Friday, October 21, 2011

sorry for the break in postings

one of our cats, gracie, (we have 5) has been very sick, and between running back and forth with mom to the vet, going back up and down to albany for follow up visits, i've been a bit tired.  will finish posting the 'hospital' portion soon.  thank you all for love, support, and prayers.  and if you could keep gracie in your thoughts, it would be greatly appreciated.

Saturday, October 8, 2011

Rule #1: Don't let a resident from Plastics put on your ileo bag

Morning.  Awake again.  But can I really consider it being awake if I didn't truly get any sleep?  See the, horrid thing about being in the hospital is the fact that you really don't get any deep, restful sleep.  At all.  The blood draws happen at 2am.  Yes folks, that's right, 2am.  All the lights pop on and they torture you to try to find a remaining vein that may or may not produce a modicum of blood to get the levels they need to measure.  This is amidst the blood pressure, temperature, and pulse oxygen measurements which happen every 2 hours or so?  And just when you finally doze back off, the i.v. lines start beeping incessantly.  As dawn finally breaks and my heavy eyes can't stand staying open anymore, I pass out for a minute.  And again, I do mean a minute because between 6 and 7am, the residents for the doctors begin rounding, again turning on all of the lights, each of them taking a turn asking you the same questions over and over, each one wanting to examine you to see the body part in which they soon will be specializing.  When you don't know if the doctors will be by later, your tired brain scrambles to try to remember the questions you want to ask, knowing if you forget to mention anything, you won't get another chance until the next overly-tired morning rounds.  They spend between sixty seconds and three minutes, and lights go out again.  Soon, the sun is blazing through the window, the food cart, rattling, is being pushed through the hallway, and your breakfast of fairly tasteless mass produced food is dropped off, stinking up your room with smells of weak coffee in plastic mugs, rubbery eggs, and tasteless, soggy pancakes.  Is it any wonder people recover better and faster at home than in the hospital?

But I digress.  Upon "waking" on day three, I'm still in pain and in the spinal unit.  Adam is my daytime nurse again, which makes me happy.  I keep tripping over myself apologizing for the prior day's pain and complaints that were lodged.  He asks how my night went, and I tell him the usual, crappy and tiring and somewhat painful.  He asks if there is anything he can do to ease my pain, and I quip "get me out of this bed...not to walk, not to look out the window.  Just get me back in my old air bed that they forcibly took away."  I absolutely HATE sand right now.  This bed has me folded in half like a taco, and my back is screaming for something hard to be underneath it.  Like a rock.  Or a plank of wood.  Or ANYTHING that could possibly give my straining, aching back muscles a rest.  Adam makes a call.  And a second call.  And about 3 hours later, blissfully, my air bed is re-delivered to me, and for the first time in three days I'm out of the sand and back on air.  As per the agreement I made with Adam, I did half a lap around the floor and then got back in the room and into my happy happy air bed.  Did I mention happy? Oh, happy bed.

It still hurt a ton to move, and I could barely shuffle my feet, but having the ability to not be totally flat on my back, to be able to roll to my side, to find a comfortable position, to get out of bed seemed like such a luxury.  I couldn't have been happier to have that bed, and with that bed came a new room and new roommate.  Okay, take away one of the 'happy' from before.  As stellar as the bed was, the new roommate definitely made things a bit more difficult.  But I'll get to that later.

Being up and moving meant they determined that I could now eat 'clears' for dinner--no longer was I npo, but was allowed to consume some broth, or Italian ice, or juice for dinner.  I passed on it.  Anyone who knows me knows I don't like soup broth on a good day, let alone when I've had nothing in my system for 3 days. 

One thing I didn't bank on with the new bed though, and the moving around, was the fact that my bag wouldn't keep holding.  I guess the first tip-off was the overly excited resident from plastics who very proudly exclaimed to her whole group of residents no less than 3 times "I put on her ileostomy bag!!"  Well, folks, rule #1: Don't let a resident from Plastics put on your ileo bag.  It may look aesthetically pleasing, but it won't hold up worth a darn.  Larry, my nighttime nurse, sure learned that one quickly.  He and Shelby quickly got a lesson in How to Change an Ileostomy on the Fly 101.....

