Catch and Release

Yesterday, earlier than expected, Renee was taken down to radiology for the nuclear stress test. Here, they put her on a table about the size of a balance beam and used a camera device that moves around you and takes pictures for eighteen minutes. Then they injected her with some wild juice that makes your heart go pitter patter and took more pictures for six minutes. She was then sent to a holding pen for 45 minutes. After the wait, they brought her back in for even more pictures.

They compare the pictures from the three stages and can tell if there is something abnormal going on with your heart. Then you are sent back to your room and wait, of course, for the doctors to review the findings and relay them to you.

In the meantime, both the gastro-doc and the staff doc stop in to tell us how well things are going and agree that if nothing major comes out of the stress test that Renee may go home.

Some friends stop by for a visit and Renee says that she’s starting to feel like herself for the first time in a year. Upon hearing this, the friends leave. They came to visit a sick person. Just kidding, they had to run, I think they left their combined six kids alone outside trashing the minivan.

The nurse pops in and says that the staff doctor has released Renee as long as the cardiologist agrees. And we wait … tick, tick, tick.

About 4:00Pm the nurse pulls the IV tube from Renee’s hand and says she’s pretty confidant about Renee going home. She said she’s called down to radiology to see if the cardiologist has an answer yet … tick, tick, tick. Her beeper goes off while she’s wrapping Renee’s hand in gauze but she ignores it. The nurse’s assistant comes in and tells the nurse that the cardiologist is on the phone…. It’s about the patient in Room 442…boo…we’re in 435. But then he says the name. It’s about Renee, yea. She rushes out to take the call.

She reappears a few minutes later and says she has called for transport. The paperwork is done and Renee can go.

Renee’s not in perfect shape but she’s good enough to recover in her own house. She is given strict orders about follow up with her family practitioner, blood specialists, gastroenterologist and the cardiologist. Numerous prescriptions are attached to the paperwork and she’s told not to miss the next scheduled antibiotic dose.

After a stop at Walgreen’s, we made it home around 5:45PM. With all of the hooks removed, Renee has been set free again to swim in the big pond.

Rubbernecking

I hope my last two posts didn’t sound too pessimistic. I’m not. But some days I just feel like I’m stuck in highway traffic in a huge delay and when I finally creep along far enough to see what’s going on, I see the flashing lights, cop cars, fire trucks, EMTs and tow trucks all dealing with the wreckage and the shock hits as I see my other car flipped upside down. I’m stuck peering over the guardrail and there’s not a thing I can do to help.

I think Renee feels the same way, like a spectator screaming at the refs trying to be part of the game. She’s watching the teams march up and down the field yelling, “remember me guys? I’m the ball.” But the ball never does have a say in how it’s tossed around.

Yesterday, we felt like we were back in the loop. Good news will make you feel that way.

The CT Scan results came back as good as they could be. The staff doctor who was scaring the heck out of Renee for the last couple of days was upbeat and almost personable. The gastro-doc was nearly ecstatic. The infectious disease doc said the infection is under control, an oral antibiotic regime for two weeks will follow after release from the hospital is all. The surgeon agreed that all looked well regarding the abscess and removed the drain.

Today we still have the nuclear stress test to look forward to but we’re not worried. Heck, the whole month has been a stress test.

At 11:00PM, Renee got the private room she pleaded for and got a little sleep last night, as much as can be expected in a hospital.

We’re not breaking out the champagne and noisemakers just yet, but it seems in perfect sequence with the season, as the last candle of Hannukah burned itself out, the spark of optimism was rekindled.

Moving Day

Unlock the briefcase with the launch codes, today we go nuclear, Nuclear Medicine that is. Renee went on an unscheduled field trip this morning for chest x-rays and tests. For the past couple of days Renee’s been experiencing some shortness of breath. This also happened a few times in Cleveland. So they figured they’d drop an atomic bomb full of dye and radiation into her system to try to locate the problem.

All of the doctors keep telling Renee how good she is going to feel after she gets through all of this. But none of the doctors told her up front how bad she was going to feel getting there.

During a break from the hospital yesterday, I shared a couple of glasses of homebrew with Brewmaster Dave. We commiserated over family medical problems. What I have found is that nothing you’re reading here is trailblazing. This is standard happenings for anyone who’s unlucky enough to land in the hospital. We both agreed that the doctors sometimes forget that, although much of this is routine to them and that they may see it on a daily basis, it is brand new to each patient and their families. But, I guess you can chalk a lot of it up to human nature. Damn humans!

Renee’s regular gastroenterologist stopped in yesterday. Renee relayed her discouragement at all of these issues that keep cropping up. In a sincere effort of encouragement (I’m not being sarcastic) the doctor said, “You’re going to get worse before you get better.” Thanks doc, that really cheers me up! He, in turn, relayed his own difficulties with a post-op abscess and a drain they ran through his rear end. (Hey, none of this is pretty folks.) He assured Renee that these difficulties all revolve around the post-op recovery process and the infection.

He was back in this morning and again put on his reassuring tone. He said that although there are a bunch of chefs here that he’s looking at the big picture. He said some of the doctors are being overly cautious in their approach. He used the word anal but that pun is too easy even for me. He wasn’t real thrilled that the drain is still producing a fair amount of discharge and that the incision though looking better today is also still draining. Renee told him how the attending doctor scared her by his talk about the fluid around her heart and all the other readings that are not turning in her favor. He came back with how the white counts are good and the hemoglobin has risen a bit, which means no transfusion, and that generally things are looking a little better. When he left Renee was feeling pretty good again about all that was going on.

Not ten minutes later the cardiologist appeared and spent a good fifteen to twenty minutes in the room. She asked about the shortness of breath and the pressure in the chest. She talked about current versus past EKG’s, platelets and blood thinners, beta blockers, cardiac catheters and stress tests, both standard and medicinal. Essentially she is concerned. She has ordered a medicinal stress test, this is where they inject you with drugs that simulate the heart activity that would occur if you were on the standard treadmill stress test. At least they realize that Renee is not in any shape right now to jump on a treadmill. This is the only way to determine if there is a possible blockage building without doing the cardiac-cath which they would like to avoid because of her post-op status. The good news, she said, is that Renee has not had a heart attack. The bad news is that Renee’s health history coupled with the EKG readings, the breathing difficulties, chest pressure, post-op recovery process and those platelets she talked about all make her a prime candidate for …BAM!

They’re not taking any chances. Renee was unceremoniously evicted from her private penthouse suite on the 6th floor and moved to a shared room on the 4th where the rooms have heart monitors. Well I exaggerate, (imagine that), it wasn’t really a penthouse and there was some ceremony. We had a parade bringing her and all her hospital belongings down to four. Renee was in the wheelchair and on her lap was a rectangular bucket filled with toiletries and a small vase with a couple of fresh flowers. She was being pushed by the purple clad nurse’s assistant who was trying to artfully drag along the IV stand without banging it into himself, the wheelchair, or anything else along the way. He was not a very skilled artisan. Behind him we had the nurse fumbling along with Renee’s Encyclopedia Brittanica sized chart and a bag of bedside goodies. Then came Cassidy with a neglected poinsettia and then me carrying a closetful of coats and totes. We really needed a marching band to round things out. The frivolity all came to an abrupt halt when Renee got a peek at the room they had ready for her. In Linda Blair fashion, she spun her head completely around and growled while spitting fire, “PUT ME ON THE PRIVATE ROOM LIST!”

Tomorrow is the CT Scan of the abscess, then the blood doctors are going to review the platelet count issue along with other abnormalities and an infectious disease specialist is coming in for a consult on what exactly is happening due to the enterococcus battle that is being waged on Renee’s system.

The stress test can’t be scheduled until Wednesday due to possible interaction with dye’s and radiation from other tests that were conducted this morning, so guess where Renee’s New Year’s Eve party is going to be.

Let’s just hope that no one at the hospital drops the ball.

Maestro raise your baton

Late yesterday right after I left the hospital, the doctor came in to check on Renee, this was another partner from the gastroenterologist’s office. In addition to the infection Renee is experiencing low blood pressure, low hemoglobin, her count dropped to seven yesterday, the normal range is 12-16 and her liver function is low. We’re told that if the hemoglobin count hits six it’s transfusion time.

After he gets through telling Renee all of this, he says, “You’re doing good,” “So why the heck is everything out of whack,” asks the patient. “You’re doing good,” says doctor again, like he either didn’t here or more likely wasn’t listening to the patient. Renee is getting frustrated and wants to know in English what the heck is going on. I wasn’t there to ask the five W”s and she let him leave without a sufficient explanation.

We know who, we know where, sometimes the when, but the what and why are still up in the air. I told Renee to take notes while the doctors are talking but that’s not happening. I’m considering getting her a digital voice recorder. But we both have to just slow the doctors down and ask them to explain better.

With so many doctors that have a finger on the spoon stirring the pot it can get confusing. Renee’s also got to watch out for her own well being. One doctor prescribed a pain medication with ibuprofen but her kidney doctor says only take acetaminophen. She’s on a soft GI diet but when she’s allowed to eat they give her menus with items that a competitive eating contestant couldn’t digest. You can’t believe the stuff that the cafeteria will provide a hospital patient. Don’t they have nutritionists that work there? Is there any coordination and communication between the departments in an effort to get the patient better?

