So, I finally made it to a room at 5 AM on April 4. I thought I would get to sleep at that point. Not so much. The transport folks transferred me to the bed and then the nurse and tech started doing things to me. First the nurse moved my offending IV to a better position. Then she and the tech put a mattress pad under me the purpose of which I could never figure out. The nurse started doing the typical intake things. She checked my skin, did a social history questionnaire and the other stuff that needs to be done when you're brought to the floor. They also finally stopped the TPN I had come in on. I didn't much care what they did to me as long as they helped me get warm. The good news was my fever was breaking. The bad news was I was having severe shaking chills as a result. I don't think I've ever had chills that bad. My teeth were chattering,my muscles were all tensed to the point that I couldn't move. They piled blankets on me and after a painful two hours, they subsided.
At this point it was nearly 7 AM. Shift change and morning rounds began. Big Academic Medical Center is a teaching hospital That means rounds are a staggered affair. First. you see a medical student, then the intern, then an attending. The med student was the one who did a lot of the work for me. He told me that my heart rate had come down with rehydration but was still high. He seemed encouraged that my fever had broken. He said they'd just observe me until the blood cultures came back. On physical exam we discovered that I had some tenderness over my kidneys. This led him to think that I might have what he called an asymptomatic bladder infection and not a line infection. I know I didn't go to medical school, but wouldn't the fact I had had a fever mean that whatever was going on was symptomatic? Anyway, he finished his exam and left just as the new tech came in to do the first check of my vitals for the day. Any illusions I had had about this being anything other than a line infection were shattered at that point.
My fever was back and my heart rate was back in the 130s. Awesome. Soon, the resident was at my bedside looking perplexed. There wasn't a whole lot he could do until the cultures came back. I settled in to wait for those. In the meantime, I continued to receive broad-spectrum IV antibiotics and fluids since I was no longer getting TPN.\ The reason I continued to get antibiotics is because central line infections can turn deadly quickly. They always err on the side of caution.
Per the GI consulting on behalf of my GI, I could get only IV saline and dextrose for up to a week and be fine. I believed him that time. After taking weeks to be anywhere near human again, I'm regretting following that advice so blindly. The thing is, TPN can't be run through a regular IV. There is a version of it called Peripheral Parenteral Nutrition that can be run through a normal IV. If, heaven forbid, this happens again, I will insist on beginning PPN as soon as I lose my PICC.
Around 1 that afternoon, the medical student came in and said that the cultures had grown staph bacteria. This organism grew on the plastic of my PICC line, even with strong antibiotics on board. The line needed to be removed before we could hope to clear the infection. A few minutes later the resident walked the med student through removing my line and snipping the tip so it could be cultured. I can't remember now whether they cultured the end that had been near my heart, or the outside end. The good news was I was already on the right antibiotics to treat staph. The bad news was that I would be stuck n the hospital until at least Monday. I would need a new PICC as soon as my blood cultures had been negative for two days. The earliest that would happen was Sunday. The thing was the people who placed PICCs weren't in the hospital during the weekends. So Monday it would be.
The rest of Thursday and most of Friday passed rather uneventfully. I had an EKG late on Thursday. I also had orthostatic vitals taken at some point to check my hydration status. I checked out fine.
Late Friday afternoon, I had an echocardiogram to make sure my heart wasn't infected. This is a very real risk of central line infection given the line's proximity to the heart. I am convinced that test irritated the pocket where my stimulator lives. Since that day I have had significant pain in that area. I had Dr. B. check it out before I left since I was on his turf and he said it was fine.
Saturday's labs showed my potassium was low, so Saturday night was spent in tears as I experienced the internal fire that was IV potassium. Sunday was a low-key day. Monday, I had my line replaced and thought I was going home. Turns out my nursing agency had declined to take me back after I was discharged but neglected to say so until a few hours before I was due to leave. So I didn't get homthate until very late Tuesday night.
Since then, it's been a long slow recovery. I lost enough weight that I noticed. We tweaked my TPN formulation pretty substantially this week to help me regain that weight. I am still more easily fatigued than before.
As awful as this experience has been it gave some much needed perspective. Before this, I thought the worst thing that could happen was losing my job. Now I see there are worse things.
Showing posts with label hospital. Show all posts
Showing posts with label hospital. Show all posts
Thursday, April 18, 2013
Sunday, April 14, 2013
It All Fell Apart Part One: Lost Jobs and Long Nights in the ER
It's been awhile. Sorry about that. Life is exceptionally sucky right now.
Remember how I said work was really important to me? Well, I lost that job. A combination of the sequester and my needing to be homebound to get help with TPN led to my being let go. That happened at the end of March.
I spent the last week and a half of March job searching, filing for unemployment, and figuring out how to get my Social Security reinstated. I struggled emotionally to understand how I could be in the position of having to find a job again. It was hard enough interviewing when all I had to contend with were people's attitudes toward my using a chair. Now, I am going to present a whole new set of challenges at some point in the process thanks to GP. Talk about stressful. So things were in major flux.
Then April 3 happened.
