I Think I Can, I Think I Can ….

The road to recovery is paved with iron rails. The patient is a fully loaded freight train trying to fire up the engine and build enough steam to get those steel wheels moving on down the track.

Required listening:
Life is Like a Mountain Railroad - Johnny Cash
http://www.youtube.com/watch?v=nQ-T_tryaE0

In mitten drinen (in MIT-en DRINE-en) adv. phr. suddenly; the midst of; along with everything else

The above is a Yiddish phrase Renee used to use a lot, except she pronounces it, im-mitten-din-nen-nen, and said it means, in the middle of everything.

In the middle of everything thing else, Renee has been battling iron deficiency, I told you about it a few weeks back. Not your average take an iron supplement deficiency, her body will not absorb and store it properly. This can set you up for all types of further complications especially while in a post-operative state. We found out recently through our own research that this is common in Ulcerative Colitis patients. It has to be fixed.

On Thursday, in the midst of her recuperation from her take-down surgery, she began Iron Infusion Therapy. Don’t you love how they come up with the names for these procedures? There is no therapy involved, here is what really happens: You present yourself at the BEeast at the same unit cancer patients report for chemotherapy. You go through a barrage of blood tests to re-check your iron levels, they sit you in a big blue chair and attach intravenous cables to your arm. The iron formula is then hung and dripped into your veins for a half hour to six hours depending upon your deficiency level and your insurance company. Insurance company you ask? Yes, they decide the type of treatment you get, not the professional medical staff at the hospital. There is a one shot session that is available and has been approved by the FDA. Our insurance company said, “Nooooooo! We’re going to make you stretch it out to six weekly sessions.”

The formula itself, as described by Renee, looks like liver in a pouch. Apparently, they take what is probably pig’s liver - direct from the JB Swift Pork Processing Plant here in town, I’m sure -place it in a food processor on liquefy, whirrrrr it up, and Well-a!, pour it into a clear plastic IV sack. I’m sure there is a Rabbi overseeing the operation, or at least an insurance executive, so the whole thing is completely kosher.

The session itself drains the patient in a similar fashion as chemotherapy. The after effects, of which there was no warning, include further fatigue, flu-like symptoms and aching bones and joints. I wonder, is there another bout of hair loss in the cards for Renee? When you go to the pharmacy and pick up your prescription you get a six page 4 point instruction sheet of do’s and don’ts and every possible side effect that is imaginable. You go for IV iron infusion and you get nothing. The more intrusive the procedure the less information they give you. You’ve got to go to the great library of bits and bytes to try to figure out what’s going on. And we all know how well documented and verifiable everything on the internet is. Take this blog, I’ve got thousands of fact-checkers working around the clock to corroborate every piece of BS I make up. It is an awesome backroom operation.

Five more sessions to go, it will take us right to the point where Renee should be returning to work. Hopefully all is back on track by then.

Hot, Hot, Hot

Required listening:
Hot Hot Hot – Buster Poindexter

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

Yes, it is a long road and, as they say here in Kentucky, Renee’s got a hard way to go. I think I’ve got the context wrong on that one but what do I know I’m from Jersey.

This recuperation is different than the previous surgeries. It is more covert. There are things going on behind the scenes that are murky to even the most keen observers. Renee expects so much from her body so soon after her procedure and is suffering letdown when her body does not comply with her expectations. There is one thing for certain, the body, especially certain parts involved in waste management, do not react well when put back on line after a year hiatus.

I’m going to try to put this in perspective for you. Do you like Mexican food? Do you like it spicy? Do you like to add Tabasco to everything and order jalapeno poppers for appetizers? Do you use habaneros as breath mints? Have you ever had the unfortunate experience of getting hit in the eyes by a massive dose of pepper spray? Well, if you’ve felt the effects of this heat then increase the worst you can stand tenfold and point it toward the business end of your digestive tract and WHOAHH! Man that’s HOT!

Since our bodies are conditioned to the daily rigors of excretion, we take for granted the tolerance developed for the acids which are expelled. When her gastro-doc warned Renee of some of the upcoming hurdles to anticipate, he said nothing about the burning. The hospital sent Renee home with some industrial strength butt paste and advised her to take Epsom baths but they didn’t give any real warning about the level of heat. Toss into this fire the abdominal effects of food re-introduction and you’ve got a code red on the hind quarter fever meter.

Continued use is the only thing that can re-build the calluses that protect the external area from the internal expulsion. Not even Extreme Makeover Home Edition could get this project done in a week. Renee’s going to be hurting for a while. At least until things cool down down-under she can go around acting like she’s hot shit.