It would be great to get all of Renee’s doctors into one room and put everything on the table so that each may know what the other’s thinking, then maybe we could devise a concerted plan of attack. But the family care physician doesn’t do hospital visits, the gastroenterologist defers to the surgeon about the abscess, the local surgeon doesn’t do drains and currently is only on board for consult, (inhale) as far as we know, the nefrologist hasn’t been consulted nor the blood doctor, we may now need a liver specialist and the surgeon that performed the operation is in Cleveland. This will give you an idea of why we are a little confused and Renee feels out of the loop concerning her own progress.

They told Renee yesterday that they’ll do an ultrasound of the liver on Monday in addition to the scheduled CT Scan of the abscess. Today they said the technician is in so the Ultrasound is being done around 11:00A.M. Results to follow.

Operation Irony

Renee got word from the surgeon this morning that she’ll get to extend her stay at least until Monday. The abscess is still draining so he sees no need to go looking at it again today. We got a hint about this yesterday when the gastroenterologist started giving us the list of the weekend doctors.

Renee’s still got three antibiotics flowing in and they’ve identified the culprit. It’s called enterococcus and the doc said that they are working to narrow it further to a particular strain. This will help them combat the bugger. Enterococci are among the most common antibiotic-resistant bacteria. Great going Renee, you couldn’t get a simple infection could you?

They must think that this is the most violent strain called VRE since it has already defied the first round of antibiotics. The irony is that you can only acquire this germ in the hospital. So Renee’s Cleveland Clinic stay results in a Louisville stay. Isn’t it good that the hospitals are sharing the wealth and helping to battle the economic downturn? It is at the patient’s expense but really it’s for the good of the country. For you stockbrokers out there, forget the Dow, S&P, employment rate and housing starts, you only need to follow one indicator, the precious commodity that is Renee.

Anyone who comes to visit be wary. Scrub up before and after entering and leaving the hospital and especially before eating. If you are healthy it is highly unlikely to affect you, but if, like Renee, your immune system is being heavily taxed, you could end up in a bed next to her. So wash your hands! My dance card is already full.

Mixed Blessings

Merry Christmas to all!

Today we harken back about 2000 years to a manger filled with straw and a visit from three wise men to an infant illuminated by a single star. The Magi set out to see if the prophecies were fulfilled. At the meeting, they presented gifts of gold, frankincense and myrrh.

Now gold we can all understand and still use today.
Frankincense is also pretty obvious, I mean look at their surroundings.
“Here’s a little something to combat the eau de stable.”

But myrrh, does anyone know what this is? I’ve read that it is primitive embalming fluid, great thing to give to a baby, right? I’m wondering if it was the fruitcake of the day. The one guy was thinking, (use your best Yiddish accent)
“Oye Vey! Vhat if it turns out he’s not the savior?”
So he stopped off at the Dollar Tent and said to the others,
“I’m not taking any chances not giving a gift, but if it doesn’t work out, I’m only in for a buck.”

The proud parents were probably very polite upon accepting it but you just know they were thinking,
“What the Jesus, Mary and Joseph are we going to do with this?”
Mary’s wheels were already spinning,
“I’m saving this to give to Joe’s mom next Christmas.”

And so a second new holiday tradition, called re-gifting, was launched and that bottle of myrrh is still being passed around today. You’ll probably get it from the person you gave the fruitcake to last year.

--------------------------------------------

Christmas Day falls right in the middle Hannukah this year, does that make it a Blue Christmas? Speaking of, I can’t get that tune out of my head. I figure it may have something to do with Renee lying in a hospital bed while Cassidy rips through her presents that Santa left under the tree. Yes, Cassidy gets the best of both worlds. We celebrate both Christmas and Hannukah in our house. But this year things are much more subdued. It’s not necessarily the economy, hmmm, I wonder what it is?

While many of you were gathering with friends and family last evening and dining on such delicacies as pigs feet, the doctors orders for Renee were NPO. This somehow translates to nothing by mouth. No latkes, no Christmas pie, I wasn’t even allowed to slip her the gelatin from the pigs feet. (I wish I could see the faces of people who just went EE-YEW!) But our patient is taking it well.

A shout out goes to Renee’s Mom and Dad today as they celebrate their 47th wedding anniversary. They’ll be enjoying a fancy meal at The Manor this evening with candles, chamber music, tuxedoed waiters - and Renee’s 92 year old grandmother and brother Jeffery in tow, how romantic!

I have decided there are really only two songs I need to listen to on Christmas. The first is The Band’s ‘Christmas Must Be Tonight.’ The other is Robert Earle Keen’s ‘Christmas With The Family.’ Neither one gets the redundancy of Nat King Cole or Bing Crosby but together they capture the essence of Christmas - religion and reality.

Cassidy and I are off now to see Renee “in hospital.” We wish instead we were visiting with all of you.

From our home (and Baptist East Hospital) to yours we wish you all a very Merry Christmas!

Accidents will happen

We got a call from the doctor’s office at about 2:30PM yesterday asking if we were thinking about showing up at the hospital anytime soon. They said the doctor was waiting. Oh, really? Well we’ve been waiting since 9 o’clock this morning for you to call us and tell us just which hospital we’re supposed to be checking into and when. No apologies, of course, just orders to get to the hospital ASAP.

We got Renee settled in to room 629 at Baptist East a little after 4:00. It’s a lovely corner penthouse suite with views of Bowling Boulevard. They did all the routine quizzes about medications and why are you here. The set up an IV line and drew blood. The blood nurse said “Oh I just missed the IV Nurse? Too bad I could have saved you from being stuck twice.” Why the heck can’t hospitals coordinate this stuff better? It’s no secret that if you’re sticking an IV in someone that you’ll most likely need to have blood drawn.

A couple of minutes later they showed up with dinner, a tray full of broccoli and other harsh on the stomach vegetables and what may have been chicken breast. One, she’s on a soft GI diet; two, she can’t have dinner she going for a CT Scan soon and they want her stomach empty for it. What a waste.
Shortly after, they hooked up three different antibiotics to the IV tube. At about 5:45 they brought in two quarts of barium. The nurse that dropped them off said that the results of the scan won’t be viewed by the doctors until morning. There was nothing more that I could do here so after a while I headed out and picked Cassidy up from the next door neighbors.

This morning I got to the hospital a little before nine. Surprisingly the doctor had not yet been in. The surgeon came in a few minutes later and told us the result of the scan and the options available. One was to open Renee back up at the incision and drain the infection that they identified and scrub all the areas around it. Or two, was to place Renee back into the CT Scanner and use it to pinpoint the abscess. The Radiologist would then insert a needle into the abscess and drain the pus. They would then insert a small tube in order for any remaining infection to drain out. He said right now that it would be better to go for option two. We agreed. Good, he said. He then said they wanted to do it today and hopefully get started within the hour.

Shortly following Cantor Lipp came for a visit bearing gifts from the congregation. So here I am the Catholic boy sitting with the Cantor on Christmas Eve. Renee starts pining about how she’s screwing up the holidays and the Cantor jokes that she must be feeling like the Grinch. And sarcastically adding that he’s sure she did all this on purpose to mess everything up. I, of course took it a step further by saying that while they’re doing all the x-rays maybe they can find your heart. The Cantor groaned, Renee bristled and the nurse who was standing over Renee couldn’t stifle her laugh. Too harsh? Nah, we all needed a laugh.

The nurse was there to administer Demerol preceding the drain insertion. Renee said, “Whew, what was that? It went straight to my head.” A few minutes later the nurse brought in a hospital gown, Renee was in her pajamas, and told her to change. Well the Demerol must have been working extremely well because Renee nearly stripped in front of the Cantor before I sprung up and stopped her. I’m not sure that she didn’t flash him.

So here’s another totally inappropriate snippet to commemorate the occasion:
To the tune of Elvis Costello’s Accidents Will Happen:

Accidental nipple, it was not a flirt
She was quite embarrassed when
It fell out of her shirt
Accidental nipple so perky and upright
I thought I wasn’t hungry but
I could go for a
I could go for a
I could go for a … bite

Surprisingly the Cantor returned after Renee got changed. He gave Renee an AJ blanket and a planter of pens made into flowers. Very nice, Thank you. But he's probably thinking that the appropriate gift would have been Bourbon Street beads.

They took Renee at about 10:30 for the procedure. She returned a little after 1:00PM with a contraption that looks like the pump to a blood pressure sleeve hanging off of her side. She’s got to stay in for monitoring now for at least a couple of days. Gotta go. Tune in tomorrow for a special Christmas message.

Thrill Seekers

Man, it’s a good thing I like roller coasters. Renee and I used to have season tickets to Six Flags Great Adventure in Jackson, NJ. Pre-Cassidy we would go out there on Saturday nights and see a concert at the arena and then ride Rolling Thunder, an old wooden coaster, three or four times in a row. We’d always sit in the back car. When you went over the rolling hills you’d come out of your seat. It was a great thrill. Rolling Thunder’s got nothing on this ride.

Two anniversaries to celebrate today, it is one year ago today that Renee was released from the hospital from her colon flare-up and today is also the three week anniversary of Renee’s colon removal surgery. She is quick to tell anyone that she would not wish this disease on her worst enemy.

Yesterday was tough. Renee said she feels like she’s going backwards. It is at these times I need to put my coach’s cap on and provide positive reinforcement. Especially with these little setbacks it is hard for her to see the progress she’s making. I’m doing my best to keep her spirits high but still it was another restless night filled with moaning and groaning. And then ….

