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.