Tuesday, December 20, 2011

Penny from Heaven

Day Five.   Pancakes.  With cranberry juice.  If there's one thing I've learned, especially with my intestines being on mandatory digestive rest, it's that high carb foods don't like to digest and go through without copious amounts of pain, and that highly acidic juices feel like my stomach is on fire.  But considering they hadn't brought me the menu for morning the previous night, they just sent up what was standard fare for that morning.  Really, I should have been on low residue for at least my first few meals but the kitchen didn't bother to find that out. 

In walks Penny.  From Heaven.  There is no better way to describe her.  It was my first time meeting my new day nurse Penny.  She looked at me and the uneaten food with a noticeable question mark on her face.  She asked me why I hadn't eaten my breakfast, and I told her it was my first 'solid' food in 5 days, and it definitely was not going to digest well at all.  She started chuckling, and immediately asked what I would eat, so she could send down to the kitchen for it.  From experience, I know there are some things that will agree with my body, namely hard boiled eggs, skim milk, corn flakes, and maybe a small muffin with some apple juice.  After leaving and placing my order, Penny returned to formally introduce herself.  I could instantly tell we were going to not only get along (she was laughing at my ascerbic wit regarding the food situation) but that she was going to be a great nurse.  She proceeded to ask me what had happened the night before, after reading my chart.  In my typical way, I filled her in on the lack of English communication which led to the blowing of my vein and the yelling at my nurse.  I promised her I wasn't too difficult but just didn't tolerate unnecessary i.v.s being put into my arm.  I also told her the problems I'd been having with my catheter, which led her to ask "well, why do you still have it in then?" to which I replied "beats me."  Penny promised me she'd get right on it and find out if there was a reason I couldn't have it still.  She also asked why I was still on the heparin shots since I was going to be heading home either later that day or the next, and again, I mentioned that no one put a dc on the orders.  Briskly, Penny walked away to seek out the answers to the questions she had just asked.  As far as I was concerned, she was the one that was going to get things done for me at this stage, since I was chomping at the bit.

A short time later, in came my breakfast tray.  Delish.  Nothing tastes so good as hospital food after a four day lack of food.  As much as I hate apple juice (after many years of using it for colonoscopy prep) it tasted very good when chilled and added with the rest of my breakfast tray.  I happily indulged on what seemed like a ton of food, careful not to eat too much for fear of not knowing how it would process through my body.  See, I had learned after trial and error over the years that anesthesia coupled with heavy duty pain meds and being npo for several days slows down digestion to the point of stuff not liking to process through and causing an inordinate amount of pain as my intestines wake back up.  So I chewed slowly and hoped it wouldn't kill me later. 

Penny returned with some happy news.  My catheter could come out.  Since they were going to be sending me home, they decided they needed to know if I could pee on my own.  That was the best news I could have gotten after the rotten night I'd had the evening prior.  She left, got some gloves and stuff, and deflated the cath balloon and removed it.  I asked, while she was at it, if there was any way she could also remove my drains.  They were in such awkward places and were making it uncomfortable to sleep and move around.  One was in my lower abomen, which I'd had before, and one was...in the crack of my cheek/leg joint toward the groin on the inside.  That one was killer.  Though they had it pinned up to my gown and boxers, it was the stitches that felt like they were ripping out a tad.  Penny checked and said they weren't, but boy was it uncomfy.  I asked how long they had to stay in, and she said until I had my discharge papers in order, since they wouldn't be able to re-install them in case I had to stay in longer. 

Penny just rocked out the rest of the day.  She was able to get the bolus i.v. removed since I hadn't been using it for the past 2 days, save for the one dose that the nurse accidentally pushed through my veins.  See, the bolus pump keeps a record of all times it's been used, to see if it's been therapeutically used or not, and when it was realized by Penny that I wasn't using it at all, she said 'why not just give that vein a rest?' and got orders pushed through to remove it.  Woot woot!  Honestly.  It was amazing.  Like being in a race car, and going from 0 to 100 in less than a minute. 

