John was asked by his GP to go to Oldham Royal hospital to have his heart checked at 10.45am on August 20th, 2021. He was told he needed a heart bypass operation and would be kept in Oldham hospital on preparatory medicine until a bed could be found in a heart specialist hospital. He waited for just over three weeks, when Hinnie, Nell and I could only see him for a brief chat in a corridor when dropping off clean clothes for him. No visits. On Sunday 12th August John phoned me to say he was waiting for an ambulance to take him to Manchester Royal Infirmary, where the surgeon and anaesthetist were waiting to prepare him for the operation the following morning.
Monday 13/9/21: Ward 3 – 0101 276 4142, by arrangement, 1 named visitor for one hour.
ICU – 0161 276 4544 – phone after 9 am daily, no visits.
1 pm: 20 mins ago taken into ICU. Please phone back in an hour, 2pm for update.
1.50 pm, Angela – sedated for 3/4 hour while warming up –
everything fine – no issues.
ring this evening before 8 pm
7.30pm Oge (day) – 7 pm off ventilator, breathing himself with oxygen, alert and relaxed. Vein from right leg used for coronary artery bypass.
Tuesday 14/9/21: 9am – had breakfast and got up to sit in chair, then back to
bed to rest, awake, on painkillers -‘feels spaced out’
Oge (day) – spoke to him and he sends love to everyone. Ring this afternoon.
2.30 pm – Oge – OK, up on chair, no lunch as a problem with swallowing –
opioids making him tired, but spoke to Hin and me.
7 pm – John: ate mash, feels nauseous, talked to him about my day. Sends love to everyone.
Wednesday 15/9/21: 9.15 am Della: Doing well, some oxygen support, sat in chair then back to bed. Drink of orange, sleeping.
3.50 pm Della: Woken up, orange drink, drains now out from chest, oxygen support likely to be off tomorrow. Probably stay ICU.
6.30 pm: Sleeping, ate some porridge, tiredness huge. Likely oxygen off tomorrow.
Tuesday 16/9/21 9.30 am – Dr. Hind: breakfast, pain well controlled with pain killers, drowsy, sitting in chair with small amount of oxygen – breathing exercises. Ring this afternoon and might be able to speak to him.
In ICU til weekend – happy about his stability.
2 pm – Dr Hind: Drowsy – not drinking or eating, trying to find out why. Head scan for mini strokes booked today and neuro will look at outcomes,
looking for possible area deprived of oxygen.
Possibly hormones lower? Bloods checking, BP and kidneys ok, the two blood vessels which were blocked are now working and heart is ok.
Limbs and head moving ok.
6.30 pm Louise: very drowsy, CT scan of head and neck done, results in hours, on feeding tube and drip. Woke John up to speak to us –
We sang American Pie and he sang two lines to Hin
Ain’t No Sunshine…Every little breeze
John repeated ‘Bye Bye’ ( as Geoff does, like Sooty) and said ‘See you soon’
Friday 17/9/21 -9.15 am: Rafi – Drs busy around John’s bed. Ring back in 20 minutes.
9.50 am Rafi: ward clerk today
Angela 1-1 nurse – Drowsy, more alert, remembered surgeon, Saleem Jahangir. stable BP, bloods show kidneys and urine fine. Needs time to wake, stands with support but not walking yet.CT scan later today via neurologist.
2.30 pm: Dr Ahmed – drowsy and a bit confused – not oriented to place MRI or time – known as delirium. Report in a few hours. Aware, conscious and all observations are stable. Delirium is a common side effect of being in ICU.
6.30 pm Rafi: John in scan now – ring in an hour.
7.30 pm Dr Ahmed: John agitated in scan and postponed this afternoon.
Scan rearranged, sedated slightly (30 mins ago) On antibiotics now as temperature went up this morning. Blood and urine cultures being examined for infection.
Nurse Julie: John asleep – not able to speak to him.
Saturday 18/9/21 9.00 am, Della – OK overnight, woke up, eyes opened – responded to Della with a nod and having a wash.
MRI results, doc will feed back if any issues, but doing rounds now, ring later.
