How My Dad Died.

Originally written in April 2007

I was asked in comments to write a story about my dad here.

The way my mind is working at the moment, I can only think of negative and horirble stories, doused in alcohol and soaked with sickness.

I have very few specifically positive stories of my dad. Plenty of lovely memories, but they are fleeting, small events like him making us Toasted Toppers or his insistence that Graham Chapman deserved a better looking boyfriend than David Sherlock.

Wedding Day

I’d never been to a wedding as a Grown Up. Nor a reception or any suchlike thing. The first wedding I remember was that of my aunt and uncle, Anne and Brian. Anne is a blonde model who appeared in speeding adverts, I’ve seen her in a bridal gown only once before, and that was on an advert on Ulster Television- “40 miles an hour!” with blood rolling apologetically down her dress. She used to come back from filming in England (“You’ve been to England?” we’d gawk at her) with those fat red dummy rocks in clutches for us. My uncle Brian is a big nosed, fresh-faced lovable man who has raised his three children to have quiet country burrs which is somewhat exotic to me when he brings them begrudgingly to their aunt’s house.

At the time I was nine years old and wasn’t taken to the wedding. My granny Molloy looked after me that day, in the only time she had ever been to our house. I remember her with her red slim face, which always looked like a warning triangle, taking my hand and us walking to the Dairy Farm, a supermarket near my house, where she bought me a pink keyboard. Then we went to the library where I proceeded to be kicked out as I was too fascinated with my first ever musical instrument. I managed to retain my dignity and my Asterix books, whereupon I rechristened myself Cacophonix.

That day I seemed to inherit a new family. At the wedding my mum met some of her family, The Mallons. Edna had a sharp tongue and fast humour, then there were her three daughters- Angela, Ceri and Michelle. Their ages corresponded roughly with the ages of me and my older sister. Michelle was the youngest so we were expected to get on. We were utterly different people so were never close.

So one wedding created a new family. The next was the day after my 18th birthday, the wedding of my uncle Michael to a quite well-to-do middle class girl called Fiona. Her family were much more respectable than our rough West Belfast one.

My uncle Michael looked like Damon Albarn. My sister Paula and I used to boast to our school friends about this. His fiancée was a social worker, tiny, buxom, blonde and beautiful. I first met her at a bedside vigil for my granda. I’d never met her before and remember feeling insulted rather than touched that she had come here while my grandad was so sick. In that respect, I’m quite traditional. For all my running-off-to-London, I believe in the family and find “outsiders” intrusive sometimes.

The wedding was in Bangor, and my dad was determined that we weren’t taking a feckin’ train that day. We got a taxi, god forbid, all of us piled into one black cab. He wanted us to be stylish, just as good as them, he said. But he was brimming over with happiness, as he always did when we were all together.

We found ourselves outside the church with a half an hour to spare and a bit peckish. “There’s a reception on later, Da,” says Michelle. Imagines of vol-au-vents, quiche, delicately decorated salmon en croute filled our minds.

But it would be hours before we had the chance to eat.

In our new clothes, we went to KFC and smeared ourselves with greasy chips and microwaved gravy. We sipped flat coke out of enormous buckets and liberally ate cold chicken.

We went at breakneck speed to the fancy Gothic church, stinking of fast food, gravy on our lips and the odour of old plastic seats sticking to our arses.

Twenty minutes later my other uncle Brendan (sarcastic, amusing vegetarian, much beloved of Paula, much resented by me for wrecking my carefully constructed house of cards) shows up, late and distressed and bangs on the window, Graduate style, to be let in. The priest shook his head and we all froze in horror and laughed as he strained to watch his baby brother getting married through a window, occasionally letting loose a fly of words that made the choirboys blush as he batted unruly twigs away from his face.

I wish

I could end the story there and that it would be Full O’ Larks. But of course with my dad in tow the day turned ugly.

He got drunk, completely pissed, and refused to be told otherwise. He was loud, embarrassing, abusive and disruptive. We ended up having to look after him, pleading, begging and crying.

I don’t think, until that point, his family believed us when we said his alcoholism was severe. But as the evening progressed and his behaviour got worse, I think it finally clicked that for all those years, we had not been exaggerating. Michelle, Paula and me were just exhausted, exhausted, humiliated and depressed, wanting to be a Proper Family out at their uncle’s wedding, instead of three ringmasters in the arena of my dad’s illness.

I have a lot of guilt concerning my dad. Not just that everything we did didn’t stop him from dying. But for childish things.

