This was a milestone day! I had an appointment with my urologist/oncologist/surgeon. I had news for him.
I have worked diligently on my exercises. As I said last time, I can see some progress each day. I had only a spot on my pad when I showered on Monday. I decided to try a day without pads. I always was able to work under pressure. You know the "write the report the night before it was due" syndrome. It is common to all us procrastinators. I thought the pressure would keep me cognizant of my requirements. It worked! I was dry all day!
Tuesday I decided to push my luck and go another day. I was astounded again. So Wednesday morning I took a pad with me; but, I didn't wear one. We sat in the reception area for about a half hour. Then Barb called my name and Sally and I went to room two. We waited there about fifteen minutes.
Becky came in to update my chart with the usual. Same medications, how you doing? stuff. I told her of my leg pains and some blood in my stool, but that this is the third day I have gone without a pad. Becky was pretty excited and said she was going to put an exclamation mark in her notes. She said the doctor would be in since I hadn't really seen him since surgery and left the room.
It was just a few minutes until the doctor came in asking, "How are you?"
I said, "Better!" I'm cancer free and this is my third day without a pad. He was pretty amazed too. He had a big smile on his face and said how great this surgery is. We talked about my leg pain and he thinks it is probably back related, not related to my surgery. I thought as much. The blood is hemorrhoids. They should resolve themselves. I told him I had worked pretty hard on the exercises and was amazed that I could see daily improvement.
He asked if I'd had an erection yet. I would call it one. Doctor Goldrath asked if I thought I was capable of intercourse. I said no it wasn't that good. Maybe 60%. He said it is just one month today. That is very early! It is encouraging and will improve. To have this much function this early is very encouraging. All the nerves and muscles are inter-related. They take time after surgery to heal and resume normal senses.
There are some studies that show improved results when treated with a regimen of Viagra. The sooner it is started the better the results. He prescribed a quarter tablet everyday for six days and a whole tablet once a week. This promotes revascularization and enhanced blood flow. The instructions were difficult for the pharmacy to translate to their system for insurance billing. They came up with 10 tablets as a seventy day supply which cost me two co pays.
I came home to figure out what they were doing and to call the insurance company. It seems that they thought it was a quarter tablet daily upto 1 tablet per week. So that would be 1 tablet every 7 days so 10 tablets equals 70 days. The pharmacy wouldn't call the insurance, but they called the doctor for explanation. They then under stood .25 tablets each day for six days. (1.5 tablets) and 1 tablet on the seventh day. (2.5 tablets per week) Repeat. That is ten tablets for 28 days or four weeks. That is one (1) copay. Half price to me. That took four trips to the pharmacy and we didn't finish until 4 pm.
But who cares! I have made three days without leaking. I'm set to return to work Monday the 4th of June 2007. Cancer FREE!! And almost as important to me, with dignity and dry!
Thursday, May 31, 2007
May 13 thru 26, 2007: The Work of Recovery
I certainly need to work on this continence thing constantly. It has improved daily. At first it was all I could do to limit the volume. Each passing day of exercise has reduced volume. But I can't count on eliminating leakage for any single action. I can almost hold it by clinching before I rise or sit; but, as soon as I relax there is a bit of leakage. Like all muscle contractions, I cannot maintain constant pressure indefinitely. Eventually the muscle gives out and leakage occurs.
Some times I start to feel discouraged. I feel like I will always leak. I will always wear pads. Worst of all I will always smell. I know me well enough to realize that I can't let myself become depressed. It is very hard for me to get up again if I let that happen. In this scenario I am not sure I will be able to get up if I let those feeling over take me. If I get down and don't conquer incontinence I would be better off dead.
The only thing to do is to maintain perspective. I may leak forever. Well, not forever but for the remainder of my life. However, the alternative to leaking was to suffer, actually SUFFER, a very long, slow, painful death. I can afford to change pads frequently to eliminate odor. I can do most things of life. I can't begin to control myself when I separate my knees for a side step, stumble, stairs, or standing. I can contract consciously, move and have just a little leakage. That is better than nothing. The pain is largely gone. Life is still pretty rich. There are possibly other procedures that can help with this now and maybe better solutions in the future.
This picks my spirit up it seems and I carry on. I can't give up on the exercises. I didn't walk the first weeks or months of my life either. I am determined not to be an embarrassment to my family or myself. I have to get to a point that I can return to work and not be so embarrassed that I can't function. We are not yet rich enough to live without income.
As I said, each day brings improvement. I can wear a single pad all day most days. If I am doing predictable things such as just rising, sitting, walking, etc. I can hold it. If I stumble and have to move quickly I forget to clinch and of course leak. If I walk on uneven ground like the garden center or yard I have some leakage. But I keep working on the exercises and hope for the best.
Some times I start to feel discouraged. I feel like I will always leak. I will always wear pads. Worst of all I will always smell. I know me well enough to realize that I can't let myself become depressed. It is very hard for me to get up again if I let that happen. In this scenario I am not sure I will be able to get up if I let those feeling over take me. If I get down and don't conquer incontinence I would be better off dead.
The only thing to do is to maintain perspective. I may leak forever. Well, not forever but for the remainder of my life. However, the alternative to leaking was to suffer, actually SUFFER, a very long, slow, painful death. I can afford to change pads frequently to eliminate odor. I can do most things of life. I can't begin to control myself when I separate my knees for a side step, stumble, stairs, or standing. I can contract consciously, move and have just a little leakage. That is better than nothing. The pain is largely gone. Life is still pretty rich. There are possibly other procedures that can help with this now and maybe better solutions in the future.
This picks my spirit up it seems and I carry on. I can't give up on the exercises. I didn't walk the first weeks or months of my life either. I am determined not to be an embarrassment to my family or myself. I have to get to a point that I can return to work and not be so embarrassed that I can't function. We are not yet rich enough to live without income.
As I said, each day brings improvement. I can wear a single pad all day most days. If I am doing predictable things such as just rising, sitting, walking, etc. I can hold it. If I stumble and have to move quickly I forget to clinch and of course leak. If I walk on uneven ground like the garden center or yard I have some leakage. But I keep working on the exercises and hope for the best.
Tuesday, May 29, 2007
May 6 thru 12, 2007: Let the healing begin in earnest
Monday was a day I longed for. My visit to the doctor's office at which I will hopefully lose the catheter and the staples. I am certain the staples will be removed because when preparing to shower I take the bandages off and they are clean. No fluids or sticking! I am less sure of the catheter because the urine still has blood in it as evidenced by looking like Lancers Rose in a bag.
Too bad I have to wait until 2:30 for the appointment. But the time does come. I get back to the room with Sally in tow. I am instructed to strip from the waist down, sit on the table and and put the paper sheet over my lap. I have often wondered why medical personnel seem so shy when we both know they will again see all I have.
The physicians assistant, Becky Luekens, knocks and comes back in. She gives me a choice of first action. Do I want to do the catheter or the staples first? Since the catheter has been the most uncomfortable I choose to have that removed first. If that is Okay?
Becky assures me that it is and has me lie back on the table. She folds back the paper sheet and uses a syringe to remove the liquid that inflates the bulb and hold the catheter in place. She then instructs me to exhale as much as I can before breathing in slowly as she pulls it out. I think they have you exhale so you don't cry out as they start to remove it. She pulls and pulls; 'til her hand is over her head. It is about two feet long (the catheter). She inspects the end for clots and detritus. Everything is goodness. WOW! That feels much more comfortable already.
Although the educational part of the visit is that first urination may be accompanied by pain or burning sensation. I don't look forward to that. In the long run, I have no problems with it. I am even amazed that my 'hemorrhoids' improve so quickly.
The staple puller is a four and half inch gadget that looks like a cuticle nipper or little scissor implement. I have six incisions. Four in a row across my waistline between my hip bones. They are horizontal and about a half inch each. The farthest on my left has no staples. It was sutured and held the abdominal drain. The other three have just a couple staples each and one has three. Then I have a vertical incision from my umbilicus (bellybutton) down. It has six or eight staples. Then there is another incision at about ten o'clock from the pivot of my umbilicus that has two. Apparently the implement causes the legs to spread as it is pulled and there is no pain for most of them. There were only two that seemed to pinch as she lifted them.
Becky daubed glue on next to the incisions and let it dry, much like contact cement. She then place steri-strips across the incisions. This takes the strain off the newly formed scar tissue. Becky said they will probably fall off in a day or two and that is fine. They can even fall off later the same day and it isn't a problem unless I pull one open. But I was healing fine and that should be no problem. No lifting of anything more than ten pounds for another week or two and do nothing strenuous. Basically I need to take it easy and do nothing more that walk.
Becky is a sweetheart. She is tall, blond and absolutely under thirty. She seems to have good training and a very pleasant bedside manor. I am again astounded at how young so many very skilled people are in the professions. I again have hope for the human race. We are not a dying breed. There are many young, bright people to carry on after us. They don't all skate board and do drugs.
While at the desk making my next appointment, my room mate Jerry was signing in. Coincidence that it is Jerry was next in surgery after me and here he is next in having his catheter and staples removed. We exchange greetings and joy at having this part done with.