I had felt exceptionally tired all day. I didn't think much of it since I'm often really tired. I also had some body pain that was new but I figured was explained by a lowish potassium found on my weekly labs drawn just two days before. As five o'clock neared, I actually took a nap at my desk waiting for my nurse to come. Weird. When the nurse came she unhooked me and I took a shower. I noticed I was weaker and had a harder time transfering than I do normally. Again I chalked it up to being tired. I got dressed while she got my next bag out and ready. She hooked me up, started the pump and started taking my vital signs. She told me my blood pressure wasn't low, but it was very "loud." My pulseox was fine, but my pulse was 135 reading from the pulse oximeter Wow. That machine is finicky sometimes, so she checked it manually and still got 110. High, but I had just been moving around and getting dressed. Then, she took my temperature. She asked me if I felt sick. No, why? My temp was over 100. Because I have a central line, a fever is a huge red flag for infection.
I had my nurse call the on-call GI covering for my motility specialist. She wanted to call my primary doctor. I knew it'd be best to let my GI handle it since I have the PICC for TPN. While we waited for the on-call to call back, I put shoes on and began gathering my supplies to sustain me through an admission if it came to that. The on-call called back and after hearing my vitals said I needed to go to the ER. I got my stuff together and headed out to the metro.
About 45 minutes later, I made it to Big Academic Medical Center. I headed to the ER and checked in. Every time someone took my pulse, they had to check two to three times to be sure it was right The first time I saw what it was, I wasn't all that surprised. It was reading 145, but I was feeling every one of those beats. I was brought back to an exam room fairly quickly.
When they hooked up the monitor, my heart rate ran between 150-160 beats per minute and my temp was hovering around 100. I was sitting still, not running a marathon as my heart rate seemed to indicate.The doc ordered a chest film and blood cultures. The x-ray to rule other sources of infection like pneumonia and the cultures were to check for an infection of my PICC line or in my bloodstream. They drew blood from my line and collected it in a jar that would be allowed to grow after being exposed to air. They drew blood from my other arm as well and collected that sample in a jar that would grow without the help of air. They also wanted a urine sample they could culture to rule out a bladder infection. Thanks to the fever and despite having TPN running, it took nearly three liters of fluid for me to deliver that.
My brother had met me in the ER and was a huge help. He distracted me and turned off my heart monitor every five minutes when it alarmed because my heart rate was so high. The rate began to come down as I was better hydrated, but stayed above 100 for the next two days. My fever trended down too, but was still high enough to be a concern.
Around 10:30, I was seen by the ER Attending. He asked some questions from behind a computer monitor. He decided I should be admitted in light of my fever and tachycardia. I called my dad to let him know I was staying, texted my mom, and then waited to go upstairs. My brother hung in there until midnight, but had to leave at that point. I hung out in my chair for another couple of hours but was transferred to the gurney at 1:30. I busied myself by eavesdropping on the goings-on in the ER. The stories I heard ranged from a woman seeking drug rehab, to a barely-drunk but very angry 19-year old college kid who was apparently there against his will thanks to a contract between the hospital and the university on whose campus the hospital lives.
Around 2 AM an internal medicine doc came down and saw me. She said she wanted them to stop my TPN in case that was a source of the infection. Apparently fungus likes to grow in TPN. Who knew? She said I would be given a peripheral IV in my right arm so that they could stop using my PICC.
The ER nurse had started me on two broad-spectrum antibiotics, Zosyn and Vancomycin which I was on for the duration of the admission at twice daily dosing. She also started an IV in my right hand that ranks near the top of my Most Brutal IV Experiences list. She found a good vein quickly. When that vein rolled, as my tiny red-head veins are wont to do, she FOLLOWED it. This fishing expedition meant an extremely awkward and painful placement into the boniest part of my hand. The bruise that line left is only now starting to fade.
Around 5 AM after nearly 9 hours in the ER, I was finally brought up to the fifth floor where I would spend the next six days.
Stay tuned to find out what grew!
Remember how I said work was really important to me? Well, I lost that job. A combination of the sequester and my needing to be homebound to get help with TPN led to my being let go. That happened at the end of March.
I spent the last week and a half of March job searching, filing for unemployment, and figuring out how to get my Social Security reinstated. I struggled emotionally to understand how I could be in the position of having to find a job again. It was hard enough interviewing when all I had to contend with were people's attitudes toward my using a chair. Now, I am going to present a whole new set of challenges at some point in the process thanks to GP. Talk about stressful. So things were in major flux.
Then April 3 happened.
I had felt exceptionally tired all day. I didn't think much of it since I'm often really tired. I also had some body pain that was new but I figured was explained by a lowish potassium found on my weekly labs drawn just two days before. As five o'clock neared, I actually took a nap at my desk waiting for my nurse to come. Weird. When the nurse came she unhooked me and I took a shower. I noticed I was weaker and had a harder time transfering than I do normally. Again I chalked it up to being tired. I got dressed while she got my next bag out and ready. She hooked me up, started the pump and started taking my vital signs. She told me my blood pressure wasn't low, but it was very "loud." My pulseox was fine, but my pulse was 135 reading from the pulse oximeter Wow. That machine is finicky sometimes, so she checked it manually and still got 110. High, but I had just been moving around and getting dressed. Then, she took my temperature. She asked me if I felt sick. No, why? My temp was over 100. Because I have a central line, a fever is a huge red flag for infection.
I had my nurse call the on-call GI covering for my motility specialist. She wanted to call my primary doctor. I knew it'd be best to let my GI handle it since I have the PICC for TPN. While we waited for the on-call to call back, I put shoes on and began gathering my supplies to sustain me through an admission if it came to that. The on-call called back and after hearing my vitals said I needed to go to the ER. I got my stuff together and headed out to the metro.
