Mission to Kansas (written June 1, 2018, completed June 11)

I've spent the past week (Sunday, May 27 through Friday, June 1) in Overland Park, Kansas assisting Mary Lou's older half-brother, Dan Manion, a 72 year old, divorced, retired ER physician who was in a rehabilitation hospital due to falling at home and injuring his left leg. Dan is childless and has residual impairment from a scuba diving accident 25 yers ago when he suffered decompression sickness (aka "the bends") and was hospitalized in Coral Gables, Florida for treatment. Dan has only one close friend, Sue, an 80-year old nurse and great-grandmother who still works 30 hours weekly. When Dan was being treated in Florida after the accident, Mary Lou, Jane Kelley, Sue and I each spent a week or more visiting Dan in the hospital.

When Mary Lou got a call from Patty about Dan's hospitalization, the news alarmed me greatly. Dan's treatment following the fall at his condominium had gone poorly due to diagnostic errors, a bad reaction to Buspar, and his pre-existing major medical conditions including diabetes and mild to moderate congestive heart failure. Sue was doing her best to be a support for Dan but was stressed by concern on top of her work and family responsibilities. Dan's difficulties coincided with one of Mary Lou's sisters and another sister's daughter having mental illness episodes requiring family intervention. Under the circumstances, I was the family member best qualified and most available to fly up and help.

I always liked Dan and felt compassion for him and I'd wanted to visit him before I heard about his current plight.  He was stable when I arrived but with a host of serious medical problems including a severe bed sore, major swelling of his right leg (the left leg was the one he injured in the tall), severe anxiety that impeded his ability to cooperate with treatment, congestive heart failure, and borderline kidney failure. He had made only slight progress in rehab regaining the ability to stand and walk.  I spent a great deal of time talking to him and getting to know Sue, who was very grounded and clearly doing everything she could to facilitate his treatment and recovery.

While there, my talents and skills proved useful in several ways. I brought Dan's notebook computer from his condo so he could pay bills and have access to email. I looked into the medication reaction and discovered Dan had been given a combination of 3 drugs, Ultram (tramadol), doxepin and Buspar (buspirone), all potent serotonin agonists. Given his symptoms, I concluded he experienced serotonin toxicity. I discussed this with Dan, who agreed, and passed the hypothesis along to his physicians. Sue and I visited two skilled nursing facilities and selected one, Tallgrass Creek, due to its overall high ratings and our favorable observations during the visit. Dan concurred and was moved there successfully the last full day of my visit (Friday, June 1).  I left Overland Park with a sense of accomplishment and flew home.

Sadly, as I write this on June 11, Dan is no longer with us in this life. Thursday night, Mary Lou called Dan and they had a long and meaningful conversation. I spoke to him and his last words to me were, "It will be a long haul." The next day, his body reached a tipping point and began to crash. Patty flew up immediately and Kayte went the next day. Dan was alive but at death's door by this time. Kayte sat with him that night and, after some harrowing agitation and discomfort, he became calm and died at 2:30am CST. The post prior to this one is the obituary I was asked to write.