My incontinence is immediately apparent to me. Every move that increases abdominal pressure cause a warm spot that is far from my heart. Moving either leg independently causes a squirt. Sitting or standing cause one. Turning into the car seat causes one. Thank goodness (not God) for Serenity pads. This is going to require some work.
Becky said that boys don't learn about their kegel muscles for some reason. She explained that little girls do at an early age. It's like they just always knew. And then she looked at Sally as if for a supporting nod or something. Basically, I should practice interrupting the flow without clinching my gluteous maximus. That is the pubocoxygeal muscle, muscle that is targeted by kegel exercises. At first practice in the mirror to see that the pelvis is not being tipped or thrust forward and the glutes are not being clinched. If done correctly there should be no visible evidence that I am contracting them. Contract them and hold for a five count. Do this five or six times. Repeat the set every hour or so. Over time this will strengthen the pc muscle and impact continence. We should all be doing these whether we had surgery or not. It is a part of continued good health.
Too bad I have to wait until 2:30 for the appointment. But the time does come. I get back to the room with Sally in tow. I am instructed to strip from the waist down, sit on the table and and put the paper sheet over my lap. I have often wondered why medical personnel seem so shy when we both know they will again see all I have.
The physicians assistant, Becky Luekens, knocks and comes back in. She gives me a choice of first action. Do I want to do the catheter or the staples first? Since the catheter has been the most uncomfortable I choose to have that removed first. If that is Okay?
Becky assures me that it is and has me lie back on the table. She folds back the paper sheet and uses a syringe to remove the liquid that inflates the bulb and hold the catheter in place. She then instructs me to exhale as much as I can before breathing in slowly as she pulls it out. I think they have you exhale so you don't cry out as they start to remove it. She pulls and pulls; 'til her hand is over her head. It is about two feet long (the catheter). She inspects the end for clots and detritus. Everything is goodness. WOW! That feels much more comfortable already.
Although the educational part of the visit is that first urination may be accompanied by pain or burning sensation. I don't look forward to that. In the long run, I have no problems with it. I am even amazed that my 'hemorrhoids' improve so quickly.
The staple puller is a four and half inch gadget that looks like a cuticle nipper or little scissor implement. I have six incisions. Four in a row across my waistline between my hip bones. They are horizontal and about a half inch each. The farthest on my left has no staples. It was sutured and held the abdominal drain. The other three have just a couple staples each and one has three. Then I have a vertical incision from my umbilicus (bellybutton) down. It has six or eight staples. Then there is another incision at about ten o'clock from the pivot of my umbilicus that has two. Apparently the implement causes the legs to spread as it is pulled and there is no pain for most of them. There were only two that seemed to pinch as she lifted them.
Becky daubed glue on next to the incisions and let it dry, much like contact cement. She then place steri-strips across the incisions. This takes the strain off the newly formed scar tissue. Becky said they will probably fall off in a day or two and that is fine. They can even fall off later the same day and it isn't a problem unless I pull one open. But I was healing fine and that should be no problem. No lifting of anything more than ten pounds for another week or two and do nothing strenuous. Basically I need to take it easy and do nothing more that walk.
Becky is a sweetheart. She is tall, blond and absolutely under thirty. She seems to have good training and a very pleasant bedside manor. I am again astounded at how young so many very skilled people are in the professions. I again have hope for the human race. We are not a dying breed. There are many young, bright people to carry on after us. They don't all skate board and do drugs.
While at the desk making my next appointment, my room mate Jerry was signing in. Coincidence that it is Jerry was next in surgery after me and here he is next in having his catheter and staples removed. We exchange greetings and joy at having this part done with.
My incontinence is immediately apparent to me. Every move that increases abdominal pressure cause a warm spot that is far from my heart. Moving either leg independently causes a squirt. Sitting or standing cause one. Turning into the car seat causes one. Thank goodness (not God) for Serenity pads. This is going to require some work.
Becky said that boys don't learn about their kegel muscles for some reason. She explained that little girls do at an early age. It's like they just always knew. And then she looked at Sally as if for a supporting nod or something. Basically, I should practice interrupting the flow without clinching my gluteous maximus. That is the pubocoxygeal muscle, muscle that is targeted by kegel exercises. At first practice in the mirror to see that the pelvis is not being tipped or thrust forward and the glutes are not being clinched. If done correctly there should be no visible evidence that I am contracting them. Contract them and hold for a five count. Do this five or six times. Repeat the set every hour or so. Over time this will strengthen the pc muscle and impact continence. We should all be doing these whether we had surgery or not. It is a part of continued good health.
Thursday, May 24, 2007
May 5, 2007: Friends
Saturday evening and great friends are unbeatable. They brought everything for dinner; Italian beef, salads, etc. It could have been bologna as far as I was concerned. It was the nourishment of my spirit and hope that was most welcome.
The support from friends is incredibly healing. I had to get around before they arrived about 5:30, to get my shower and try some slacks. I have a pair of trail pants that the lower leg zips off. That was pretty good to accommodate the bag. I was up and down. Sit, stand, trips to the head, eat my dinner. It worked pretty well.
The only problems I had was a little bypass leakage and some pain. I can't seem to avoid either. I called the doctors office and was told that happens. I was foolish in wearing slacks that required a belt. The belt put a bind around my abdomen that at one point felt as if I was tearing something as I sat down. In my present condition I was in free-fall when I went to sit. That painful.
We talked and shared. I can't say enough about how good this has gone. I had not suffered with cancer! I had no symptoms. I was lucky enough to be regular about my annual physicals since my heart attack five years ago this month. The following year I had my first physical including PSA, DRE, colonoscopy.
Everything was good. The colonoscopy discovered a pre-cancerous polyp and a couple of routine polyps. They were removed and I needed to return in three years. Don't skip a colonoscopy! That is one screening test that can cure or prevent cancer. Snip and its gone.
The following year I had an elevated PSA. It was repeated and still elevated. That was my first encounter with Dr. Goldrath. I went through the history and examination with very little embarrassment. But I had to schedule a TRUS (Trans-Rectal Ultrasound Scan) and needle biopsy. Prep is similar to that for a colonoscopy. While lying on my side, the probe (about like a curling iron) is inserted and the image is viewed for evaluation. The doctor prints some images for my file and uses the view to guide the placement of the biopsy; a spring loaded needle jabs rapidly to collect a core. The needle is about an eighth of an inch wide and two inches long. They are so fast that there is virtually no pain. Especially when one considers that this is fighting cancer (maybe).
This was May, two years ago. My daughters wedding was just days before. I felt lucky; there was no cancer! It probably was something else like prostatitis.
That July I was diagnosed with Diabetes Type II. Oh well, I can live with that. It was certainly better that cancer!
And through it all, I have had great friends and family supporting me. Even though I let them down. I was the bad guy who smoked, who didn't take care of myself, who seemed to beat the odds. Now it was all catching up to me.
At my November physical I started with one thing and another. But over all I had no additional blockage in my coronary arteries. They did a Bilateral Carotid Doppler Ultrasound to check for blockage. That was good. No eminent stroke. Repeat the colonoscopy, a couple more polyps. And this oops. I sometimes find it hard to believe that I have battled three major killers and am still on top.
I have my scars. Figuratively as well as literally. I can't do what I could five years ago. On the other hand, I can do something I couldn't a month ago. I can get away with peeing my pants a tad. But, when I think of how this might have gone without the heart attack I am astounded.
I know that I wouldn't be getting physicals regularly. I had made an appointment and went in just because I was fifty and thought I ought to get a baseline. The doctor took a history and asked about complaints. I had a history; but, I had no complaint other that being over weight.
He listened to my lungs and heart, ordered no tests, suggested that I walk to lose some weight. I am pretty sure that due to my disappointment with that experience, I would not have gone again. I would have had colon cancer developing and it would probably have killed me before I knew that I had adenocarcenoma of the prostate.
This all adds up to being truly blessed. I have had really great luck and great friends.
Morning's at seven; The hill-side's dew-pearled; The lark's on the wing; The snail's on the thorn; God's in his Heaven - All's right with the world!
The support from friends is incredibly healing. I had to get around before they arrived about 5:30, to get my shower and try some slacks. I have a pair of trail pants that the lower leg zips off. That was pretty good to accommodate the bag. I was up and down. Sit, stand, trips to the head, eat my dinner. It worked pretty well.
The only problems I had was a little bypass leakage and some pain. I can't seem to avoid either. I called the doctors office and was told that happens. I was foolish in wearing slacks that required a belt. The belt put a bind around my abdomen that at one point felt as if I was tearing something as I sat down. In my present condition I was in free-fall when I went to sit. That painful.
We talked and shared. I can't say enough about how good this has gone. I had not suffered with cancer! I had no symptoms. I was lucky enough to be regular about my annual physicals since my heart attack five years ago this month. The following year I had my first physical including PSA, DRE, colonoscopy.
Everything was good. The colonoscopy discovered a pre-cancerous polyp and a couple of routine polyps. They were removed and I needed to return in three years. Don't skip a colonoscopy! That is one screening test that can cure or prevent cancer. Snip and its gone.