About 45 minutes later, I made it to Big Academic Medical Center. I headed to the ER and checked in. Every time someone took my pulse, they had to check two to three times to be sure it was right The first time I saw what it was, I wasn't all that surprised. It was reading 145, but I was feeling every one of those beats. I was brought back to an exam room fairly quickly.
When they hooked up the monitor, my heart rate ran between 150-160 beats per minute and my temp was hovering around 100. I was sitting still, not running a marathon as my heart rate seemed to indicate.The doc ordered a chest film and blood cultures. The x-ray to rule other sources of infection like pneumonia and the cultures were to check for an infection of my PICC line or in my bloodstream. They drew blood from my line and collected it in a jar that would be allowed to grow after being exposed to air. They drew blood from my other arm as well and collected that sample in a jar that would grow without the help of air. They also wanted a urine sample they could culture to rule out a bladder infection. Thanks to the fever and despite having TPN running, it took nearly three liters of fluid for me to deliver that.
My brother had met me in the ER and was a huge help. He distracted me and turned off my heart monitor every five minutes when it alarmed because my heart rate was so high. The rate began to come down as I was better hydrated, but stayed above 100 for the next two days. My fever trended down too, but was still high enough to be a concern.
Around 10:30, I was seen by the ER Attending. He asked some questions from behind a computer monitor. He decided I should be admitted in light of my fever and tachycardia. I called my dad to let him know I was staying, texted my mom, and then waited to go upstairs. My brother hung in there until midnight, but had to leave at that point. I hung out in my chair for another couple of hours but was transferred to the gurney at 1:30. I busied myself by eavesdropping on the goings-on in the ER. The stories I heard ranged from a woman seeking drug rehab, to a barely-drunk but very angry 19-year old college kid who was apparently there against his will thanks to a contract between the hospital and the university on whose campus the hospital lives.
Around 2 AM an internal medicine doc came down and saw me. She said she wanted them to stop my TPN in case that was a source of the infection. Apparently fungus likes to grow in TPN. Who knew? She said I would be given a peripheral IV in my right arm so that they could stop using my PICC.
The ER nurse had started me on two broad-spectrum antibiotics, Zosyn and Vancomycin which I was on for the duration of the admission at twice daily dosing. She also started an IV in my right hand that ranks near the top of my Most Brutal IV Experiences list. She found a good vein quickly. When that vein rolled, as my tiny red-head veins are wont to do, she FOLLOWED it. This fishing expedition meant an extremely awkward and painful placement into the boniest part of my hand. The bruise that line left is only now starting to fade.
Around 5 AM after nearly 9 hours in the ER, I was finally brought up to the fifth floor where I would spend the next six days.
Stay tuned to find out what grew!
Monday, December 31, 2012
The Hardest Year:2012 in Review
As I sit on the threshold of a new year, I am doing what many are doing tonight. I'm looking back on the year nearly over. I am marveling at the struggles 2012 brought for me, medically, professionally, and personally. With all this reflection I'm left wondering how the hell am I still standing? How did I not crumble? The answer is astonishingly simple. I was unwilling to make a choice that was anything but getting on with it.
Lest you have forgotten what I fought through in 2012 here it is again.
I was admitted to the hospital three times this year. I spent a total of 12 days in the hospital. I had two major surgeries this year, separated by just three months. Collectively, these procedures meant I lost a month worth of work time.
I had another gastric emptying study, an MRI, a head CT, a chest X-Ray, a Ph-probe study, a swallow study, an endoscopy, an MRA, and two doppler ultrasounds. I wore a Foley catheter for six days. I had testing of my bladder function. I now take nine different medications a day and two more as needed.Yes, I remembered all of that on my own, though I do have it written down for when I see a new doctor.
Speaking of doctors, my team grew by three this year. I now see: a primary doctor, two gastroenterologists (a general GI and one who specializes in gastroparesis and nutrition support.) a pulmonologist and a uroligist.
Yet despite all of that, I have excelled at my job I'm doing so well that I got a performance award during my year-end review in November. I have the best work family I could ask for. I am valued for what I bring to my job, and am missed when I can't be there.
So, while this year may well have been the hardest of my life, I made it through. 2013 is shaping up to start off just as roughly as I will be starting Total Parentral Nutrition (IV nutrition) in the coming days or weeks. I will make it through that too. As I tell everyone who stands in awe of my strength or courage or bravery, there is simply no other good choice. Just do it!
Lest you have forgotten what I fought through in 2012 here it is again.
I was admitted to the hospital three times this year. I spent a total of 12 days in the hospital. I had two major surgeries this year, separated by just three months. Collectively, these procedures meant I lost a month worth of work time.
I had another gastric emptying study, an MRI, a head CT, a chest X-Ray, a Ph-probe study, a swallow study, an endoscopy, an MRA, and two doppler ultrasounds. I wore a Foley catheter for six days. I had testing of my bladder function. I now take nine different medications a day and two more as needed.Yes, I remembered all of that on my own, though I do have it written down for when I see a new doctor.
Speaking of doctors, my team grew by three this year. I now see: a primary doctor, two gastroenterologists (a general GI and one who specializes in gastroparesis and nutrition support.) a pulmonologist and a uroligist.
Yet despite all of that, I have excelled at my job I'm doing so well that I got a performance award during my year-end review in November. I have the best work family I could ask for. I am valued for what I bring to my job, and am missed when I can't be there.