My mum and dad had prolific and devastating fights almost every night. My dad would eventually stumble upstairs, screaming obsenties. And my sisters and I would huddle in their bedroom and talk about how if we pushed him downstairs, we wouldn’t have to put up with it anymore.

We had many comical scenerios as to how we’d get rid of my parents. And they were comical, we didn’t actually want them to die but craved silence.

My dad rang me up on my 16th birthday. It was one of the periods he wasn’t living at home and I had assumed he was calling to wish me a happy birthday. Instead, he told me he was going to kill himself.

Sometimes I wish he had done. There were times when I violently wished that something, anything would end his and our suffering. I knew always that alcoholism was a disease and an addiction but it’s scant comfort when you’re in the living room with your little brother and sister trying to block out the crockery breaking in the kitchen.

I wanted something quick and painless and it would be over.

I was outside work once. At the time, a friend of mine was suffering from serious depression and they had rang me earlier to tell me they were going to kill themselves. This was sometime during 2005. I took the phone outside and tried to talk them down but I was petrified and shaking.

When Vicky died, I prayed to whatever gods there were that I would never have to go through it again. The stark memory of sitting down on the chair being told she had hung herself, the starker memory of walking down the forest the same night, vision blurring with tears, standing on the roadside we had walked upon destroyed me.

I got off the phone to my friend and lay back against a wall with a cigarette.

Suddenly, the image of someone calling to tell me my dad had killed himself flew into my head and took my breath out. All those times I wished it had happened pulverised me and I felt like the worst person in the world. The reality, the already-grief of his dying laid me on a fold up chair in tears.

I had always believed he’d get better. I held that hope to my chest, to my heart, to every minute of the day. I believed that with our help and willpower, he would recover and live to say, “When I was an alcoholic”…

The Reality of it

When it happened, I didn’t know what to do.

My dad had been in hospital for two weeks or so. It started innocuously enough. I was on the phone to my brother when he made a joke about my dad looking like one of the Simpsons. I asked him what he meant and he said, “He’s bright yellow”.

That night was a Saturday and I was alone in my flat. And for some reason, I got my mum on the phone and said, “I think daddy has liver failure”.

She didn’t really take me seriously so I told her I was going to call NHS direct. I described my dad to the nuse on the phone. Jaundice. Alcoholism and, in the background, his slurred voice.

I rang my mum back and told her I was calling an ambulance. I rang them in London and asked them to transfer me to Belfast. Rang them up and sent them to the house.

I was on the phone when they came. I heard my daddy protesting that he had an appointment with the doctor in June (it was the end of April) and that he was fine. I told my mother to keep trying and spoke to the ambulance staff, telling them I think he’s very ill and please make sure he goes.

He didn’t. He refused the ambulance and my mum called someone else, I can’t remember who, I think it was psychiatrist services. He finally went.

A few weeks passed. Phone calls here and there. I didn’t go home as nothing sounded serious. He was filled with fluid and had acute liver failure. I assumed he would get a transplant.

I had a holiday to Belfast booked on the 18th of May to introduce Rob to my parents. It had been booked for a while. I had spoke to my daddy on the phone and he was looking forward to seeing me and Rob on the 18th. He sounded fine.

On the 16th of May, while I was in work, my sister Michelle sent me a text saying daddy was dying now, right now, and to get home.

I called her, then called my sister Paula who was in the airport on her way back to London. She didn’t want to make a fuss so I called the nurse to make sure Michelle wasn’t being hysterical.

The nurse told me to come home.

Paula turned round and went back to the hospital. I had no money whatsoever and couldn’t change my flights. Jo and my boss at work started printing out train and flight times. I appealed on Livejournal for someone to help me get home. A friend lent me the money, I booked my flight, kissed goodbye to Rob and flew home.

I met my friend Tracie at the airport. She had some ham sandwiches and a bar of chocolate for me. I was filled with dread. I couldn’t, would not think of my dad dying. We sped down the long, dark, 10pm roads. I laid my head against the passenger window and stared at the greyscale countryside.

I met my sisters in hospital. I was not prepared for what I saw.

My dad was so clearly and obviously dying. I burst into tears.

When my grandad died, my drunken, grieving father shouted that the next funeral we would be at would his own.

I had not believed him. And here it was, his dying.

He was so afraid of death and that’s mostly what was on my mind. Did he know? A nurse leant over his bed and told us it wouldn’t be long. I was horrified, what if my dad heard? Was he afraid?