The following year I had an elevated PSA. It was repeated and still elevated. That was my first encounter with Dr. Goldrath. I went through the history and examination with very little embarrassment. But I had to schedule a TRUS (Trans-Rectal Ultrasound Scan) and needle biopsy. Prep is similar to that for a colonoscopy. While lying on my side, the probe (about like a curling iron) is inserted and the image is viewed for evaluation. The doctor prints some images for my file and uses the view to guide the placement of the biopsy; a spring loaded needle jabs rapidly to collect a core. The needle is about an eighth of an inch wide and two inches long. They are so fast that there is virtually no pain. Especially when one considers that this is fighting cancer (maybe).
This was May, two years ago. My daughters wedding was just days before. I felt lucky; there was no cancer! It probably was something else like prostatitis.
That July I was diagnosed with Diabetes Type II. Oh well, I can live with that. It was certainly better that cancer!
And through it all, I have had great friends and family supporting me. Even though I let them down. I was the bad guy who smoked, who didn't take care of myself, who seemed to beat the odds. Now it was all catching up to me.
At my November physical I started with one thing and another. But over all I had no additional blockage in my coronary arteries. They did a Bilateral Carotid Doppler Ultrasound to check for blockage. That was good. No eminent stroke. Repeat the colonoscopy, a couple more polyps. And this oops. I sometimes find it hard to believe that I have battled three major killers and am still on top.
I have my scars. Figuratively as well as literally. I can't do what I could five years ago. On the other hand, I can do something I couldn't a month ago. I can get away with peeing my pants a tad. But, when I think of how this might have gone without the heart attack I am astounded.
I know that I wouldn't be getting physicals regularly. I had made an appointment and went in just because I was fifty and thought I ought to get a baseline. The doctor took a history and asked about complaints. I had a history; but, I had no complaint other that being over weight.
He listened to my lungs and heart, ordered no tests, suggested that I walk to lose some weight. I am pretty sure that due to my disappointment with that experience, I would not have gone again. I would have had colon cancer developing and it would probably have killed me before I knew that I had adenocarcenoma of the prostate.
This all adds up to being truly blessed. I have had really great luck and great friends.
Morning's at seven; The hill-side's dew-pearled; The lark's on the wing; The snail's on the thorn; God's in his Heaven - All's right with the world!
Monday, May 21, 2007
May 2, 2007: And the next few days
The drive home was like reading the seams of the highway via a stylus in my penis. Every stone and ripple seemed to be read by sensitive parts in the nether regions and telegraphed to each incision, stitch and staple holding me together.
By the time we got home I was ready to go to bed. I needed to figure out the logistics of going to bed with a catheter and bag that home beds just are not designed to accommodate. For that matter clothing is not practical either. Those awful hospital gowns are really well designed for their purpose. Lacking that, I have to settle for just the tee shirt and a foot of adhesive tape.
Tape placement becomes paramount over the next few days. The catheter can't be taped to the entry point. If it is taped anywhere else, the length is fixed but doesn't correlate to the foci of a flexing body. As the body bends the tube slides in to poke and the tube slides out to pull. All sense seems concentrated on a recently reconstructed bladder to urethra connection. Over the following week this would prove to be a major discomfort. It also caused major hemorrhoids. I looked up the anatomy and all systems seem pretty closely associated in the region. At least I can understand how they are all involved in the recovery.
On the brighter side of the pains and constant awareness I realize the skill of the surgeons in sparing the nerves in the area. I take this as a good sign for latter recovery of control. I will probably be able to pass remedial potty training 101.
Bowel movements are effected for five or six days by what I was given in the hospital . They were a dark green, viscous matter that lay in the water like a cold lava lamp. No matter what I ate, it was always what I thought BILE would look like. It was also probably the result of the erythromycin and neomycin changing the bacterial content of my system. Eliminating most if not all bacteria. The effect was much appreciated in my condition. There was absolutely no straining allowed or needed.
By the time we got home I was ready to go to bed. I needed to figure out the logistics of going to bed with a catheter and bag that home beds just are not designed to accommodate. For that matter clothing is not practical either. Those awful hospital gowns are really well designed for their purpose. Lacking that, I have to settle for just the tee shirt and a foot of adhesive tape.
Tape placement becomes paramount over the next few days. The catheter can't be taped to the entry point. If it is taped anywhere else, the length is fixed but doesn't correlate to the foci of a flexing body. As the body bends the tube slides in to poke and the tube slides out to pull. All sense seems concentrated on a recently reconstructed bladder to urethra connection. Over the following week this would prove to be a major discomfort. It also caused major hemorrhoids. I looked up the anatomy and all systems seem pretty closely associated in the region. At least I can understand how they are all involved in the recovery.
On the brighter side of the pains and constant awareness I realize the skill of the surgeons in sparing the nerves in the area. I take this as a good sign for latter recovery of control. I will probably be able to pass remedial potty training 101.
Bowel movements are effected for five or six days by what I was given in the hospital . They were a dark green, viscous matter that lay in the water like a cold lava lamp. No matter what I ate, it was always what I thought BILE would look like. It was also probably the result of the erythromycin and neomycin changing the bacterial content of my system. Eliminating most if not all bacteria. The effect was much appreciated in my condition. There was absolutely no straining allowed or needed.
The pain was so intense getting into bed, that once I sat, I couldn't reposition myself at all. Sally had no more idea how to get me in the bed than I had. We were able to set me pretty well. Lying down was not good. Any leaning required me to use core muscles and they burned like hell; but I was afraid to take that leap of faith and just fall over to my side. Once on my side I couldn't lift my butt or shoulders to get further into the bed. I lay clinging to the whipcord trimmed edge to keep from falling out of bed, perched like a fledgling on twig, holding desperately to the thin branch of trim. What a night! Perhaps I should have stayed in the hospital.
After a few years of a nightly trip to the head interrupting a good nights sleep, I thought I would be able to sleep eight to ten hours straight as no pressure would build in my bladder and no people padding around to check things. Sleeping is no more possible at home than it was prior to the surgery or in the hospital. After a very few hours my hip and knees and shoulder were extremely painful without my Aleve for a week and my mobility to roll on to my other side. The hose is just long enough to lay on the one side, stretch out under the cover to the bag, which we hung on the low drawer of a small game cabinet placed by my bed side. A longer hose would help that, I think.
I wasn't feeling like a party; but Sally wanted the kids over on Wednesday evening. It went pretty good. Sally bought me a very nice robe and I was getting better by the hour. I learned to maneuver in and out of a chair and to the bathroom. The home toilet is much lower than the hospital version. The trick to sitting and rising on my own is to be able to position my feet under my center of gravity. That changes the muscles used to rise from the core of my body to the strength of my legs and arms. I was also starting to feel pretty well past my prime for bathing; but, I couldn't bath 'til Thursday.Tuesday, May 15, 2007
May 1, 2007: Release!
The morning started with Harry, my day nurse, on duty from 7 to 7. He was a nice guy. My breakfast came as clear liquids, broth, gelatin, juice. Harry was right on top of it. He called the 'kitchen' told them to send a general diet tray up as per doctor's orders. So I had more than one breakfast. The food was pretty good.
Harry was just getting on my 'good side'. He came back later in the morning to get me out of bed. WOW! That was not good. First off when he moved the bag to the base of the IV pump he pulled my hose. That was a panic situation. I wasn't sure what would come off! I told him not to pull that. It wasn't taped down.
That was just the tip of the iceberg so to speak. When Harry took my hand and tried to pull me up I thought I was going to rip in two. It was all that both of us could do to sit me up on the edge of the bed. It felt like the row of incisions (my perforation line) wasn't going to stay together.
After a short rest for Harry and me, I stood up and held onto the IV pump to take a short walk. Out the door and down the hall to the left. Only about twenty feet then a right, another twenty-five feet to the parallel hall, another right and twenty feet back to the cross-over and straight into my Stepdown 2 bed. That was slow, but I was moving on my own power. And at the end of the walk, my arms were tired from supporting myself on the pole of the IV pump. Harry sat me in a chair in my room.
At least the next trip didn't require me to get out of bed. But it was still not possible to sit forward in the chair to get up. I had not been hooked up to the oxygen when I returned from the first walk; but, my O2 saturation was up at 99%. Now that my gut was rumbling, I needed help getting up and into the bathroom. I had no idea what to expect. But I had to take my third of the bathroom time. My room mate Jerry had already made a couple trips. The little old lady went everywhere. I had to get on the board. The things that I get competitive about!
I ordered lunch. It was a decent tuna salad sandwich. It punctuated my day. I was looking forward to the doctors visit to release us about 2 pm. So after lunch Harry got me unhooked from the monitor and out of the chair so I could walk again. This time we went down two blocks then over and back. I felt I had to do it faster than last time. In my mind Harry was charting my liquid intake and output, bathroom trips, and activity. I wanted to be sure that I was showing progress so the doctor would discharge me.
Jerry was really disappointed when they told us the doctor was tied up in surgery 'til two-thirty. I was kind of glad. I thought if the doctor came now I wasn't strong enough to be discharged. I needed more time to get more points on the board. I needed another trip to the head and another walk before he came up.