It is not uncommon in our house to have the phone ring before 9:00AM and the caller ID showing a doctor’s office. It is uncommon for the doctor herself to be on the line. A day early on the CT scan results, no news is good news so this must mean …another trip to the hospital.

There is inflammation in the small intestine. There is an abscess in the fat pad over the bowel on the incision. The family doctor has conferred with the gastroenterologist, there does not appear to be any obstruction, but they are not taking any chances. Renee is being admitted to the hospital here in Louisville for a dose of intravenous antibiotics and to also have another scan, this time with the IV contrast. They couldn’t see the full picture with yesterday’s results and they don’t know why. They are also calling the surgeon at the Cleveland Clinic for consult.

The doctor said that there is a possibility that they may need to go in and take a look at the abscess and to see what is causing the inflammation. They have lined up a local surgeon whom they say we can trust is excellent. We are now in a holding pattern waiting to hear which hospital and what time to report.

Wheee!

Whoa, I got the fever

To the doctor's office again today, this time to check out this fever business. The doc doesn't like that the antibiotic for the drainage situation is not also taking care of the sinus blockage. She's thinking there is more to this than a bout of sinusitis. She orders blood work, of course. Can't go more than a couple days without poking a hole in the patient. She also orders a CT Scan of the abdomen and pelvis.

It was 2:45 and they told us you need to get to the diagnostic imaging center by 3:00. No problem. I've got a wife who's shuffling slower than a one armed blackjack dealer and you want us to sprint across town. We made it at exactly 3:00PM, to the parking lot that is. It took another ten minutes for Renee to walk back to the office.

We checked in and again went through all the verification of paperwork. The doctor's office failed to put a diagnosis on the requisite from so there was extra time waiting for the trading of phone calls and faxes to find out if Renee had to take Barium and get IV contrast. At 4:00PM they finally figured out that it was to be barium only. The technician gave Renee a cup of what is supposed to be some easy on the stomach barium. She downed it and then we had to wait an hour before they took the pictures.

This is all grueling for me but for Renee its excruciating. It's not easy getting comfortable in a waiting room chair when you're healthy but when your gut is still sore from surgery and you've got a fever and you just downed a quart of liquid metal, well it's impossible. They took Renee in a little past 5:00PM. After a quick stop at the grocery and another to pick up Cassidy from her friend's house, we finally made it home at about 6:00PM. Renee ate a small dinner and went right to bed.

The results of the scan won't be available for the doctor until the 24th. We're hoping Santa only has good surprises for us come Christmas Eve.

Happy Winter and Happy Hannukah!

The staples are all gone. Renee wouldn't let me take them out. I don't know why. She'll let me change her bag but not pull a couple of staples? Oh well, I'll just have to find someone else to practice on.

The fever is still here, it's hovering around 101. The nurse wants us to see the family doctor tomorrow and hopefully figure out what's causing it. Renee's on antibiotics so it shouldn't be from the incision drainage.

I'm probably jumping the gun but Renee's down to two pain pills a day. And no it has nothing to do with her parent's thinking that she's becoming an addict. The doc says if you need them them take them. Don't suffer if there's relief available. Luckily the pain is reducing normally through the healing process.

The drainage continues but no one thinks it's abnormal or worrisome. A light dressing changed a couple times a day is keeping it clean and dry.

It is the first night of both Hannukah and Winter so in honor of this auspicious occasion I offer the following:

Hannukah Solstice
By Bob Masterson

Awake ye maidens of winter
Unfold your blanket of white
The shortest day’s upon us
The sun gives way to night

Unwrap your olden candles
Eight torches glowing bright
Retell the tales of splendor
And ancient text recite

A miracle has happened
The Temple was the site
Of the first oil crisis
Low fuel that stayed alight

Bring forth your merry tidings
Exchange rewards tonight
Celebrate the season
In Festivals of Light

Cut the Cord?

Renee’s little adventure to the pre-school yesterday really knocked her out. It drained what little energy she had and brought on a slight fever. The warm weather yesterday also sparked a sinus headache. There was a work party last night that she had every good intention of attending but her strength was sapped. She’s still feeling it today.

This afternoon, Renee’s Mom who has been here since just past Thanksgiving has returned to NJ. I had to wait until she left to say this, you know all that family tension and stuff, but she was a …, a …, a … huge help. You didn’t really think I was going to say something less than nice, did you? I don’t want her getting a big head about it but she did an outstanding job holding down the fort while Renee and I slugged through Cleveland. This, at least, allowed Cassidy to keep a little stability to her schedule.Having Renee’s Mom close by for support during the initial phase of recovery was also extremely helpful. THANK YOU Gale!

Cassidy was disappointed she couldn’t travel back with her Sugar Nana but no matter how much the girls thought this to be a good idea, I think Renee’s better with her close by. Now that her mom has gone home, she needs that other mother-daughter bond working full-time.

Yesterday was the one year anniversary of Renee’s Emergency Room outing which turned into a five day stay over. It was the forewarning to this year’s medical events.

We were scheduled to head east on Monday but for the second year in a row Renee's hospital visits have trumped our Holiday visits. We just canceled the kennels for Polly and we’re hunkering down here for the Winter Solstice and the foreseeable future.

Renee’s current mood – delivered with an Elvis twitch:

I’m Locked up in Louisville
Oh, I can’t go forward and I can’t sit still
I’m uh .. locked up in Louisville
Feelin’ under the weather and over the hill
I’m uh .. locked up in Louisville

Slowly I turned, step by step

Renee put on her Susquehanna Hat and ventured out today. Don’t worry she had a chaperone and she wasn’t going anywhere near Niagara Falls. (Oh no, you’ve said it now!) But she did head toward Bagel Street, well close, to the Temple Pre-School. The youngsters will need to check out Abbott & Costello on YouTube for translation (links below).

Renee was moving pretty slow getting ready and shuffling toward the car. But, she felt compelled to visit her co-workers and the kids in the Duck Class. It was her first trip out of the house except for the doctor visit on Tuesday. Her mother accompanied her so I don’t know what transpired. She was back in an hour and said she couldn’t believe how much energy that took. Renee was wiped out and went straight to bed. Right now I’ve got no further info.

The home care nurse was in yesterday. Renee’s drainage from the incision is slowing down. She pulled a couple more staples but left about four inches worth along the bottom length of the rift. She was reluctant to pull them all as both she and the doctor had mentioned that the wound could split open when soft from the seepage.Neither one of them wants Renee moving around with whatever’s left of her insides hanging out. Excuse me? Isn’t that what the surgeon did on purpose? Apparently it’s only OK if it is predetermined which parts get to air themselves out.

The rest of the staples are scheduled to come out on Sunday. I didn’t know this until today but the hospital sent home a Skin Staple Remover. Whoowee! I can’t wait until Renee goes to sleep Saturday night. I’m not waiting for the nurse. I’m going in and yanking the rest. I’ve got to work on my new career (Certified Staple Remover Specialist if you weren’t paying attention earlier) and I think Renee should support me.

What do you think?
Do It?
Don’t do it?
C’mon, someone dare me.

Just don’t mention Niagara Falls or the Susquehanna Hat Company I may not be able to control myself.

http://www.youtube.com/watch?v=-WIQ67vRg6c

http://www.youtube.com/watch?v=9pQii1L8fGk&feature=related

Office supplies

Times are tough, the expensive stuff is easy to get but it seems everyone has trouble with stocking the basics.

Yesterday we visited Renee’s gastroenterologist here in Louisville. On Sunday, the home care nurse called and set it up for us. Renee’s got incision drainage, swelled feet, throbbing in the gut and a pain in the ass that surprisingly isn’t me this time. The on-call physician, after being told of the symptoms, said come on in on Monday. On Monday, the office called and said we can’t squeeze you in. How’s Tuesday? Great, I got one extra day of changing wound dressings every three hours. A nursemaid’s job is never done.

Upon check in, we were, of course, handed the clipboard for the mandatory redundant paperwork. Yes it’s the same insurance, Why are you here today? Because the doctor who works here said to come. Check off all of the exotic diseases you contracted since the last time you were here. Any surgeries? Well yes, that’s why we’re here. Are you allergic to anything? Yes, doctor’s office questionnaires.

We turned in the completed forms along with a list of medications and were shown to the examining room. We laid out the problems for the nurse and said that we think the staples need to come out also. We got a real quizzical look on this one.

The doctor came in and we went over everything that happened in Cleveland. This is the doctor I mentioned in one of the earliest posts. Renee’s really comfortable with him and so am I. He’s got a good attitude and is easy to talk to. He explains things in plain English and has a sense of humor. He told Renee that she’ll be hurting for a while and categorized her hospital complications resulting in the insertion of the NG tube as minor. Doctors have such a different perspective than the rest of us. He wasn’t too concerned about the ooze from the wound but prescribed antibiotics just in case of infection.

Again the staple question came up and the doctor said, “I’m not a surgeon.” He reminded me of Bones from Star Trek, “Dammit, Jim. I’m a doctor not a surgeon.” But he did say that at least some of them should come out. They did some digging around the office but couldn’t find a medical staple remover. I asked, “Is this really a doctor’s office?” You could tell he just wasn’t equipped for this task. Most people return to the surgeon’s office for this but that’s a little off the beaten path so we needed someone local. We never thought for a minute that we needed a specialist. I wonder if I started training for that now if I could be good enough to do it full time after I retire. I’m looking for a promotion from nursemaid already – Bob, Certified Staple Remover Specialist.