2 pm, Dr Isa: when free will ring back re MRI plan. Very little change, sitting on side of bed with physios. No dialogue, passive but no reason to suspect visual issues.
18/9/21 2.45 pm Dr Isa – MRI result shows multiple small enfarcts in the brain which could be bypass related and stroke team referral made to neurology. Embolic stroke possibly as already on blood thinners. Same management in place, stable and no changes. Temperature high 38 and ongoing antibiotics. Bloods results establish not sepsis. Waiting for neurology assessment on Monday.
7.20 pm Della – doing well, sleepy, John listened to me and said I love you. Della gets nods from him and is sure he can see her.
Sunday 19/9/21 9.15 am – nurse busy with John, ring back in 20 minutes. 9.35 am – same
10 am Sister: drowsy and sleepy for 3 days. Being washed and referral made to Salford Royal neurology – ring later.
12.45 pm -John is listening and responded to me re dinner and garden and yes/no to questions. Responded to Andrew sends love with Yes.
“All these beautiful songs…”
Eric and drumming – ” Eee…”
“Bye bye Miss American Pie”
“Hiya…”
John has been sleeping and in bed all day today. Some positive moments this morning when he was able to respond briefly to Hinnie and I and to getting love from Andrew and hearing Eric’s voice. More news tomorrow.
6.30 pm Angela -physios not able to wake him to stand him up and John not alert enough to sit in chair. Nurse said no ward phone available.
20/9/21 9.20 am – ward mobile in use, ring back in 15 minutes.
9.40 am- Della – John is restless and wants to lie on the floor, then back to sleep. Still on feeding tube and small amount of oxygen. Dr Gureshi is on ward all day.
2.05 pm Dr Qureshi -first neurology assessment done today. Needs more time to wake for another assessment. Stroke causing drowsiness. John has been talking and giving his name. Antibiotics ongoing four days and settling infection risk
6.15 pm – Della – same, sleepy – she calls him but not waking and is asleep. Stroke team will return for assessment after first insignificant outcome.
9.15 pm Sister – hoping for him to wake in a couple of days for stroke team to come back for assessment.
Tuesday 21/9/21 9.15 am – Gina – Sleepy, eyes open. Dr Ahmed – seems to be improving alot. Will ring back in a few hours after Stroke team. We spoke on phone –
“Good morning”
“Lovely to hear your voice”
“Gina”
“I can see a window and another window. Concrete. The light is on”
“Blue. Chalky blue, dark blue”
“It changes when the light goes out”
“A bit of yellow wall”
“Damp and cold”
(I said ‘Sweden colours, I’ll tell Andrew)
“Andrew…Sweden…”
(I sang ‘Daisy daisy’ and he finished lines..)
2.45 pm Oge – stable and ok, sitting up in bed and comfortable.
More conversation –
“Yeah, am sitting up on the bed”
“What is it?”
“Oge. She’s the one you spoke to”
(‘She’s lovely’)
“Yeah she is”
(‘and Gina’)
“Yeah we have spoken together”
(‘What can you see?’)
“I can see a bit of…looks a little bit misty light”
(‘Season of mists and…’)
“Mellow fruitfulness”
“Can you hear me alright?”
“Oh good”
“I might start coughing at some point”
“It’s just a bit difficult”
(‘I’ll sing you a song’)
“Yeah go on, I’m listening”
(‘I see your face, the summer kisses, the sunburnt hands I used to hold…’ D’you remember that one?’)
“Yes, vaguely…Who was it sung by?”
(‘It might be French, translated into English’)
“Oh yeah”
“Hinnie!” Hello…hiya”
“Can you hear me alright?”
“I’ve been trying to cough but it doesn’t work”
“I can see a longer building – it’s all concrete but it looks more like sandstone”
“It’s been quite a busy afternoon – a few differnet people today”
“Let me just get me cough going”
“Hello – a little better, Yes, I think so”
“Give them my love too”
“Are they alright?”
“Is it Friday in school?”