I finally had some measure of success with body functions and the third walk was left three blocks and back four blocks then to my chair. That was good. I was on a faster pace and went double the distance of my last walk. Harry pointed out his children on an employee bulletin board. They were cute kids just about school age. Harry was still in vacation mode. This was his first day after four weeks in the Philippines visiting family.
Now word is that the doctors are in surgery until 4 or 4:30. Jerry was upset and I was only a little less agitated. Jerry was having pain with his catheter; so he had his wife ask if I was experiencing pinching every time I moved. We compared notes and he was definitely having an issue that I didn't have. So he called his nurse and she checked it out and lubricated the tube. He was apparently experiencing the first signs of irritation and infection. The Bacitracin should help that. I heard her saying to make sure we put that on twice a day.
Jerry was finally ordering something to eat. I was skipping it because I was sure that I was being released soon. Even though it was after five, I was sure I was getting released today. Well, kinda sure. Now word was that they were in another surgery and would be up about seven o'clock. Sure, we've heard that before. Jerry was fit to be tied and I wasn't far behind him. Surely they could take a break between surgeries to come up and discharge us.
The hospital needed our beds since about two thirty. They had people coming out of surgery and needed to put them in monitored beds. We were past needing monitors but they had no where to move us to. They didn't want to put us in another room and then discharge us but we didn't want to be put in the hall. Good thing we didn't move to a hall; since they kept us another five hours and we would not have had nurse assignments or facilities to use.
About seven thirty, doctors Goldrath and Troy were talking to Jerry. Checking his chart and writing his orders. Giving him his directions and talking to his wife. He thought I was progressing faster and better than he and I thought Jerry was doing better than I.
Then Doctor Troy came to my bed followed by Doctor Goldrath. Sally asked him if they sold movies of the operation. She told them I had wanted to stay awake to watch because I was so fascinated by the robotic surgery. He said in fact they had a DVD that I get now. But then they had to find it. They left it in Jerry's area. We talked about my expectations in the coming week and to come to the office in one week to get the staples removed and the catheter. I felt pretty smug that I had an appointment already made for next Monday.
Doctor Troy checked the drain in my side and the drainage was slowed considerably. I'm pretty sure if he had looked at two o'clock I would have gone home with it in place. Harry had been emptying about a half cup, then a third of a cup, then a quarter cup, about every two hours. Now it only had a tablespoon or so. Doc clipped a stitch that tied it in and said, "Exhale and then slowly breathe in while I pull it out."
That was NOT pleasant! That was like a perforated drain tile a little over a foot long and was uncomfortable out almost as much as it was in. I guess he has you exhale before he pulls it out so you can't yell. That burned like fire and pulled my gut as it was coming out slowly. He tugged on the suture and put a dressing over it. I got my directions for the week. Don't bathe before Thursday. Resume medications immediately but no NSAIDs until after the office visit. We need to not start bleeding. Lift nothing over ten pounds, no driving, no chores, etc. Basically I can walk as much as I can tolerate and practice control. Stop mid-stream and hold it for a minute.
Harry worked an hour overtime to get me discharged just because he had started the day with me and wanted to see it through. He was really a very good nurse. All of the nurses were generous, courteous and good at their job. The techs were also very helpful. All things being even I'm still VERY glad to be going home.
Harry was just getting on my 'good side'. He came back later in the morning to get me out of bed. WOW! That was not good. First off when he moved the bag to the base of the IV pump he pulled my hose. That was a panic situation. I wasn't sure what would come off! I told him not to pull that. It wasn't taped down.
That was just the tip of the iceberg so to speak. When Harry took my hand and tried to pull me up I thought I was going to rip in two. It was all that both of us could do to sit me up on the edge of the bed. It felt like the row of incisions (my perforation line) wasn't going to stay together.
After a short rest for Harry and me, I stood up and held onto the IV pump to take a short walk. Out the door and down the hall to the left. Only about twenty feet then a right, another twenty-five feet to the parallel hall, another right and twenty feet back to the cross-over and straight into my Stepdown 2 bed. That was slow, but I was moving on my own power. And at the end of the walk, my arms were tired from supporting myself on the pole of the IV pump. Harry sat me in a chair in my room.
At least the next trip didn't require me to get out of bed. But it was still not possible to sit forward in the chair to get up. I had not been hooked up to the oxygen when I returned from the first walk; but, my O2 saturation was up at 99%. Now that my gut was rumbling, I needed help getting up and into the bathroom. I had no idea what to expect. But I had to take my third of the bathroom time. My room mate Jerry had already made a couple trips. The little old lady went everywhere. I had to get on the board. The things that I get competitive about!
I ordered lunch. It was a decent tuna salad sandwich. It punctuated my day. I was looking forward to the doctors visit to release us about 2 pm. So after lunch Harry got me unhooked from the monitor and out of the chair so I could walk again. This time we went down two blocks then over and back. I felt I had to do it faster than last time. In my mind Harry was charting my liquid intake and output, bathroom trips, and activity. I wanted to be sure that I was showing progress so the doctor would discharge me.
Jerry was really disappointed when they told us the doctor was tied up in surgery 'til two-thirty. I was kind of glad. I thought if the doctor came now I wasn't strong enough to be discharged. I needed more time to get more points on the board. I needed another trip to the head and another walk before he came up.
I finally had some measure of success with body functions and the third walk was left three blocks and back four blocks then to my chair. That was good. I was on a faster pace and went double the distance of my last walk. Harry pointed out his children on an employee bulletin board. They were cute kids just about school age. Harry was still in vacation mode. This was his first day after four weeks in the Philippines visiting family.
Now word is that the doctors are in surgery until 4 or 4:30. Jerry was upset and I was only a little less agitated. Jerry was having pain with his catheter; so he had his wife ask if I was experiencing pinching every time I moved. We compared notes and he was definitely having an issue that I didn't have. So he called his nurse and she checked it out and lubricated the tube. He was apparently experiencing the first signs of irritation and infection. The Bacitracin should help that. I heard her saying to make sure we put that on twice a day.
Jerry was finally ordering something to eat. I was skipping it because I was sure that I was being released soon. Even though it was after five, I was sure I was getting released today. Well, kinda sure. Now word was that they were in another surgery and would be up about seven o'clock. Sure, we've heard that before. Jerry was fit to be tied and I wasn't far behind him. Surely they could take a break between surgeries to come up and discharge us.
The hospital needed our beds since about two thirty. They had people coming out of surgery and needed to put them in monitored beds. We were past needing monitors but they had no where to move us to. They didn't want to put us in another room and then discharge us but we didn't want to be put in the hall. Good thing we didn't move to a hall; since they kept us another five hours and we would not have had nurse assignments or facilities to use.
About seven thirty, doctors Goldrath and Troy were talking to Jerry. Checking his chart and writing his orders. Giving him his directions and talking to his wife. He thought I was progressing faster and better than he and I thought Jerry was doing better than I.
Then Doctor Troy came to my bed followed by Doctor Goldrath. Sally asked him if they sold movies of the operation. She told them I had wanted to stay awake to watch because I was so fascinated by the robotic surgery. He said in fact they had a DVD that I get now. But then they had to find it. They left it in Jerry's area. We talked about my expectations in the coming week and to come to the office in one week to get the staples removed and the catheter. I felt pretty smug that I had an appointment already made for next Monday.
Doctor Troy checked the drain in my side and the drainage was slowed considerably. I'm pretty sure if he had looked at two o'clock I would have gone home with it in place. Harry had been emptying about a half cup, then a third of a cup, then a quarter cup, about every two hours. Now it only had a tablespoon or so. Doc clipped a stitch that tied it in and said, "Exhale and then slowly breathe in while I pull it out."
That was NOT pleasant! That was like a perforated drain tile a little over a foot long and was uncomfortable out almost as much as it was in. I guess he has you exhale before he pulls it out so you can't yell. That burned like fire and pulled my gut as it was coming out slowly. He tugged on the suture and put a dressing over it. I got my directions for the week. Don't bathe before Thursday. Resume medications immediately but no NSAIDs until after the office visit. We need to not start bleeding. Lift nothing over ten pounds, no driving, no chores, etc. Basically I can walk as much as I can tolerate and practice control. Stop mid-stream and hold it for a minute.
Harry worked an hour overtime to get me discharged just because he had started the day with me and wanted to see it through. He was really a very good nurse. All of the nurses were generous, courteous and good at their job. The techs were also very helpful. All things being even I'm still VERY glad to be going home.
Friday, May 11, 2007
April 30, 2007: OH MY GOD.
What? No recovery room?
I thought one always went to a recovery room and some beauty would stroke the brow and spoon ice chips in and shush softly.
Wrong! I missed that part. I first remember prying my eyelids up from the inside to see a dimly lit room with Cheri pulling a curtain across the foot of my bed saying, "Well, he's back with us now." At least that is what I remember.
Ah, there is my beauty. Sally was right there with the ice chips. I think it was between two and three in the afternoon of the thirtieth. It didn't matter to me. I felt like crap. I couldn't move; I must weight a thousand pounds! I am really, really, really tired. I'm going back to sleep.
