Question: My 37 yr old son left this earth in March. He had: kidney failure, he did his own hemodialysis at our home 4 or more times a week for 3 yrs; he had chronic pancreatitis; severe aplastic anemia, Transfusions every few months this year; a huge slowly painful dying spleen that had begun to create Splenic Infarctions. Dr said anemia was too bad, couldn't remove spleen. He wouldn't survive surgery because it was so huge, four times the normal size so of course it couldn't be done with laparoscopicly; staff infection in both legs; on oxygen constantly because he couldn't breath enough to get very far without it; low testosterone; and insomnia, just to mention a few. He Did NOT have diabetes, cancer, congestive heart failure, or chronic obstructive pulmonary disease. He saw his hemotologist Dr on Tuesday just 5 days before he'd leave us. We left in good spirits, his hemogloblin was up to 7.5 which was ok for him. And we planned to be back Monday for the ultrasound. Dr gave strong antibiotic for staff. It always zapps his energy but he took them for 5 days and became more fatigued each day. On Sunday he was much worse. He had it in his mind that if he could dialyze he'd feel better but he tried and alarms went off and he was too weak to deal with it so I re-set it up but he wasn't given time to try again. I do Not know if he had started the dialysis when the machine alarm went off. but he wasn't on when I was in with him. He said he was scared. I wanted to call an ambulance which was commom place around our home, but he just ask me to call the DR. I listened to his chest and back for any fluid and heard none, but did notice his heart did not sound as loud as usual. I took his blood pressure and it was a little low for him 164/87, after about 5 minutes I took it again 146/69.heart rate wasn't low but he took a lot of Tenormin for BP. His body could stand high bp readings of 225/120 from time to time, which terrified the medical community. So, blood pressure that was lowering was foreign to us.He said he felt funny. Real weak, too weak to lift an arm. I ask about pain, he said none except a little headache. then he grabbed the small bucket and threw up with no warning. A few minutes passed and he said frantically, I can't breathe (four times). On hearing it the first time I ran to turn the O2 up to 5, grabbed the extra tank with the mask and cranked it up to 5. But when I held it up to his face
he tried hard four times to inhale but the air wasn't going in then his eyes rolled back in his head and his head fell forward. I listened for a heart beat, felt for a pulse, and listened for breathing. Gone. my son was gone. I can't live with myself because I should have tried to revive him but he'd been sick for 12 yrs and had a DNR. He was just there and then he just wasn't. I grieve badly daily because I feel like I should have done something or noticed something before it reached that point. My question to you is a simple one...what do you think caused my son to pass over to be with his Lord? I have read, researched, studied. I get lots of different possibilities. FYI, here are some more historical facts: his blood had begun to shunt the day we saw dr but we didn't mention it because we didn't know what it was till a nurse told me at his funeral- we just thought his fingers were cold. He'd been hospitalized possibly 3 times in the last year for hyperkalemia, and several times for primarily dehydration, and once for Hyperphosphatemia. He had had pleural effusion 3 times in the last 3 yrs, but not in the last year and it colapsed a lung once but those were extreme frantic times unlike the day he left us. In the past, once he talked out of his head in the ER and an idiot dr who knew nothing but one philosophy i.e.,young people who do that are either on
drugs or alcohol almost let him die--That philosophy is not true; he was severely dehydrated and simply needed iv fluids. But I digress. He was Not talking out of his head the day he left. He had No fever. He was pale but I'd seen that before. He complained of No pain except a little headache. The vomitting came sudden just the once. So, Doctor, what do you think.... Heart attack or Cardiac arrest without pain? Pulmonary edema without chest tightness or crackling sound with stethscope? Pulmonary embolism? Thorasic aneurysm? Splenic Exsanguination/hemoragic shock possibly from a slow leak around one of the splenic infarctions? I'm at a loss. Thank you

Thank you for your response Dr Sundriyal. Your insight makes me feel better. You have said what I believed all along, that his death was due to cardiac arrest or sudden cardiac death. They always told him he had a very strong heart but he had lost more weight the last month and had become more frail looking to me. He had even asked his hematologist if he believed he was worsening faster than they'd expected. He did not tell me the dr's response and I never pressed him for answers. There is so much I wish I'd asked. I'm sorry I didn't respond sooner but my mom who is 90 has been in the hospital with a very bad UTI and I am very tired. God bless you for answering. It really does help. XXXXXXX