Put Me In Coach

Required listening: Centerfield by John Fogerty

http://www.youtube.com/watch?v=_Bmukj1YFLg&feature=related


We’ve made it to Thursday without any major medical events since Renee returned home on Sunday. She has managed to sleep at night and is starting to move about the house. She is back to Tylenol for pain which is being taken occasionally rather than routinely. There are no signs of dehydration although the output is still much higher in volume and thinner in consistency than previous to surgery. Post-surgery pains and weakness are still persistent reminders that there’s still a long way to go, but she may have stuck the landing on her vault from the hospital this time.

This week has been a series of battles waged in an effort to distance this unit from the month of chaos we have just endured. This house has been operating like the Yankees did at the beginning of the season, just getting by and struggling to keep near .500. One of our star players is on the disabled list. She’s not even ready for her rehab stint in the minors. I feel like Mark Texiera batting near the Mendoza line. The pitching has been thin and the defense full of holes. We thought we’d have her back by the all-star break but that didn’t happen.

The rest of the summer will be dedicated to getting Renee back in the lineup. This means Cassidy and I need to carry this team to the playoffs. Cassidy’s rookie colors have shown through this week which is part of the battle. She’s our Joba Chamberlain and the crack baseball committee is still debating whether to put her in the starting rotation or keep her in the bullpen. She’s resisting the advice of the seasoned veteran as teenagers will do but every now and then she shows off that 98 mile per hour fastball by doing something she wasn’t asked to do. Our main goal though is to get Renee play-off ready, ‘cause we’re going baby, and then it’s another off-season surgery.

Have I hit you with enough sports metaphors yet? I can’t help it, the Yanks are alone in first place and Renee seems to be in solid recovery mode. It’s a good week. So good in fact that tonight I’m going to bail out of the house for a little while and try to drum up some material for the BeerWerkes blog. It has been sorely neglected.

(raising beer glass) Here’s to your good health!

And Go Yankees!

And Go Renee!

She Huffed, and She Puffed, and She …

Renee is back to Recovery - Day One. I should have entered her in the Tour de France. She is a vicious cycler.

I’m glad Renee is home but I’m still not sure what caused the about face in the doctor’s position. I’m also not sure if the releasing doctor, that’s the doctor who represents our family doctor at the hospital, consulted with Renee’s GI doctor. Apparently, Renee had worn out her welcome at Park Tower BEast, perhaps she wasn’t tipping the staff well enough. You would think that she earned extra rewards points for being in the holding cell for four days.

Saturday afternoon about 3:00PM they re-hooked the IV for fluids. There had been no reduction in output. It was increasing. They unhooked the IV later that night. (Why does re-hooked need a hyphen and unhooked not? I love the English language.) Renee had a nice long chat with her gastro doc on Friday. He gave every indication that he wanted her to stay put until they figured out the output problem. Yet Renee’s been home a day now and we have no answer and no slow down.

Renee was able to sleep last night. I decided not to get up every hour and poke her with a sharp object like her hospital nurses would have done. I must be getting soft.

The visiting nurse came today, no, not Huffnpuff. We fired her. She watched Renee go downhill all week. She should have recognized the dehydration on Saturday. She only called Monday and did not mention dehydration to Renee. It was only brought up on Tuesday when she called. When we had a similar occurrence in December, not only did the nurse spot the downhill slide, she called the doctor and the hospital to arrange a room for when we got there. There was no Emergency Room visit. Renee could have had the luxury suite all week. Thanks, Huff.

There was another Huffnpuff incident that Renee did not share with me until she was back in the hospital. I was out running errands during the nurse’s visit on Saturday. Huff helped Renee get a fresh bag on. Not that kind of bag, this is much more intimate than a bartender and patron relationship. I think I’ve covered this before but, in order to get a tight seal there are powders and sprays used to treat the sight. The area needs to dry before applying the paste and bag. Nurses use various personal techniques to achieve dryness quickly before an eruption happens and causes a repeat of the cleansing process. Some use a paper fan, some fan it with a towel, you get the idea. Nurse Huffnpuff, you remember her, the one who I nearly had to call an ambulance for since she was breathing so heavy after climbing one flight of stairs. Well, this fine specimen of a trained caregiver bent down over Renee’s pelvic region and huffed and puffed on Renee’s stoma. Renee froze, she didn’t know what to do. Holy Florence Nightingale, Batman! She ain't just whistlin' Dixie!

Renee was too scared to relate this story to me immediately. She thought I was going to freak out. She said she doesn’t know what I would have done if I was there. I told Renee, I’m pretty sure I would not have freaked. I think I would have calmly walked over to the same side of the bed, dropped my drawers and said, “me next.”