Free of my cath bag, I was up peeing on my own.  And I had one of my two i.v. poles removed.  If you had told me that I had won the lotto, I don't think I would have had any sort of excitement compared to how I felt in that half hour after both were gone.  Slowly things were being removed from my body instead of being put into it.  I went for a long-ish walk and enjoyed that too, without having two poles and a cath bag hanging from my walker.  Actually, I didn't even need a walker at this point.  I was pushing my solitary pole all by my lonesome.  It's funny--as much as I was still attached to things, I could see the progress I'd made, when noticing the others on the floor who were hunched over their walkers.  I seemed like I was lightyears better than they were, and it had only been a few days in actuality. 

I returned, got my sponge bath from mom, and got even more good news from Penny...the heparin was done! This was like a great belated birthday present.  Lunch showed up (overly grilled cheese, to the point of not being able to eat it) and a garden salad (holy fiber batman!) and some chocolate pudding.  I ate the soft part of the grilled cheese and the chocolate pudding, happy to be having food.  The breakfast from morning still wasn't really working its way through, so I was trying to drink water in addition to the apple juice to help move things along. 

Penny came back in before her shift was over just to chat.  She was a blast.  During the winter season, she also moonlit as a snowboard instructor at Windham Mountain, where I do the Warrior Dash.  We were recounting my hospital stay thus far, and the two of us were laughing hysterically.  I loved her.  She was just so down to earth and had such a great bedside manner.  She mentioned that I was possibly going to be discharged that afternoon, but we told her it wasn't possible as my dad was 2 hours away and couldn't get up there in time.  Happily, before she left, she told me to hold tight, since she'd be back tomorrow and be my nurse again.  Tuning into the Food Network, I watched the Paula Deen and waited for dinner to arrive. 

Mmmm.  Another grilled cheese, but this time edible.  It came with more chocolate pudding "parfait" (that's hospital speak for topped with whipped cream) and a fruit cup.  I ate out the melon and mom ate the rest of the fruit.  All in all it was a great day, except now I had to remember to pee and not call for someone to do it for me, but what a luxury that was :)  The only small problem was that they tried to give me my heparin shot during the night shift, but I reminded them that it had been dc'ed.  Victory.  Mom settled in with her dinner, I turned on The Cake Boss marathon, and eventually passed out.  Mom woke me up and said goodnight as she headed over to the hotel for the night to sleep, and I settled in for sleep, knowing I'd be going home the next day.

2am.  Lights on.  "We need a blood sample."  "Nope."  "Yes, we need a blood sample from you."  "I'm refusing."  "Do I understand, you're refusing to submit to the daily blood draw?"  "My veins have been abused enough.  I'm going home later today.  You do NOT need one last blood draw.  I'm putting my foot down and you're not drawing."  "Well, we'll have to note that in your chart."  ::giggle:: "Go right ahead!"  Lights off.  Victory again. 

Day 6.  Feeling empowered, when the residents came in at 6ish-am, they asked me why I hadn't gotten my blood draw.  I politely/sleepily/smugly reminded them that I was going home today, and had the nurse two nights prior not blown my vein, I might have been willing to be stabbed yet again, but since I'd had 7 i.v.s/attempted i.v.s in the last 6 days, that there was no way in hades that any more needles were going in, but instead they'd be coming out.  At this point, with not much in the way of pain meds in me, the sarcasm started dripping from the corners of my mouth and pooling on the sheets around me.  I bet they were not used to people like me on that floor, just speaking my mind at 6am.  But at that point I wasn't going to not stand my ground.  What could they do to me?  Nothing! 

Breakfast arrived.  More hard boiled eggs, corn flakes with skim, and an apple cinnamon muffin.  Mmmm.  Considering how well the prior day's breakfast processed through me, I figured I was safe with doing the exact repeat.  Penny arrived soon afterward, with word that I'd be going home definitely since I was self-peeing and keeping food down and outputting it as well.  Oh.  Happy.  Day.  Not for nothing, but after that amount of time in a hospital bed, without my cats, there is nothing like hearing you're going to be sprung.  Something like letting the inmates out of the assylum. 