Another Hospital Trip

Wow, the new Norton Brownsboro Crossing Hospital is pretty nice. We’re not talking BEast Park Tower nice but it’s nicer than the shared rooms at the Cleveland Clinic. While the hospitals here are going toward the hotel look, the newly remodeled floor at the Double C is going old style psycho ward look. White walls, white floors, industrial artwork, the only thing missing is the straightjacket hangars. It’s no wonder we wanted to get the heck out of there.

Did I leave something out? Why am I telling you about the new hospital? Why do you think? I’m telling you because Renee just can’t stay away. Four days out of Cleveland and she just couldn’t help herself. She must have been going through withdrawals. Just because we came home does not mean all is well. Take the patient, she expects complete recovery overnight. She is getting frustrated with the continuing pain and the inability to eat like she did before the surgery. Uh, hello! Abdominal surgery equals abdominal pain and appetite and diet may be affected by this. Do you think? Cream of wheat and tea have been her staples. Boy she likes her tea, I wonder why she doesn’t have a cup out when it is offered?

I started back to work Tuesday so I’m juggling car pool, housemaid and nursing duties along with my regular shift. Juggling is easy, it’s just keeping all of the balls in the air at the same time that is tough. Wednesday was a tough day of fielding panic calls about an ambulance and hospitals from Renee and her mom. Now I must confess that for a change none of this was about Renee. It’s about Other Nana, her 92 year old grandmother, and her admittance to the hospital. For a change Renee is not the patient but the visitor. Sorry folks I just couldn’t resist leading you on a bit.

Other fell in the bathroom, needed x-rays and some other tests so took an ambulance ride to Norton. The fall has knocked her further out of lucidity and raised her level of care to 24/7. Not that she wasn’t there before the fall but now I think her primary caregiver, Renee’s mom, is finally accepting that this has reached a degree beyond her abilities to handle at home.

Renee must be feeling little better because one, she got out of the house to visit Other and two, she was arguing with her nurse, me, over a bandage versus a band-aid. She has two incisions, one being the stoma site which is pretty large and the other a small slit to drain the knot that wasn’t a knot. Both sites are healing nicely. It was my turn to change the dressing, since it’s always my turn, and Renee felt the need to tell me how to do my job. Which one of us went to nursing school here? I think I can tell when a tiny wound requires only a band-aid rather than a 4x4 bandage with enough tape to wrap a mummy. OK, so maybe I didn’t go to nursing school but I have almost a full year of on-the-job-training with Renee and, at least I looked at the wound before I decided what size band-aid to pick. Just to make Renee happy I picked the biggest in the box.

I’ll allow a certain amount of post-op antics as I understand the frustration of the patient, but if she pulls a stunt like that again I’m going all Nurse Ratched on her. Nurse Ratched guys? C’mon do I have to explain everything? One Flew Over The Cuckoo’s Nest? Ring a bell? You should know that if you’re reading this blog that there’s going to a heck of a lot of insanity references. It helps keeps me sane – and not a word from you hecklers.

The good news is that Renee is slowly progressing rather than going in the opposite direction like her previous surgeries. The bad news is that she has the added stress of her sick grandmother and we just can’t seem to distance ourselves from those dang hospitals.

My Old Kentucky Home

We finally made a break for it and left Cleveland behind. Don’t think it was easy. Renee was feeling good and did fine with breakfast and lunch. Her body was telling her it was time to go but her head was a little reluctant to cut the cord. The other shoe has dropped so many times before that the prospect of standing up on her own two feet produced queasiness. Facing that long drive made me a little nauseas too so I can understand her trepidation. She was expecting something else to go wrong. It didn’t. It was time.

Required listening:
Same Kind Of Crazy - Delbert McClinton
http://www.youtube.com/watch?v=mTZaO4BMfPc

We can debate the psychology factor all day long but I’m not sure who with. I read a report in yesterday’s paper that less than one-third of psychologists receive the proper training needed to adequately diagnose and treat their patients. If this is the track you’re taking to get some control over that aspect of your wellbeing than you’ve got better than a 67% chance of picking a quack and spending the rest of your days walking around in your duck pajamas. That’s why I’ve carefully researched the situation. My shrink is Dr. Guinness. Brilliant! I keep sending those bills to my insurance company but they refuse to reimburse me. And speaking of refusals, although there is no denying the high quality of the results, Renee refuses to use my doctor. She says he smells and his prescriptions make me snore – from both ends. That may be true but he makes house calls and as long as I’m not engaged in that bizarre activity called work I can take advantage of his services almost any time.