Friday, October 7, 2011

Q-Tips are a girl's best friend

Pain.  Oh, the pain.  Upon waking on day two, I was in pain.  The oh so special bed was proving to wreak havoc on my back.  Though it sounded like it would be a lovely and comfortable thing, and maybe it would be if you had a foot infection and weren't cut open, for an abdominal patient it killed.  I'm cut from about an inch above my belly button down to my pelvic bone on the front, with muscles that have been detached and rearranged.  I'm also cut on the tush.  This bed is very similar to a water bed in its fluidity, and thereby provided absolutely no support for my back.  Though I had an abdominal binder on (think large, Velcro girdle) it didn't do much to support me.  The binder did a great job of keeping my incision together but wasn't stiff enough on my back.  The bed allowed me to sink so far down in the middle that I couldn't get comfortable.  I was flat on my back.  As in flat.  Staring at the ceiling.  No pillow.  No way to roll, prop, even move.  To make matters worse, my 'pain button' aka the pcs, which is supposed to give me a jolt of the phentanol, doesn't appear to be working.  I press it, and continue to feel the pain getting worse. 

Barbara and Adam were my daytime nurses.  Barbara asked me to roll over to look at my incision on the backside, and i broke down in tears.  Not only was the pain getting worse and worse, but I couldn't move.  I felt totally immobile.  She kept arguing with me and I flat out refused.  She called down to the surgical unit to see if there was a way to get me to do it, and a representative came up and said I didn't have to if I didn't feel up to it.  I kept trying to convey to them that it wasn't a matter of me being belligerent, but if they could get me in a NORMAL bed and get my intensifying pain under control, that I'd roll over and show them.  They tried a bolus of the phentanol, which did absolutely nothing.  When Barbara and Adam realized that I wasn't just being difficult, they called down for the pain team to see if there was any way to better manage my pain.  For five hours I laid in the bed, unable to move, unable to do much of anything except whimper.  I was brought a basin and soap so I could get washed up.  I just stared in disbelief.  If I can't move, can't roll, and am in a severe amount of pain, do I REALLY care if my skin smells pretty? 

Well, 5 hours later, the pain team arrived and adjusted the dose of ketamine.  I went from being in extreme pain to in very little within 2 minutes.  Amazing.  I became a completely compliant.  Well, not completely, since I still was having a dickens of a time trying to roll over.  And since I was cleared of having to roll over until I was ready, I pretty much passed back out. 

I woke a short time later realizing I wasn't breathing too well.  All along, I was in a panic over breathing and the risk of vomiting, coughing, all of it.  Should any of that happen, I couldn't manage to lift my body up enough to clear my mouth or throat.  It's such a crappy feeling.  To help me from feeling like I was going to drown in bodily fluids, I asked Mom to pass me my Q-Tips.  I can't extol their praise enough.  See, one thing I don't think patients realize is you lose your ability to blow your nose when you're 1), cut open and 2), flat on your back.  Diamonds hold nothing over Q-Tips for me.  I was able to finagle the Q-Tips enough to clear my nose.  Truly, they are a girl's best friend.  Well, at least this girl.  Or any other ones who have been cut open for any particular reason.  Passing back out and breathing better with my oxygen still up my nose, it felt good to be pain free, if only for a few hours.....

Tuesday, October 4, 2011

Like the beach, only worse

Eyes fluttered open.  Pain.  Which means I'm alive.  But I'm in pain and immobile and flat on my back.  I lay there in recovery, not moving, waiting for a nurse to come over.  She asks me what my pain level is, and I tell her it's a 9.  She says that's too high and I have to wait for it to come down.  Eyes close again.

I wake, not sure how much longer later.  I notice I have not one but two i.v.s, one in my right hand and one on my left arm.  The nurse stops by again, asks my pain level.  I again, tell her it's a 9.  She again tells me it's too high, though she informs me that my hair looks amazing.  I'm not kidding.  She tells me that it looks like I could walk out and go to a club, and that hair never looks that good post op.  Not caring, I pass back out.