Dr. Polynice had been in the day before, and said that he was very pleased with how I was healing.  Said everything looked perfect and that I should be back to my normal self in no time.  That thrilled me to pieces, but also made me want to get out that much sooner.  Penny told me she was checking to see if the paperwork had been filed, and in the meantime if she could get out my remaining i.v. and drains. 


And Waiting.

Penny returned.  She said she had paged down to the doctors to see what was going on, and that reconstructive had signed off on my release, but colorectal hadn't yet, and she didn't know what the holdup was, but to sit tight and she'd get back to me.  My roommate was driving her nuts too.  Apparently she too was to be released today, but was arguing with Penny about how to get home.  She kept telling Penny that her husband was supposed to come at some point, but she didn't know when, and frankly didn't care.  She was also, again, complaining about the coffee.  Really?  Penny wasn't the cause of it.  And how was it that Penny was the one who was supposed to brew a fresh pot? 

Penny actually came over, rolled her eyes a bit with a head nod toward the other side of the curtain and said 'I'm so sorry, I'll be RIGHT back and check again.  I still have the page down to them for the discharge papers, and the last I heard if they don't get to it today you'll have to stay in until tomorrow.'

WHAAA?!?  Really?  It's going to be that hard to obtain a resident's signature just to get me sprung?  Penny sensed the desperation in my face and voice, because getting sprung also meant that I could get my final i.v. and drains out, and she knew how much they were bugging me. 

Lunch got delivered.  Grilled cheese again.  Don't worry, the hospital DID offer more choices in food, I just kept writing in what I knew would sit well in my stomach.  Except for one problem.  I was fed up with grilled cheese and chocolate pudding by now since I was itching to go home after breakfast.  I did manage to nibble at the grilled cheese, but there was no way that chocolate pudding was going down yet again, which considering it's chocolate and I love chocolate, is almost unimaginable for me to be saying.  Penny returned with a surgical resident who had scissors.  Know why she had scissors?  I was getting my drains out, I was getting my drains out, na na--na na, I was getting my drains out.  Truthfully, at this point, I think they hurt more than the actual recovery from surgery.  When something is embedded deeply within, and the tissues have healed around it, and all of the sudden it's being pulled out from whence it came, it tends not to tickle too much.  But the stitches got cut, the drains got pulled, and I was almost home free.

Around 1pm Penny returned and asked just how much I loved her, with a big cheese on her face.  Could it be true?  Did she really get orders to get me sprung?  She informed me that it was all but a done deal, and that she could take out my remaining i.v. and I could get dressed.  I had to wait for a half hour after the i.v. was taken out to make sure it sealed over fine, and for the paperwork to be officially signed, sealed, and delivered, but in the meantime she read me all of the discharge instructions she had to help expedite things.  There is nothing like taking off the gown after that last i.v. is removed and putting on legitimate clothing.  Aaah.  A t shirt, comfy dance pants, and a hoodie.  I felt human.  I stood at the sink without poles or tubes and brushed my teeth like a human being.  No rinse and spit with a series of cups and the kidney shaped dish.  No worry about bending my arm and the i.v. line beeping.  It was a glorious feeling.  I did love Penny.  Bunches. 

About 2pm the final paperwork was delivered, and my chariot arrived.  I was plopped delicately in the wheelchair on my tush pillow (not donut, that would hurt too much) and whisked down to the waiting car in valet parking. 

Free at last.  Fresh air, green grass, changing leaves.  I know how prisoners must feel with their first taste of freedom after a long stay in the clink.  Now home to see my cats and dog and take a shower 48 hours later.       


Thursday, December 15, 2011

The leaky vein gets the i.v.

Morning has brooo-ken, like the first moooooorning. Alarm bells are riiiiinging soon after dawn. IV is beeeeping, nurses aren't coo-oooming. Roommate complain-ing, over and o'er.

I love retrofitting songs to my liking. Maybe a bit too much. :) Anyhoo....