At this point , Renee was asking if she should go the Emergency Room as the chance of getting this simple procedure completed here was quickly diminishing. The doc said, you don’t want to do that. You’ll be there for six hours waiting and then they’ll run a battery of tests before they even acknowledge that you have staples. He was determined to figure this one out.

The doc popped out for a few minutes and came back with the proper tool. He borrowed it from the surgeon’s office down the hall. I asked Renee, “How much is that going to cost you?” The doc just grumbled. Now both Renee and I are wondering if he knows how to use it. Face it doc, you didn’t give us a whole lot of confidence. But he pulled half of the staples without too much trouble. He left the rest for the home health care nurse and wrote a prescription for it to be done.

He wrote us down for a couple of other prescriptions to help ease Renee’s torture and told her to return in two weeks. He said he wants to monitor her pretty closely which was reassuring considering the surgeon is 350 miles away. We yucked it up for a few more minutes and he sent us on our way after some more bloodletting into a test tube.

At least now I think I know what to get a certain doctor for Christmas, I’m mailing him a coupon to Staples.

You ooze you lose

Eleven days in the hospital and all types of different surgical issues to deal with yet not once did the incision come into play. One day at home and the base of the stapled divide has decided to expel some slime. The home care nurse who made her second visit today wasn’t happy about it. We’re off to have the doctor check it out tomorrow.

Depending on what the Doc says the staples may come out tomorrow also. Renee won’t let me do it. I don’t know why. I operate a pretty mean staple remover.

We’re up to about 24 hours nausea free. Renee hasn’t taken the medicine to control the sensation all day. Her gut reaction to the introduction of small meals has been good.

Speaking of the home care nurse, she helped Renee change the bag today. Her methods differed considerably from the hospital nurses. The biggest difference is she had Renee sit up for this. In the hospital we were instructed to lie down if you have an assistant. Right in the middle of the changeover, Renee performed a stoma chuck and made a complete mess of the bathroom. To make matters worse about a half hour after the nurse had left, Renee discovered that the seal around the bag was leaking. This left even more of a mess to clean up.

Nurse Bob to the rescue, I donned my scrubs and gloves and dove in. I had been paying attention when the Stoma Nurse in the hospital gave the how to. Maybe the home care nurse needs a refresher.

Things are always a little different in practice than when you watch so it was slow going. I got the leaky bag off as there was no way to plug the seal. While Renee cringed and moaned, I cleaned the goop and crud from around the stoma, cut and attached the new bag. That seal is now tighter than a duck’s rear. The only problem may be getting it off. You are supposed to use superglue right Renee? I’ll let the weekday nurse figure that one out.

So there it was, our first ‘bagcident’ and we survived. Now excuse me while I go hose myself down.

Exit Stage Left

And away we go …

Uh, not so fast Snagglepuss.

I got to the hospital pretty early expecting good news based on Renee’s recent improvements. I was not disappointed. I was hardly in the door when Renee said, “I’m going home.”

But what is this, the IV was hooked back up? Renee’s potassium level dropped during the night so they had to crank her back up. Not to worry its coming back off. The nurse brought in some oral pain meds and said she’d go start the paperwork for discharge. A few minutes later without warning nausea grew and though she did not purge, Renee let out a vurp for the ages. (Vurp – for the uninitiated, is a vomit tinged burp. No I didn’t make that one up, but I wish I had.) This really shook up our patient, literally, figuratively and emotionally. She said, “I can’t do this.” A pretty soggy breakdown ensued.

The nurse observed a good portion of this as well as the physician’s assistant. We all took our turns and talked her through it. As Renee admitted, she’s scared. I could tell this yesterday and knew this was coming. This is operation number four, its straight out of the Renee playbook. She is entitled to her breakdown and as I told her, “let it out.”

Renee was still trying to compose herself when her roommate, Dawn, offered to her why she was nauseous. They had given her the pain meds on an empty stomach and they should be taken with food. Dawn is a young pro at this, a Colitis sufferer since the age of eight, she knows the territory. She’s also a nurse when she’s not a patient. Her Mom then came over and had a nice chat with Renee. Their intervention helped to settle Renee down and resign herself to getting out of the hospital. Thank you.

Renee hit the shower. I was joking around telling her I wasn’t going to let her in the car smelling like that. She took me at my word. I already have a no puking in the car rule which in Renee’s case makes for some mighty adventurous pullovers. In all honesty, she hadn’t showered in two weeks and was exhibiting a pungency reminiscent of the NY/NJ Port Authority’s men’s room on a rainy day.

During Renee’s scrub down the nurse came in and said now she’s not sure if they are going to release her and if they were so inclined it would be late in the afternoon. I gave her a ‘we’ll see’ look. Renee’s baring of her anxiety had scared the staff more than I or Renee. They didn’t want to release an emotional wreck from the hospital. This is understandable but Renee cleared it up when she emerged from the shower fresh and feisty. She told the nurse “I’m ready to go now and if you’re not letting me go home then you better admit me to the psychiatric ward.”

The nurse returned a couple minutes later with the good news. We went through all the usual checkout procedures and had a last minute visit from the Stoma Nurse with some clarifications and pointers. At 12:30PM, we were on our way south on I-71.

I-71 begins in downtown Louisville and ends in Downtown Cleveland. You don’t need mapquest to figure out the return trip. We hit numerous snow squalls throughout, heavy traffic though Columbus and rush hour standstills through Cincinnati. Renee needed to stretch a few times but was mostly dozing from the combination of Oxycodone for pain and Phenegren for nausea.

We pulled in to the driveway at about 7:20PM to balloons and hugs from Renee’s Mom and Cassidy but I think Polly was more excited to see Renee than either of them. It’s good to be home.

They giveth, they taketh away

Thursday AM – The catheter came out at 11:00AM yesterday. Renee was given eight hours to void her bladder, a strange way to say pee. Even the hospital staff has trouble dealing with the terminology of releasing bodily waste. Every 20 minutes they were coming in and asking, “Have you voided?”
“Huh? Oh, you mean pee. No not yet.” Geez, speak English.

At about 3:30PM, after a couple of false alarms, the time had come and Renee emerged from the bathroom saying, “Drinks are on me. I peed.” Um, don’t you mean voided?

Renee said that during the night she had to hit the nurse’s button. She got scared when she heard some loud rumblings from her innards and she called for help not knowing what was happening. She was thinking the movie Alien. Her organs have all awakened with a vengeance and are screaming out to let her know. It is a little disconcerting hearing these different noises. Yes, they are completely discernable to anyone in the room. Renee’s bowels have not been functioning properly for over a year and now they are set up a bit differently. She can’t even remember what they’re supposed to sound like. Then, you have the addition of a plastic collection bag glued to her side. As it fills you have various tunes being played out ranging from a soothing mountain stream trickle to a wet whoopee cushion. It’s going to take some getting used to.

This morning about 8:45AM they administered Percoset orally. Food Services showed up about the same time with, wonder of all wonders, food. Eggs and French Toast were on the plate and Renee was allowed to eat them, slowly, with a warning to take it easy. She managed a few bites and understandably felt a little queasy. It’s been a while since anything solid has hit her stomach.

Renee got cleaned up and we went for a walk. On our return, the nurse disconnected the IV pain pump. I don’t think I mentioned it but they reconnected the pump on Saturday during all the hoopla. They knew at that point it would be a while before we were leaving and Renee’s pain level had jumped back to 10. She’s at a 2-3 level now. Then they continued to disconnect the other IV lines. She’s still got two needles in, just in case a reconnect is needed, but she is currently unencumbered by hoses and wires - Freedom.

She has taken her first walk without her IV cart and managed pretty well holding on to the hallway railings. Renee is currently sitting up and eating lunch, mashed potatoes, green beans and turkey. They have given us word that discharge may be as early as tomorrow but more likely Saturday.

Progress, progress, progress.

With advancement toward release comes the realization that the stoma and bag are for real. Renee showed some reluctance and some raw emotion when the nurse told her that she had to empty her own bag from here on out. I was told, quietly on the side, that although they are teaching me how that Renee should be doing this on her own. It helps with the full acceptance. This is part of her life now and after the pain of surgery has subsided will help to improve her quality of health back to a level she has not enjoyed in years. Right now that does not make the reality any easier.

Hump Day

Wednesday morning update:

Renee’s doing well without the NG tube. As I said last night it looks like the catheter comes out today. We still have some questions about the amount of discharge from the rectum and the doctors are monitoring. A light room temperature liquid diet will be introduced around lunch time. Renee’s oxygen level was just measured at 96. She’s read through all of her magazines and is starting to watch a little TV. Walks are coming more frequently and the bed is starting to annoy her, all good signs.

She still wants no part of the computer and due to the pain meds it is doubtful that she remembers anything I’ve read to her. But don’t let that stop you from commenting. I’ll even have to start responding to a few that I’ve been too distracted to focus on.

Renee continues to expand on her visions that took her on her little vacation the other night. They keep getting wilder. So I’ve written the following in honor of her new no so favorite drug. It’s a pub tune so grab a glass of your beverage of choice and sing along.