This is a family blog so I will go no further on that one. But, oh boy, do I know how to pick a nickname!

And, oh boy, did I have Renee laughing hysterically in the hospital after she told me about this. I think she popped a few of her internal stitches. We followed this by making a laundry list of all the ridiculously unprofessional behavior of the staff in the CDU. It was the only time while she was in the "Clinical Depression Unit" that she was laughing. Who needs sitcoms? We've got the Renee show.

Today’s nurse was an ostomy specialist and came in and did what she needed to do and was gone. Boring! Maybe we should have kept Huffnpuff around for the entertainment value. Nah, if we kept her around any longer Renee may not be.

Fickle Findings

Required listening today:
Darling Be Home Soon – both the Lovin’ Spoonful and the Joe Cocker versions

http://www.youtube.com/watch?v=AMYJ6yZHwGc

http://www.youtube.com/watch?v=B_2bnAA9wjw

Doctors can be fickle, one day they’re hooking you back to the IV and telling you to prepare for the long haul, the next they’re sending you home. I was just about to cut the lawn this morning when Renee called and gave me the news she was being released. I let the grass wait and headed to the BEast. I got her home at about 12:30. Polly, the wonderdog, ran in circles around the house. I guess she was happy. And we all are. Now it is up to Renee to hydrate herself, eat properly and get back to recuperating. This is a great song but I was getting a little tired of singing it.

Go
And beat your crazy head against the sky
Try
And see beyond the houses and your eyes
It's ok to shoot the moon
So darling
My darling be home soon
I couldn't bear to wait an extra minute if you dawdled
My darling be home soon
It's not just these few hours but I've been waiting since I toddled
For the great relief of having you to talk to
- John Sebastian

We’re moving on up!

Good night Walter, you took me to the moon and back. It was a hell of a ride.
Walter Cronkite 1916-2009
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While we haven’t slain the BEast just yet we have tamed her down. Yesterday Renee was moved from the Clinical Decision Unit to a private room in the brand new Park Tower building of the hospital. It was like being moved from a prison cell to the Four Seasons Hotel. The patient care was immediately improved. This begs the question, how can there be so much disparity in care within the same hospital?

Renee had a breakdown early yesterday over the treatment that she either was or wasn’t receiving on the first floor. I mentioned one or two things in a prior post but there is a whole laundry list of items that could make you cringe and start thinking about choosing a different facility. Isolated incidents are understandable, we are all human and no one is perfect but taken as a whole and comparing the care to the sixth floor of Park Tower someone has to realize there is a breakdown in the management of the CDU.

Renee spent the first four days of her visit advising the staff on how to deal with her condition. Shouldn’t it be the other way around? If Renee is going to have to teach the nursing staff how to perform their duties shouldn’t she receive some type of compensation?

Someone mistakenly wrote on Renee’s chart that she has Crohn’s Disease. They also wrote that she is in for Ulcerative Colitis. The UC went away with her colon in December. She has neither of these maladies. She’s post-op with recovery complications. There is no need to treat something that she no longer has or never had.

The first day Renee was in CDU she was completely dehydrated and was in renal failure. She had shooting pains in her abdomen. She needed help doing the little things that you and I take for granted, like going to the bathroom. But they hooked the IV and wires directly to the bed so she was held captive. They also needed to monitor everything coming out. This meant bedside care. A catheter was inserted for urinary output and a plastic jug type urinal was provided for output from the ileostomy. What they failed to provide was a nurse with any ostomy experience. Two nurses were working bedside to empty the bag contents, one had not seen an ostomy bag in 35 years, the other had never seen one. I do believe that neither of these nurses were in school the day the science teacher covered gravity. It is a rare occasion for liquid to travel up but they tried and tried to get the goop into the bottle by holding it higher than the bag and trying to figure out why it was not working. They squeezed the bag here and there hoping to coax the fluid out. Renee was uncomfortable but she wasn’t in a coma, she walked into the ER, she was perfectly capable of standing up and kept telling the nurses this. Still they worked away. Finally, Renee said “let me up and I’ll go in the bathroom and do it.” They were shocked and surprised at this. They sat Renee up and had her stand and, glory be, gravity took hold and did the work for them.

The above operation did not happen without a little spillage. The sheets and Renee’s gown were soiled. There was more shock and surprise by the nurses when Renee asked for a fresh gown and for her sheets to be changed. “Really? Did you expect me to lay back down in this?” They secured fresh bedding and took the dirty sheets and laid them on the sink where they stayed for a long while. This also blocked them from washing their hands after this procedure. Did they? And if so, where?