I don't even know if I went to sleep. I was sooo out of it. I wasn't experiencing nausea. I was steadily come back to this world. And I was beginning to feel. Feel what? Ohhh. Don't ask. Just feel is enough.
I must have been drug through Hell. Somewhere in the process I either caught fire or was scratched up cause they smeared me with gel all over. It was in my eyes, in my ears, in my nose, in my hair, in my ... Let's just say in every orifice and some places in between. I thought that stuff was just put in your eyes to keep them moist. Apparently they used it to caulk around the cannula in my nose for oxygen (keep it up at 8!) and to keep my brain from falling out my ears. Hey! Some of the holes are new!
I think they use that silicone caulk so they can blow you up with a gas to about 90 psi. They continue to ask if I have gas or had gas. They know damn well they pumped me full of it. I am now a part of the National Strategic Reserve System. It was really so they could see during the operation.
And another thing. Is there no way they learn to settle someone in a bed? They pull flesh in every unusual direction and then lay me on top of it. As the feeling comes I begin to realize this just ain't right. But I can't move myself. I don't know if I am that weak or if it hurts too much.
It was hours before I understood that this pain wasn't from the surgery directly, but just because I was lying strangely in bed.
Sally kept filling me with ice chips and giving me sips of water like it was going to make me well. I don't remember if she fed me "dinner". I think it was clear liquids around 7 pm. The nurse kept looking for my heart in my stomach. She said it was all quiet. And I could have told her there was nothing going on down there. She said to be mindful that my bowel was put to sleep too. If nothing is happening there and we put too much in I will be nauseous and that is NOT good. The way my stomach hurts, I believe it would kill me to cough or vomit.
The old lady in bed three had a party. They mostly argued or conjured images in my head that made me wand to poke out my minds eye. Jerry, in bed one, had a party too. Wife, kids, who knows. They stepped in and asked if they could have the chairs in my area. I said, "Sure, as long as we can have it back for my party." I wasn't having a party. I didn't want the kids to come up or Sally's folks. There was nothing they could do and I knew I wasn't presentable. "Leave me alone; I'm fighting cancer!"
Sally couldn't stay in the room for the night because of the privacy rights of other patients. I guess privacy is guaranteed at night but not during the day. So the nurse got her a blanket and pillow and showed her the lounge. It was full of people so she got to come back for a while. I was glad to have her looking out for me. I am always concerned not having an advocate with the patient. And Sally is a great advocate.
Since both Sally and the nurse were there I thought I would remedy my problem. I couldn't stand it any longer. I asked the nurse if she thought that she and Sally could pull my sheets enough to roll me back and forth a couple times to relieve the pressure on my flesh. She assured me that she would do it but would go get a helper. She didn't want Sally to hurt herself.
Ah. That feels better. I can sleep the night now.
Well, technically I could if I were allowed to sleep. They come in and empty the Foley bag. They give me a shot of fire in my belly (that's heparin to prevent clotting). They check my breathing. The oxygen is still up around six litres per hour. My throat is so sore. The nurse listens to my stomach. It was just starting to come back. It was percolating. She also noted that the monitor kept going off because my respiration was six per minute; but, my O2 level was 100%. At one point while the nurse listened to my gut she looked at the monitors. Well your oxygen is at 100% and your respiration is back up around 12 but your heart stopped. I had rested my hands on my chest because I didn't want to put pressure on my stomach. That messed up a lead. Moved my and and voila! My heart was beating again.
It was a wonderful room on the fourth floor with a wall of windows facing East. I watched the dawn and eventual sunrise. To my right was a fellow who had followed me in the prostatectomy line. I felt like Jerry was recovering faster and better than me. Past the foot of my bed was an older woman who had bowel surgery a week before and was anxious to eat food. But she couldn't have food until her bowel was active again. That was entertaining conversation.
I thought one always went to a recovery room and some beauty would stroke the brow and spoon ice chips in and shush softly.
Wrong! I missed that part. I first remember prying my eyelids up from the inside to see a dimly lit room with Cheri pulling a curtain across the foot of my bed saying, "Well, he's back with us now." At least that is what I remember.
Ah, there is my beauty. Sally was right there with the ice chips. I think it was between two and three in the afternoon of the thirtieth. It didn't matter to me. I felt like crap. I couldn't move; I must weight a thousand pounds! I am really, really, really tired. I'm going back to sleep.
I don't even know if I went to sleep. I was sooo out of it. I wasn't experiencing nausea. I was steadily come back to this world. And I was beginning to feel. Feel what? Ohhh. Don't ask. Just feel is enough.
I must have been drug through Hell. Somewhere in the process I either caught fire or was scratched up cause they smeared me with gel all over. It was in my eyes, in my ears, in my nose, in my hair, in my ... Let's just say in every orifice and some places in between. I thought that stuff was just put in your eyes to keep them moist. Apparently they used it to caulk around the cannula in my nose for oxygen (keep it up at 8!) and to keep my brain from falling out my ears. Hey! Some of the holes are new!
I think they use that silicone caulk so they can blow you up with a gas to about 90 psi. They continue to ask if I have gas or had gas. They know damn well they pumped me full of it. I am now a part of the National Strategic Reserve System. It was really so they could see during the operation.
And another thing. Is there no way they learn to settle someone in a bed? They pull flesh in every unusual direction and then lay me on top of it. As the feeling comes I begin to realize this just ain't right. But I can't move myself. I don't know if I am that weak or if it hurts too much.
It was hours before I understood that this pain wasn't from the surgery directly, but just because I was lying strangely in bed.
Sally kept filling me with ice chips and giving me sips of water like it was going to make me well. I don't remember if she fed me "dinner". I think it was clear liquids around 7 pm. The nurse kept looking for my heart in my stomach. She said it was all quiet. And I could have told her there was nothing going on down there. She said to be mindful that my bowel was put to sleep too. If nothing is happening there and we put too much in I will be nauseous and that is NOT good. The way my stomach hurts, I believe it would kill me to cough or vomit.
The old lady in bed three had a party. They mostly argued or conjured images in my head that made me wand to poke out my minds eye. Jerry, in bed one, had a party too. Wife, kids, who knows. They stepped in and asked if they could have the chairs in my area. I said, "Sure, as long as we can have it back for my party." I wasn't having a party. I didn't want the kids to come up or Sally's folks. There was nothing they could do and I knew I wasn't presentable. "Leave me alone; I'm fighting cancer!"
Sally couldn't stay in the room for the night because of the privacy rights of other patients. I guess privacy is guaranteed at night but not during the day. So the nurse got her a blanket and pillow and showed her the lounge. It was full of people so she got to come back for a while. I was glad to have her looking out for me. I am always concerned not having an advocate with the patient. And Sally is a great advocate.
Since both Sally and the nurse were there I thought I would remedy my problem. I couldn't stand it any longer. I asked the nurse if she thought that she and Sally could pull my sheets enough to roll me back and forth a couple times to relieve the pressure on my flesh. She assured me that she would do it but would go get a helper. She didn't want Sally to hurt herself.
Ah. That feels better. I can sleep the night now.
Well, technically I could if I were allowed to sleep. They come in and empty the Foley bag. They give me a shot of fire in my belly (that's heparin to prevent clotting). They check my breathing. The oxygen is still up around six litres per hour. My throat is so sore. The nurse listens to my stomach. It was just starting to come back. It was percolating. She also noted that the monitor kept going off because my respiration was six per minute; but, my O2 level was 100%. At one point while the nurse listened to my gut she looked at the monitors. Well your oxygen is at 100% and your respiration is back up around 12 but your heart stopped. I had rested my hands on my chest because I didn't want to put pressure on my stomach. That messed up a lead. Moved my and and voila! My heart was beating again.
It was a wonderful room on the fourth floor with a wall of windows facing East. I watched the dawn and eventual sunrise. To my right was a fellow who had followed me in the prostatectomy line. I felt like Jerry was recovering faster and better than me. Past the foot of my bed was an older woman who had bowel surgery a week before and was anxious to eat food. But she couldn't have food until her bowel was active again. That was entertaining conversation.
Thursday, May 10, 2007
April 30, 2007: It's Show Time!
The day I have both dreaded and looked forward to is finally here. God, I hope I have made the right decision. 'What if...' is not an option now, the tiller is lashed, the sails are set, come Hell or high seas we are bound.
I had started the "bowl" lavage Sunday noon. Four litres of 'GoLytely' over the course of six hours and numerous visits to the head had proven very effective. On a less than musical note, my last 'movement' was 2:30 am. I can't sleep well so I get up at 4:30 or so. Take what may be my last pee in my control and shower and shave. Ironic to say I shaved, since I have a full beard and mustache.
I roust Sally and she finishes her preparation for the day right on time. She doesn't eat yet because I can't. I wonder if she will quit peeing too.
We arrive at the hospital at five minutes before 7 am. I always like to be a little early. We got the closest parking spot in the 'Day Surgery' line and stop at the information desk. Sally gets her visitor pass and I'm on 'the list'. The guards direct us toward the area.