So, while this year may well have been the hardest of my life, I made it through. 2013 is shaping up to start off just as roughly as I will be starting Total Parentral Nutrition (IV nutrition) in the coming days or weeks. I will make it through that too. As I tell everyone who stands in awe of my strength or courage or bravery, there is simply no other good choice. Just do it!
Sunday, October 28, 2012
In Which I Become a Cyborg Part Two: Surgery
I am ready to continue the story of my experience having a gastric nuerostimulator. placed. My mom and I took a cab to Big Academic Medical Center bright and early on the morning of September 24. We got there way ahead of my scheduled arrival time of 7:30, so stopped off in the cafeteria so Mom could grab a cofee. Then we made our way to the surgical waiting room where we installed ourselves in a corner to watch shows on her laptop until it was time to check in. Eventually I was called to register, then we waited a bit longer and were brought to pre-op with several other patients.Mom helped me change into a gown, we transferred me to a gurney, an IV was placed, then we just waited.
Once the IV was placed, Mom mentioned that she had seen on the cover of my chart that they were calling the procedure day surgery. She asked how I would feel about going home right afjter surgery. I was hesitant, but knew that I'd be in good hands with my mom. Soon, Dr. B. came by to look at my chart. While he flipped pages, I asked where he planned to place the external part of the stimulator.
The system has two parts, the generator which is placed right under the skin of the abdomen generally on the left side, since that's where the stomach lives. The second part is the leads that are implanted into the wall of the stomach. The device is used as a treatment for the nausea and vomiting associated with gastroparesis that doesn't respond well invasive therapies like medications. It works by sending counter signals to the nerves of the stomach that would otherwise tell my brain I was nauseated. For some, it's the best tool they've found to help manage symptoms.
Dr. B. told me that he'd place it on the left side. He also told me that he hoped I would be willing to complete a questionaire about my symptoms before and after the surgery for MALS. He is doing a study of who are really good candidates for surgical correction of that syndrome. There was pre-op questionare and a post-op questionarre. Since nothing really had improved from before the surgery, it was easy to fill them both out after the fact. As unique as I am, I've never been part of a study. I'm weirdly excited about that.
Soon after Dr. B.left, the most attractive anesthesiologist I have ever seen came in. Seriously, he was so handsome. Awesome eyes, a beard that fit his face perfectly. He was just very fun to look at. He was impressed by my knowledge of myself. He gave me the awful ant-reflux junk. I told him about my history with Scanner/ OR Tables of Death. That would turn out to be the most important thing I told him. I said goodbye to Mom and don't remember anything until the recovery room. He must have given me something really good. After about three hours, the surgery was over and I woke up in recovery.
The thing I remember most about recovery was the pain. It huirt a lot more than I thought it would, especially in the area where the generator was implanted. In retrospect, they created a pocket where pockets do not naturally exsist, it was bound to hurt. It was also where the largest incision was. I was so glad to have my old friend morphine to keep me company! Afteer only an hour ore so in recovery, I was moved to a room. I got to bring along some oxygen this time as my lungs were trying to go on strike and my saturations were dropping a little.
Once I was in a room, I began the Wait for Pee. I wasn't going to write about this part, but figured it would be good for others to know. General anesthesia paralyzes all the muscles, including the bladder. That's why you'll often have a foley catheter placed during surgery. I discovered in June that my bladder is particularly suseptible to freezing up after having a foley in and then taken out. I ended up being sent home with a foley in place in June because my bladder just wouldn't cooperate. Anyway, this time around I didn't have a foley because I was already at risk of infection because I was having something implanted. It was up to me to break through and go on my own. This proved difficult and involved literally hours of trying. I tried different positions, while drinking, even got out of bed to try on a commode. After hours of trying without success, I let the nurse take care of things for me just so they'd leave me alone. After that and my nightime meds, we sertled down for the night. It was a restless night. I had realized the morphine was making my nausea worse, so I wasn't using it and was in a lot of pain. Morning rounds found me in a lot of pain still but eager to go home for my birthday the next day. I convinced them to let me go. I was still in significant pain, but not as nauseated and was now peeing just fine.
Before I left, I had my mom get me a bagel from the cafeteria. I took a bite and almost cried for the joy of it. It was the first taste of food I'd had in over a year that actually tasted good. I ate about a quarter of it then was full. I was ecstatic. Maybe, just maybe this was the answer I'd been hoping for.
Once the IV was placed, Mom mentioned that she had seen on the cover of my chart that they were calling the procedure day surgery. She asked how I would feel about going home right afjter surgery. I was hesitant, but knew that I'd be in good hands with my mom. Soon, Dr. B. came by to look at my chart. While he flipped pages, I asked where he planned to place the external part of the stimulator.
The system has two parts, the generator which is placed right under the skin of the abdomen generally on the left side, since that's where the stomach lives. The second part is the leads that are implanted into the wall of the stomach. The device is used as a treatment for the nausea and vomiting associated with gastroparesis that doesn't respond well invasive therapies like medications. It works by sending counter signals to the nerves of the stomach that would otherwise tell my brain I was nauseated. For some, it's the best tool they've found to help manage symptoms.
Dr. B. told me that he'd place it on the left side. He also told me that he hoped I would be willing to complete a questionaire about my symptoms before and after the surgery for MALS. He is doing a study of who are really good candidates for surgical correction of that syndrome. There was pre-op questionare and a post-op questionarre. Since nothing really had improved from before the surgery, it was easy to fill them both out after the fact. As unique as I am, I've never been part of a study. I'm weirdly excited about that.