“Sorry, I’m getting mixed up”
“I’ve been trying to work out which day it is – in a diary”
“Let me think what happened today”
“A lady doctor saw me this afternoon”
“Physiotherapist – occupational”
“And she wanted to do a bit of a scan on my heart, rolling over on the bed – ultrasound”
“She might be Lorraine”
“She said my heart is ok”
“Later on I had two more people – occupational therapy to do with moving – chair like a throne”
“Special hoist and er, yeah, I did a bed wash”
“I don’t know, maybe it’s just before the operation”
“Ok – well, I can, that’s right, cos I went in the shower. I trimmed my hair”
“It was just to make sure the rest of my beard was trimmed right”
“Was that the 19th?”
“Oh yes, the 12th – Martin’s birthday”
“It’s really nice to talk to you”
“Lovely to hear you”
“Tara for now”
“Yeah”
“I couldn’t work out what happened…I think it was -“
(‘ You needed to rest for longer’)
7 pm Dr Thomas of Stroke Team had spoken to Dr Qureshi – on bloodthinners and usual medication. Orienting himself to time and place and can be moved to Stroke ward on Thursday if progress continues.
7.15 pm Gina – I said goodnight to John and told him we’d been to Morrisons for tea with Eric and Ella. He’s looking forward to seeing them. He asked if I’d like to say goodbye to Gina and gave phone to her. I thanked her. She said he’s doing well and knows her name and Doctor’s name.
Wednesday 22/9/21 -10.40 am – please ring back in 20 minutes
11.50 am – please ring back in ten minutes
12 noon Jasmine – John is confused but settled
Ward Manager Julie Stone – as John has now been in ICU for ten days, I was invited to visit him today for one hour 2 – 3 or 3- 4. He is breathing without support, still has feeding tube and on antibiotics.
John knew me and introduced me to his nurse, although clearly anxious and preoccupied with the ICU paraphernalia supporting him, trying to remove pipes.
A talk with Paul, an ICU Advanced Practitioner confirmed the stroke was multi-focus at the front of the brain, with motor functions not affected, but it is not possible to know the cognitive impact. John will be moved to Cardiac Critical Care where physios will begin the stroke therapy needed. The Care Plan includes a further move to a neural unit in the future and this might mean a wait for a bed. The long-term prognosis is a six month recovery period. John was supported to sit on the bed near me and listened to Paul. He struggled with nurses and said ‘I want to go home. Leigh will take care of me.’ the nurses encouraged him to lie down and I kissed him and told him the doctors and nurses would take care of him . I gave him love from everyone and he sent love to you.
Thursday 23/9/21 9.20 am – Drs busy with John, please ring later.
10 am – phone line busy.
10.10 am – Doing well. Likely to go to Ward 3 today. Ring Caroline later to get ward phone number. and news.
3.15 pm – call at home fromMRI – John has been moved to Cardiac Critical Care in Ward 4
3.30 pm- Charlotte – John asleep, was confused ‘but he’ll be better now he’s out of ICU’
Visiting allowed 2pm – 5pm or 6pm – 8pm Ring ward to book in advance.
Friday 24/9/21 9.10 am Clare, no concerns, someone stays with him all the time at the moment in a sideroom. Loose stools and culture needs to show negative. Can visit 2-3 pm Sunday
3.10 pm – Connor, staff nurse – feeding tube checked for position in stomach via aspirate – fluid prescribed. Aspirate not possible. Xray done at 1 pm re MG tube placing – currently reviewing, then will start feeding again. Speech and language team will review for safe swallow and speaking on Monday.
Saturday 25/9/21 12 am – John taken by ambulance to Fairfield Hospital Bury and was speaking . Asked the ambulance crew how long he would be in Fairfield. Leah, sister – Acute Stroke Ward – John very confused, feeding and required 1-1 supervision. After capacity assessment has fluctuating capacity and now has capacity deprivation of liberty and wearing mittens to prevent removing of MG tube.
Ward 5, no visits at all. Phone to speak to John.
Phone Manager Emily on Monday to ask about visit. Phone again after 2pm
Sophia – John settled
MRI staff nurse phoned, please collect John’s valuables from MRI on Monday.
