Kria Fahmi Pasaribu

Three cancers and two septic shocks later…

Dad was a happy-go-lucky person. Despite his chronic illnesses, he led a full and happy life. He enjoyed working, travelling, dining out, going to the movies and playing with his grandchildren. No one would have thought that he had been battling three types of cancers for the past 15 years. (Sepsis and Cancer)

My dad was diagnosed with bladder cancer in 2001, prostate cancer in 2011 and kidney cancer in 2013. To save his life, he had his bladder and left kidney removed. He also underwent external beam radiation for his prostate cancer. His right kidney -which was unaffected by cancer- had lost more than 80% of its function, requiring my dad to go through dialysis treatments twice a week since 2013.

When he was diagnosed with septic shock –the most severe stage of sepsis- I told myself he will be all right. If he could beat three cancers, he can definitely beat sepsis. He was, after all, a true fighter.

Here’s his story.

On 15 March 2017, I went to Kuala Lumpur for a day trip. I usually fly back to Jakarta with the 7 p.m. flight. However, I felt an inexplicable urge to be home. I decided to return to Jakarta at 3 p.m. – a rather odd timing considering I only arrived in Kuala Lumpur at 11:30 a.m. earlier that day.

My dad had been unwell for weeks. He had been exhibiting symptoms similar to the flu and cold; a high body temperature (above 38C), headache, chills, and shaking. These symptoms usually subsided after he consumed medicines. His blood pressure also dropped drastically during his last two dialysis treatments. I thought nothing serious of it. It was probably due to cold, fever or fatigue – or so I thought.

I arrived home from the airport around 5 p.m. My dad was lying in bed looking exhausted. He had been feeling an unusual pain in his abdominal area which did not subside with painkillers. The pain persisted and became more intense. I rushed him to the nearest hospital where he was admitted to the emergency room.

The doctor performed an abdominal ultrasound. The result showed that dad’s kidney was swollen due to a bacterial infection. Pus had developed inside the tissue of his kidney. To drain the pus out, the doctors had to perform an emergency surgery at 1 a.m.

We were called in 30 minutes later. Then came the bad news; his infection had spread, his bloodstream was now overwhelmed with bacteria. He had unusually low white blood cell counts. At the time, I still didn’t know that my dad was fighting a life-threatening illness.

I Googled his symptoms and the word “sepsis” came up. I have never heard of sepsis before. Not once. I asked the doctor whether my dad suffered sepsis. He said yes. Little did I know it would take my dad’s life away 19 days later.

On 16 March 2017, my dad was transferred to High Care Unit (HCU) to allow the doctors to closely monitor his heart rate, pulse rate, blood pressure. He was still conscious but his health started to go downhill. Around 1 a.m., I was called into the HCU. Dad was delirious and had pulled the drain tube out of his kidney. He insisted to go home. The doctors gave him sedatives to calm him down. He finally fell asleep. I, on the contrary, was wide awake worrying about what the future holds.

Fast forward to two days later, 19 March 2017. Dad was having difficulty breathing. I was never prepared for what came after. The head of ICU called the family in and informed us dad’s prognosis was poor. We were asked to prepare for the worst. They also needed to transfer him to the ICU and place him on a ventilator to help him breathe. It was the one thing we feared most – we all broke down. I remember standing at my dad’s bedside shortly after, crying so hard my chest hurt.

The next two weeks was a roller coaster ride. My life was thrown into chaos. Dad drifted in and out of consciousness. One day he was conscious, the next he seemed unresponsive. Some days he was in so much pain he cried, other days he smiled and laughed a lot.

Dad was given intravenous antibiotics on a daily basis, oxygen, and vasopressors to keep his blood pressure stable. He also received regular dialysis treatments and suctioning of the respiratory tract.

At some point, dad was making good progress. His white blood cell count, hemoglobin and albumin levels returned to normal range. His vitals were also stable. He was finally taken off the ventilator on 27 March, and was scheduled to be transferred to the ward on 1 April. However, he lost a lot of blood on that day. I also remember he repeatedly recited short prayers aloud, causing his blood pressure and heart rate to skyrocket to unsafe levels.

The next day, a miracle happened. He was fully alert and smiling, as if he didn’t feel any pain. Despite the heavy bleeding, his face was bright and happy. He greeted all of us by name – he even remembered our full names! We were deliriously happy and took a selfie together.

Then he asked us where he was, why he was in the hospital, what happened to him, how long he had been there, and whether he fell down. He mentioned he wanted to sit, drink, eat, and go home. He even made a few jokes. He didn’t look sick at all despite being gravely ill.

A few hours later, at around 11 p.m., my big sister who was in the hospital at the time called. Dad was struggling for air. His respiratory rate was more than 40 breaths per minute (bpm), while the healthy rate is only between 12 to 20 bpm. I agreed to put him back on ventilator.

The next morning, the doctors performed an endoscopy on my dad to examine his internal organs. Dad had severe internal bleeding of throat and stomach. He continued losing blood, a lot of it. My mum also noticed his body no longer tolerated the dialysis treatment. In that moment, she burst into tears. She asked me and my sisters to discuss dad’s prognosis with the doctors.

As expected, the doctors were not optimistic about his recovery. Dad had developed another septic shock and was beginning to experience multiple organ failure. His condition was worse than when he first entered ICU. To complicate things further, they found a mass in dad’s kidney, likely cancerous taking into account his medical history. They suspected cancer to be the underlying cause of his sepsis.

We were given four options; to give dad full medical support, to maintain the level of support as it is, to gradually reduce it, or to withdraw it altogether. We chose the first option, but my heart already knew that only God’s miracle would cure him.

After meeting the doctors, I went to see my dad. He was deteriorating before my eyes. I cried uncontrollably. That night, for the first time ever, I told him I was prepared to let him go.

Dad passed away the next morning on 4 April 2017 at 5:40 a.m.

I will always remember that feeling of fear and helplessness as I was called into the ICU at 4 a.m., exactly 1 hour and 40 minutes before his heart stopped beating. The doctor came to me and said, “Despite our best efforts, your father continues to deteriorate.”

I looked at his bedside monitor; his heart rate, pulse rate, and respiratory rate were weakening. His blood pressure undetected. I knew what that meant. I turned to my husband and asked, “What’s the date today? This is the day I am losing my dad.” He hugged me tight as tears rolled down my face. My whole body shook. He, too, broke down.

The hardest part was having to inform my family of dad’s critical condition. In tears, I called my little sister, “Please come here as soon as you can. Dad is leaving us. I can feel it.”

After that brief phone call, I held dad’s hands and whispered in his ear, “Everyone is on their way here. Please don’t go yet. Promise me you’ll wait until everyone gets here.” He did exactly just that.

My mother, sisters and I were all there in his final moments, holding his hands, kissing his forehead, reciting prayers, and promising him to fulfill our shared dreams.

I miss him so much, I still grieve, but I take comfort in knowing he is in a much better place now. He passed away with a smile on his face. I have never seen such a beautiful smile on a deceased person.

One of the greatest gifts he’d given us was hope. He showed us that it is absolutely possible to lead a normal life while living with chronic illnesses for more than a decade. We truly hope his story inspires others who are battling cancer (or three cancers, as in my dad’s case). If you ever need someone to talk to, don’t hesitate to email me at appetriny@gmail.com.

Rest in peace, my first love, my mentor, my best friend. I love you with all my heart, now and always.

Source: Audrey Progastama Petriny (Daughter)