It took more than two days of asking to get a rolling IV cart so that Renee could get out of bed. Lying in bed will not do any good if she is well enough to get up. It will only delay recuperation. She was not suffering dizzy spells or anything that would prevent her form moving around. I kept telling Renee to lean on the nurse’s button to get what she needs. “Be the squeaky wheel. Don’t let them ignore you,” which they were. They ignored her over bedding changes. They ignored her about checking the hat in the bathroom which they were supposed to be measuring. They ignored her about changing her IV which was making her arm swell.

One nurse got affronted when Renee refused to take medication she never heard of and didn’t know who prescribed it, and since the nurse didn’t know when asked, made her check. Another nurse had to come running when Renee hit the call button in the bathroom. “Bagcidents” happen, especially since Renee had leakage problems with the new setup. What you do not want to hear when the nurse responds, hopefully to help, is “What do I do?”

There were similar episodes throughout the four days in CDU, what I have deemed the Clinical Depression Unit because there was just no way to feel good about what was happening, but let’s move on to a different world.

Required listening for today: go to song 12
Moving On Up by Lady Dottie and the Diamonds

http://www.lala.com/#album/2017894108323522602


I walked in to the Park Tower and Renee immediately told me to check out the bathroom. Ooh, ahh, artisan tile, corian and marble, huge stall shower, there was sanitary paper wrap on the toilet seat and the toilet paper was folded in to a V. It is just not right when the hospital bathroom is nicer than the one you have at home. The rest of the room is appointed with hardwood floors and cabinets, leather chairs, marble countertops, flat screen TV, crown molding and artwork. Now I know where all the money went from Renee’s previous visits.

The nurses carry scanners for the barcode on your wrist to mark the time and type of medication you are receiving. They tell you their names and smile and ask you if you need anything. They know what an ostomy is. They put a little card on your tray telling you to feel better and it has a number for patient services if everything is not up to snuff. They set up your meal tray for you. They do not just drop it and run. There was a small glitch when it came to dinner but it was immediately remedied. I remarked that if this keeps up we’re taking our business to the Seelbach. That’s a fancy hotel here in town. (Sorry, MS but The Brown just isn’t as funny.)

If you’ve got to be in hospital this is definitely the way to go. We have improvement in the care and we have improvement in the patient, mentally and physically. The doctor is still saying we need to monitor Renee. Her output is still too high but she did not need to be re-hooked to IV fluids last night. Prognosis for return home, I think we’re looking at Monday.

Until then, I’m calling Renee Weezy, because the rest of her stay is in the deluxe hospital room in the sky. She finally got a piece of the pie!

Forgotten but not gone

Hospitals are busy places, there is a lot going on. The paperwork alone in these institutions rivals any overregulated bureaucracy. You can forgive these folks for missing an item here or there on their checklist. They do have a checklist I hope. But it goes beyond forgiveness, I think, when they forget to order breakfast for the patient. This happened this morning, Renee was just laying around waiting for her morning meal and I had to tell her to hit the button and ask for breakfast. After she informed the nurse over the intercom that she did not get a tray, I heard a howl from the nursing station followed by, “This is unbelievable!” I guess she discovered that no one got fed. Unbelievable, I have to agree, yes it is. It goes beyond oversight when it turns out they forgot to order breakfast for the entire unit. The folks in the kitchen were probably sitting back saying, man, it’s a light day. But nobody noticed that an entire wing of the hospital didn’t get fed?

Renee was sent home from Cleveland with strict dietary procedures. She is supposed to be eating six small meals a day. All of these are supposed to be Soft GI, foods that are easy on the digestive tract, no nuts, raw vegetables, or roughage. Not only are they forgetting to feed her in the “BEast,” that’s shorthand for Baptist Hospital East, but when they do she is getting foods on her tray that are on her forbidden list. Certain vegetables even when cooked should not be eaten. She got a huge helping of broccoli for dinner yesterday. They did try to cook it until there was nothing left of it but the smell, which had me reaching for the gag bag it was so overpowering, but this still does not qualify it for her post-op fare.

Renee is doing much better and is wishing she could get up and leave. No one wants a repeat of this little adventure so that is not going to happen today. The doctors are still trying to figure out what’s behind the high output and watery consistency from the ileostomy. If this function doesn’t slow down and firm up then the cycle will continue and Renee would be back in next week with dehydration. She really can’t risk putting her kidney through renal failure again. Her blood doctor says all the tests are coming back positive, white counts and platelets are moving in the right direction. They should be switching her to an oral antibiotic soon for the UTI. They did a test for C-diff and it came back negative. They are planning on removing Renee from the fluid IV today to see how she fairs without it. All of this is great, but they still don’t answer the question why.

Her regular GI doc is supposed to be consulting with the surgeon in Cleveland for some answers but they said this after Renee’s setback following her last surgery and it didn’t happen. I emailed the surgeon just to let him know what’s going on but we’ve received no indication that he has been in touch with her doctor here.