He was yellow and ancient and couldn’t breathe- he couldn’t see or talk and he was so clearly dying. I started crying as soon as I saw him, held his hand and tried to tell him I was here but I don’t know if he knows I was. I thought at least he would be able to talk, there was so much to say. He looked so different and my sister assured me he had only become this bad within the past 24 hours. Before that, he was able to talk and I hate myself for not going home 24 hours earlier.

We stayed the whole night in the room, holding his hand, talking to each other, going to the smoking room and watching his monitors. I’d bought him the issue of Kettering- I had thought he would be conscious enough for me to read him to him, he had wanted to read my Neil Innes interview, because he was a fan and he was proud. He’d gone round telling everyone I was interviewing him. I had been so hopeful he would be conscious. I desperately wanted to speak to him. Wanted to hear him say my name.

Michelle left to sleep and Paula left to smoke and I tried to tell him that I love him, he made no sign he’d heard, just groaned and fiddled with his breathing mask.

He kept trying to take his mask off, and we kept putting it back on. A few times he’d clutch his head, like he had a headache, like something so normal, a headache. He tried to sit himself up a few times. He tried to sleep.

He must have known we were there. He kept holding Paula’s hand while I stood on the other side and stroked his hair. It made him sleep. In his sleep, he said our names. All our names, his five children.

He said. And he did say, although my sister denies it, “I don’t want to die”. It could have been a trick of the ears but I am sure he said it. And my heart cracked in two.

He was obviously in a lot of discomfort but the doctor said he wasn’t in pain. He kept pulling out his wires and tubes- he was so scared of ending up like my granda that Paula told me he’d been pulling them out since the beginning. He always believed he’d be going home and on some level, so did I. I thought this would be a lesson, he would stop drinking and get better. I thought he was brilliant because recently he’d been sober more, and he was going into rehab this month.

Hours passed of him taking off his mask, falling asleep, waking up. The morning came, we hardly knew. About eight am or so we called our mum and asked her to come take our place for an hour while we ate something. We didn’t want to leave, we agonised over it but we needed something to eat. We expected to be there days, we were getting ready for it.

Before we left, Paula stroked his arm and said she’d see him soon. I kissed his forehead and told him we’d be gone an hour but we’d be back.

At about 8am, our mum came and we went home to get some food.

A half an hour later, the nurse phoned and told us to come back. We tried to wake our little brother up but he wouldn’t wake up. After some exhausted, frustrated screaming at him, he got up and smashed the china set my dad had bought for my mum.

We got to the hospital. Liam went to the toilet and we went up to the ward. Tacked on the curtain was, “NO VISITORS”. And my dad had died there, without us at about 9am on 17th May, a day before Rob and I’s visit. Aged forty seven, a month before his 48th birthday.

We howled. I had to go and find Liam and tell him. He was in the corridor and I didn’t know what to do or say. I just had to tell him that his dad died. How do you tell a fifteen year old that?

I remember standing by my brother and sisters and crying, I remember hugging my uncles, his brothers, and his mother, who had lost her sister two weeks ago and her husband seven months ago. It is not fair, I remember thinking that over and over.

A nurse came in and said, “Did he have a wedding ring on?” Nothing else- “NO” and then, “Did he have any gold teeth?” “NO” get out of my sight and she did and I hated her so much.

They took him away and kept hassling us saying they needed to do it now. We said wait because his brother isn’t here yet, my uncle Michael was on his way. Before they took him away we said our separate goodbyes and had our time with him. No-one will ever know what we all said, and I am glad.

They took him and we organised the wake at my grandmother’s. It was best to be there, it was his real home.

I slept after that and the next day Rob got here. We spent the next days at my grandmother’s. He met everyone in my family, except my dad. I wrote the obituary with my little sister and it appeared in the paper with many others, and flowers arrived and two big wreaths, “DAD” and “BROTHER”. I got away with much as a lot of my extended family and friends didn’t realise I was his daughter, so there weren’t many, “I’m sorry”s or tearful hugs. That hurt me slightly because I wanted some hugs but I had Rob, my sisters and uncles and brother and that’s all I needed, all we needed.

The coffin was in the room and they did a good job, he looked like my dad. I couldn’t understand why he was there, none of us could.

The priests came and went and on Friday night, Paula, Brendan my uncle and I stayed with him on his final night. We talked about a lot of things, not really my dad, and didn’t sleep. Everytime the automatic air freshener went off, we jumped.

The funeral was on Saturday and at first I didn’t think I could do it. My sister held my hand as we listened to the priest before they took him away. I couldn’t stop crying. I said goodbye again, I said I’m sorry.

My fifteen year old little brother had to carry his dad’s coffin.