The drive back was uneventful on the traffic front. All of the construction tie-ups were north bound. We did get a good glimpse of the Ohio Autumn color spectrum and the sunset over Northern Kentucky, although it was mostly with the visors down to shield our eyes from the blinding orb. One stop is all we made. One stop! Not bad for a post-op patient and a bladder challenged old man. We arrived back in the ‘Ville about half past eight. We picked up the child, dog and hermit crab, - yes, Cassidy’s got a crawling crustacean – at the Nanas. “We” unpacked the car and I made it to the couch in time for the ninth inning of the Yankees’ brooming of the Twins. I felt more sapped than the fans at the Metrodome, it took all my strength to carry my eyelids upstairs to bed.

This may sound strange from a couple of Jersey-breds but the Old Kentucky Home sure feels good.

Oh, Fickle!

Required listening for today:
Closer to Fine – Indigo Girls

http://www.youtube.com/watch?v=bsU57x59ejM


This is a fickle business. It’s all ups and downs and back and forths, I feel good, I feel lousy. I’m going home, I’m staying. We search for definitives but there are none. Heck the darn wordprocessor doesn’t even recognize the word. The doctor comes in and asks, “Do you want to go home?” “No Doc, it’s such a great place I want to stay here forever. You’re kidding right?” The doc is asking Renee to see where she stands on the issue, hoping the patient has some better insight. It’s a strange little tennis match. “You’re the doctor, am I going home?” Here’s some more fickle for you. “Well, let’s see how you do with breakfast and lunch.” This is a fill in doctor, the surgeon went on vacation after yesterday’s visit. “Bye, see ya, have a good time, we’ll be here trying to figure this stuff out on our own.”

Renee’s got her appetite back. She was supposed to get a normal meal for breakfast but she got the soft diet tray with nothing heavier than cream of wheat. Now we’ve got to order a fresh tray so that we can get food in her system and see if it stays down and flows through. Monitoring this operation is called the Lipton Tea Bag method.

Doctor Fill-in ordered a bedside ultrasound to make sure that Renee’s spasms are just part of the normal healing process and there is nothing else causing the pain. They’ll do that test sometime this morning. Its wait and see, hem and haw - we’re standing on the edge of the diving board listening for the lifeguard to blow the whistle saying it is safe to go in the water and swim down I-71 home.

True to form Renee has surpassed the estimated in hospital recovery time. And for a few moments the other day we doubted her. Is there no trust in the world? She may be fickle but she is consistent. Consistently fickle? Is that possible?

We might be headed home today and we mightn’t. Right now we are dancing on top of the fence. It’s a fickle business and things can go either way.

For Pete's Sake

Renee's getting pretty chummy with a nursing assistant. The new aide signed in last night and is a nursing student who only works weekends. I’ll call this NA Peter because Peter’s packing equipment most of the other NA’s are not. After I left last night to get some grub and watch the Yanks – I hope you watched the whole game – Peter comforted my girl here with a little backrub. He handed her some mouthwash first, not making this up folks, because, I guess, a guy named Pete just doesn’t want to get in that close with a girl who’s still got ralph on her breath. First she’s hanging with Ralph and now rubbing with Peter, maybe I should be concerned. I’m not. Hey Pete, next time don’t just rub, scrub. She’s been lying in the bed since Tuesday, set your stinkometer a little higher than bad breath and clean her up completely, dang part-timer.

Renee’s feeling a lot better today. She’s doing her laps, joking, making comments on the blog and facebook and even ate a whole banana. She’s still hooked up to the IV and is still experiencing abdominal spasms but the contraction like pains are a lot less frequent. The banana was not part of the liquid diet they have her on but she got hungry and ate it without asking. So far Ralph has not returned, I think Peter chased him off.

Progress is the word of the day. The culture results came back negative for the UTI. The surgeon stopped in early this morning and said everything is moving in the right direction. Now, if Renee can hold down her food, which should come on tonight’s dinner tray, we may be out of here before the Designated Discoverer of America Day. Maybe we can get her cleaned up before then too, for Pete’s sake!

Anybody Got A Match?

Despite what some of you may believe I try to keep this blog pretty clean. It is very rare when I purposefully try to gross you out. This is not a pleasant subject, it is something that is more natural than just about anything else we do but still no one is real comfortable talking about it. Taking out the garbage at home is no big deal. But talking about human waste, ewe, I don’t want to hear it. Can we please change the subject? Uh, no. You can not realize what an important subject this is until your body says, I’m not doing it anymore.

