Important note: Cassidy and Renee specifically asked me where the blog post about the surgery is. Be careful what you ask for.
Here goes:
Cardiac Clearance
Morning of October 23, approximately 6:00 a.m.
You do everything that is asked. You advise the staff of previous conditions yet, on the morning of surgery, the hospital decides they have to hunt down a cardiologist at six a.m. to get cardiac clearance. Cassidy is now waiting on the tarmac like a commercial airliner waiting on the tower for clearance for takeoff, or more like an Apollo rocket waiting for launch. Houston we've got a problem.
They've called the surgeon and told him to take his sweet old time getting to the hospital since we are officially in a holding pattern. I hope we don't run out of gas.
But I haven't told you why we're here. Our patient is Cassidy this time. The young lady, yes, no longer a child, has decided to dispose of an internal organ. She's also decided to use a surgeon. In this day and age it's frowned upon to yank the thing out all by yourself. The whole healthcare monopoly could come crashing down. Rich doctors would be forced to toil in other employment less suitable to their educational level, kind of like our college graduate who can only find a job in retail in a city where the percentage of college graduates is at 7.5%. (Ugh, that’s a whole other blog.)
But I digress, and as you should well know by now digression is my specialty. I'm a Doctor of Digression, take that you MDs and Phds!
The organ in question here is the gall, as in bladder, not just the bladder, no one wants to yank that, but the gall bladder, which apparently shares the ranking of the appendix and tonsils as unnecessary.
I've still got all three so they're necessary to me but you can go and get them yanked to your heart's content or at least to your insurance company's pre-approval.
Cassidy's got the gall sludge and most likely stones. They can't be sure about the stones since they can't see through the sludge. We found out about the sludge after a brutal attack of pain had the girl standing on her head. When she informed us in the morning of her pain and prayers to the porcelain I immediately diagnosed it as her gall bladder. Yes I'm that good, in case you didn't know I sort-of work in healthcare so I'm practically a doctor. I’ve also had the experience of Renee going through the same pain thirty-plus years ago.
"She's a go! Cleared for surgery. " That's what the nurse just said. This was after Dr. Mayonnaise (that's not his real name but it does rhyme with a popular brand of the stuff), the anesthesiologist, reviewed the echocardiogram and said the surgery is low risk for the patient.
For those of you just tuning in or have completely forgotten (it has been ten years since our last surgical excursion), Cassidy was born with a few heart problems - pulmonary stenosis, which in layman's terms is a bum valve, and holes. Yes, I said holes. The holes were not the serious problem, this was surprising, a little leakage can be tolerated and they can heal on their own. A bum valve won't heal on its own though, so they blew it up, literally with a balloon, twice. Once at four months old and the second at three years old.
So for the rest of her life special precautions must be taken before any surgical procedures or teeth cleaning. I bet you didn't you know you could die from clean teeth. They don't warn you of this while they're handing out the free toothbrushes in grammar school but they should. It's got something to do with bacteria from your mouth traveling to your bum heart. Antibiotics are a must prior to any procedure and the doctor will administer these along with anesthesia.
Cassidy also gets anti-heartburn meds in case the anesthesia is too spicy. They offered Cassidy meds to relax also which she declined. Renee on the other hand was begging for them. Mothers are like that, more nervous than the child.
The surgeon just stopped in and explained how he will blow carbon dioxide inside the patient. This is to make room while they poke around. The proper medical term for this is giving you a fizzy wizzy, I looked it up (or made it up, whatever, keep moving). I wonder if this will improve her bubbly personality. For me it's good news that my daughter is being carbonated like a keg of beer. I wonder what psi they're using? And on a side note, the lady at the next table in the waiting room just exploded her tonic water. Let's hope this doesn't happen to Cassidy when they pop her top off or however they open her up.
They are re-prepping the Operating Room (OR) since the surgeon took another patient while we were waiting patiently to hear from the cardiologist who we never heard from but they decided to trudge forward anyway (that’s a mouthful of run-on). So then what was the holdup doc? Did I tell you they had weeks to work this out prior to today?
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| Cassidy giving us the look when asked about religious objections |
Another even Sider-note: It's amazing what you hear in pre-op. (Renee and I were allowed to spend time in pre-op while they palpitated over a solution to the heart question.) In a purported HIPAA compliant world, I overheard some real stories from other patients I was not supposed to hear. I won't go into too much detail but when a patient tells you they are a recovering addict and are scared of the meds why the Hell would you tell them you will be sending them home with high octane Schedule II opiates? Not every patient needs the highest level of pain meds after every procedure. Doctors have to stop pushing them and start listening to the patient.
Enough of the soap box, they just came to roll away Cassidy to the OR.
10 a.m. And the waiting room is pretty darn full, a whole bunch of people going through the same thing we are. I have become an expert at waiting rooms. Maybe I should set up a business where I coach people how to properly wait. Some folks have no idea. I won't turn this into a gripe session but c'mon people you are not at home, don't dress like it or act like it.
We are at Baptist East Hospital, which I refer to as The BHeast (pronounced beast, h is silent). The mix-up with the anesthesiologist this morning is one of those reasons. Another is the cafeteria. It is closed from ten to eleven a.m. daily. Why? And no posting of the cafeteria hours in the surgery waiting room? You hike across the BHeast only to find locked doors. Brilliant! Because no-one ever gets hungry mid-morning when they’ve been at the hospital since 5:45, staff and public alike. As a seasoned veteran of hospital waiting rooms I had plenty of snacks but it would have been nice to have a choice.
11:38 surgery is done.
We met the surgeon in conference room A. Surgery went well. The surgeon mentioned Cassidy's anatomy being different. One minor duct usually about the size of an inch long thread was the size of his pinky so he had to staple it vs. clamping. He didn't expect anything on Cassidy to be bigger than average-sized humans due to short stature. [Cassidy is 4’8” and that’s as tall as she’ll ever be. She has been diagnosed with Noonan Syndrome which is notorious for stifling growth.]
He said the gall bladder was rubbery which is an anomaly. It was scarred and near grey. (How does an internal organ develop scarring on its own?) The gall bladder was in bad shape apparently for a while, he said. It's a good thing it came out. Cassidy has probably been ignoring pain for a while before her 1st acute attack.
We'll cover that scarring question and the different anatomy in more detail next week during the post-op follow up.
Cassidy is in recovery and expected to go home this afternoon.
1:30 pm they invite us back to see the patient. She is of course groggy. The nurse says she had a small chat with Ralph after they have her a pain pill. They administer zofran for nauseau. Nurse says they gave Cassidy crackers with the meds but Cassidy had no memory of this. One thing I've learned over multiple surgery escort missions is you don't administer oral pain meds on an empty stomach. Messy situations usually follow. This is a hospital don't they know this? Da BHeast strikes again.
The Zofran didn’t take so they administered phenergran, it’s stronger and also makes you sleepy which is great when you are trying to get the patient properly awake to release them to recuperate at home.
After watching Cassidy sleepily nibble down a cracker and take a couple sips of sprite they released her to our care and we were home at about 3:45 p.m.
This is an unusual situation for me. With Renee the minimum stay was always a week. Same day release was never an option. Luckily Cassidy is not following her in that regard.
I’ll follow up on Halloween after we see if there is anything scary that comes from the post-op visit with the surgeon. He should have the pathologist’s result on the rubbery gall bladder and stones. And hopefully we can get some of the other important questions above answered. You know like cafeteria hours? Oh, you thought I meant about the patient, well who wants to know that?
Happy Hallows!