My arms reject i.vs. I've touched on this fact before, but it never ceases to amaze me when the nursing staff seems surprised that I've been warning them that my veins are going bad and then they do. It seems like a novel concept, like I'm psychic and can predict it. Either that, or since I'm the current occupant of my body, I know when things feel off kilter sooner than their technology does.

Morning of day four started out like every other morning. Obnoxious blood draw at unholy hours, residents rounding before 7am, asking you the same questions the residents had asked day before (and prompting me to bite my tongue from replying 'read my chart for the answers and let me sleep, will ya?'), and the arrival of the ever present clear liquid assortment tray. I don't know what I can stomach less, though, the thought of more tepid apple juice having to be sucked down to prove that i could hold down liquids or my roommate chewing loudly, belly aching that her coffee wasn't hot enough, her french toast wasn't perfect enough, and her eggs tasted a bit overcooked. Hello, I'm not allowed to eat. Could you keep your complaining about your legitimately solid food to yourself?

Shortly thereafter, the nutritionist showed up and asked what and how much I had eaten for breakfast. I pointed to the mug of beef broth and said, "What do you think?" "Well, haven't they sent you any solid food?" "Nope, I haven't been approved for anything yet by the doctors." "Well, how do they expect you to go home if they don't know if you can keep down/process through solid foods?" "Beats me."

She leaves. Day four begins like normal, with Mom coming over from the hotel attached to the hospital and starting the day. I had a whole new staff during this day, with not one nurse I'd had before on the previous 3 days. My nurse came in, took one look at my arm and said, "Does it hurt? It's quite swollen and hot, and it looks like your i.v. is going bad." Had it not been her first day with me, I would have blinked and said DUH, but considering this was her first look at my arm, I acknowledged that my arm was indeed hurting and swollen to about double the size it should have been.  Jasmine (my nurse) decided to run the rest of the bag that I had on the line, and then change it afterward.  After that, she was going to take it out and put in a new iv, even knowing how difficult my veins are.  The swelling just wasn't going to get any better and we both knew it.

Because my veins tend to be....fragile...Jasmine went and got a hot pack and wrapped my arm in a towel to get the blood flowing. I had ivs in both arms, so though we were taking one out of the arm, it had to go back into the same one again. The amount of bruises and bad spots already were making it difficult, and they couldn't put it above the one they had just taken out, or it would have continued to pump fluid down in the already blown section of the vein.  So Jasmine manages to find a small but functional vein, takes out the old iv and runs a new one with a bit of difficulty, but at least it will give my already overtaxed vein a break.  She notices on my other arm that the iv that was there was also swollen and hot, and asks if I want to replace that one as well.  I told her no, since that was strictly for the pain bolus that I wasn't using, and that I was going to try to keep that one intact for as long as possible to prevent yet another iv being run.  Thankfully she understood, and just let me keep it for the time being. 

The day progressed without incident.  The roommate was yelling at the nurses and sleeping with her tv on as usual.  I went for two laps around the floor with my trusty walker, UGGS for stability, and much to the envy of the floor, did NOT flash the general public.  We had rigged up a system a few years back with my original surgery (thanks to Carrie) with my black watch plaid boxers over the catheter and up on my legs covering my bum so that I didn't have to try to balance with a walker, a gown open in the back and flashing, and another gown draped on my shoulders to attempt to keep me modest. It was a beautiful system that served me well as I trudged along the corridors and made fun of the decor.  I did notice when I stood up to do my walk that my bladder felt full and my catheter collection bag seemed empty, but pushed the thought aside for the time being, just proud of myself for progressing as quickly as I was.