When I wake the third time, I again get seen by the nurse.  I ask how soon I can get out of recovery and up to my room to see my family, and she says, "..when your pain level decreases," at which point she asks it.  I tell her it's a 6 (it was still a 9) just so I could get transferred up to a room.  She calls for transport, and I'm on the move.

As I get wheeled on my bed into the elevator, I notice we are headed to the fifth floor.  Normally I've been on the second floor when I've had surgery with Dr. Lee, and I'm not quite sure why we're headed that much further up.  Once on the floor, I'm wheeled into a room much like Surgical Step Down at Vassar, with a nurses station in the center, 24 hour care, and 5 or 6 bed slots.  As I'm being wheeled in the door, I feel my catheter bag get caught on the door, so I let out a bit of a yelp.  The guy wheeling me asks what's going on, and I told him, and he rearranges my bed and tells me not to worry, that it wouldn't really have pulled out.  Easy for him to say, he didn't feel the tug of the line as it got caught on the door frame.  But I got placed into slot 4, and soon thereafter, in walk Mom, Dad, Aunt Donna, and Joe.  What a welcome sight.

All ask how I'm doing, and are happy to see I've come out of it okay.  I ask where I am, and I'm told by my nurse Rich that I'm in the spinal trauma unit.  Normally if I was on a different pain medication, I'd be on a different floor, but since they had me on ketamine and phentanol, the ketamine had to have continuous monitoring for the first 24 hours that it's being put into my veins.  My 'neighbor' in bed slot #5 is Amish.  His parents came in from Michigan because of his spinal injury.  He was a new father, and his wife was there with their 2 week old baby.  Apparently, his horse acted up and he ended up having an accident and broke the tendons/ligaments in his neck, and if I remember correctly, he broke his back as well, so again, when everyone thinks I've gone through the ringer, remember him in prayer.  He's looking at a 6 month recovery with a brand new baby and young wife.  He'll have some obstacle to overcome.  His family took him home after only 48 hours because his mom said he'd recover better at home, and I have no doubt she's correct.

So Mom tells me my surgery went well.  It was shorter than anticipated because, well, it ended up being a different surgery than originally anticipated.  Dr. Polynice had drawn a diagram thingie to show Mom and Dad what happened instead of what was planned.  Originally, I was supposed to have the gracilis muscle taken from my thigh, but when Dr. Lee opened me up, they solved the answer to one of the problems I've been having.  Wait for it, wait for uterus had tipped over!!!!!  Yes, that is worthy of five exclamation points.  Apparently, where my large intestine used to be was a large empty void (kind of like my head on most nights) and my uterus decided to be lazy and take a nice long nap.  It laid down in the hole where my intestine used to be and was kinda stuck to the pelvic floor next to the sinus tract that needed to be removed.  When Dr. Polynice saw this, he realized it needed to be propped back up, and my gracilis muscles weren't going to be sufficient enough to do it, so they took one of my abdominal muscles instead.  Everyone has two rectus abdominus muscles, better known as the 6 pack muscles.  The left one of mine (the side under my heart) helps to support my stoma, so they detached the right hand one at the top and flipped it upside down, threading it behind my uterus, and eventually stuffing it down into the sinus tract area of the rectal spot that wasn't healing.  Technically, they killed two birds with one stone, or rather, filled two holes with one muscle.  Dr. Polynice filled the now missing muscle space on the right side of my abdomen with some sterilized pork tissue stuff.  Does this mean when I sweat I'll smell like bacon?  Boy, that'll get me a husband in no time!  And the further good news in all of this?  My value for black market spare body parts has decreased that much more. 

Okay, so back to post op.  Within five minutes of being in the room and getting settled, they bring in a new bed, but it's not just any bed.  Oh no, it's some special fancy schmancy bed that all of the nursing staff seems to be in envy over for me.  Apparently, the bed is called a cavillon or something like that, and it's filled with sand and is hard as a rock, but the minute they plug it in, it becomes like a sandstorm under your body, 'gently cradling it and promoting healing.'  They told me it's like experiencing a water bed.  I protested being transferred, but they insisted and before too many more minutes had passed, a moving crew had passed me from my air bed into this sand bed.  I was in too much pain to notice, but soon I'd find out.  The bed was like the beach, only worse....