Sunday 26/9/21 John settled this morning – nurse on break so ring after 12
12.30 – Meds via MG tube, in side room because of infection
4.30pm I spoke to John. He knows where he is and is looking forward to when I can visit him. He checked with me that I know where Fairfield Hospital is. I do! Love to you all, more news tomorrow.
Monday 27/9/21 9.35 am Busy with meds, please ring later.
11.30 am Stacey – John has had a seizure but has recovered ok. He is tired. Monitoring him for more epileptic seizures. Speech and language will be at a later date.
2.30 pm – no reply
2,45 pm – rang but cut off twice.
Stacey – settled but temperature rise this morning. ECG OK and is more alert than when seizure happened. Emily, Ward Mgr will be in tomorrow morning.
6.30 pm Stacey – meds for John because of low sodium level, bloods results tomorrow. More alert and wants to speak. I told him about going for tea in Morrisons and he listened and responded.
Tuesday 28/9/21 ANSAPHONE call at home Please ring Ward 5.
7.45am – Robora – at 1 am John got very poorly and has been moved to ICU with infection. On oxygen and Xray done.
Ward clerk Dr Kineev – blood pressure high, got worse in ICU and John had a brief cardiac arrest but was resuscitated in five minutes. He is on ventilator and is sedated in an induced coma. Unstable but coping and very poorly.
10.15 am – Hinnie and I met Drs Jolly and Mahmoud and Alison, John’s nurse. Infection source might be in the lungs. ECG is fine, but there is a risk of organ failure as his kidney function is low but not in need of dialysis.All over support from ICU and they feel they need John to respond.
Wednesday 29/9/21 Theresa – no change overnight. No news of infection source and drs arranging a CT scan. Please ring later.
7.40pm line busy
8.10 pm John settled, slight improvement, bloods a bit better, still on ventilator, sedation reduced but no responses. Might reduce it further tomorrow. Chest and abdomen clear.
Thursday 30/9/21 Staff nurse asked me to give a password. Wuthering
John has been off sedation since 7.45 am, being washed and consultant wants to check if he’s waking. On ventilator and spontaneous movement from time to time. Monitoring BP meds and heart rate. Dr Baker and Dr Jolly. Ring again after lunch.
12.45 pm Lynn – Same situation. Not waking. John is on ventilator, sedated and with support for BP and heart rate.
After 24 hours John will be moved to ICU in Salford Royal – or could be within the hour. Just waiting for ambulance. Dr Climm Jolly said they’d tried to see if they could wake him, but no response.
3.30 pm John arrived in ICU at Salford Royal and is being settled in. Please ring later.
5.20 pm Ilias -John under sedation, doctors with him overnight and tomorrow. Visiting can be next of kin only – Hinnie and I, phone to book an hour.
Friday 1/10.21 – 2.30 pm Dr Anfal rang and our 5 to 6 pm visit has to be cancelled. John has been off sedation all day and is not waking. Is on antibiotics and chest drain for pneumonia. Kidney and bloods seem to be improving, but further brain scan needed to explore if any additional damage since last scan. Unable to visit today, but can visit tomorrow.
Saturday 2/10/21 12.30 pm Dr Dan and Virginia – no issues arising from recent brain scan. The antibiotics are correct for infection and ongoing checks being made on this three times daily. John is breathing for himself and no longer on blood pressure meds. Sedation was off from 9 am today and he’s trying to open his eyes. Dr is hoping to remove ventilator tube later today or tomorrow. We gave him your love and sang to him.
Sunday 2/10/21 1-2 pm Hinnie and I visited John. No signficant improvement as his blood pressure rose again yesterday evening and again this morning, so John is back on BP and heart meds. They are still lowering sedation, but John is making minimal response. His breathing still supported by ventilator. We gave him love from all.
Monday 4/10/21 Paula, bed 8, visited 5 – 6 pm and we spoke with Dr Jackie and nurse who told us the medical team had reached the limit of life support they can give John. Over the next few days the cardiologist, stroke team and multi=dis ICU team will examine his failing organs: brain, heart,, lungs and kidneys and we will get feedback in next few visits. John’s blood pressure and heart rate increase dangerously each time they reduce sedation and he is not responding. We arranged for Nell to visit with me tomorrow and gave him your love.