It looks like Renee will be held over for the weekend on the summer circuit of the Hospital Blues Revue. There are some tickets left. Don’t miss the show! Let’s just hope the promoters don’t forget she’s still on tour.

Horror Flix

Yesterday we had Freddie Kruger and Edward Scissorhands doing their best Mack the Knife on Renee’s veins. Renee said, “put in the blog that Freddie’s got pretty eyes.” Yeah, he was dreamy all right, and, he’s oh so cute while he’s stabbing the life out of you.

Today we’ve switched over to comedy. The stoma nurse was having a little trouble attaching a new bag. It was like the guys from Three Men & a Baby trying to change a diaper. Stuff was squirting everywhere. She’s telling Renee not to laugh because its increasing output. Every time she thought she had it under control, blurp there goes another one. She’d get it all dry and ready for the seal to be applied, blurp there goes another one. It continued on like this for a while, maybe a little too long like many of the Saturday Night Live skits. Renee finally stopped spouting long enough to pouch that thing up.

But we’re sure glad the horror show is over. The nefrologist said that the kidney has begun functioning and is expected to increase its productivity and return to normal. Renee’s pain and suffering, aside from normal post-op, are twofold, one is dehydration and the second is a urinary tract infection. Renee’s output from the stoma was too high. She could not eat and drink enough to keep up with it. The extra pains were being caused by the UTI, which was brought on by the catheter in Cleveland, but were misread by the patient as normal post op pain. The increased discomfort reduced her appetite further and brought on the dehydration.

They’re encouraging eating and drinking and backing it up with pain meds, fluids and antibiotics. They’re going to make sure everything is working and that they have the output stabilized before release. We’re looking at Friday most likely. Just in time for the weekend. Maybe we’ll take in a nice movie.

Somebody bring me some water

Memo from: The Center for the Office of Redundancy Department
Subject: It’s Déjà vu all over again

Hopes for overnight improvement were dashed. This morning brought more of the same, nausea, shooting abdominal pains, lack of appetite. I called the home health care nurse to let her know I was bringing Renee to the emergency room. She said, “I thought you were bringing her last night.” Renee sort of left out the part that the nurse said, get there NOW and the lecture on dehydration that she received. She told me it could wait until morning. The patient is now playing the doctor and botching up her own medical care. The only consolation being that the ER was almost empty when we got there.

It was a typical emergency room runaround. I’m sure that that who ever devised ER procedures was also a technical expert on the Spanish Inquisition. It was the perfect combination of questioning and torture. My hand is just starting to get the feeling back, Renee nearly squeezed it flat during the IV insertion phase. A bed of nails has less sharp points than were flying around that room and all but one were dug fruitlessly under the skin. They weren’t too sure about the one that did hit the mark either as it didn’t backdraw like it should have. Luckily it worked.

One bag of fluids was hung and put on full blast. Renee sucked it up in about a half hour. A test came back that her creatine (sp?), a kidney enzyme level, was four times what it should be but white cell counts were around normal and red were slightly elevated. The ER doc was figuring it was just dehydration and put orders for a room in so Renee could receive fluids overnight.

A while later Renee was moved to the Clinical Decision Unit. The doctor came in about two hours later, did a check-up, asked more questions and laid this out. The elevated enzymes along with the dehydration and blood tests indicate that her kidney has shut down. The shooting pain Renee is experiencing is typical of a kidney stone. Being post-op this may not be the case but a CT Scan was ordered and the staff doc is calling in a nefrologist.

For those who have joined us in progress, Renee has only got one kidney. That other one is long gone along with that nasty little tumor bearing cyst that was encased inside it.

Hearing kidney shut down freaked Renee out! But the doc was cool about it. He told her she’s been through much worse and had her smiling and laughing. He impressed on her that it all could be due to the dehydration but that we just need to make sure. He also said we need to know what caused the nausea, appetite loss and pains that led to the dehydration. This sounds better than Renee’s approach of laying there in agony hoping things will get better overnight, don’t you think?

But here we are repeating steps we took just a few months ago following surgery one. On the night of the All-Star Game we’ve got Yogi Berra to put it all in perspective for us. "You've got to be very careful if you don't know where you're going, because you might not get there."

Weekends were made for ...

No one said it would be easy
But no one said it’d be this hard – Sheryl Crow

Most people look forward to Friday, even thank God for them. For the last two years I’ve dreaded the weekends. Healthwise, Renee does not know how to deal with weekends. The aches and pains and bugs and strains all are screaming TGIF as they turn Renee’s body into a party house. They’re just saying to her, “go ahead, try to find a doctor on duty now,” and laughing their pesty heads off. All of her major attacks and setbacks have happened on weekends.