There is no one on the Day Surgery desk yet but directions on the wall instruct us to hit the button and enter. We advance and meet help inside. The 'hostess' escorts us to '3' and gives simple instructions to strip and put on the gown with the opening in back. Sally can have a seat in the chair and I on the gurney. I figure as long as there is a restroom right next to '3' I should avail myself of the facilities. Never pass an opportunity to use the facilities! Beside, I may not be able to for a long while or ever again.
It wasn't long before one of our servers arrives to take a history. She was a lovely lady in the prime of her life lets say. Old enough to have compassion for people at a dicey time in their lives. We covered what medications I am taking now. What does that mean? I was taking those listed when I called for pre-registration last Monday. Since then I have not taken any of those on the list; but, I have started taking Erythromycin and 'Neomycin' antibiotics.
She is stunned that I am not taking any meds for my heart or blood pressure. So I told her the tale of who had told me what not to take and why at each juncture, the surgeons scheduler, the surgeons nurse, the hospital pre-registrar, my primary care physician and the pharmacist. She said that was too confusing and agreed I wouldn't know what to do.
She explained the process we would go through today and that I get prepped, socked and booted. All that before I get cut. Sound too violent to me. I received, at no additional charge, a pair of shorty tube socks with little gripper treads on top and bottom. I don't know if that is so I can't put them on wrong or if it is so I can hang over the curtain rod by my toes. So I tried to put them on wrong and was equally comfortable with the treads running up both SIDES of my feet as I was with them bunching in front of my ankles.
Fortunately we didn't have a lot of traffic past my station, since '3' was pretty well the end of the line. Those gowns are nice for airing out ones business. When she came back to put my boots on she also gave me a blanket. That was the last time anyone could see what I pack. From now on they have to be looking on purpose.
The boots are lower leg wraps that are pumped up about four time a minute. They expand at the ankle and it spirals toward the knee. This forces the blood into the deep veins and prevents blood pooling in the legs causing a Deep Vein Thrombosis. DVT is what killed Bloom, the NBC reporter, in Iraq a couple years ago. A clot can break off and course through your circulatory system to some place that is devastating (like your brain, lung or heat). At first I thought the boots would be annoying. But by the time I came out of surgery they were very nice. I thought she looked very sweet and gave a terrific massage.
Then a nice lady came by and gave me a two bit hair cut. She reminded me of Eartha Kit with a clipper. She lay a pillow case beside me and tuck slightly under. she would run the clippers toward her and softly brush my stomach to that side. She switched to the other side and repeated the process. When she finished she rolled the pillowcases up and to hair and all to the laundry.
My in-laws showed up. Although we told them not to bother, they had to do something to show support. In just minutes it would not be a problem for me cause I'll be out of it all.
Doctor Toth and the surgical nurse came by to talk a bit about meds and history and the procedure I was expecting. We all seemed to be on the same page. The little nurse unlocked my ride and strained to push this overloaded cart toward the OR. She could have used the 100 pounds I could afford to give her. It would have made our masses closer to equal. She just kept saying, "Keep your hands inside the cart, please." It was like riding on a bumper boat. I had the urge to fend off. But to her credit, as close as we'd come, she never touched a wall, cart or piece of equipment.
The OR looks like a storage room! Big piles of junk covered with a sheet. Several of them. Looks like brooms or mops sticking up under the throws. All but the patient cart.
It was long and narrow. It looks about eight feet long and fifteen inches wide. In the middle is a red pad that looks like it is made from sorbothane. You know those gel shoe inserts that are kind of squishy. She wheeled the gurney up beside it and leveled them. "Slide your self over to the table, please. And use your hand to feel the other side. It's narrow and we don't want you to fall off the other side. Then pull your gown out from under yourself.", she said. Let me tell you, I covered that baby. When I pulled out my gown ... DAMN that's colder than a well diggers ass.
Then Dr. Toth came in and leaned over to tell me that they would have to stick me a couple times for the drugs they would administer during surgery but not to worry because I'll be out before that. He starts to look over my arms and is impressed by my right arm and the fine vein there. (here we go again)
I explained, "DON'T touch that one! Every fool falls for that, but it is not worth a shit." Sound familiar?
That's the last thing I remember. I don't recall the surgeons coming in. I don't remember the machines being uncovered. I don't remember them even asking me to count backwards.
I had started the "bowl" lavage Sunday noon. Four litres of 'GoLytely' over the course of six hours and numerous visits to the head had proven very effective. On a less than musical note, my last 'movement' was 2:30 am. I can't sleep well so I get up at 4:30 or so. Take what may be my last pee in my control and shower and shave. Ironic to say I shaved, since I have a full beard and mustache.
I roust Sally and she finishes her preparation for the day right on time. She doesn't eat yet because I can't. I wonder if she will quit peeing too.
We arrive at the hospital at five minutes before 7 am. I always like to be a little early. We got the closest parking spot in the 'Day Surgery' line and stop at the information desk. Sally gets her visitor pass and I'm on 'the list'. The guards direct us toward the area.
There is no one on the Day Surgery desk yet but directions on the wall instruct us to hit the button and enter. We advance and meet help inside. The 'hostess' escorts us to '3' and gives simple instructions to strip and put on the gown with the opening in back. Sally can have a seat in the chair and I on the gurney. I figure as long as there is a restroom right next to '3' I should avail myself of the facilities. Never pass an opportunity to use the facilities! Beside, I may not be able to for a long while or ever again.
It wasn't long before one of our servers arrives to take a history. She was a lovely lady in the prime of her life lets say. Old enough to have compassion for people at a dicey time in their lives. We covered what medications I am taking now. What does that mean? I was taking those listed when I called for pre-registration last Monday. Since then I have not taken any of those on the list; but, I have started taking Erythromycin and 'Neomycin' antibiotics.
She is stunned that I am not taking any meds for my heart or blood pressure. So I told her the tale of who had told me what not to take and why at each juncture, the surgeons scheduler, the surgeons nurse, the hospital pre-registrar, my primary care physician and the pharmacist. She said that was too confusing and agreed I wouldn't know what to do.
She explained the process we would go through today and that I get prepped, socked and booted. All that before I get cut. Sound too violent to me. I received, at no additional charge, a pair of shorty tube socks with little gripper treads on top and bottom. I don't know if that is so I can't put them on wrong or if it is so I can hang over the curtain rod by my toes. So I tried to put them on wrong and was equally comfortable with the treads running up both SIDES of my feet as I was with them bunching in front of my ankles.
Fortunately we didn't have a lot of traffic past my station, since '3' was pretty well the end of the line. Those gowns are nice for airing out ones business. When she came back to put my boots on she also gave me a blanket. That was the last time anyone could see what I pack. From now on they have to be looking on purpose.
The boots are lower leg wraps that are pumped up about four time a minute. They expand at the ankle and it spirals toward the knee. This forces the blood into the deep veins and prevents blood pooling in the legs causing a Deep Vein Thrombosis. DVT is what killed Bloom, the NBC reporter, in Iraq a couple years ago. A clot can break off and course through your circulatory system to some place that is devastating (like your brain, lung or heat). At first I thought the boots would be annoying. But by the time I came out of surgery they were very nice. I thought she looked very sweet and gave a terrific massage.
Then a nice lady came by and gave me a two bit hair cut. She reminded me of Eartha Kit with a clipper. She lay a pillow case beside me and tuck slightly under. she would run the clippers toward her and softly brush my stomach to that side. She switched to the other side and repeated the process. When she finished she rolled the pillowcases up and to hair and all to the laundry.
My in-laws showed up. Although we told them not to bother, they had to do something to show support. In just minutes it would not be a problem for me cause I'll be out of it all.
Doctor Toth and the surgical nurse came by to talk a bit about meds and history and the procedure I was expecting. We all seemed to be on the same page. The little nurse unlocked my ride and strained to push this overloaded cart toward the OR. She could have used the 100 pounds I could afford to give her. It would have made our masses closer to equal. She just kept saying, "Keep your hands inside the cart, please." It was like riding on a bumper boat. I had the urge to fend off. But to her credit, as close as we'd come, she never touched a wall, cart or piece of equipment.
The OR looks like a storage room! Big piles of junk covered with a sheet. Several of them. Looks like brooms or mops sticking up under the throws. All but the patient cart.
It was long and narrow. It looks about eight feet long and fifteen inches wide. In the middle is a red pad that looks like it is made from sorbothane. You know those gel shoe inserts that are kind of squishy. She wheeled the gurney up beside it and leveled them. "Slide your self over to the table, please. And use your hand to feel the other side. It's narrow and we don't want you to fall off the other side. Then pull your gown out from under yourself.", she said. Let me tell you, I covered that baby. When I pulled out my gown ... DAMN that's colder than a well diggers ass.
Then Dr. Toth came in and leaned over to tell me that they would have to stick me a couple times for the drugs they would administer during surgery but not to worry because I'll be out before that. He starts to look over my arms and is impressed by my right arm and the fine vein there. (here we go again)
I explained, "DON'T touch that one! Every fool falls for that, but it is not worth a shit." Sound familiar?
That's the last thing I remember. I don't recall the surgeons coming in. I don't remember the machines being uncovered. I don't remember them even asking me to count backwards.