Tuesday 5/10/21 11.30 -12.30, Vikki – Nell and I visited. No ventilator and oxygen levels are down. Cardio-respiratory team is monitoring and physiotherapy monitoring assessment of breathing. Blood pressure stable, legs moving, arms weaker, pressing my hand. More monitoring during the afternoon and we will get feedback. We sang to him and gave him your love.
Wednesday 6/10/21, 11.30 -12.30 Dr Thomas and Vikki – John is awake and alert after having the ventilator tube removed yesterday. The Stroke team have visited and as his heartbeat is regular and no sign of atrial infibrillation, it is likely he will be moved from ICU to the Critical stroke ward in the near future. Another MRI scan is planned to check again on the damage caused by the stroke. His breathing is supported minimally by oxygen and he is still fed via MG tube. His inability to swallow or speak will be central to stroke rehab work over the weeks ahead. The ICU consultant was clear that “we can’t predict the future…” and adverse reactions are always a possibility. Intensive care is not needed now and John will be equally well supported in the Stroke ward. God bless ICU. During our visit, he listened, watched, turned his head, winked, enjoyed the music we played and was looking and listening to everything going on around him. We don’t think he knew us. John is still waiting for a bed in the Stroke ward. We gave him your love.
Thursday 7/10/21 10.30am phone call from Jay Qwan, Stroke consultant with update after she was asked to see John urgently. Sepsis being treated with antibiotics, no speech and very poorly neurologically. MRI scan to see amount of brain injury not right to do when John is so poorly. New fever, very breathless New blood cultures taken, oxygen support. ICU cannot offer more life support. Please come in asap to ward B3 on ground floor.
Hinnie and I arrived at 11.45am and walked to B3 from main car park.Met Robbie, his nurse and Lisa, a palliative care nurse, who explained John is close to death and possibly not far from now. Jay Qwan, consultant who phoned us called in to see us. Lisa went to find the chaplain for us and we sat with John for an hour. Hinnie played John some music and the Chaplain came and talked with us. She said prayers and blessed John and said we could contact her at any time. Two ‘cygnets’ came – Janet and Lisa – palliative care volunteers. Janet lives near Clara St on Coppice and knows John from her pub, the Royal Oak. They stayed with John while we left…it was Eric’s birthday and we knew John would want us to go home for his party.
Robbie phoned us as we were driving home to say ‘John has taken his last breath’ – and to contact Robbie when we got home. He was preparing to wash and move John to the mortuary.
This is the update we sent out to his friends and family…
“With great sadness, we have to tell you that John died at 2 pm this afternoon, 7th October 2021.
We were called at 10.30am because his condition had deteriorated severely from the early hours and we were asked to visit as quickly as possible. He had a new fever and was very breathless, with a very poor neurological prognosis and no MRI scan had been possible. The consultant confirmed that there was no more that ICU could do and that John would remain in the Stroke ward.
We arrived at 11.45am and stayed close to him with love, music, and the comfort of Last Rites administered by the hospital chaplain. We left at 1.30 pm and were driving home when Robbie, his nurse, called us to say John had taken his last breath at 2 pm. We send you all our love and will be in touch later tomorrow.”
John’s funeral was arranged for 2.30pm on 28th October, 2021, at Hollinwood Crematorium, Oldham, according to the wishes he left.
John Cook – 16th March 1950 – 7th October 2021
We gather together
Welcome and Introduction by Sue
We light a candle
Hinnie reads
We remember and give thanks
Leigh speaks
Music
Chris speaks and reads
Hinnie speaks
Charlie speaks
Music
The Committal
Music
We move forward in Love
Music: Sibelius No. 4 Final Movement
Labi Siffre: It Must Be love
Buddy Holly: True Love Ways
Arturo Marquez – Danzon No. 2
Everyone is invited to join us for a drink and a bite to eat as we celebrate John’s life at The Victoria Hotel, Oldham.