I’m not going to go crazy here describing stool and consistencies and the like. But we do need to have a word about flatulence. So hold your noses and let’s get to it. Flatulence as you all know is the gas that is produced as a by-product of the digestive process. It can be expelled two ways via the mouth or via the … a …. other end. See I can’t even write it. Why don’t we go British for a few moments and call it a bum. Great now the bums are going to protest. They’ll probably hold one of those sit-ins in Central Park. I can see the headlines. Dumbass Offends Bums - Bums Park On Bums In Park.

For the last 10 months Renee has not been able to produce any flatulence. Oh, there was still the expulsion of gas into her colostomy bag but it’s not the same when you can’t just rip one off. Easy girls, you know you’ve all done it. And guys, you’ve done it with a lit match against your bum. Don’t deny it. Since the surgery Tuesday, Renee has had serious cramps. The doctor says it is due to the sewing up of the muscles and how they are trying to adjust to their new configuration. The muscles are just now figuring out how to work again. The whole system that points south has been dormant for a long time. It is jerking itself awake in fits and starts. It has been trapping the gas while it stretches and contracts. The gas didn’t know whether to move up or down so it just sat and increased the discomfort that came with the violent spasms. Then last night it started working its way out. Renee can fart again. Ahhh! What a relief!

Renee’s pain level immediately diminished. Her nausea has quieted. We can genuinely start thinking about discharge, maybe tomorrow if the re-introduction of food has no ill effects.

The moral of this story? Let her rip!

It's All Good

Don’t get me wrong here folks, it’s not all bad news, this is post operative abdominal surgery recovery and remember who the patient is. This is Renee, at least one of us knew what to expect. Routine expectations are three to four days in hospital, for a resident to get Renee all hyped up about going home without even a visit from the surgeon on the second day was just wishful thinking and not medical pragmatism. Wednesday’s fabulous feelings were just the calm before the storm. If any of you are road racers, be it running or cycling, you know that the day after the race is never as bad as the second. That is just how the body works. There are exceptions but in post-op situations you’ve got to pay attention to the rule more than the exception, especially when you’ve got a patient history file thickerer than a twelve-stack of Chunky bars. It is her modus operandi, it is right there in the manual. I should have cut the whole thing off but I got swept up in the notion that maybe just once Renee would change her methods. Nope, I just extended my hotel stay. We’re back to chapter one.

The good news - I got Renee out of bed for a walk this morning. She was attacked by the dreaded hiccups but the walk cleared them up. (You can scan the posts from December’s visit for clues on why I think hiccups may be the worst post-op affliction that Renee has dealt with. The red allergy bracelet she’s sporting is a not so gentle reminder as to how not to treat them. Really Bob, hiccups vs. renal failure? OK How about the most entertaining, life threatening, post-op affliction?) Renee’s back on the IV since she’s not taking in much during meals. Her stomach is in knots and they have started antibiotics due to a possible urinary tract infection. I say possible because the lab tests haven’t come back yet but all the symptoms are pointing that way. There was no catheter insertion this time around so how this happened we’re not sure, but it is a hospital and Renee is an infection magnet. I put this in the good news category because this is a pretty simple and manageable post-op problem.

Also in the good news category is the fact that all of Renee’s plumbing is continuing to work. The urine stream is pretty low but hopefully we’ve got that addressed. The back-end renovation has been working well since Wednesday night. So far there have been no surprises there as Renee has recognized the urges and has managed to control them until she gets to the porcelain pew. Controlling them once we get on the road will be a whole other adventure. Now, if we can get the upset stomach under control we’re probably back to where we were before we called in the bucket brigade on Thursday morning.

Tomorrow is day 4, still within the projected range. Can we make it out of here without doubling the normal patient discharge expectation range? One day at a time folks, one day at a time.

Renee is doing better today than yesterday. The zofran for nausea and the morphine for pain bring drowsiness which holds her back from doing the exercise laps that she should do. The treatment causes delays all on its own or masks progress due to the dulling of the senses. Renee’s coloring tells a better tale of how she’s progressing. She’s got some pink back in her cheeks and she just changed over to her own pajamas so its all good.