Renee shuffled out to the front porch for a few minutes yesterday and chatted with a couple neighbors. It was obvious she wasn’t at her level best. It was one of those typical Kentucky summer days, hot & humid with an air quality alert. Healthy people have no business going outside in this weather. On top of her troubles related to surgery, Renee also has some major allergies. She is on a medication plan to combat these but she hasn’t been to the allergist in a while due to her condition. She experienced some shortness of breath and immediately went into panic mode. Geez woman, a marathon runner needs a respirator out here, get your butt back inside!

On top of this her nausea returned Saturday, after the visiting nurse left, of course. Her appetite still has not returned and she’s still just generally feeling ill. Now if Renee was a skier she’d be in good shape. She can work the downhill. Problem is she’s got an uphill battle. I made her call the Cleveland Clinic today to speak to the doctor. No one answered the phone so she had to leave a message. By close of business there still was no return call. Nurse Huffnpuff did call, she’s also scheduled for a visit tomorrow, but she advised that if there is no improvement to get Renee to the emergency room to hook her up to fluids to make sure she doesn’t dehydrate.

Another weekend has knocked Renee down to the mat. This is not the kind of hangover to wish on anyone. I’m pretty sure where I’ll be spending the day tomorrow. So pass me a drink, we don’t need both of us dehydrated.

Calamity Came

From quietude to chaos, there is no warning. It can change in an instant. Serenity overwhelmed by calamity. Such is the home with a teenage girl. I bet you thought that I was talking about Renee, didn’t you? Worry not, today all things are still relatively quiet on that front. But I think a huge helping of raging hormones has sprouted in the child.

Wow, it’s like the Fourth of July followed by the great flood. How does one so small explode with such a massive array of emotion? Nothing major here just the small stuff igniting upheaval, “Cassidy, please walk the dog.” Wham, boom bam! The best part is when she gets like this she is a cleaning fool. I guess she showed me, her room was clean in minutes and I hadn’t asked her to do that one yet. Yeah, hormones! Got to love them.

Renee is still weak and mostly sleepy but not really sleeping. Small steps of progress are being taken and lead us into the weekend. Let’s hope the eruptions of the child do not bleed over to the patient. I am outnumbered by females three to one in this household and don’t stand a fighting chance against multiple feminine conflagrations.

Don’t Look Up

The last of the staples have been removed. Again, Renee refused to let me pull them. This lack of trust in my surgical skills has me really ticked off. “NO! Just let the nurse do it!” So, I get to deal with a bag-o-BM but staple pulling I’ve got to leave to the pros? I know where that puts me on this totem pole, sandwiched between the cold earth and the bottom of Nurse Huffnpuff. Ouch!

As you can tell from the above, the patient is getting a little more boisterous. This means progress, if Renee’s got the strength to fight off my ridiculousness than she’s on the right road to recovery. Her appetite is non-existent, she tires out faster than a home health care nurse facing a flight of stairs, she’s got extreme soreness throughout her abdomen (imagine that!) and at this stage there does not appear to be a way to get a solid seal around the stoma. Nothing here is out of the ordinary for a J-Pouch surgery patient.

We are told the bag fitting should be easier after normal post-op swelling has reduced. Strength will return after the pain subsides and after her taste buds wake up. They seem to have taken a break also. Renee says she can’t taste anything so she’s not really eating. This may be due to the general numbness which comes along with the pain pills.

Don’t worry I’m feeding her. How’s shrimp scampi over linguini sound? That’s what I made for dinner last night. I even let Renee watch me eat it. Yes, I let her have some. How cruel do you think I am? But if she can’t taste it, isn’t that a waste? Shouldn’t I just blindfold her and give her white bread with butter and tell her its shrimp scampi?

I must now put on my apron and whip up another gourmet meal to waste on a set of deadened taste buds. Renee’s taking portions so small right now that it doesn’t much matter. I’m really just cooking for me and giving her a “taster” plate. She’s really living on jello and diced peaches with maybe a yogurt thrown in.

“Oh, and how about Cassidy,” you’re asking? She bailed out to a friend’s and is probably trying to figure out a way to sponge a meal off of them. She’s also on a non-eating week. I don’t think she’ll do too much damage to their pantry.

I’m going Italian tonight, sausage rigatoni.

Arrivederci!

Quietude

I fear I may have spoiled the lot of you. Some are bellowing for news. It is not as though I brought back the entire Cleveland Clinic team with me, I am now a staff of one. There is work to be done. Nursemaid, housemaid, maintenance man, shuttle captain, pup patroller, child overseer, grocery getter, chef, laundry clerk, bread winner, scalawag, beer guzzler - I’ve got my hands full here and you want me to be a blogger too? Oh well, if I have to.