Thorazine
To the tune of Moonshiner

I’ve been a good patient
For many a year
I’ve took all me meds
That they’ve given here
But I got the hiccups
And they just wouldn’t flee
so they gave me a shot of
chemical lobotomy

Oh, thorazine, Oh, thorazine
Oh, how I hate thee
You messed up my mind
On just 10cc
I can’t eat when I’m hungry
I can’t drink when I’m dry
And if thorazine don’t kill me
I just might survive

You don’t cure my hiccups
Hallucinations you bring
The visions I see
They don’t mean a thing
My neck is all twitchy
My brain’s ill at ease
They treated the symptom
But not the disease

Together now,

Oh, thorazine, Oh, thorazine
Oh, how I hate thee
You messed up my mind
On just 10cc
I can’t eat when I’m hungry
I can’t drink when I’m dry
And if thorazine don’t kill me
I just might survive

Breakdown, go ahead give it to me

Yesterday, I began reading your comments plus all that I have written since pre-op to Renee. Soon she’ll be up to speed. It is a little tough though, she told me I’m not allowed to make her cry (it hurts) or laugh (it hurts more). This limits my repertoire.

Last night was a night of sleeplessness followed a morning of turmoil. Renee was walking the halls at midnight, unescorted and breaking the rules (see leaf sticker on bracelet). Over a week in the hospital bed has screwed up her internal clock so sleep comes when it comes and being wide awake can happen at any time. All the hospital disruptions will also wreak havoc on your sleep schedule.

The posse of doctors showed up at 6:00AM. They travel in groups. I guess they think there is safety in numbers. But it’s really because this is a teaching hospital and if you’ve seen Scrubs you know that they travel in packs with the leader showing off for the cubs. The leader was not happy that Renee’s been melting ice chips in her mouth. She was told nothing by mouth while the NG tube is in. “It screws up the measurements,” he said. He canceled a scheduled CT Scan because he said ALL that fluid from the ice will mess up the pictures. It wasn’t her fault. The nurses gave them to her. She thought the order had been rescinded. Now Dr. Never Learned Any Bedside Manners has got her thinking that she’s set back her recovery even further.

He really upset Renee. She had a breakdown over it when telling the nurse, then telling me, then telling her mom. It was a triple play. Thanks doc, good way to build the morale of the patient. Where's Molly the Therapy Dog when you need her?

Renee’s had almost nothing by mouth except a couple of spoonfuls of ice chips since Friday. The doctor expects her to survive for four straight days on nothing but a mouth swab, a soft sponge on a stick that you dip in water and rub in your mouth. One nurse called it cruel and unusual punishment. Her blood sugar dropped yesterday to 57 and 70 is the absolute minimum they’ll allow. They slipped Renee an ice pop but it didn’t raise it enough. They had to follow up with some sugar water solution to get her back in range.

Good news:
The physician’s assistant came in this morning and adjusted the NG tube. X-rays yesterday showed that it was kinked. At 2:00PM they clamped it off. At 6:00PM they reconnected to see how much nasty goop they could suck out, if less than 200 ML then the tube comes out and Renee gets to slowly start back on fluids. Almost nil was recorded so this is a good indication of the awakening of the bowels. The tube was immediately extracted. Our Pinocchio has turned into a little girl.

Tomorrow, hopefully, we’ll address the tube at the other end - Hellooooo tube.

After a rough three day weekend it looks like Renee is back to work on the hard job of recovery.

Enter and sign in please

We’re pretty much on our own up here but that doesn’t mean we don’t get visitors. Yesterday, Rabbi Pepperstone, formerly of Louisville, dropped by. He lives up here in the Cleveland area now.

Today we had a hospital volunteer stop by, an older gentleman who has lived with a colostomy bag for 58 years. He had some great post WWII stories and also told us about an organization that collects excess colostomy supplies and sends them to third world countries.

Rabbi Schecter made a return visit and a couple of ladies from a Jewish services group.

Renee has also got a new roommate. She lives in NJ and is a Giant’s fan. We talked about Taylor Ham and bagels and bread and pizza and Jersey life in general. She’s on her own here following surgery. Her mom won’t be back until she’s released and it’s time to drive her back home. She’s from the land of the Sunday Blue Laws. If you ain’t from Joizey you probly have no ideeya what I’m talkin’ ‘bout.

But the biggest hit of the day was a visit from Molly and as they say a picture is worth a thousand words.

Molly is a Therapy Dog. She stops by the hospital every Monday. She lifts the spirits of patients by just showing up. The Colorectal Surgery floor is the only adult patient area that is currently enjoying Molly's company.

Laundry

It’s Miscellany Monday, just a laundry list of stuff.

It’s Monday morning. Renee is looking a lot better but we got word that it will be a couple to a few days before we think about release.

The NG Tube is still in. That’s the nasal tube. Renee just asked, “What does NG stand for?” We’ll find out, but I’m betting on Nasty Goop.

O2 is off. Good

All of you pre-school teachers will appreciate this one. Renee got a sticker last night. A little leaf sticker is on her wrist band and by the door. But, it’s not for good work it’s for ‘patient prone to falling.’ She said I told them that she’s a klutz. I didn’t. They figured it out all on their own.

Speaking of laundry, I had to do my own last night. Renee didn’t even offer to get out of bed, come to the hotel and do it for me. And all I do for her. It was a modest miracle but somehow I ended up with the same number of socks I started out with. See, I’m no good at this stuff. So I’m not planning on making it a habit.

It’s off topic but a brief in this morning’s paper caught my eye. Heiress Martha “Sunny” Von Bulow died after 28 years in a coma. I wonder how old Claus is taking it? I wrote this a while ago and I don’t know why. So, here’s to you Sunny:

Stand In The Rain
By Bob Masterson

Comatose, frozen
Wired and caged
Medicine pumped through my veins

I lie here screaming
But not making a sound
How long til I go insane?

My soul is alive
My soul is alive
But my body is useless and lame

I want to move from this bed
Step into the night and
Stand in the pouring rain
I want to stand out in the rain

I’m lost on the inside
I can’t see the outside
I can’t even feel my own pain
I want to move from this bed
I just want to move
And stand out in the rain

I want to stand out in the rain

A machine for my breathing
Keeps my heart beating
A machine hooked to my brain
I can’t feel my body
All I have is my thoughts
I think I want to stand in the rain

I think I want to stand in the rain
I think I want to stand in the rain
I just want to stand in the rain
Won’t someone bring me out in the rain?

I think …….

House - Part 2

You do know that House never gets to the real answer in the first half hour, right?

The drama continues.

Of course the sleepwalking diagnosis was a little off base. According to our patient this morning, they were full blown hallucinations and they continued on well past where I and the doctors knew. Renee just wasn’t sharing last night, either because of pain or maybe she just wasn’t able to communicate what was going on in her head. Just to be sure we’re never going to let them administer thorazine again.

Renee took a great little trip yesterday back to the Temple Pre-School in Louisville and some kind of exercise with the kids building stick people out of butter. She then traveled to a car dealership in Brick, NJ and saw a palm tree on its side and lights coming out of it. This was during the CT Scan, well after we thought she was back with us in the real world. She then went on to Cassidy’s old cardiologist’s office, also in Brick.

Wow! The Grateful Dead wasn’t even in town. Coincidentally, there was a PBS show on the other night I watched about the great songs of the 60’s hosted by Michelle Phillips of the Mama’s and Papa’s. In-A-Gada-Da-Vi-Da and other psychedelic nonsense tunes were featured. Didn’t come close to the long strange trip Renee took.

I don’t think we can blame the introduction of just one drug for hiccups as the single issue in Renee’s surreal tour of the country. The pressure on Renee’s lungs, esophagus and diaphragm from the build up in her stomach had a lot to do with it I’m sure. The pain meds were probably a pretty big factor, also. Whatever it was, it sure sprang nearly this whole hospital into action to figure out how to fix it quick.

This morning things are so much calmer. Renee was sitting up when I got here. We got her cleaned up and changed. The attending physician came in and said they canceled the additional CT Scan. He remarked that Renee looked “clinically good.” This was a big improvement over yesterday where she looked, I guess, clinically like sh*!.

After the wash-up, Renee was ordered to take a walk. She did good. One of the nurses, the one who held Renee up when she teetered on yesterday’s walk, commented that she looked different this morning. “Oh, you’ve got the nose tube and oxygen.” (Renee calls it her Pinocchio nose.) Renee replied that it was all part of the new winter fashions. “It’s all about the bling,” she added. This got the nurse laughing and sharing the line with others.

I think we’ve got our girl back. Hopefully, we can keep it light from here forward. Now, someone please send a wake up call to those bowels so we can get Renee well enough to get the heck out of here!

House

You've seen or heard of the show, House, the know-it-all doctor. Well I'm not, but today I'm playing one on TV. I'm putting my white smock and stethoscope on - how do I look? - just because it's my blog.

A couple of hours of sleep and a hot shower will allow you to gather your thoughts and re-evaluate what you saw during the previous day. And I'm doing it without the drugs or a cane. Here's my theory on yesterday's confusion/delusion/hallucination episode with Renee.

It was none of those.

She was sleepwalking. Yep, she started talking in her sleep after things calmed down a little later so there my clue and that's my theory. Some kind of drug interaction, maybe adding thorazine to the mix for hiccups, spurred some heavy dream activity. When she felt the discharge from her rectum. She bolted the bed still sleeping, dreaming that something else was happening - the butter experiment comment. I thought she was waking up and talking to me but now I think she was sleeping the whole time. She didn't wake until the doctor got there and started asking the tough questions.

So there you go. That is my unprofessional opinion in less than 30 minutes and no commercials.

Now I'm off to solve the rest of the medical mysteries of our patient.

Stay tuned.