Upon getting back to bed (ooooh, fresh sheets, and they don't smell and aren't covered in my hair [I shed like a dog in springtime after surgery]) I was visited by a resident, who informed me that there was no reason I had to still be on clear liquids, and that the next morning I'd be delivered a food tray with real ::gasp:: food on it! As happy as I was to hear it, I had to refrain from informing her that going from clear liquids to a 'normal' diet isn't the best thing for my intestines, and figured that I'd just order things that were a bit easier on my system. I laid back down and was in pain, something I hadn't really felt in about 24 hours. It wasn't just pain, though, but pressure too, and no amount of rearranging my body seemed to be making it better. DING! My bladder was killing me. Again, I had reached the point in the hospital stay where my catheter had stopped emptying my bladder, and it was all backed up inside of me. Considering all that had been cut, stretched, pulled, unbent, and rearranged inside of me, a full bladder putting pressure on it all surely didn't feel like a hug from the Snuggle bear. Rather, it felt like a little gnome was trying to poke his way out of my bladder with a dull butter knife.

I paged and the afternoon tech and nurse came in. I explained my pain, and that I've dealt with it before. They seemed a bit incredulous, until they started manually manipulating the tube and surprise! it filled the whole catheter collection bag right up. The one guy seemed fairly amazed that 1, my bladder could hold that much at one time and 2, the catheter really didn't seem to be working. He graciously told me that if it happened again, to just page him and let him know, and he'd be back down to empty my bladder again. The rest of the day finished without incident, mom went back to the hotel, and I got ready for what I hoped would be a good night's sleep.

BEEP. BEEP. BEEP. Page #1 to nurses station that my i.v. was beeping and I needed a fluid change. This was around 2am, and the response time was slow. Page #2 about 10 minutes later, and I was assured that my night nurse (who I hadn't yet met) would be there to fix it in a jiffy. BEEP. BEEP. BEEP. About 15 minutes after it began, my lovely roommate pages the nurses station screaming about how my i.v. won't let her sleep. After me having to deal with her tv at all hours of the night and morning, after all of her complaining about everything, she really had the nerve to call the nurses station and complain about me? In rushes my nurse, who speaks very little English, doesn't turn on the lights and just starts pressing random buttons.

Oh. My. Good. Gracious. Know the bad i.v. that was still in my left arm? The one that we were nursing? The one that was only for the pain bolus and nothing else? Well, the nurse blew my vein. Instead of stopping the beeping on my other i.v. like I was trying to tell him, he just kept repeating "you in pain?" and hit a big bolus of the pain meds. Have you ever bruised yourself? Like a good whack on the forehead or arm, and you instantly feel the pressure as the bruise expands? Add in severe pain into an already bruised vein and I literally felt it blow in my arm. I started yelling, he panicked, and I insisted on him getting someone else after he told me that he could run a new i.v.  There was no way, considering he couldn't even understand what he had done wrong, that I was going to trust him to to put a new i.v. in my arm.  He sent out an urgent page for an i.v. tech, and in the meantime stopped the rest of the bag from going in.

Know what the kicker was in all of this?  Roomie was complaining, very loudly, that the lights were on over my bed and they were disturbing her sleep.  UHHH.....REALLY?!?  If she hadn't have paged for the urgent attention of my nurse, he wouldn't have rushed in and pressed a bunch of wrong buttons and blown my vein.  And if he hadn't blown my vein then there wouldn't be an i.v. tech in there at whatever hour of the morning with the lights on running a new i.v.  So thanks, roomie.  And by the way, you have NO room to complain.  None.  So suck up the lights being on for a half hour since you're the one that caused it.

Rant over.  Stepping off of my soap box.  But you get the point.

Once the new i.v. was run, my nurse put his tail between his legs and slunk away, sending in assistants the rest of the night when my catheter needed to be drained, too afraid of me yelling at him again.  I can't say I was too happy to have the new i.v. in, as I hadn't been using the bolus of pain meds anyway, but considering it was the middle of the night they couldn't get orders to discontinue the line.  Eventually, catheter re-drained and new i.v. run, I passed out for a mere few hours until the residents came in to do their rounding.    

Saturday, December 3, 2011

The Roommate from H-E-Double Hockey Sticks

End of day three, I was still in pain at this point, but at least it was being better controlled by the medications.  I had done my lap around the floor as I'd promised, and exhausted, got back into bed.  Mom was there, as she always is by my side when I'm hospitalized, and would help the nursing staff in whatever was needed with me to get me clean and comfortable. 