The house is quiet. There must be something wrong. Aside from the gentle swish of the washing machine and occasional background noise from the TV, I can’t detect any sounds. Maybe I should take the MP3 earplugs out every once in a while.

Renee hobbled down the stairs to the couch this morning. Half of an egg, scrambled, was all she could take for breakfast. She’s having a much better day than yesterday. Away from the hospital she’s managing some rest which is the greatest piece of the recuperation puzzle that can not be found at that healing center.

The home health care nurse called last night to check on Renee and to see if her second bag application was successful. There were no post-visit hysterics so I believe it was. Throbbing quotient is low now that Renee has resumed her prescribed dosage of Oxycontainmypain™ and nausea is under control.

Yesterday was Cassidy’s first day back at the neighborhood pool and she got a pretty good sunburn. I forced her to put on a generous helping of sunscreen before she left the house but she forgot to reapply. The child continues to learn her lessons the hard way. A liberal portion of aloe applied before bedtime soothed it enough for sleep.

I’ll have to get Renee off of the couch and up walking around a little later but I’ll let her loiter for a while. She’s quietly enjoying a well earned respite. So please keep your bellowing to a low roar!

Double Duty

Oh, the good and the bad of being back home. The good is sleeping in your own bed, being on familiar turf, seeing the friends that you’ve been shut off from; the bad, the dog won’t walk herself, the child is acting like a child and worst of all, the wife won’t get out of bed to cook or clean. This is just not right. It’s been two weeks since surgery.

I may have used that joke before but it is a classic so why not bring it out again?

I’ve been waiting to post until after the visit from the home health care nurse. Imagine me waiting for a medical professional before I give you the report. I must be getting soft.

Renee had a slight fever yesterday and was still feeling the effects of the ride home. I-71 in Kentucky is a pretty rough road. They’ve improved a couple of sections but KY-DOT needs to repave most of it. The whole stretch was brutal on the patient.

The nurse showed up and was not too happy about having to negotiate a flight of stairs. She made it but not without huffing and puffing and some visible discomfort. I think she’s in worse physical shape than Renee. I needed to get a chair for the nurse! How can she hear Renee’s chest if she’s breathing that loud?

She hollered at Renee for not taking her pain medication. Her parental units put it in her head that she’s going to get hooked so she’s trying to tough it out. Big Mistake!


Too much information portion:
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Renee’s been having problems since the surgery with leakage. The seal on the bag is giving her some trouble. The old stoma was an end ileosomy, the end of the intestine hangs out the side. The new stoma is a loop ileostomy, there is a hole cut in the side of the intestine and they kind of jam the edge with the hole in it out.

Renee and I changed the bag yesterday and we did what the professional stoma nurses in Cleveland couldn’t, we got it to stick. The nurse today came in and had to look at the stoma so she ripped off the perfectly placed bag and then fit Renee with a new one. There is an art to choosing the correct connection, everyone is different. You would not believe the number of choices available to colostomy patients. Straight, convex, one piece, two piece, glues, pastes, sticky rings, powders and belts all made to ensure a comfortable seal on your plastic pouch. Nurse Huffnpuff failed. An hour after she left, clean-up aisle 1.

I needed to run Cassidy to a friend’s and pick up a nausea prescription for Renee, who’s been having a tough time on the north end too. I did not have time to clean up after the specialist. Renee called the service and the nurse had to come crawling back up the stairs. When I returned she was still there finishing up. She was already in her street clothes. Renee must have been her last stop of the day. A stop she got to make twice. Oh, but that's what she gets for using our supplies after she told us that her company provides them all as part of the fee. She got hit with some bad leakage karma.

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Renee is now resting after sucking down a good portion of a vanilla milkshake, the only thing she's eaten all day. With the pain medication kicked in and the nausea pill doing its stuff maybe she can continue in this restful state until morning.

Where's My Hairnet?

I had to make my own coffee this morning. I should have brought one of those ladies in a hairnet home with me. Oh, did I forget to mention we’re home! We finally got everything sorted out yesterday and by the time we got on the road it was almost 6:00 P.M. I pulled into the driveway at midnight. I told myself I was going to wait to unpack the car until morning but I was still keyed from driving so did it anyway.

Renee made it up the stairs without assistance. She tossed and turned and grumbled throughout the night. Neither one of us got any real sleep. The ride home was uneventful. What a good thing that is. We did witness the bright moonrise over the clear skies and cornfields of central Ohio and a couple of random blasts of fireworks but no traffic or construction delays. Interstate 71 is nothing like the Garden State Parkway at the end of a holiday weekend. Sorry Jersey but you can keep your traffic.