Hiccup - Part 2

I wrote Hiccup – Part 1 between 2:00 and 2:30PM Saturday. The following is the rest of the day.

This morning after her walk Renee complained about a shortness of breath. The nurse took all her vital signs which looked good including oxygen. The O2 number was 93. They look for a 93-100 range.

A little after 3:00PM, Renee woke from a nap. She was talking to me then all of a sudden she swung her feet over the side of the bed and got up. I jumped up to help her. I noticed some blood so made her stop in her tracks and rung the nurse.

We got Renee back in the bed so they could check her out before she goes strolling. But the quick exit from the bed disoriented her. For a few minutes she didn’t know where she was. She said she was in the wrong room, this one was too small. The nurse’s assistant was there at the time. I said, “she’s delusional.” She went for the nurse. The nurse came in and Renee then said that she was at school and they were doing a butter experiment. I said to her “she’s hallucinating.” She went running for help. Before long we had two nurses, a doctor and the assistant at her side.

The doctor started questioning her. “What’s your name?” What’s the year?” Where are you?” They put the oxygen back on her. Renee answered all the questions correctly. She was back with us. The doc did a quick rectal exam, the source of the blood. The blood was just some discharge left over from surgery. Nothing to worry about, but the confusion, this made the doctor concerned. The nurses were working feverishly to find a vein in order to take some blood samples. They were not having much luck vein fishing as I called it. Renee was saying “That’s enough, give up already.” The doctor was still asking questions, “Where does it hurt?” Renee said her chest. She pointed to the spot. Tests were ordered, EKG, chest X-ray both performed bedside. The doctor kept getting beeped for other patient problems but wasn’t leaving. A portable workstation for the doctor was set up at the foot of the bed. Nurses were coming to the room to ask her questions about those other problems. She told me she was going to stick around for a while until she figured out what was going on.

The EKG looked OK to the doctor but she sent it off to a heart specialist to be sure. The heart specialist said it looked good also but was concerned about the lungs. He ordered a CT Scan to check for a clot in the lungs. He said the hiccups were an indicator.

They put Renee in a wheelchair, attached two IV pumps and four IV bags and an oxygen canister and grabbed her chart. We were almost out the door when they remembered to empty her colostomy bag before it blew up. Another false start when the nurse said she better change out the saline drip. Finally, with Renee’s head tilted to the side away from the pump units and almost doubled over with abdominal pain, we hustled to the basement where they hide the heavy equipment. Luckily the wait for the scan was short and she was in and out in under fifteen minutes. But now we had to wait for transport back upstairs.

Renee’s pain was increasing. She had just endured a blood letting, a fantasy trip back to school, hours of poking, prodding and inquisition. In all of the excitement they had forgotten about her pain meds. I asked the CT Scan operator if transport was coming. He took a look at Renee, grabbed her chart and pushed her down the hall to X-ray, an unscheduled stop. Nobody had told us about another X-Ray but he showed me. It was written in big bold letters on the front of her chart. Another quick batch of photos and Renee was back with me waiting again for transport.

Renee could not tolerate the pain any longer, she was moaning. I went to the desk and inquired about transport. She called and checked. They’ll get here as soon as someone is freed up, she said. I asked if I could just wheel her back up but this is not allowed. I guess the moaning got to her because she came out of her office and pushed Renee back to her room. That’s two employees who left their stations to help out a patient. We were very thankful and said so.

The night nurse who had just come on and I got Renee re-situated in bed after detangling the IV hoses. When the nurse finally brought the pain medication she said, hey, it’s been a while since you had this. No kidding, really?

Another doctor came in a very short while later and said the CT Scan was negative for clots in the lungs and that the heart also looks good. He was recommending another CT Scan for the stomach and bowels because they only did the chest area. He said that Renee’s stomach was distended. He went to consult with another higher level physician first.

A few minutes later a nurse and an assistant came in with a big pitcher and hoses which they started putting together. They told us the doctor ordered the insertion of a nose tube to extract the fluids from the stomach. They explained what was going on to Renee and then asked me to leave while they installed the apparatus.

I returned after they were finished and Renee had already filled one pitcher and they were coming to empty the second. About fifteen minutes later the two doctors came in and said they may still order the other CT Scan. The problems they think stems from Renee’s bladder and bowels which are still in sleep mode from the surgery. It’s backing everything up into the stomach. They think the tube has alleviated the problem but it looks like more testing will be needed to ensure there is not a blockage. They asked Renee if she was feeling better and she said yes. They said you could see it in her face. You could. With this episode finally under control they left. Tomorrow we find out if it is just sleepy organs or an obstruction.

At about 10:30PM, while Renee was dozing, I snuck off to the pantry for a quick bite. When I returned she seemed to be resting peacefully, or as peacefully as one can with tubes stuck in both ends and a big slice up the middle. It was lights out and Renee stirred, so I said my good nights and hit the snow slicked streets of Cleveland.

Hiccup - Part 1

First business today is to send prayers and well wishes to Renee’s cousin Lyle. He is in the hospital. The report I just got is that he is doing well. Lyle’s part of our family support group in Louisville and tolerates a Rutgers grad at U of L football games – that’s me. BTW what was the final score of that game on Thursday? (Hint - at the half, Rutgers was up by 7 touchdowns!) Lyle also performs psychiatric counseling for me during the the rides to the games. Ask him about it when he’s back up and around. We’re 350 miles away but we’re with you buddy. Godspeed back to good health.

Snow is falling as I write this with 1-3 inches predicted. I am sitting in Renee’s room. They told me the WiFi connection wouldn’t work here but they were wrong. I’ve got four solid lines of connectivity. As soon as Renee is up to it I can just pop the laptop in front of her.

8:50AM arrival today, Renee is up and having tea. A new patient is in the next bed. Renee quietly said to me that her visitors were here until 11:00PM last night, all ten of them. It sounded like they were having a party. This is not the kind of night Renee was hoping for when I left. Peace and quiet was what she wanted. I know we can’t ask nurses to be bouncers but sometimes the hospital staff has got to draw the line and call in reinforcements if needed.

Renee’s doing better today. At about 10:00AM we walked the circuit around past the elevators. She did get a little wobbly right toward the end but it was a big improvement over yesterday.

I’m getting pretty good at hooking and unhooking all the devices, cords and tubes that need to be re-arranged for our jaunts. But I wish I could re-program the IV pump to play a different tune when it goes off. I think Renee would be happy with some Clapton. Maybe I can download a Layla ringtone to the thing. If anyone knows how to hack an IV pump send me the info.

Some real good news is that her stoma and bag really started working overnight. This is not only good from the successful surgery standpoint but also for the gut relief. Unfortunately her bladder has still not woken back up and the catheter is still in place.

Some fluids are still being pushed through the IV but slowly Renee is taking a little more by mouth. The progress is sluggish but forward. Renee said that she didn’t think it would be like this. I’m not sure what she expected but this is pretty much how I remember it from her previous surgeries.

This is the second day of hiccups for Renee. We don’t know why. They say it has something to do with her esophagus. They just gave her thorazine to try and stop them.

Wow, food service just delivered a menu for tomorrow. Let’s hope they’re not teasing. Of course her selections are limited to mush based foods for the next six weeks so giving her a full menu is a bit of hospital harassment.

Catch a Wave

One day you've caught that wave, you're riding high. The next, you can't even get up on the board. The surf pounds you and you feel like the undertow is going to sweep you to the sea.

I arrived at the room at just past 9:30AM. Renee was pale and did not look happy. The nurse was by her side. Renee said, "I had a horrible night." I asked why and she just shook her head. Nurse 1 was about to prick her for a new IV line. She left to get some more supplies. I'm not sure how long the IV had been disconnected at this point but it was long enough that they had to administer pain medication orally.

Renee said this is the second time they had to re-do the IV this morning. They changed it early and then she went for a walk. When she returned the line clotted closed. Nurse 1 got a little peeved and scolded Renee saying it was her fault for fiddling with the IV pump while walking. Renee was with a nurse escort on the walk and didn't touch it and told the Nurse 1 so. But either way now you have both a huffy nurse and upset patient and the nurse is about to stick her with a sharp object.

A little background – Renee’s IV pump is electric with a battery. When plugged in it is supposed to charge the battery. After about three minutes unplugged the alarms start dinging. They continue to get louder and more annoying the more you ignore them. They’re a lot like some children (and some adults come to think of it). Any nurse passing by while this thing starts dinging away to “Three Blind Mice” – yes, that’s the alarm - will hit the hold button. The hold button just doesn’t silence the alarm, it stops pumping medicine. So yes, it is highly likely that a clot could form at the spot of IV insertion since nothing is dripping through the line to prevent it. The nurse was probably right about the cause of the IV clog but vented in the wrong direction.

The nurse returned, she then started digging with the needle saying "it just disappeared," meaning the vein. I thought Renee was going to slug her. She finally gave up. Nurse 1 said, "I call someone else if I don't get it on the first try" and left.

But you knew before she started she wasn’t going to hit the vein. There was too much bad karma there. She either wasn’t trying very hard or maybe trying too hard to make amends for her little slip of the tongue with a patient. Plus, Renee was probably willing her veins to move.

Enter Nurse 2. Same scenario and almost the same exact words, “it disappeared.” I said, “That's the second nurse in a row who said that.” Oh, and she was very sure of herself going in saying “I’ll be quick.” Embarrassed, she left quickly.