April 29, 2007: The Great Fast
Sundays are usually our big breakfast day. Sally and I will have a breakfast meat and eggs, potato, biscuits and gravy, juices and coffee. This is one of two Sunday meals. But I am on a clear liquid diet this Sunday. Cranberry juice, apple juice, water. all day.
After the first few hours i am not really hungry. Somehow the body gives up hope of being fed. I am also off ALL medicine since Tuesday the seventeenth. That was one of the questions for the doctor. I hoped he could sort out which I continue and which are discontinued. When I picked up the pre-meds at the pharmacy they had gone over more that I could not take. For example Erythromycin and Lipitor combine to cause deafness. Holy crap! I was only left with Altace so I quit that too.
I feel bad for Sally, she is trying to not eat in front of me. I told her it doesn't matter to me but there is no dissuading her. She ran the store Sunday afternoon and stopped to get herself a meal. She shouldn't feel bad about doing that; I'm glad she ate. Tomorrow is looming on the near horizon.
What does that mean? Isn't there only one horizon?
After the first few hours i am not really hungry. Somehow the body gives up hope of being fed. I am also off ALL medicine since Tuesday the seventeenth. That was one of the questions for the doctor. I hoped he could sort out which I continue and which are discontinued. When I picked up the pre-meds at the pharmacy they had gone over more that I could not take. For example Erythromycin and Lipitor combine to cause deafness. Holy crap! I was only left with Altace so I quit that too.
I feel bad for Sally, she is trying to not eat in front of me. I told her it doesn't matter to me but there is no dissuading her. She ran the store Sunday afternoon and stopped to get herself a meal. She shouldn't feel bad about doing that; I'm glad she ate. Tomorrow is looming on the near horizon.
What does that mean? Isn't there only one horizon?
April 20, 2007
The pre-admission physical is required by the hospital and no procedure will take place if it isn't done. Or so I was told by the scheduler. I dutifully scheduled it for April twenty, exactly ten days before the procedure just as I was told was the perfect timing.
We waited for a short while to get in. A man I had never before seen came to the waiting room in blue jeans, sneakers and a button down.
"Greg?", he asked rather tentatively.
I rose and walked toward him. Sally was right behind me. She comes along schlepping my note pad and documents and our new digital voice recorder. I always kid her about wanting to be there the minute they say anything that might let her file the life insurance claim. Anything to speed that process along. She knows I'm only kidding her. It's her way of showing that she cares.
As we walk down the hall to a patient room, he explains that he is Doctor Harris. He just comes in to keep them in line. He was head of some department at Condell Hospital until three years ago when he had some seizure malady, brain surgery, etc. He doesn't practice medicine but has kept his license up and just helps out around the office.
This is okay by me. He had some misfortune (like I don't) and they are taking care of him by letting him work up to his abilities. I see that as nice. He takes my blood pressure and updates my medicine list and leaves us for the doctor.
Kathy comes in with an EKG machine and a fist full of leads. He helps her hook me up to the twelve lead EKG and get a strip run. Sally and I sit and talk while waiting for the doctor. Sally has a list of questions we have for the doctor.
Doc comes in, sits down and starts to read my chart. Which is huge after five years of my history. He is apparently reading for the first time many of the test results and says nothing. Line by line following the text and occasionally underlining phrases. Like we did when we highlighted in school. He asked haltingly, "Did ... you ... maybe have ... just below... your... knee... on the left...some... damage?
I said, "Yes. I fell down a flight of stairs when I was a kid. They called it a 'green stick break'."
"That would explain that. We need some blood drawn, go with doctor Harris." And I followed to the lab room just down the hall.
He started on the left arm and asked if that was where they usually drew from. I said no that has not worked for many years. They usually get it from my right forearm or hands. He moved around to my right and said, "Oh yea! That looks good."
I quickly informed him that what he saw was really like a rubber band stretched through my arm. I know it looks good; but it isn't worth a shit. Even I would think that I could get blood there; but that well is dry. He insisted that he was the MASTER and could get blood where no others could. He taught others to draw blood.
So I watched as he pricked my arm and proceeded to slide it in and out. Maybe a little higher angle. No, maybe if he held it from from the side so it wouldn't roll. No, maybe if he pushed a little further in. DAMN that 1 1/2 inch needle is just too short. Oh well just push harder.
He had the needle in all the way and the syringe was pushing in a big dimple. Finally, blood! Glorious blood. He had to pump the little vial to draw any. The flow was almost imperceptible. Ever so slowly we got about half of each of three vials in ten minutes. Of course there was also blood coming out around the syringe too. That blood has been exposed to air and is contaminated. We can't suck that up to inject in the vials.
I went back to the patient room and Sally was still waiting for me. I asked if she had asked the doctor about our questions; but he had not come back after I left the room. Kathy came by and said she thought we were done; she would ask doctor. He had moved on and was a with another patient we were free to go. Kathy gave me a big hug and wished us good luck.
We waited for a short while to get in. A man I had never before seen came to the waiting room in blue jeans, sneakers and a button down.
"Greg?", he asked rather tentatively.
I rose and walked toward him. Sally was right behind me. She comes along schlepping my note pad and documents and our new digital voice recorder. I always kid her about wanting to be there the minute they say anything that might let her file the life insurance claim. Anything to speed that process along. She knows I'm only kidding her. It's her way of showing that she cares.
As we walk down the hall to a patient room, he explains that he is Doctor Harris. He just comes in to keep them in line. He was head of some department at Condell Hospital until three years ago when he had some seizure malady, brain surgery, etc. He doesn't practice medicine but has kept his license up and just helps out around the office.
This is okay by me. He had some misfortune (like I don't) and they are taking care of him by letting him work up to his abilities. I see that as nice. He takes my blood pressure and updates my medicine list and leaves us for the doctor.
Kathy comes in with an EKG machine and a fist full of leads. He helps her hook me up to the twelve lead EKG and get a strip run. Sally and I sit and talk while waiting for the doctor. Sally has a list of questions we have for the doctor.
Doc comes in, sits down and starts to read my chart. Which is huge after five years of my history. He is apparently reading for the first time many of the test results and says nothing. Line by line following the text and occasionally underlining phrases. Like we did when we highlighted in school. He asked haltingly, "Did ... you ... maybe have ... just below... your... knee... on the left...some... damage?
I said, "Yes. I fell down a flight of stairs when I was a kid. They called it a 'green stick break'."
"That would explain that. We need some blood drawn, go with doctor Harris." And I followed to the lab room just down the hall.
He started on the left arm and asked if that was where they usually drew from. I said no that has not worked for many years. They usually get it from my right forearm or hands. He moved around to my right and said, "Oh yea! That looks good."
I quickly informed him that what he saw was really like a rubber band stretched through my arm. I know it looks good; but it isn't worth a shit. Even I would think that I could get blood there; but that well is dry. He insisted that he was the MASTER and could get blood where no others could. He taught others to draw blood.
So I watched as he pricked my arm and proceeded to slide it in and out. Maybe a little higher angle. No, maybe if he held it from from the side so it wouldn't roll. No, maybe if he pushed a little further in. DAMN that 1 1/2 inch needle is just too short. Oh well just push harder.
He had the needle in all the way and the syringe was pushing in a big dimple. Finally, blood! Glorious blood. He had to pump the little vial to draw any. The flow was almost imperceptible. Ever so slowly we got about half of each of three vials in ten minutes. Of course there was also blood coming out around the syringe too. That blood has been exposed to air and is contaminated. We can't suck that up to inject in the vials.
I went back to the patient room and Sally was still waiting for me. I asked if she had asked the doctor about our questions; but he had not come back after I left the room. Kathy came by and said she thought we were done; she would ask doctor. He had moved on and was a with another patient we were free to go. Kathy gave me a big hug and wished us good luck.
Tuesday, May 8, 2007
April 9, 2007: The Longest Week
Well it has been a long wait for action to start. I tested on April fourth and won't get results until I go to my primary care physician on the twentieth for a pre-admission physical.
The hospital requires that I be healthy enough to be admitted? They are rather persnickety. The physical should be ten days before the planned procedure. That is close enough to be relevant. Too many things can change if it were twelve days, for example. Ten days allows time for additional lab results to return and be evaluated. I suppose if I were not healthy enough they would have to give me a death sentence by slow torture. I don't want to even ask about the possibilities. Why should that surprise us? After all, we have to prove to a financial institution that we have money before they will lend to us.
It isn't as though I am sitting around with nothing to do. I am going to work every day. Well, I show up most days. I haven't mentioned before how great my boss has been about this. She has not assigned any additional projects and allows me to go any time I need to for appointments. She has made this a lot less stressful than it could be. I have great co-workers who are taking over my projects when I leave. (one more stroke of good luck in my life)
I have had a couple strange phone calls to make. I had to call the urologists scheduler to set a date. The conversation, like most calls for an appointment, starts with, "When would you like to do the procedure?" No suggested available dates? Should I know what lead time is?
I suggest, "A couple weeks?"