A Three Hour Tour

There is a girl in New York City
Who calls herself the human trampoline
And sometimes when I’m falling, flying
Or tumbling in turmoil I say
Oh, so this is what she means - Paul Simon

We go through our lives and we watch other people slide down. Sometimes it is a child gleefully steering their Flexible Flyer into the bumps on the snow covered slope. Sometimes it is a relative who has lost a job and can’t stop the downward spiral. I once stood there inches away from Cassidy as she rode her bike with training wheels in the driveway. She was three and had the same smile on her face as that child on the sled. Then she hit the edge of the driveway and tipped and fell – FLASH – that quick, broken arm. You can do your best for everyone around you, you can be right where you are supposed to be, still you are left watching as others go down. You are a spectator, the best you can hope for is being there on the sidelines, waving the pom poms with all the youthful enthusiasm of a high school cheerleader, willing them to get the hell up!

I am again caught watching one of those slides. The lady who was practically dancing around the halls yesterday has again taken to the bed and her face has assumed the same ashen grey complexion of a Halloween ghoul. She is grabbing her side like a boxer who has taken one too many body blows. She is clutching the bucket like a college girl after her first frat party. She was given false hope by trained professionals who should know better. She now lays drugged and dejected and guilt-ridden because she thinks somehow this is her fault that she felt so good and now feels so bad. And I am doing my best to root her on but I just don’t have the legs for those skimpy outfits.

It feels like we’re stuck in a whole season of Gilligan’s Island episodes. We somehow booked a cruise on the S.S. Minnow. This morning, we started out on a pleasure cruise. We were three hours from homebound. Then the tidal wave hit and sliding down the side of it was the Minnow. I’m still trying to figure out which of the characters we are. The Howell’s, Thurston and Lovey? Nah, ain’t got the bucks. The Skipper, Gilligan? Nah, we’re not part of the crew. The movie star? Not even close. So that’s it, we’re the rest. You remember the song right? The first season it didn’t even mention the Professor and Mary Ann, they were “and the rest.”

We are shipwrecked in Cleveland. The surgeon is the Skipper, a man who has so much sea and medical experience but can’t relay how the tides and routine recovery work to his passengers. Gilligan is any one of the surgeon’s first mate residents who try their best but come off only as clowns with their misdiagnoses and their accelerated optimism, not yet experienced enough to know the dangers of the seas and post-op recovery. Renee is Mary Ann, she is running around half naked without a darn clue as to what is happening. I am the Professor, I can build a radio from coconuts but it will only receive and not transmit. I can build huts that can withstand hurricanes but I can’t fix a 3x3 hole in a boat or build a raft that will hold together in calm seas. I can do almost anything to simulate the creature comforts of home, I just can’t get us off of this dang island.

At the end of every episode of Gilligan’s Island, no matter how close they were to going home or how high their hopes were for getting off that island, there was always some setback that placed them right back where they were at the beginning of the show. That is where Renee and I are now, and the worst part, no laugh track. I’ve got to supply that all on my own. I hope its working.

Tune in tomorrow to see if this crew can somehow overcome this 60’s sitcom curse.

We Have All Been Here Before

Just once, just once, just once, that’s all we were asking, that just once things would go smoothly, no complications, no setbacks. The car was packed, the discharge papers started. We were all waiting for Renee to get through lunch and to see how things went and then … ralphhhhhhhh. That guy will get you every time.

This isn’t déjà vu. We have been here before and this is really happening again. If I wasn’t expecting it and wasn’t prepared for it I might be upset but still ….. just once. Cleveland’s a fine city but it’s not the best place to watch Yankee playoff baseball. The Double C is a fine hospital but the novelty has worn off. I’d head back for the rooftop and the good karma zone but it’s raining on that parade too.

Ralph wasn’t even big, just a little guy. You’ve got to watch out for the little guys they’ll get you every time. Ralph carried a big wrench though, and he tossed it right into the going-home-works. Direct hit, how come when you’re trying to fix something with that same wrench it never works that well?

Stay tuned, we have all been here before.

Check this out while you're waiting: CSN live - Deja Vu

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

Surprise, Surprise

About 10:00 P.M. last night Renee got the call. It came from the nether-reaches, the dark area hidden from sunlight that has been silent since last December. She rejoiced with the same enthusiasm as a parent who has been attempting to potty train a reluctant toddler observing the child handle things on her own for the first time. Somewhere on the near horizon lies the diaper free zone, the colostomy bag free zone, the gut-wrenching pain free zone, the operating room free zone, the gastroenterologist free zone.