Enter Nurse 3. This is the floater nurse. No assignments, she’s been there for 22 years, the troubleshooter. She bails out the other nurses. Perky and determined, she dove in. Rubber tourniquet on, rubber tourniquet off, rubber tourniquet back on in a different place, searching for that beautiful little lode. She got it, a cute little ribbon of blue just above the thumb. The needle went in, the lines attached, the pump back in action, a complete success.

Alas, Renee was still not a completely satisfied customer. She said, “I can feel it.” Nurse 3 did not hesitate. She retorted, “Just think of it as a piece of rubber. Don’t worry, it’s not sharp. It’s flexible.” I could read Renee’s mind, “What kind of BS are you selling?” But Renee just groaned. She had already been used as a voodoo doll enough today. She gave up and hit the plunger for the pain.

It was now 10:17AM. It took three nurses and over 35 minutes of acupuncture to set one IV line into the hand of our patient. I was exhausted just being there.

Renee proceeded to tell me about her night with the catheter. Remember I said they had to re-insert yesterday? Well, they removed it after they drained her bladder. Then in the middle of the night they had to re-insert again. Ten minutes later the overnight doctor wanted to remove it. Renee said, “I don’t think so. They just put it back in and I’m not going through that again."

Renee was wiped out. She was asleep by 10:30AM. She didn’t stir until a little after noon. About this time the IV painkiller ran out and the nurse removed the empty bag. She has now switched over to oral pain medication.

Renee began complaining of nausea. They gave her a shot in the arm for this but not before she had a talk with Ralph. Pain was growing along with the nausea. Not a good day. They checked her vitals to make sure there was no fever and no blood pressure spikes or drops. She was miserable enough for them to have her checked out by the floor PA-C. I’m not sure what the initials stand for (physicians assistant - colorectal, I’m guessing) but he was a little concerned that the digestive tract was quiet. He recommended going back to the ice chips and staying away from the broth and other items on the lunch tray that was just dropped off. By the looks of Renee she wasn’t going to be touching that tray anyway. The entourage of nurses left and Renee dozed back to sleep.

A couple of hours later just as Renee was trying to pull herself out of her nap, the Stoma Nurse appeared for the first bag replacement lesson. It didn’t matter to her that the patient who needs to learn this was in a complete medicated haze. She proceeded to show us anyway.

I did a lot of reading before hand but it was mostly about the J-pouch surgery. I should have done some more research on the colostomy bag and stoma. I was not prepared for what I saw. You may not be prepared either but I’m going to say it anyway – Warning, not for the squeamish!

Scroll past if you don’t want to read it.

Seriously, I'm going to be gross for a minute.

I’ll line it off so you know where to scroll to.

I’ll wait.

________________________________________________________

OK, here it goes, but I warned you.

A piece of Renee’s small intestine is sticking out of her body! The hole in the bag goes over it and the bag is glued to the skin around it. That’s right, a piece of Renee’s small intestine is sticking out of her body! It’s about as wide and tall as a quarter and it is red like a fresh piece of steak. I have searched for a way to describe it but the only thing I can up with is…it looks like someone turned a penis inside out. Youch! Amazingly this is not the area where Renee is feeling pain. It’s on the other side.

I honestly thought that Renee’s internal organs would stay inside of her and that the connection to the bag would be via some type of drain installed. We learn something new everyday.

I just wonder about the looks from his associates the first time a doctor came up with this procedure.

Surgeon 1 – “Once we take the colon out how are we going to build the drain?”

Surgeon 2 – “No problem, we’ll just hang the small intestine out the side.”

Then they laughed their heads off.

But then someone actually tried it and it worked.

_________________________________________________________

With Renee dozing, the nurse put on her show for me - how to cut the hole in the bag to the right size, how to remove the glue from the existing bag, how to clean the area around the stoma, how to apply the glue and then how to install the bag. Wow, fun, huh? She finished. I applauded. Ooh, show me more Stoma Nurse! But she didn’t. She cleaned up the mess and left.

That was it for the day, except, a short while later Renee had a breakdown while talking to Nurse 1. She was really upset with herself that she wasn’t feeling well enough to go for her proscribed walks or use her breathing machine. It seems any ill will between these two had passed as quickly as those waves I mentioned at the start. With compassion in her eyes and voice, that nurse talked Renee through this little meltdown.

And the tide turns.

Tomorrow, we test the waters again.

+ 2

I arrived at the hospital a little before 9:00AM. Renee was sitting up in her chair looking fairly cheery. I told her about all the great comments on the blog. Thanks for reading and sending us these notes. Renee may be able to read them starting tomorrow. There are computers at the end of the hall so hopefully it's a little incentive to get her up and moving. Not that she's not motivated on her own.

She did get up and walk four times today, each time a little further. The last time she made a full circuit around the nurses station. We're on our way. Pain level she said was down to 4.

We got a visit from the local Rabbi today. He gave me the code to the Kosher Pantry on site. Generous donors have stocked a small kitchenette with all sorts of goodies for patients and families of those of the Jewish faith. Later two volunteers from the Pantry stopped by to say hello. Very nice! They saved me from buying lunch. It looks like we're going to be making at least two more trips to Cleveland so I'm going to be pinching pennies. So I send hearty thanks to those who provide this resource, even to a Catholic boy.

The surgeon visited again today and seemed pretty happy with Renee's progress. He was impressed with her ability to work on the breath machine. He's saying five to six days in hospital, which means travel back to Kentucky maybe Sunday or Monday. He started her on a liquid diet. Now she gets a little more than ice chips - broth, tea, jello. So she's back on the same diet she was on before surgery. With luck we'll have her on mashed potatoes before Sunday.

Gross update - turn away if queazy - Catheter came out today. Urges to go but no luck so catheter went back. Bag also started working and needed to be cleaned while I was there. Luckily it was well before lunch because I lost my appetite for a while. The regular bags will be disposable so the mechanics of cleaning and changing will be a little different. I think tomorrow the Stoma Nurse starts the lessons. They are also setting up a visiting nurse to come to the house at the beginning to make sure Renee knows what she's doing. She'll be a pro at it in no time.

Now we just need to work to make sure she is well enough to travel home.

Surgery + 1

The patient is doing well. I arrived a little later than Renee expected. I slept in a little. Not having the dog to wake me is a nice little luxury. I then had a little more trouble finding parking than yesterday. The parking garage closest to the building Renee is in is under construction. They leave that part out on the maps. I then went to purchase parking coupons. It looks like we'll be here for five more days and coming back so I took advantage of the deep discount.

I arrived at just the right time to see my wife getting a sponge bath by another man.

Should I give you two a little time?

A male nurse was scrubbing her down due to some accident involving the connection to the colostomy bag. It was a bag-plosion by the looks of it. A female nurse was helping out on the other side of the bed. I really wanted to take pictures. What a Kodak moment! But I backed down knowing there would be further repercussions that I probably don't want to endure. Renee said, "I better not see this on the blog. TMI" I completely agreed with her, too much information. So I won't say a word about it.

Following this jostling around Renee was complaining of pain at a level 10. If you've been through this before you know that is how the nurses ask you to describe it. On a scale of 1 to 10 with ten being the highest what is your pain level. 10!, 10! 10! It subsided after she settled back down. But while she was dozing I caught her performing the motion of hitting the button for a morphine shot when it wasn't in her hand.

At 12:40PM, Renee's surgeon did his rounds and checked her out. The ileostomy looks good he said. He also told us something new about the surgery. A good portion of the rectum was left. To prevent internal infection related to this disconnected piece he attached the interior open end into Renee's skin under her belly. If infection occurs, it will appear as a skin rash at the site. Then they just cut a small opening in the skin and drain off the infection. Doesn't sound like a big deal, does it?

These are little things doctors tell you that probably don't mean a lot to us lay people - right over our heads. Small life saving details that we don't give much thought to. Geez! THANK YOU DOC probably is not enough. The description was so matter of fact I almost missed it. Was he bragging? No. He was just stating that with the knowledge at hand he was doing the best for his patient. Details - he was attending to details. Double Geez! you just don't know how good that made me feel.

He saw lot's of scarring from previous surgeries and especially from the 20 year old gall bladder removal. He confirmed the estimate for J-Pouch surgery at 6 months but also said it depends on Renee's recovery progress. He wants her in good health for that one. He used the butter analogy again, saying if he lightly rubbed his thumb and fore finger together - he was doing it as he was saying it - on the colon it would disintegrate. I think we're pretty lucky we got the surgery done when we did. If we waited too much longer the colon could have ruptured and Renee would be facing some much more serious problems.

He cleared her to drink some fluids. Ice chips is all she's been allowed so far. He ordered her to use the blow tube they give to all abdominal surgery patients. And he told her to take a walk. Then he disappeared.

I know I took a few shot at the staff yesterday due to lack of notifications about Renee's status. Today I'm telling you that they are very pleasant and helpful. They are doing their jobs and very well. She's in good hands.

Renee was complaining that she's not really sleeping. She forgets that the hospital seems to be the worst place to try and get some rest, especially after an operation. They need to take your vitals. They need to give you shots. They need to change your dressings. This goes on 24/7, there's no way around it.

A little after 2:00PM I helped Renee out of the bed and into a chair. She slept pretty soundly for almost and hour sitting up. At 3:00PM, she took her first walk. A short jaunt out of the room, fifteen feet down the hall and back. She was wiped afterward and I put her back in bed.