Soon after Dr. B.left, the most attractive anesthesiologist I have ever seen came in. Seriously, he was so handsome. Awesome eyes, a beard that fit his face perfectly. He was just very fun to look at. He was impressed by my knowledge of myself. He gave me the awful ant-reflux junk. I told him about my history with Scanner/ OR Tables of Death. That would turn out to be the most important thing I told him. I said goodbye to Mom and don't remember anything until the recovery room. He must have given me something really good. After about three hours, the surgery was over and I woke up in recovery.
The thing I remember most about recovery was the pain. It huirt a lot more than I thought it would, especially in the area where the generator was implanted. In retrospect, they created a pocket where pockets do not naturally exsist, it was bound to hurt. It was also where the largest incision was. I was so glad to have my old friend morphine to keep me company! Afteer only an hour ore so in recovery, I was moved to a room. I got to bring along some oxygen this time as my lungs were trying to go on strike and my saturations were dropping a little.
Once I was in a room, I began the Wait for Pee. I wasn't going to write about this part, but figured it would be good for others to know. General anesthesia paralyzes all the muscles, including the bladder. That's why you'll often have a foley catheter placed during surgery. I discovered in June that my bladder is particularly suseptible to freezing up after having a foley in and then taken out. I ended up being sent home with a foley in place in June because my bladder just wouldn't cooperate. Anyway, this time around I didn't have a foley because I was already at risk of infection because I was having something implanted. It was up to me to break through and go on my own. This proved difficult and involved literally hours of trying. I tried different positions, while drinking, even got out of bed to try on a commode. After hours of trying without success, I let the nurse take care of things for me just so they'd leave me alone. After that and my nightime meds, we sertled down for the night. It was a restless night. I had realized the morphine was making my nausea worse, so I wasn't using it and was in a lot of pain. Morning rounds found me in a lot of pain still but eager to go home for my birthday the next day. I convinced them to let me go. I was still in significant pain, but not as nauseated and was now peeing just fine.
Before I left, I had my mom get me a bagel from the cafeteria. I took a bite and almost cried for the joy of it. It was the first taste of food I'd had in over a year that actually tasted good. I ate about a quarter of it then was full. I was ecstatic. Maybe, just maybe this was the answer I'd been hoping for.
Friday, August 24, 2012
A Tale of Two Surgeries Part Two: Showtime!
The weekend before I had surgery to correct Median Arcuate Ligament Syndrome was an anxious one. You'd think that a surgical veteran like me wouldn't contend with those pre-op jitters. You'd be wrong. Sunday morning I even had a nightmare about the surgery. I'm not even sure what it was about. I just remember waking in a cold sweat absolutely positive that I had narrowly escaped some terrifying fate. tried to think positively. I reminded myself countless times that day that I knew what was coming, that I would be fine. In the end though, a lot was going to be different about this surgery, at least on the surface.
This would be the first time that the decision to have surgery and the signature on the consent form would be all mine. That was just too strange to me. Having all of that responsibility also meant that if anything happened or the procedure didn't go as planned, I would have to live with the consequences. Sometimes, being a grown up is way overrated!
This would also be the first time that my beloved surgeon Dr. M. wouldn't be doing my surgery. Not that he could've, he's a bone guy, a pediatric bone guy. Not so helpful when you're looking to do abdominal surgery. Still, I found myself missing him that day. I liked Dr. B. well enough, but one office visit cannot create the relationship I and my parents built with Dr, M. A relationship made of 20 years of quaterly office visits, clinic visits and of course the surgeries. As a small child, I had surgery almost every summer. That is a lot of time for you to get comfortable with someone. That lack of familarity with Dr. B.threw me a bit on surgery eve. At the end of the day, I knew I was in good hands. Dr. B. is at least nationally if not internationally known as an expert in GP. I also knew that anytime I could nap in the middle of the day should be looked at as a gift!
The morning of June 18, my brother and I braved an especially packed rush-hour train and made it to Big Academic Medical Center just at my "call time" of eight. After waiting for nearly an hour in the waiting room, we were herded up to the pre-op area. He helped me change into a gown and slippers, lifted me onto the gurney, and then we settled in to wait. We talked about the meaning of life. Eventually a nurse came, looked fruitlessly for a good vein to start an IV, and promptly left to find someone known for mining those tiny veins. Soon, the expert came and placed an IV. Dr. B. made an appearance, flipping through my chart, introducing himself to my brother, asking if we had questions. Then he was gone. Next the anesthesiology team came in. We went over my history and when they heard that I had a history of reflux, they brought me a medication that tasted akin to what I imagine turpentine tastes like, with a sour lemon aftertaste. Delightful Next it was time to sign the consent, don a stylish hat and say goodbye to my brother. This was it!
Because of the reflux, they let me sit up until we got into the OR. Once they moved me over to the table, they kept my head elevated with foam. One thing I had forgotten in the time since my last surgery was how cold they keep the OR. Thank goodness for toast warm blankets. The room was a hive of activity. The anesthesiologist worked on positioning me, a nurse strapped boots to my legs to help with my circulation and prevent blood clots. (Those things were amazing! I had never had warm feet until they put them on.) Somewhere in the crowd I spotted Dr B. Then the plastic-smelling mask was over my face and I was asleep.