On the way up to the church we noticed one of the men carrying the coffin had something written on his bald head and neck in green marker. He didn’t know he had it.

After the funeral, we went to the PD, a Republican bar my dad and our family went to often, and had a buffet and a drink. Since then, I’ve felt very little. I’d been sleeping in his bed and going through photographs, taking some and not taking others in the knowledge he’d kill me. But he isn’t here now and I can’t really understand how. As time wears on, the truth of it, the real truth of it, is beginning to dawn.

I don’t know what to do now. There’s years ahead without my dad but I still feel as though he’ll be back. I never want to remember him as that man I saw in the coffin. I hate Catholic services. I’m worried about the future for my mum and the kids. I’m worried about my granny. I don’t know what to do without my dad. He’s the one who understood us and helped us. He paid my rent once and bought our Christmas presents. He taught us how to read and ride our bikes and taught us how to write and taught us our history. He got me into comedy and music. I have all his David Bowie vinyls now, as promised.

The last time I saw him was Christmas 2005 and he had stayed sober, it was lovely. There is a photo of him in the bedroom, arms outstretched and smiling and you’d think he didn’t have a trouble in his heart until you notice his wrist, a huge gaping wound. He was not a happy man and that kills us. We tried. We love him so much.

My sisters joked we should put lots of IOUs in his coffin with him because he helped us with money when he got ourselves into scrapes. I wanted to put his comb in there with him. Paula could barely look at him but when she did it was to fix his hair. He would be mad at us if he’d known we didn’t shave his head for him.

Mental Illness and Mortality

Last night when my brain was car-crashing, I was reading about 10 articles per five minutes. One them was this about serious mental illness and mortality.

That was the article that triggered my panic attack. Here’s another:


 

Clinical & Research News

Death Data Have Researchers Searching for Answers Eve Bender

People with serious mental illness are dying at higher rates and at earlier ages than people in the general population who don’t have mental illness.

Metabolic dysfunction caused by some medications may play a role. People with serious mental illness in one sample of psychiatric inpatients had more than three times the rate of death of those in the general population without mental illness and died an average of 32 years earlier.

The leading causes of death among people in the sample, most of whom were diagnosed with a psychotic disorder, were heart disease, suicide, accidents, and cancer.

The findings call for increased screening and monitoring of patients with serious mental illness for medical comorbidities, according to the authors of the study, published in the October Psychiatric Services.

Researchers collected medical information on 20,018 patients hospitalized on at least one occasion at one of nine hospital sites associated with five behavioral health care organizations in Ohio’s public mental health system between 1998 and 2002.

They matched patients’ hospital records with death records from the Ohio Department of Health and identified 608 patients who died during the four-year period (hospital deaths were included in the sample).

The patients who died had been diagnosed with a number of mental disorders, including schizophrenia (134), schizoaffective disorder (128), alcohol abuse (101), bipolar disorder (87), alcohol dependence (85), major depressive disorder (80), cannibis abuse (59), other mixed or unspecified drug abuse (56), and cocaine abuse (35). The majority of patients in the sample died from heart disease (126), suicides (108), accidents (83), or cancer (44).

Researchers also measured years per life lost for those who died, which is a measure of premature death based on the current mean survival age for a cohort matched by age and gender in the general population. Patients with serious mental illness died an average of 32 years earlier than patients in the general population, according to the findings.

The average age of death for the people in the sample was 47.7 years. When researchers calculated the standard mortality ratio for patients in the sample who died, they found 3.2 times the rate of death as that of the general U.S. population.

The most prevalent comorbid medical conditions for patients in the sample who died included obesity (144), hypertension (136), diabetes (70), chronic obstructive pulmonary disease (62), and injuries (39). Among the 126 patients who died of heart disease, leading comorbidities included hypertension, obesity, diabetes, chronic obstructive pulmonary disease, and disorders of lipid metabolism.

Previous research has yielded similar results. For example, a report released by the federal Centers for Disease Control and Prevention in April said that patients with schizophrenia or bipolar disorder lose as much as 20 years off their average life expectancy compared withsimilar individuals in the general population without seriousmental illness and had elevated rates of heart disease (Psychiatric News, July 7).

At a 2004 meeting convened by the American Diabetes Association and attended by several APA members, the organization issued a consensus statement confirming the risk of metabolic changes associated with second-generation anti-psychotics and calling for careful monitoring of patients on these medications.