An hour and a half later Renee had me call her mother and she spoke directly to both her and Cassidy. She was in good spirits but tired. She sent me packing for some supper.

A Long Flight

Surgery waiting rooms are a lot like being trapped on an oversees flight. Hours and hours in uncomfortable chairs, overhearing conversations you don't want to know about, carts banging around and blocking your way and everyone hoping that the next announcement over the loudspeaker let's you know that you are no longer over troubled waters.

We arrived at the hospital a few minutes early and found some premium front row parking. We got Renee checked in at desk P20 at exactly 9:34AM. I was given a beeper with text capabilities and a NaviCare brochure. NaviCare is a system similar to the big boards at airports. They assign a patient code and then the information is put up on screen so you may track the progress through each stage of the process.

They quickly passed us off to the finance office so they could collect our co-pay. This stage does not go on the big board. I don't know why. They then sent us down the hall to the pre-op. After escorting Renee to pre-op room M28 I was asked to leave so that Renee could change to her surgery gown and they could set her up for the IV. About 20 minutes later they called me back in. The luck with the needle was limited to yesterday. Renee was turned into a pin cushion as they searched for a good vein. They finally found one after a few tries by a couple of different nurses.

At 10:44AM an orderly came in and said it was time for transport to the surgery holding room. I quickly took out the camera, got scolded by Renee, and took the picture anyway. I was then told that she better not see the picture on this blog. I guess I don't listen so well. Hugs and kisses and off he took her.

I was sent back to the waiting room at P20. The pre-op nurse said the surgeon had blocked off five hours for the operation so I did what anyone else would do and got some lunch.

Returning to the waiting room I checked the board. According to Navicare Renee was taken to the Main Operating Room at 11:27AM. At 12:06PM the beeper went off - incoming text message - Surgery started. I was settled into a corner by then with a cheap novel. I was ready to not hear anything until 5:00PM.

At 2:00PM I was called to the desk for an incoming call from the doctor. I had a quick chat with the surgeon over the house phone. The surgery was done. Renee was stable and doing well. She was on her way to the post-op holding room, PACU. She would be awakening from the anesthesia in about 20 minutes.

Just as he had warned yesterday the complete operation could not be performed. Inflammation was too sever. He said the colon was like warm butter. This is not a good consistency for an internal organ. The internal J-Pouch surgery will be put off until a later date after the rest of her insides have a chance to recover and adjust to the ileostomy. The ileostomy is the connection of the small intestine to the exterior colostomy bag.

The best news is that Renee came through the surgery well. Now starts the recovery.

Following the doctors call I was instructed to return to the waiting room. I would be called when Renee is moved from recovery. Then they said I could go see her then. Back to the corner I went and waited. I made my phone calls. Yes I know I broke my own rule but Renee begged me so I figured I'd humor her. No need to rile her up in recovery. I'll wait till later for that.

At 2:30PM I was called to the desk for an update. She's doing fine, she is still in recovery but it will be a little while until I can go see her. They'll call me. Back to the corner I went and waited and waited.

The afternoon was dragging on. The waiting room was still very crowded. Where's the call? It's a pretty good book but this room is getting old. My impatience finally got to me at 5:30PM. I went to the desk and asked for an update. The girl there complained that recovery was not updating anyone. Yes, beepers and fancy tote boards still don't cut it. Somebody's got to put something into the system for it to work. She called upstairs, validated my parking and gave me a post it with a room number, H50 Bed 12. I had to give up my beeper.

She directed me to building H and off I went. I found my way to H50 bed 12 and no Renee. What gives. I head to the nurses station and am promptly ignored by the first couple of administrators I approached. I move down the counter and find a nurse who's willing to acknowledge my existence and ask her what's up? Renee is still in recovery. She hasn't made it to her room yet. I am sent to another waiting area and told I'll be notified as soon as she gets to her room.

A little while later I got up to stretch and checked the room again. There's our girl. Thanks for the notification Cleveland!

Renee was awake and looked pretty good for someone who was just split up the middle. She is of course in some serious surgery pain and is leaning heavy on the Jeopardy plunger - I'll have morphine for $500 Alex - but otherwise is fairing pretty well.

I retrieved some of her things from the car - socks, glasses, magazines - and she got a little testy when I couldn't find her chapstick quick enough. She was fading in and out because the anesthesia hadn't completely worn off yet but still was concerned that I hadn't eaten dinner yet. These are good signs that she'll be fine.

At 8:30PM the nurse asked if I was staying the night in the hospital. Renee was pretty much out at that time so I took the hint, said my good nights and headed on back to the hotel.

No fear

We're off to admitting, Renee’s body has told her that it is time but that does not mean that she, or I, are not apprehensive about her “going under the knife.” Surgery is scary. It sucks and so does the recovery. You deal with the fear, it’s natural.

To Renee I say, you’ve already faced much scarier moments than this. You’ve known more pain and fear than many will ever feel. Use what you’ve been through to carry you through now. Shake off the fears and use these harsh experiences for a positive approach.

I wrote the following song while a friend’s daughter was going through cancer treatment, she is doing well after a couple of surgeries and chemotherapy. She is completely in remission. May it never return! Their dealings with doctors and hospitals brought back the flood of emotions that came with trusting Cassidy’s health to complete strangers. It is written from a parent’s perspective after facing their worst fears in dealing with a sick child and surviving the ordeal. Hopefully, it provides some inspiration and courage to those facing difficult situations. Renee, today that means you.

No Fear
By Bob Masterson © Old Paint Music 2006

You can not scare me now
You can not tear me down
I know the bitter taste of fear
You can not scare me now

I’ve struggled to be strong
Held together all along
I know the bitter taste of fear
You can not scare me now

You’ve blown my world apart
And torn apart my heart
I know the bitter taste of fear
You can not scare me now

Fear, steal my sense of self
Fear, come take control
Fear, drive me to tears
And test my very soul
But I’ll find my steel resolve
And I’ll stare that demon down
I’ve faced the hardest thing in life
You can not scare me now

I’ve faced the hardest thing in life
I’ve choked down that awful bite
I know the bitter taste of fear
You can not scare me now

I’m doing what I must
Trusting in blind trust
I know the bitter taste of fear
You can not scare me now

I’ve faced the hardest thing in life
I’ve choked down that awful bite
I know the bitter taste of fear
You can not scare me now

A day at the races

No, it wasn't a Marx Brothers movie, although I thought I saw Dr. Quackenbush. What we were doing is racing around from station to station today for five and a half hours.

At the Cleveland Clinic each check-in desk is given a letter and a number. We were playing hospital bingo. Desk A10 for labs, A31 for consultations, A13 for EKG, you get the picture.

At the first stop, Renee raved about the nurse who took her blood. She was smiling and laughing when she came back out to the waiting room. She's a hard stick and usually it takes numerous tries in her arm and hand before they can draw what they need. But not today, first poke, done and out of there. It was the only time we were on time the whole day.

Second station was where they give you your surgery booklet. It has all that great information you should have had before you get to the hospital. Then they ask why you didn't know about this stuff ahead of time.

The meeting with the surgeon was supposed to be at 1PM but he was running late so they sent the Stoma Nurse in. She tells you about how great you're going to feel after the operation. She goes through her whole spiel about life with the bag. She is also the one who took a Sharpie marker and drew a big black X on Renee's abdomen where the bag will be attached. This is where the surgeon is supposed to make the hole. So tomorrow I guess he puts on his pirate costume and starts digging at the X. Let's hope he hasn't had too much rum.

The surgeon came in almost an hour and a half late and in his best bedside manner starts throwing out worst case scenarios. He is preparing us for the fact that this may be a three stage operation. Right now the hope is for two surgeries. One to remove the colon, install the external bag and build the J-pouch and one a few months from now to disconnect the external bag and connect the J-pouch. A third surgery may be needed if the J-pouch cannot be built at this time. The severity of the current inflammation in the colon and rectum will be the deciding factors. It was the same speech we received in July but a lot less tactful.

If the inflammation is too great they will not build the interior pouch because the chance of failure. Essentially the pouch will not be able to heal correctly. It all comes down to Renee's swollen colon. He won't know until he goes in and takes a look around. Swollen Colon, that's what I should have named the blog. Or, its a great name for a band. Appearing tonight, Swollen Colon.

Following this uplifting experience we were sent to see an internist to see if Renee was healthy enough to have surgery. Apparently, they're not letting any sick people in for surgery anymore. I think the insurance companies have put a stop to it. Somehow Renee passed the test.

We were then shepherded to see the the anesthesiologist. She was at least the fifth person of the day that was very concerned that Renee had taken a multi-vitamin this morning. We didn't get the memo not to. Oh, that's right, it was in the material that you gave us today that we were supposed to read yesterday.

After Renee had been completely poked, prodded and quizzed, we were finally sent to the pharmacy to pick up a gallon jug of some concoction that Renee must drink this evening. It is a colon rinse. How sadistic is this? You have someone who has been telling you all day long that she goes to the bathroom over twenty times a day and you give her medicine that is going to make her go more. It's cruel and unusual punishment. I won't go into it too far but let's just say she isn't taking it well and neither is her bottom.

Major milestone: Today I became privvy to one of the most heavily guarded secrets on the planet, a woman's weight. Previous to this CIA interrogators couldn't have ripped it out of her. She must be ill.

Tomorrow at 9:45AM I will check Renee in at the surgery compound. At about 11:30AM they will begin the operation which should last at least 4 hours.

Good Night