow.

Tuesday, October 7, 2008

Progress

Hello Everyone

Dad has made some real progress over the past two days. I saw a glimpse of my old dad tonight. That was reassuring.

He has gone through two days of therapy. He is doing very well in all three therapy types. They say he is in good spirits and is getting stronger physically. Tomorrow they are doing a test for his swallowing. He is still on a special diet because he continues to cough when he swallows. Hopefully we will find results and answers for this soon.

The therapists and a case worker will be having a conference about dad in the next few days. After they meet, we will know more about their overall assessments. This will help us figure out where he will live when the Rehab center releases him.

Sunday, October 5, 2008

Nothing new

Not much to say today. Dad will start Occupational, Physical and Speech therapy tomorrow. Most therapy will be done by 3pm everyday.

The hospital phone number is 406-6300. His room number is 823 and he has a phone in his room. If you wish to call him, please be sure to introduce yourself and if he seems confused don't take it personally. It will help if you quickly start with a conversation topic that will help him place you and how he knows you. This may not be needed, it just depends on how he is doing at the time. He has more moments of clarity then not.

We should know more in the next couple of days. Thank you for all your prayers and support.

Saturday, October 4, 2008

New Information

I had a crazy day trying to find dads new location. The hospital told me the wrong place so it took a while to finally find him. He is at the Central Texas Rehabilitation Hospital. That is located on the 8th floor of Seton hospital on 38th street.

http://www.getfave.com/locations/14977898-central-texas-rehabilitation-hospital

I got to see him late this evening. He was sleeping when I got there so when he woke up his confusion seemed greater than normal. I want everyone to understand that the move to the Rehab center is because he is stable and eating again. He has no need to be in a "hospital". Also, please understand that the Rehab center is for his physical needs. Not really the mental problems that he is having. The doctors told me today, he may be at his best mentally at this point. There is a chance that as days go by and he continues to eat healthy and not drink, he may become a little more clear headed, but maybe not.
It was explained to me that the effect alcohol has on the brain is with short term memory. He may remember great details to something that happened many years ago, but he won't remember what he had for breakfast. (that very thing happened today) The doctor says another thing to be aware of is that if you or I couldn't remember what we had for breakfast, we would be very concerned or upset about that. Dad doesn't have any emotional attachment to the memory. He could care less that he can't tell you something like that. If fact what he does instead is make up some information. Like filling in the blanks and he doesn't really even know he is doing it. I am seeing this sort of thing with him at almost every visit. If you all speak to him, please listen politely but take everything lightly. You just never know what is real and what isn't. I find he takes part of the truth and then extends it with is own new information.

Maybe some of you have noticed over the last few years that his motor skills seemed to be off. He trips and waves with the wind a bit. Well, that was all the neurological damage happening.
The Rehab center is focusing on teaching him how to manage his life with his loss in motor function. After a few days at the center, they will let us know if they feel he needs to have assisted living or if there is a chance he would be safe to live on his own.

That is all I can think of for now.

Good News!

Dad's being moved today sometime to a neurological rehab facility. I was up there this morning and talked to the physical therapist. He did very well yesterday with his session with them, walking 75 feet with only 20% help from one person. That's a significant increase from his 50 feet walk two days ago which required full help from two people.

He's eaten four full meals, and his potassium levels are staying higher but not quite in normal range. They think that will continue to get better as he eats more.

I'll post again later today after I get the details on where they are moving him to.

If you're planning on sending cards please just send them to me at:

Leanne Stovall
c/o Dave Jongeling
5035 Hwy 71 E
Del Valle, TX 78617

I'll make sure he gets them wherever he ends up.

Friday, October 3, 2008

Dave and Piper


Friday Visit

Went and saw dad this evening. Brought Richard and Piper along with me tonight for the first time. I wanted to see how he would handle new visitors and he did quite well. If any of you decide to visit him, be prepared you may have to introduce yourself as he thought my baby was Taylor at first (Rachelle's youngest).

He seemed stronger tonight than yesterday. We were with him when he had dinner and he fed himself for the first time. His hand-eye coordination looked great. He ate all of his dinner which was all solid foods (fish, rice, carrots, roll, peach cobbler).

He said he did better with physical therapy today. He walked but I will have to find out tomorrow how far.

He is having some low back pain which I'm hoping doesn't agitate him too much.

Mentally he seemed better with only slight confusion about what city he was in.

That's all for now.

Posted with LifeCast

Thursday, October 2, 2008

Busy day at the hospital

I spent the morning with Dad. He had a lot of scheduled visits today.
I will first get us caught up with a history of his condition.