In the study of hospitalized patients with serious mental illness in Ohio, researchers could not draw conclusions about cause of death. They speculated, however, that underlying factors may have included medication-induced weight gain, poor personal hygiene, reduced physical activity, increased prevalence of smoking and substance use, and inadequate social support, according to C. Bayard Paschall III, Ph.D., chief of the Ohio Department of Mental Health’s Office of Performance Improvement.

“The question is how we tease some of these characteristics away” from others to be able to associate them with cause of death for patients with serious mental illness, Paschall told Psychiatric News.

Study findings indicate a need for closer collaboration between psychiatry and primary care, according to lead author Brian Miller, M.D., M.P.H., a PGY-2 psychiatry resident at the Medical College of Georgia. In ideal circumstances, patients with serious mental illness could walk from their psychiatrist’s office to an office across the hall to see a primary care physician “who might screen them for some of the comorbid medical conditions we observed in our study,” he said.

In addition, he suggested that psychiatrists and other physicians treating patients who take second-generation antipsychotics carefully monitor these patients for side effects associated with metabolic dysfunction and also write orders for tests of fasting blood glucose, lipid profiles, and liver and thyroid function. Miller and Paschall are conducting further research on some of the factors that may be contributing to excess death rates among people with serious mental illness.

 


 

I’m not sure what to draw from that as they don’t mention if the alcohol/drug abuse is co-morbid with mental illnesses. Still, it is sobering and frightening. Especially given just how low on the agenda mental illness is in Britain.

My dad died right on the money- aged 47.11 years.

Belly’s gonna get ya

Ooh. Now I have this new toy, I will probably write in it tediously often.

A common complaint from people taking medication for manic depression is the weight gain. I’m on three “Gainer” medications and, for a while, I outran the extra pounds that were chasing me.

In the past month, I’ve been caught. And pizza has been smeared all over my face.

When I was admitted to hospital in October, I was the lightest I had been in years. Pure manic energy had shaken the meat from my bones. I forgot to eat, forgot to sleep and blubber fizzled away.

Since then, I have gained a grand total of 21lbs. That’s one stone and 7lbs of weight.

I started taken Paroxetine in January. I suspect Paroxetine may be the culprit. It’s an SSRI and, as Crazy Meds lovingly informs us, its side effects are:

The usual for SSRIs – headache, nausea, dry mouth, sweating, sleepiness or insomnia, and diarrhea or constipation, weight gain, loss of libido. Everyone I’ve read on the subject of how long side effects last (Dr. Stephen Stahl’s Essential Psychopharmacology: The Prescriber’s Guide, Dr. Diamond’s Instant Psychopharmacology, Dr. Drummond’s The Complete Guide to Psychiatric Drugs , Preston et al.’s Consumer’s Guide To Psychiatric Drugs) agrees that everything but the weight gain and loss of libido usually goes away within a couple of weeks. Paxil is notorious for having the worst impact on your libido of all SSRIs.

Sounds brilliant, doesn’t it.

It’s been since January that I have gained a ton of weight. Christmas didn’t add a pound to my frame and I came home from Belfast feeling especially smug as people struggled with their belts and picked their teeth with turkey bones.

My smugness has dissolved. I also have PCOS which makes it difficult for me to lose weight in the first place, due to insulin resistance. The most successful weight loss plan I ever followed was The Atkins Diet. It works on people with PCOS as it has a low-carb, no-sugar philosophy.

However, because I now take Lithium, I can’t follow the Atkins diet as I may get kidney failure. Lithium hits your kidneys hard, as does the Atkins Diet.

So, what to do? Technically, I should be exercising my arse off. But you have no idea how hard that is when you take Seroquel. I feel drugged all day. The mists don’t begin to disperse until I’m taking my next dose.

I could go on a diet, but nothing works for me but Atkins. I’ve been eating a lot less recently, but actually gained 4lbs instead of losing them.

I could resort to my old, dear friend, Bulimia. I suffered from bulimia for seven years. It’s only been fairly recently I have got a handle on it. I had a big scare when I choked, went unconscious on the bathroom floor and came to with blood streaming down my nose. It’s fear, rather than sense, that is stifling my vanity.

For the time being, I am trying to be reasonable. It’s more important for me to be stable and used to my medication than it is for me to be thin. And when I feel better, I will start exercising again and hopefully lose weight. I am not dangerously overweight by any means. It’s vanity more than health that makes me sad when I feel the spare tyre around my waist.

I will maintain a sensible outlook for now. It is so very tempting to flush all the medication down the toilet and live like a “Normal Person”. However, I know the consequences of my being untreated. My choices are be fat or be dead.

I’m going to congratulate myself for my logic by ordering a pizza.