The next thing I remember was that it hurt to breathe. I cried for meds, and eventually was a bit more comfortable. I saw Dr. B. who promised I would soon be in a room and given clear liquids. Soon ended up being an interminable SIX HOURS later! I was never so happy to see a hospital bed.
By now, I had figured out why it hurt to breathe. I had four small incisions scattered over the upper left part of my stomach. These looked like deep paper cuts. I also had one bigger incison where the "main port" went. This was pretty close to my diaphragm, which is why breathing was so unpleasant. Dr. B. had told me that the first 12 hours would be the most painful. He was right. Over the next three days, PT helped me get into my chair, respiratory did treatments every four hours and I was kept comfortable. Aside from having to bring home a souvenir appliance and the logistics inherent in it, I did really well. I didn't feel better yet but was willing to give it time. Dr. B. had told me that it could take up to three months to notice improvement. I wasn't sure I could wait that long, but promised I'd try to be patient.
This would be the first time that the decision to have surgery and the signature on the consent form would be all mine. That was just too strange to me. Having all of that responsibility also meant that if anything happened or the procedure didn't go as planned, I would have to live with the consequences. Sometimes, being a grown up is way overrated!
This would also be the first time that my beloved surgeon Dr. M. wouldn't be doing my surgery. Not that he could've, he's a bone guy, a pediatric bone guy. Not so helpful when you're looking to do abdominal surgery. Still, I found myself missing him that day. I liked Dr. B. well enough, but one office visit cannot create the relationship I and my parents built with Dr, M. A relationship made of 20 years of quaterly office visits, clinic visits and of course the surgeries. As a small child, I had surgery almost every summer. That is a lot of time for you to get comfortable with someone. That lack of familarity with Dr. B.threw me a bit on surgery eve. At the end of the day, I knew I was in good hands. Dr. B. is at least nationally if not internationally known as an expert in GP. I also knew that anytime I could nap in the middle of the day should be looked at as a gift!
The morning of June 18, my brother and I braved an especially packed rush-hour train and made it to Big Academic Medical Center just at my "call time" of eight. After waiting for nearly an hour in the waiting room, we were herded up to the pre-op area. He helped me change into a gown and slippers, lifted me onto the gurney, and then we settled in to wait. We talked about the meaning of life. Eventually a nurse came, looked fruitlessly for a good vein to start an IV, and promptly left to find someone known for mining those tiny veins. Soon, the expert came and placed an IV. Dr. B. made an appearance, flipping through my chart, introducing himself to my brother, asking if we had questions. Then he was gone. Next the anesthesiology team came in. We went over my history and when they heard that I had a history of reflux, they brought me a medication that tasted akin to what I imagine turpentine tastes like, with a sour lemon aftertaste. Delightful Next it was time to sign the consent, don a stylish hat and say goodbye to my brother. This was it!
Because of the reflux, they let me sit up until we got into the OR. Once they moved me over to the table, they kept my head elevated with foam. One thing I had forgotten in the time since my last surgery was how cold they keep the OR. Thank goodness for toast warm blankets. The room was a hive of activity. The anesthesiologist worked on positioning me, a nurse strapped boots to my legs to help with my circulation and prevent blood clots. (Those things were amazing! I had never had warm feet until they put them on.) Somewhere in the crowd I spotted Dr B. Then the plastic-smelling mask was over my face and I was asleep.
The next thing I remember was that it hurt to breathe. I cried for meds, and eventually was a bit more comfortable. I saw Dr. B. who promised I would soon be in a room and given clear liquids. Soon ended up being an interminable SIX HOURS later! I was never so happy to see a hospital bed.
By now, I had figured out why it hurt to breathe. I had four small incisions scattered over the upper left part of my stomach. These looked like deep paper cuts. I also had one bigger incison where the "main port" went. This was pretty close to my diaphragm, which is why breathing was so unpleasant. Dr. B. had told me that the first 12 hours would be the most painful. He was right. Over the next three days, PT helped me get into my chair, respiratory did treatments every four hours and I was kept comfortable. Aside from having to bring home a souvenir appliance and the logistics inherent in it, I did really well. I didn't feel better yet but was willing to give it time. Dr. B. had told me that it could take up to three months to notice improvement. I wasn't sure I could wait that long, but promised I'd try to be patient.
Wednesday, July 25, 2012
Hospital Days Three -Eight:In Which I Realize this Story Could Take Forever
I realized that if I didn't hurry up, I'd still be blogging my last hospital stay for a year! So, I'm going to try to do the rest of the stay in five paragraphs or less. Away we go!
Day three was Sunday. I saw Dr. Lungs early. We agreed to continue with the status quo to try to get the cough under control. He started to talk about involving the GI team to investigate the reflux that was clearly playing a role in the cough. He left me his cell number and I settled in for a long day. At lunch, I refluxed on my Ensure for hours. Eventually I asked the nurse to have the doctor make me NPO, and order a swallow study the next day. I just wanted to make sure that every thing was working as it should. The doctor quickly agreed and I was started on IV fluids.
Monday. Dr. Lungs came in and told me he was going to have GI come talk to me at some point. They came in the afternoon. After some discussion, it was decided that I'd have another edoscopy the next day, followed by more tests if necessary to find answers. Oh, and the swallow study was unclear in terms of aspiration. So, the day dragged on and that was the end of that day.