We are not quite there yet. We are hoping this is not one of those false positives that faked us out following previous surgeries. The nurses and doctors are very upbeat about the progress. Renee got placed on solid food this morning and had no problem with an omelet. Someone mentioned the big D word, discharge. One meal at a time is where we’re at.

Renee said the pain is worse today and there seems to be more swelling from the stoma site than yesterday. She’s sleeping more today also. Was yesterday just an adrenalin rush day? Was this patient so overwhelmed that she wasn’t knocked completely out of it by this surgery that she overdid it? I will tell you that I prefer the Renee from yesterday. Both of us were completely surprised at how quickly she popped out of the anesthesia fog. Both of us were completely surprised that she didn’t get and didn’t need the morphine pump. They said she would. Both of us were completely surprised that she was able to get out of bed and walk upright as if no-one had been poking around inside her abdomen the day before. Don’t you just love surprises? Let’s not let anything go and spoil it.

Bionic Butt Woman

It’s Renee’s birthday month. I got her what she’s been asking for the whole year, a bionic butt. She loves that line and uses it often. I think I’ll start calling her Jaime. C’mon guys, Jaime … you remember, Lyndsay Wagner played Jaime Sommers, the Bionic Woman. It’s a classic, better than the Six Million Dollar Man with Lee Majors, basically because you had slow motion shots of a nubile Lyndsay Wagner running and kicking everyone’s non-bionic butts to that stuttered metallic soundtrack - dunnunnununununun. (That’s metallic, not Metallica, you metal heads.) http://tinyd.net/70bionic.wav There was a short lived remake last year that was pretty good but it faded quickly. So it’s Jaime from now on. Everyone play along.

And catch all the shows here:
http://www.hulu.com/the-bionic-woman-classic

I got to the hospital before nine this morning, Renee was awake and had color in her cheeks and had already finished breakfast. No solid food yet but she’s doing well with the liquid diet. She got cleaned up and was about to take a walk when the nurse came in and asked if she wanted her IV disconnected first. Yes folks, less than 24 hours after surgery and she is tube free. It took a while to cut away all of the tape holding the line in place. Whoever set it up didn’t want that line to move a hair of a centimeter, it took the nurse about fifteen minutes to liberate Renee. It was like watching Greenpeace cut a dolphin free from a tuna net, quite a production.

Following Renee’s unshackling she practically ran away from the bed. She did three full laps in the outside lane of the fifth floor loop and was passing other patients like she was in the Nascar Cup Chase. Dunnunnununununun, you go Jaime. Where’s the slo-mo shot?

The best part of the morning is they let me watch them change the dressing. Yes, I heard that many of you were complaining about the lack of graphic descriptions of the unpleasant medical stuff this session. Don’t fret, I haven’t lost my touch and you really need to know. For example, you need to know what a stoma site looks like after it is reversed – a pair of raw, red pursed lips sewn together. There, that wasn’t so bad, was it? That’s because I lied, it looks more like a stitched up anus. That is after all what it was. I’ve told you before folks, this stuff ain’t pretty. You knew it was coming. You were waiting for it. Deep down you really wanted it. I could not disappoint.

Now, should we go into the description of the impending output from the new plumbing set up? Nah, I’ll save that one until we’ve got some more solid info for you.

The worst part this time around is there are no staples in Renee’s incision. You know I have a staple fascination and tried unsuccessfully to get Renee to let me pull them. She just wouldn’t let me have any fun. This time I can’t even play that game. Say awwww.

Remember the boom boom boom brawl I told you about that kept us up the other night? The culprit was a Cleveland Browns player who because of his antics got kicked out of town to the NY Jets, another episode of Celebrity Fringe for Renee and me. If this happened post-op rather than before, Bionic Butt Woman could have broken the whole thing up before the cops got there. Dunnunnununununun, Bionic Butt Woman to the rescue! Now we’ve just got to come up with the right costume.

Second Season

11:33 A.M. – pre-surgery
Sitting in the pre-surgery waiting room I was reading a collection of tributes to departed friends and celebrities by an Eastern Kentucky writer, Anne Shelby, who I met a few months back. Wow! I’m telling you this is absolutely the wrong thing to read while your loved one is having intravenous tubes hooked up in preparation for major surgery. Damn! You just don’t want to be stirring up that kind of emotion at a time like this. You want positive survival energy going, no negative vibes, no descriptions of how someone who has passed touched your life. I had to put it down.