The nurses always offer to give me a sponge bath of sorts.  Having been through them at other hospitals, I know that they're not always as gentle and understanding as needed.  With Mom, I know that if I say "Stop, it hurts" she knows I'm serious.  She's gotten used to seeing my hairy arm pits and hairy legs after surgery, and I don't feel self conscious about it.  Yeah, I know nurses are used to seeing that sort of thing, and used to bathing patients, but with Mom I know I'll have exactly what I need without worry.  So bathed with clean sheets and exercised  for the day, I'm assisted back into bed.  The dinner tray had been brought. Again, clear liquids on the tray. I drank some juice, but I did not want the rest of what was offered, so I pushed the tray table off to the side, Mom turned off the lights, and I started dozing in and out of sleep.   

Mom had the tv on low so she could keep up with what was going on daily.  If you know me, you know I can sleep with full lights on, tv blaring, on a train in the middle of an accident, and would still not wake up.  Compound that with pain medications that cause drowsiness, and I'm down for the count as long as I can find a comfortable position.  Vitals were done yet again, waking me back out of my slumber, but I passed back out quickly.  Technically speaking, visitors have to be off the floor by 9pm, but since we were quiet and I was young, the nurses were generous in letting Mom stay in my room.  They had one of those chair thingies that pushes back into a sleeping surface of sorts.  I won't call it bed because that would be too nice.  But it was sufficient.  After sleeping in it for 3 nights in a row, I urged Mom to go to the hotel attached to the hospital to actually get a good night's sleep for once and reluctantly, she complied. 

My tv went off, and around 11pm I had one of my last vitals checks of the night and figured I was good for the time being.  I found a comfortable position at last.  Between the pillows provided by the hospital and the thick memory foam pillow thingie Mom brought for me I was able to squash, rearrange, and mash myself a little nest in the bed.  I also prefer sleeping almost vertically, so I put the head of the bed upright.  For some reason, it puts less pressure on my abdomen when needing to get in and out of the bed.  The nurses always urge me to lay down more flat, but I simply can't. So anyway...lights off, tv off, getting a few precious moments of shut eye when...

Am I dreaming?  Am I back in the OR?  Why is it so bright all of the sudden?  I open my eyes, look at the clock which reads 1am, and realize my roommate has turned on all the lights to her half of the room and turned her tv on full blast.  Apparently she couldn't sleep and decided to entertain herself at my sleeping expense.  Had there been a bedpan within reach, so help me, I would have launched it at her.  Even in my weakened state, I'm sure I could have at the very least gotten her attention with it.  But not wanting to make waves, I rolled over, tuned it out, and went back to sleep.  When the nurses came in mid eve to do vitals, they had her turn it all off, so I felt vindicated.  Wham!  Lights on again.  It was the 2am blood draw.  They turned all the lights on in the room to do hers!  But when it came to doing my veins, they shut her lights off so that she could relax.  Really?!?  With the selective and split lighting system in the hospital rooms, there is no reason they couldn't have done that with me too, but apparently she asked that the lights be turned fully on to make sure they could see.  Ugh.  Arm pricked, blood drawn, I pass out again.   That is, until she turned it all back on again. At 330am.  I'm not prone to violence (well, sometimes when drivers don't use their turn signals I yell) but I wanted to take my i.v. over and jab it in her arm so that my pain meds would make HER drowsy.  What gave her the right to ruin my precious moments of sleep?  Again, the nurses turned her set off when they realized it was on. 

Was I really going to have to graciously put up with her for the rest of my duration?  When sleep is a precious enough commodity, and is so instrumental in healing, could I afford to have her blaring the tv during what were normal slumber hours?  Truly, in my 20 years of being in and out of the hospitals, she was the real roommate from H-E-Double Hockey Sticks.  Yes, the roommate from hell.  And if you think that label isn't justified just from turning the tv and lights on, I promise you, she only gets worse.