Tuesday was scope day. I was again NPO. Transport came and fetched me early and we made the trek to the GI lab. While waiting for the procedure, all of the nurses were trying to give me stuff to stop the cough. When I was brought back to the procedure room,. the anesthesiologist was very worried about me. Truthfully, I was worried about me too Before the GI put me under, I tearfully asked her not to send me home without answers. She promised they wouldn't.The scope didn't find anything aside from some mild inflamation in my esophagus. More tests would be ordered for the next day.
Wednesday morning looked a lot like Tuesday morning. I was brought back to the GI lab. A nurse came and we chatted for a minute about my symptoms while she programmed a receiver I would have with me during the test. Then the real fun started. The back of my throat was sprayed numb and a tube was placed in my nose and fed the length of my esophagus. The end of the tube had a sensor that measured the pH of the stuff in my stomach and esophagus. The receiver had buttons for me to push when I had symptoms, changed position or "ate." The most fun part of the test was that since my main symptom was/is a cough, I had to push that button about 1,000 times in the 24 hours I had the probe.
Thursday was really awful. I coughed non-stop. I was sad to learn that the magnificent Dr. Lungs' time on-call was over. I survived having the the probe taken out. Friday was a long day of waiting for discharge orders that were never written. Finally on Saturday morning the train was set in motion and I was discharged. We didn't really know what the story was. Dr. Lungs suspected reflux, but my numbers were not bad enough to concern GI. Story of my life these days!
Day three was Sunday. I saw Dr. Lungs early. We agreed to continue with the status quo to try to get the cough under control. He started to talk about involving the GI team to investigate the reflux that was clearly playing a role in the cough. He left me his cell number and I settled in for a long day. At lunch, I refluxed on my Ensure for hours. Eventually I asked the nurse to have the doctor make me NPO, and order a swallow study the next day. I just wanted to make sure that every thing was working as it should. The doctor quickly agreed and I was started on IV fluids.
Monday. Dr. Lungs came in and told me he was going to have GI come talk to me at some point. They came in the afternoon. After some discussion, it was decided that I'd have another edoscopy the next day, followed by more tests if necessary to find answers. Oh, and the swallow study was unclear in terms of aspiration. So, the day dragged on and that was the end of that day.
Tuesday was scope day. I was again NPO. Transport came and fetched me early and we made the trek to the GI lab. While waiting for the procedure, all of the nurses were trying to give me stuff to stop the cough. When I was brought back to the procedure room,. the anesthesiologist was very worried about me. Truthfully, I was worried about me too Before the GI put me under, I tearfully asked her not to send me home without answers. She promised they wouldn't.The scope didn't find anything aside from some mild inflamation in my esophagus. More tests would be ordered for the next day.
Wednesday morning looked a lot like Tuesday morning. I was brought back to the GI lab. A nurse came and we chatted for a minute about my symptoms while she programmed a receiver I would have with me during the test. Then the real fun started. The back of my throat was sprayed numb and a tube was placed in my nose and fed the length of my esophagus. The end of the tube had a sensor that measured the pH of the stuff in my stomach and esophagus. The receiver had buttons for me to push when I had symptoms, changed position or "ate." The most fun part of the test was that since my main symptom was/is a cough, I had to push that button about 1,000 times in the 24 hours I had the probe.
Thursday was really awful. I coughed non-stop. I was sad to learn that the magnificent Dr. Lungs' time on-call was over. I survived having the the probe taken out. Friday was a long day of waiting for discharge orders that were never written. Finally on Saturday morning the train was set in motion and I was discharged. We didn't really know what the story was. Dr. Lungs suspected reflux, but my numbers were not bad enough to concern GI. Story of my life these days!
Friday, June 15, 2012
Hospital Day Two: CTs and DVTs?
We are up to April 14 in the telling of this saga. It was a Saturday, which I would soon discover is actually a very good day to get things done in hospitals.
Having gotten exactly no sleep the night before, I was anxious to see Dr. Lungs. Luckily, he liked to stop by early and we soon had a plan for the day. I would get some morphine for the pain This was decided after I told him that all the milder pain meds wreck my stomach now. I'd also have a CT of my sinuses at some point.Then I settled in for the long day that was sure to await me. Breakfast came. It was some kind of Jello, and a meal replacement juice. Yummy.
Sometime after breakfast, the nurse came to give me some more drugs Zofran, steroids,and a teeny tiny amount of morphine, only one ML,not even enough to take the edge of. Oh well,I wouldn't have known if I hadn't tried.
About an hour after breakfast, and a half hour after the morphine, I got extremely nauseous. Worse than I could ever remember since the beginning of GP. It got so bad that I asked for a basin. I asked for my next Zofran really early, and swore off morphine.
Around ten o'clock, transport came to take me to CT.My nurse was there to help lift and she was very worried about how I was looking. She almost called to cancel the scan. I managed to pull myself together enough to convince her to let me go.One benefit of feeling so awful was that I hardly had the energy to care that I was precariously perched on a Scanner Table of Death. I just closed my eyes and focused on not throwing up. It worked and soon I was back in my room.
To distract myself from the mind numbing boredom, I called my dad and cough-talked to him while watching some house flipping show on TV. There are way to many of those shows on, I've decided. </p>
Sometime in the mid afternoon, I began experiencing sharp pain in my left leg. I pulled back the sheet to get a better look. Crap! It was swollen and red looking. Those are the hallmarks of a Deep Vein Thrombosis, or a blood clot in the leg. Think Greg House, and you'll understand why those are no fun.
