My grandfather, 95 y/o, has been hospitalized for the past 31 days and prior to that he was in and out of the emergency room nearly daily in January due to severe pain and blood in his urine. My family decided not to tell me until I had taken the American Board of Periodontics exam, which I took on the 28th of January. I'm currently staying in the hospital with him as I write this.
Things are not looking good. Doctors found a mass on his bladder that is obstructing his left ureter. He developed an atrial flutter, which meant it was contraindicated to take him to surgery to do the biopsy. He also has a coagulation problem as well. Because his left ureter is obstructed, his left kidney started going into kidney failure. This led to severe peripheral edema and some central edema. The doctors were debating doing cardioversion to correct the atrial flutter because he was not responding to the amiodarone. They did a last ditch effort with the amiodarone and increased it to the max dose. That worked in converting his atrial flutter to an atrial fibrillation. With the a-fib, the surgeons felt more confident in safely doing a nefrostomy to allow that kidney to drain. This finally resolved the edema and allows that kidney to regain some function.
However, the coagulation issue is not resolved, and the a-fib is ongoing. His platelets were at 44,000 on the last count. This, I think, is the primary reason why they find that the risks of doing the biopsy outweigh the benefits. The urologist tells me that she thinks it's almost certainly a bladder cancer, however, without the biopsy they can't determine what type of bladder cancer, nor how fast it will progress. Either way, the internist, nephrologist, urologist, cardiologist, and hemato-oncologist all are in agreement that he is too weak to survive chemo. They fear he may bleed out during the biopsy. Even if he survives the biopsy and is discharged, his life expectancy is of about 6 months.
We are a small family. Mainly consisting of my sister, my mother, my grandfather, and I. My uncle lives in Sarasota and he was here for about 5 days taking care of him. Unfortunately he had to fly back to Florida because of work. My girlfriend, has been amazing throughout all of this. He's also stayed over with my grandfather overnight when she's not in work. She's a nurse too (at a different hospital). My family is very grateful to her for all her help. (After all this is over, I'm going to start thinking about how I'm going to propose to her.)
This is overwhelming. The three of us are taking turns caring for him and staying in the hospital with him and we are exhausted. I stayed over on Wednesday tried my best to sleep here in the hospital bed. My mom and my sister needed to rest because they had been here all day and night the prior couple of days. Unfortunately trying to sleep in a hospital room is extremely difficult for me and it's affecting me to the point that my academic and surgical performance are being compromised.
I hate seeing him in this state too. It seems so frustrating for him. He was always such an independent and strong man. The first week, he was disoriented, and uneasy. He tried removing the IV lines, EKG leads, nasal cannula, and the folley catheter on multiple occasions. He's started developing ulcers from being bedridden so long. I don't want him to suffer, but I'm also not ready to let him go. In spite of that, we did sign the DNR and DNI. 