He was brought in Monday the 29th of September. We found him on the floor in his living room and he did not know where he was and was hallucinating different things. Such as smoking a cigarette that wasn't really in his hand.
In the ER there were hours of waiting for many lab results to come in. His counts in his blood and urine added up to many different issues all happening at the same time.
1. Lack of food - they said he was in total starvation status. We believe he had the flu making him vomit the Wednesday to Friday prior to this. His roommates have not been around for a couple of weeks so there was no one home to cook or make sure he was eating. So combining the loss of food with the flu and the lack of food for recovery, we figure he had not eaten in over 6 days when we found him.
2. He was showing signs of internal infection somewhere in the body. They think it is because he possibly inhaled food (or vomit) and this gets stuck in the lungs and gets infected.
3. His electrolyte levels were completely off. They still have not balanced out.
4. He has a dark purple big toe on his right foot. They thought maybe he was diabetic. Turns out he stubbed or dropped something on it and it is a small fracture.

They moved him to IMC (Intermediate Care) on Tuesday evening. They continue to give him potassium on a regular basis along with magnesium through a drip bag. Of course he is constantly on sugar water to keep him hydrated. He is also getting a few drip bags of antibiotics to keep the internal infection under control.

He became slightly aware of his surrounding for the first time late into the night Tuesday (early morning Wednesday). He was still very confused about where he was, but he did feel hungry and that was the greatest positive sign of recovery thus far.

They gave him solid food for the first time Wednesday morning and then again at lunch. However, at lunch a physical therapist was in the room with him and he didn't like that dad would start coughing while swallowing. They are afraid that he could inhale his food and get it stuck in his lungs. This would continue the internal infection issues. So, they took him off the solid food diet until someone came in today to assess him. They have put him on a soft food diet as of dinner tonight. Good news!

He had his first physical therapy session yesterday. With 2 people helping him he was able to walk about 50 feet. Today however, he seemed in general much more tired than yesterday. (I think it is lack of food, but who knows) When the Physical therapist came in, dad only had the strength to pull himself up onto the walker two times before he felt very dizzy. His blood pressure had dropped significantly so they called it a day for PT.

This morning he seemed to be more confused mentally than yesterday as well. When the doctor came in we had a good talk about his condition as of today. This is what I learned.

When you drink alcohol as much as he does, for as long as he has, everyday you kill a bit more of your memory brain cells. He asked if I had noticed this happening over the years. I think anyone who knows him, knows he has been slipping with his memory more and more over the last 5 years or so. What they call this is his baseline. It steadily gets lower and lower over the years of abuse. However, this time coupled with the starvation his baseline decrease is very significant. At first the doctors were telling us that perhaps once they get his electrolytes leveled and get a real diet going then his confusion may correct itself. Today the doctor says he may not get a whole lot better than what he is right now. Also this sort of dementia comes in waves. Some moments he will know exactly what is happening and then with out warning he will be confused again. There is still a chance that as he gets stronger this will get slightly better but the doctor wants to prepare us for the worst case. The great news is that I have not seen him hallucinate anything since Tuesday night, so I hope that part of it really was related to his alcohol detox.

Our general conclusion is that he drank all his alcohol in the house this past weekend and was too weak to get to the store to buy more. This put him in detox. That is why he was so confused when I found him. FYI for everyone: Alcohol and heroin are the only two drugs that can kill you from withdraw/detox. It is so intense for a drinker like dad that there is no way he could stop drinking with out ending up in a hospital. They kept him sedated the first 2 days he was there to minimize any tremors and/or seizures that are common with detox.

Back to the doctor visit today. I asked why his electrolytes are not stable yet. He explained that until dad gets some fat built up on him that he has no place to store the electrolytes. So they are just keeping him healthy the best they can with drip bags until we get him to eat enough to produce a fat storage.

Where does that leave us now? He has to eat regularly, hold his electrolytes on his own then build strength to get through physical therapy sessions. After all of these things balance out we will know what will improve with him mentally. Until then they will keep him in the hospital.

The doctor did tell me today that his eyes are still not as focused as they should be which is a sign of some brain damage. That is why he wants us to be prepared for him not bouncing back a whole lot from where he is now. Lets all keep our fingers crossed and pray he gets a little better with the solid food diet.

Sorry this entry was so long. The others will probably be very short with any new updates. I will try to resend the blog link anytime I add something very important but please just save this link and check it periodically and I will try to keep you all informed.

Here is the hospital information he is at. If you would like to send cards or something it may help us remind him of people's names that are thinking of him.

University Medical Center Brackenridge

601 East 15th Street, Austin, TX 78701
Phone: 512-324-7000

Wednesday, October 1, 2008

Dave's Condition

Updates to Dave's progress will be made to this blog periodically. Stay tuned.