12: 25 P.M. – transport to surgery
After they transported Renee away for surgery, I then moved over to the P20 surgery waiting room. Oops, I mean the Surgical Center Family Lounge. Really? The lounge? I love how they try to soften every bit of authentically descriptive phraseology in the language. A new twist here, they had a violinist providing what I guess they thought would be soothing classical compositions to the overstressed masses awaiting word on their loved one. How about choosing something a little more upbeat, buddy. I like classical music as much as anyone but the sound of a singular violin scratching out a hundred year old score was haunting. I don’t think this was the result they were looking for. Couple that with my mis-chosen reading material and as Christine Lavin put it in Rockaway, her song about the end of summer, “it’s enough to make me lay down and cry.”

http://www.youtube.com/watch?v=BXk_Lt9GIWQ

I believe in karma - good karma, bad karma – so I had to break free of the negative forces pushing on my fragile nerves. Without even telling the P20 desk attendant I was leaving – I was told twice to inform them if I was leaving the lounge - I went and grabbed a sandwich and headed for the rooftop. I needed some air. I’ve told you about the pavilion on the roof of the Cleveland Clinic before. Oh by the way, I’m not calling it the Cleveland Clinic anymore, it’s now the Double C. Continually using the word clinic sounds like we’re having a sexually transmitted disease looked at. We’re not talking about a case of the crabs here. This is a triple dose of majorly invasive maneuvers. And, since we’re removing the possibility of psychologically damaging connotations from everything, I can’t go around calling it a clinic. Someone might get the idea that sick people are here. We must remove all reference to real life situations from real life situations. If you want reality you’re going to have to watch it on TV in between a bunch of laundry detergent ads.

Now back to the rooftop – It’s a beautiful autumn day in Cleveland. Visibility is good and the downtown skyline is framed by Lake Erie and some low hanging clouds passing lazily above the points of the hi-rise cluster. The clouds are casting a few shadows, hiding the reflections in the glass and granite, but the sun is winning the battle between light and dark - fresh air and a fresh view, just what the doctor ordered. I took a few good deep breaths and headed back to the lounge and settled in with a new book.

01:39 P.M. – surgery has begun
Estimated surgery time is two hours, I roost in to a chair away from the bustle of parading patients and impatient family members.

03:58 P.M. – Paged to the P20 desk for a doctor’s call.
The surgeon said all went well. For once he only performed the basic surgery as advertised without any complications. The knot he thought he would have to remove turned out to be a fluid filled sac and it only needed to be drained. Renee is doing fine.

4:26 P.M. – Renee was taken to the recovery room.

5:45 P.M. – received page - Patient is stable, in recovery – they will page again when I can see her.

6:20 P.M. – Report to P20 for room assignment – Renee was being moved from recovery to Room H50/15. They validate my parking. I beat Renee there by about three minutes. She reported that her pain level was a 3 out of 10. She got up on her own and went to the bathroom. She said yes when they asked about dinner. She was fairly coherent and in pretty good spirits. All right, what did you guys do with my wife?

9:00 P.M. – Bob leaves a groggy Renee to get some dinner and some rest.

9:25 P.M. – Bob hits pub across the street from hotel and catches the 12th inning of the Twins/Tigers marathon. Tigers choke with bases loaded and less than 2 out. Twins don’t choke.

The baseball playoffs start tomorrow, what some call the second season. Renee did well today and tomorrow …., tomorrow starts her second season.

Good night and Go Yanks!

Bucking the Trend?

Everyone keeps saying how easy this surgery will be, the nurses, the surgeon, staff, is this the first time they’ve dealt with Renee? The surgeon was pretty cagey when trying to describe the surgery and the possibilities. He tried to nonchalant the chances of splitting Renee up the gut. Give us the darn worse case scenario doc. There is a good amount of muscle stitching in this operation, he already knows he’s got to deal with a knot that has formed on the incision from the previous surgery, handling all of that through the stoma access hole will be tricky. Renee’s got a long history of adhesions, it’d be pretty surprising if he didn’t have to clear some of these that have formed on important tubing. I’m not trying to jinx anything, I just know our girl. I told the doctor that I booked the hotel for six weeks just in case. This got a laugh out of him, I didn’t think he had it in ‘em.

We’re off to the hospital now. I nearly finished a whole book in the waiting room yesterday and I forgot two more that I thought I had packed. I am under-literaturized. A trip to the book store will happen soon but not today. The doc did give an estimate of three days post-surgery in the hospital. Renee has doubled the estimate on both previous surgeries, we’re hoping she’ll buck the trend on this one. Later.