Speaking of Jersey versus Kentucky, while we were frolicking in Cleveland, Renee’s parents closed on a house in Louisville. I may need to start a whole new blog for the antics that will follow. If anyone in Louisville thought Renee and I are hardcore Jersey wait until you meet her Dad. This is a reality show in the making, only there will be real drama. If someone in this town doesn’t figure out how to make an authentic bagel there is going to be hell to pay!

I’ve got chores to attend to, although one of them won’t be cutting the grass, one of my great neighbors took care of that for me. There is a dog to pick up from the airport and a child to retrieve from the kennels … err ….oh something like that.

Waiter, check please!

You missed a spectacular site last evening. Renee and I took a road trip to the other building. The nurse transferred her IV pump and bags to a transportation trailer and I wheeled her on up to the penthouse to watch the downtown demonstration of patriotic pyrotechnics. We had a panoramic view of all of the displays booming through the skies in the Cleveland metro area. It was a fantastic spectacle. I tried to count just the professional productions and gave up at thirty.

We set up on the outdoor patio on the roof with Renee’s toes up against the glass panels protecting her from the twelve story drop. This is the highest building in the area. There is nothing to block the view of the downtown and the surrounding suburbs. It was like someone switched on the dolby surround system. We were encircled in the clamor. Our eyes did not want for stimulation. Our nostrils piqued by the burnt powder. We were in the thick of it. All of the colors lit up the sky of this foreign city highlighting the fact that we’re still not home. Renee grew uncomfortable in her chariot and we bailed out before the climax.

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Unbridled optimism is the spirit of the day. I packed everything for the trip home before leaving the hotel this morning.

The posse doctors were in early this morning. They did not pull the two staples the surgeon told them to yesterday. They forgot. Renee asked, “don’t you guys take notes?” Today they said maybe all of them can come out. They also asked Renee the big question, “Do you want to go home?” “Uh, yeah!”

They said everything is looking good. Renee’s responded well to her meals and the output from the stoma has declined to reasonable levels. BUT …. you knew there was going to be a but didn’t you? Her white blood cell count is a little bit elevated.

We learned more about white cells in December than we wanted to. This could be a sign of infection, it could be nothing more than regular post-op increase due to the incision or, as we found out with magnesium levels last week, it could just be a fluke in the testing. There is no fever or any other indication of abscess. Renee’s feeling good. She said she’s a lot better than the day we left Cleveland in December. They do have doctors and hospitals in Louisville who are quite familiar with this patient. If her best tactic for recuperation is to lie around she can do it in her own bed away from the place where she contracted her last infection.

The residents have to check with the surgeon but as of 10:45 A.M. we are cautiously optimistic that we can check out of the city by the lake sometime later today.

The Pursuit of Edibles

Sandy, the fireworks are hailin over Little Eden tonight – Bruce Springsteen

Yeah, yeah, and the rockets red glare and all that jazz ……
They don’t let you grill in a hospital room but Renee should be starting on a soft diet at lunchtime. We don’t know what that means as far as release, possibly tomorrow, more likely Monday. This could cause some logistical problems with the child and pup but we’ll figure it out.

We’re here long enough that they are talking about pulling a couple of the staples. It has been ten days since the surgery. The forecast was for three to five days in the hospital. The weatherman was wrong again.

Renee told the nutritionist that she feels good. She’s still got the feed bag dripping and will probably continue to get the IV treatment until real food is re-established in her diet. The doc said there is too much output from the stoma. He is hoping some food will absorb the liquid and regulate it better. So now the lack of food is becoming a problem. Can we find some balance, please.

Nothing much more to report ....

Happy celebrating!

Table for one, please

Cleveland is empty. This is not the Independence Day mecca that the hordes flock to, apparently, it is just the opposite. There was a free concert on the square last evening and fireworks that followed. Everyone must have bailed out after the grand finale.

It is a legal holiday which means there is a skeleton crew here at the clinic…. Skeleton crew at the hospital! Nyuk, nyuk, nyuk! ….. This also means that we get the brand new, low on the totem pole, resident physicians overseeing Renee’s care rather than her surgeon and staff doctors. So what does Cowboy Doc, as Renee calls him, do first thing this morning? He tells Renee she’s here til maybe Tuesday. He still has her at NPO. How the heck are we ever going to tell if the bowel has reawakened if we don’t reintroduce food to Renee’s system? It has been six days since she has seen even a cup of clear broth. In every sense we’ve really got to get things moving.