And she sets me straight, "The doctors are famous for this da Vinci operation and people come from all over the country to have it done. We couldn't hope to have it done before middle of May. There is a possibility of April thirtieth if Dr. Troy changes his schedule. He is supposed to go out of town but may not go."
Well that changed my perspective and I kindly asked for the first available slot in mid May. I really don't want to wait that long.
I also took note of how important her role is to me. She has to work with her two doctor's schedules and the hospital schedule for the da Vinci surgical robot. And the only days they can use the robot are every Monday and the first, third and fifth Tuesday. She recited the rules to me about only clear liquids the day before. That would be water, apple juice, cranberry juice, NO orange juice or tomato juice because they aren't clear you see. And no caffeine, no carbonated drinks and no dairy. She will of course detail all this in a letter to me confirming my appointment. These rule must be very important because we covered them more than once in the conversation.
I should also stop taking my medications the week before, that are not for my heart . (You know the MI that was the first stroke of luck) Stop synthroid, Folbic, nuproxen, aspirin, Metformin, all herbals and supplements, Lipitor, zetia, tricor. Only take my Toprol XL, for heart rate, and Altace, for blood pressure. I don't want these in my system at the time of the procedure because they will react with what they need to administer then. This too will all be in the letter.
I commiserated with her on the difficulty of her role and thanked her profusely. Hoping for preferential treatment her lady. Please don't sentence me to death!
The hospital requires that I be healthy enough to be admitted? They are rather persnickety. The physical should be ten days before the planned procedure. That is close enough to be relevant. Too many things can change if it were twelve days, for example. Ten days allows time for additional lab results to return and be evaluated. I suppose if I were not healthy enough they would have to give me a death sentence by slow torture. I don't want to even ask about the possibilities. Why should that surprise us? After all, we have to prove to a financial institution that we have money before they will lend to us.
It isn't as though I am sitting around with nothing to do. I am going to work every day. Well, I show up most days. I haven't mentioned before how great my boss has been about this. She has not assigned any additional projects and allows me to go any time I need to for appointments. She has made this a lot less stressful than it could be. I have great co-workers who are taking over my projects when I leave. (one more stroke of good luck in my life)
I have had a couple strange phone calls to make. I had to call the urologists scheduler to set a date. The conversation, like most calls for an appointment, starts with, "When would you like to do the procedure?" No suggested available dates? Should I know what lead time is?
I suggest, "A couple weeks?"
And she sets me straight, "The doctors are famous for this da Vinci operation and people come from all over the country to have it done. We couldn't hope to have it done before middle of May. There is a possibility of April thirtieth if Dr. Troy changes his schedule. He is supposed to go out of town but may not go."
Well that changed my perspective and I kindly asked for the first available slot in mid May. I really don't want to wait that long.
I also took note of how important her role is to me. She has to work with her two doctor's schedules and the hospital schedule for the da Vinci surgical robot. And the only days they can use the robot are every Monday and the first, third and fifth Tuesday. She recited the rules to me about only clear liquids the day before. That would be water, apple juice, cranberry juice, NO orange juice or tomato juice because they aren't clear you see. And no caffeine, no carbonated drinks and no dairy. She will of course detail all this in a letter to me confirming my appointment. These rule must be very important because we covered them more than once in the conversation.
I should also stop taking my medications the week before, that are not for my heart . (You know the MI that was the first stroke of luck) Stop synthroid, Folbic, nuproxen, aspirin, Metformin, all herbals and supplements, Lipitor, zetia, tricor. Only take my Toprol XL, for heart rate, and Altace, for blood pressure. I don't want these in my system at the time of the procedure because they will react with what they need to administer then. This too will all be in the letter.
I commiserated with her on the difficulty of her role and thanked her profusely. Hoping for preferential treatment her lady. Please don't sentence me to death!
Sunday, May 6, 2007
April 4, 2007: Testing
Ready for my close-up, Mr. DeMille ...
Well I am way behind in keeping this updated. But, here goes the flood of events.
Sally and I started on April 4th at 6:00 am in Lake Zurich, I was at the High Tech Medical Imaging office for a body scan. They injected 25.4 mCi of Tc-99 MDP (another flavor of glow-in-the-dark crap). And we waited two hours for it to be taken up in my skeleton. It should show up on the scan in areas of unusual celluar activity. The staff was nice; but, as always with me, they had some challenge getting a vein for the injection. When my turn came I lay on a table about 12 to 14 inches wide with my arms over my head and waited as the machine passed over me, humming monotonously, for twenty-five minutes.
End of test 1; go dress and leave for the next imaging center.
We had some time bfore we were due at Bright Light Radiology in Elk Grove Village so Sally and I went shopping at a Staples. We wanted to get a digital voice recorder so we could get everything the doctors would be saying to us. We skipped lunch because we weren't sure that we could be done in time for my appointment.
Once at Bright Light, about 1:00 pm they took me in and did a front and side Chest x-ray or Chest PAL. I returned to the lobby to wait further directions.
A nice young lady came out with a big plasic cup of water for me. Sally didn't get any. The young lady directed me to drink it and informed me that I would receive another 16 oz. every 30 minutes. Nice of them to keep me hydrated.
I was actually ingesting some kind of contrast agent that need to fill my bowel. It wasn't 'horrible', more like a bicarb. But drinking a half gallon was a bit much.
They took me back about 3:00 pm and tried to find a vein. I felt so sorry for the girl. She was very frustrated and so apologetic for sticking me six times.
I told her, "It's not you. It's just me. You can't help the way I am."
She went to get the doctor to do it. I know one should NEVER profer a guess at a lady's age; but, she was about my age. We had a nice conversation while she tried to find new ground to stick. And more than stick, she needed a big, good vein that could take 3 ml per second of the die.
I learned that she has a husband my age who also had a heart attack. She can't keep him on his diet or exercise. Amid the many appologies she did get a vein in my right forearm and I was set for my abdominal and pelvic CT scan. This is where I find out if my older sister is crazy or not; but more on that latter.
A scan before the injection takes about 1 minute while I hold my breath. Then the girl comes in and holds my hand while the machine pumps me up. Actually she was there to verify that the 100 cc of Isoview370 IV was going IV and not subcutaneously. The idea was to get the contrast agent into the abdomen not my arm.
Wait five minutes and through the imaging machine again holding my breath.
The tech checked the images and said they were good. I could get dressed.
So we left about 4:00 pm.
Sally was so kind that she didn't eat because I couldn't eat. So we decided to go out for dinner and enjoy ourselves. Now we wait for the results.
Well I am way behind in keeping this updated. But, here goes the flood of events.
Sally and I started on April 4th at 6:00 am in Lake Zurich, I was at the High Tech Medical Imaging office for a body scan. They injected 25.4 mCi of Tc-99 MDP (another flavor of glow-in-the-dark crap). And we waited two hours for it to be taken up in my skeleton. It should show up on the scan in areas of unusual celluar activity. The staff was nice; but, as always with me, they had some challenge getting a vein for the injection. When my turn came I lay on a table about 12 to 14 inches wide with my arms over my head and waited as the machine passed over me, humming monotonously, for twenty-five minutes.
End of test 1; go dress and leave for the next imaging center.
We had some time bfore we were due at Bright Light Radiology in Elk Grove Village so Sally and I went shopping at a Staples. We wanted to get a digital voice recorder so we could get everything the doctors would be saying to us. We skipped lunch because we weren't sure that we could be done in time for my appointment.
Once at Bright Light, about 1:00 pm they took me in and did a front and side Chest x-ray or Chest PAL. I returned to the lobby to wait further directions.
A nice young lady came out with a big plasic cup of water for me. Sally didn't get any. The young lady directed me to drink it and informed me that I would receive another 16 oz. every 30 minutes. Nice of them to keep me hydrated.
I was actually ingesting some kind of contrast agent that need to fill my bowel. It wasn't 'horrible', more like a bicarb. But drinking a half gallon was a bit much.
They took me back about 3:00 pm and tried to find a vein. I felt so sorry for the girl. She was very frustrated and so apologetic for sticking me six times.
I told her, "It's not you. It's just me. You can't help the way I am."
She went to get the doctor to do it. I know one should NEVER profer a guess at a lady's age; but, she was about my age. We had a nice conversation while she tried to find new ground to stick. And more than stick, she needed a big, good vein that could take 3 ml per second of the die.
I learned that she has a husband my age who also had a heart attack. She can't keep him on his diet or exercise. Amid the many appologies she did get a vein in my right forearm and I was set for my abdominal and pelvic CT scan. This is where I find out if my older sister is crazy or not; but more on that latter.
A scan before the injection takes about 1 minute while I hold my breath. Then the girl comes in and holds my hand while the machine pumps me up. Actually she was there to verify that the 100 cc of Isoview370 IV was going IV and not subcutaneously. The idea was to get the contrast agent into the abdomen not my arm.
Wait five minutes and through the imaging machine again holding my breath.
The tech checked the images and said they were good. I could get dressed.
So we left about 4:00 pm.
Sally was so kind that she didn't eat because I couldn't eat. So we decided to go out for dinner and enjoy ourselves. Now we wait for the results.
Subscribe to:
Posts (Atom)