A Boom Boom Boom

A Boom Boom Boom,
A Boom Boom Boom,
All night long

We got a late start on a Sunday so you would have thought traffic would be light for the trip up to Cleveland, but no, it was a slow, stop and go filled ride. Construction and breakdowns and accidents brought three lanes of highway down to one too many times to count. We pulled into the hotel after 11:00 P.M. so that nice restaurant dinner we had planned was replaced with pretzels and beer cheese, two things you should never travel without. We got a room on the front side of the hotel close to the elevators and turned in. Our sleep was disturbed by the booming bass of the nightclub across the street. Their patrons then decided to spill into the street about 3:00 A.M. and have a brawl. I watched the cops break it up from the bedroom window. They quickly disbursed at the site of the taser. No arrests and even better no cops hurt. Good for them but for us not a good start to the visit.

I complained today about the noise from across the street and the front desk assured me that the nightclub does not operate during the week. We’ll see. They tried to find another room on the other side of the hotel but none were available so they comped last night’s stay. It pays to complain.

Renee had a list of places for pre-op appointments. We started at 8:30 A.M. in the basement of the H Building in Radiology. Her only clue to what they had in store was the word procedure. She got a real how-do-you-do-good-morning when informed “procedure” means Water Soluble Enema with X-Ray. The technician said, “at least we’re using the pediatric tip.” Hoo-ah! There’s nothing like the smell of enema in the morning. This test was done to check for seepage in the piping structure that was built during the last surgery. They filled her posterior canal with water and took a bunch of pictures, kind of the inverse method to checking an inner tube for leaks. We got to carry the x-rays of this over to her next appointment with the surgeon. I’ll be posting them later.

The surgeon, after reviewing Renee’s history file of her post-op troubles, regaled us with stories about how common dehydration in J-Pouch* build patients is. Merrily we played along. Renee was also a victim and it landed her back in the hospital for another week after the last surgery. Why the heck didn’t he tell us these stories before when we really needed this information? If it is so common how about preparing us to deal with it rather than skipping that part and have your patient end up in renal failure? I wanted to slug the lug but I figured I shouldn’t damage the doc a day before surgery.

(*J-Pouch – a refresher, this is the internal pouch built from the small intestine which will serve as the replacement to the large intestine which was removed last December.)

The rest of the morning was filled with routine blood tests and surveys and consultations and CYA paperwork for the hospital. We left the compound and headed for lunch. Renee was given until noon for her last meal but the nurse who gave her the instruction advised us to be flexible with that timing since she knew Renee would not get out of the pre-op maze until well after. We sat down at the lunch table about 2:30 P.M.

Renee’s now on a fluid only diet. We report to the surgery center at 11:30 A.M. which means they won’t start the operation until mid-afternoon. We’re going to try and do a little better on sleep tonight. If I hear one peep out of that nightclub I’m going to go boom, boom, boom …..

Ducks in a Row

Getting ready for these surgery trips is a lot like preparing for vacation with the grand exception being we’re not planning any fun into it. This time around we’ve got Renee’s family living here so kennel and child care arrangements are a little less cumbersome to negotiate. Renee, unlike vacations, is packing light. Most of her fancy gowns will be supplied by her fastidious fashion designer at the Cleveland Clinic. The one-size-fits-none ensembles are perfect for those red carpet moments, especially when accentuated by the plasticized wristband and conduit accoutrements. You can hear Joan Rivers and her churlish offspring just drooling the word, “Exquisite!”

I topped off the anti-freeze in the X-Country and the house watcher has arrived. We’re all set. Now we’ve just got to time our arrival around the Cleveland Browns vs. Cincinnati Bengals game. Every one in Ohio is planning their day around this game. We’ll have to be extra diligent about moving road hazards as we near Cleveland.

Renee said good-bye to her Ducks on Friday, her last day of work for a while. That’s her pre-school class handle, named after a California hockey team I guess, because there are so many hockey fans here in Louisville. (That’s outright sarcasm folks, the only ice they know about here comes in plastic bags and gets put in a cooler for tailgating at high school football games.) It’s cute for the kids but Renee’s gone overboard with duck themed clothing and jewelry. The last thing Renee needs right now with all of her medical problems is to be inundated by quacks.

Renee gets two nights in a real hotel this time. She’s facing a full day of outpatient pre-op testing tomorrow and reports Tuesday morning for surgery. We’re hoping for a good restaurant dinner tonight as Renee has no meal restrictions or fasting requirements for tomorrow. We’ll catch you on the north end of I-71.