There has been no change in status for Renee since yesterday, she’s on maintain. Pain is there but tolerable, nausea comes and goes. She gets up and walks around, gets worn out and returns to bed. At least since they set up the picc line she has not had to get stabbed every couple of hours. The only shot she’s getting is Heparin, a blood thinner. It burns going in and creates a nice pattern of bruising on the upper arm. The nutrition bag is still hanging and dripping what looks like lemon-lime Gatorade into her IV.

I’ve just sent the nurse to check on removing the NPO muzzle from Renee’s chart. They’ll probably have to set up a visit from a mastication specialist to re-teach her how to use those pearly protrusions lodged inside the oral cavity.

Sounds like lunchtime to me.

Tube Free

The NG tube is gone. Oh, I miss the sucker but Renee sure doesn’t. They were supposed to do this re-hook and measure output and follow a precise medical procedure but they just yanked it. No tube but it was still a rough night for Renee. Nausea and pain continued. She is still NPO, nothing by mouth. They want to ensure that she’s shaken the ileus before they put anything in her stomach.

She’s doing much better this morning and I’ve had her up and about roaming the halls. She’s got lots of grumbling coming from her abdomen. She said last night, “There’s a dance in my pants.” Maybe it’s the ghost of Michael Jackson. This is good but we need to make sure that it is not another false positive.

Since there has been no reintroduction of food, Friday is off the table for release. They are taking it slow and easy so they don’t cause another setback.

MK requested the Ballad of the Ileus, the nasty sleepy bowel syndrome which is holding Renee and I hostage here in Cleveland, so here’s my knee jerk response. I’ve cheated a bit, but only in the same vein as the pros. The following tune has a familiar melody. It has been passed down through the ages with different words by numerous messengers. It is a ballad that has been kept alive in pubs and carried news of war and strife. You may know it as the Irish rebellion tune Patriot Games or more recently tweaked a bit by Dire Straits as Brothers in Arms. There are still echoes of war in the melody but here they are more personal, the fight closer to home. I present to you:

The Ileus Song
By Bob Masterson

Well I’m not a poor man
But I’m also not rich
I’ve landed a good wife
Though she suffers hardship
Her health has been threadbare
Her misery long
She endures the quiet
Of the ileus song

There is not a horseman
To sound the alarm
What of the Greek man
Who said do no harm
My patience is stretched
My faith almost gone
As I witness the spate
Of the ileus song

Slumber is known to
Replenish the soul
But slumber it too
Can take its toll
When sleep grabs a hold of
A part of the loins
That succumbs to the lull
Of the ileus song

How to awaken
An organ so deep
That needed intrusion
To shock it to sleep
It counters all notions to
Prod it along
And reverse the ills
Of the ileus song

While my good wife slumbers
Viscera wakes
We welcome the rumble
Of wind as it breaks
Stir now my love
You’ve lumbered too long
Under the spell
of the ileus song

Time is our ally
A friend we know dear
It holds no compassion
For short-sighted fear
It bolsters resolve
From that which is wrong
And shutters our ears
To the ileus song

Let's Go Tubing

The NG tube just brings out the most interesting things. In quick summary (as opposed to long summary), it is a stomach vacuum. I call it the Nose Goop tube because that is where it is threaded through. Medical professionals have corrected me and provided the proper technical term but, is this really a time to be paying heed to medical professionals? I mean really, look where that got Renee.

Yesterday, NGt started spewing out some reddish sludge. Turns out that this is not a good thing, this happens to be the same color as blood. Blood, as you may well know, works best when it remains in the bloodstream within the body. If you take it out of its regular environment it can induce panic. We did not panic. What’s a little blood floating around when you’ve got all these other problems to address? We calmly informed a nurse. By calmly I mean hitting call buttons and screaming, “We need a nurse, there’s blood pouring out of the tube!”

Sticking a vacuum into the stomach is a precarious project. It sometimes bangs against the stomach wall and attaches itself just like it would if you get too close to the curtains with your Kirby. The stomach tends to dislike this and gets irritated. The blood was an indication of this irritation. Turning off the suction for a while usually allows the hose to reposition so you may return it to its intended function. After about a half hour of clamp off, the nurse hooked the hose back up to the suction and observed the liquid flowing forth. “Back to bile,” she exclaimed with a wink and a thumbs up! And added, “you’re never going to hear that statement again,” as she turned and left laughing at her own humorously succinct observation.

So you see it’s not all somber tones, we do get to laugh every once in a while, even though it hurts at least one of us.

Back to the tube, they clamped it again today. Not because of blood, because they need to see if the sleepy bowels are stirring. Eight hours of clamp off and then they’ll measure output. If it is 200 ml or less, the tube comes out. Then we can start the whole reintroduction of nourishment through the mouth.

Renee’s doing much better today and is moving around more. She’s been up and about a few times doing laps as instructed. We are marking progress for the second consecutive day. On your marks ………