Anyway,I had a visitor,so I tried to put the pain aside. I couldn't, though and eventually called for my tech,who called the nurse, who called the doctor. No one ever came back to tell me what the doctor said, so I figured that he was either totally unconcerned or had ordered more tests. Supposition two was the correct.one. About twenty minutes after I had set the train in motion, transport was back. This time I'd have an ultrasound of my legs.
The journey to get to ultrasound was an Odyssey through the bowels of the hospital, up and down hallways and elevators until we got to the brightly painted pediatric Emergency Room where the scan would be done. The scan itself consisted of the tech spreading icy gel down the length of my legs, using a transducer as she went to ferret out any hidden clots. After what seemed like forever, she was done, and. I was taken back to get my nightly meds and try not to freak out that I might have a clot.
At midnight, my nurse came in to tell me that the doctor had called to let me know that the scan was clean. Hooray for living to fight another day!
Having gotten exactly no sleep the night before, I was anxious to see Dr. Lungs. Luckily, he liked to stop by early and we soon had a plan for the day. I would get some morphine for the pain This was decided after I told him that all the milder pain meds wreck my stomach now. I'd also have a CT of my sinuses at some point.Then I settled in for the long day that was sure to await me. Breakfast came. It was some kind of Jello, and a meal replacement juice. Yummy.
Sometime after breakfast, the nurse came to give me some more drugs Zofran, steroids,and a teeny tiny amount of morphine, only one ML,not even enough to take the edge of. Oh well,I wouldn't have known if I hadn't tried.
About an hour after breakfast, and a half hour after the morphine, I got extremely nauseous. Worse than I could ever remember since the beginning of GP. It got so bad that I asked for a basin. I asked for my next Zofran really early, and swore off morphine.
Around ten o'clock, transport came to take me to CT.My nurse was there to help lift and she was very worried about how I was looking. She almost called to cancel the scan. I managed to pull myself together enough to convince her to let me go.One benefit of feeling so awful was that I hardly had the energy to care that I was precariously perched on a Scanner Table of Death. I just closed my eyes and focused on not throwing up. It worked and soon I was back in my room.
To distract myself from the mind numbing boredom, I called my dad and cough-talked to him while watching some house flipping show on TV. There are way to many of those shows on, I've decided. </p>
Sometime in the mid afternoon, I began experiencing sharp pain in my left leg. I pulled back the sheet to get a better look. Crap! It was swollen and red looking. Those are the hallmarks of a Deep Vein Thrombosis, or a blood clot in the leg. Think Greg House, and you'll understand why those are no fun.
Anyway,I had a visitor,so I tried to put the pain aside. I couldn't, though and eventually called for my tech,who called the nurse, who called the doctor. No one ever came back to tell me what the doctor said, so I figured that he was either totally unconcerned or had ordered more tests. Supposition two was the correct.one. About twenty minutes after I had set the train in motion, transport was back. This time I'd have an ultrasound of my legs.
The journey to get to ultrasound was an Odyssey through the bowels of the hospital, up and down hallways and elevators until we got to the brightly painted pediatric Emergency Room where the scan would be done. The scan itself consisted of the tech spreading icy gel down the length of my legs, using a transducer as she went to ferret out any hidden clots. After what seemed like forever, she was done, and. I was taken back to get my nightly meds and try not to freak out that I might have a clot.
At midnight, my nurse came in to tell me that the doctor had called to let me know that the scan was clean. Hooray for living to fight another day!
Wednesday, May 30, 2012
Catching Up: Weird Illness Chronicles
I'm still alive, I swear! A lot has happened in my little corner of Sick Girl Land as you'll soon see. Over the next week or so, I'll be catching you up. We have now made it up up to April 10, week two of the Coughlympics.
On Monday, I threw myself into work, hoping for a distraction from how badly I felt. It worked to a point. Around lunch, I called the office where I usually see Dr.Lungs to make an appointment. The office told me he wasn't going to be there for two weeks. The practice he's with has two offices and he was at the other one while on call at the hospital. I made an appointment to see him there the next afternoon., arranged for paratranist and let my boss know what was going on. Not that she needed much warning, my cough gave me away. The next morning, paratransit got me to the new office with plenty of time to spare. I drank my breakfast and finished up a book on my Kindle and then headed up to the appointment.
After checking in, a nurse brought me back to a do a mini Pulmonary Function Test called spirometry. This is the first thing I do at every visit to Dr. Lungs. The nurse puts an oh so attractive nose clip across my nose, and I have to breathe into a device hooked up to a computer. The test measures the amount of air you can inhale and exhale. Asthma is actually a disease that impacts how you exhale,. not inhale, even though it feels like the opposite. The test was particularly hard for me that day. Since last September when I began seeing a pulmonologist, we've known that I can't exhale for the required six seconds of the test. We've chalked that up to my positioning. On this day, I couldn't even do it for the second and a half that is my normal. We did the test three times. In the end the nurse handed me the nose clip and the mouthpiece to hang on to in case the doctor wanted to run the test again. I went back to the exam room and eventually Dr. Lungs came in. We talked for a few minutes, made longer by breaks for coughing. He advised that I start the Azithromocin and give steroids a try. He said that if the steroids didn't help, we might be looking on an admit to the hospital to get straightened out. He gave me the first steroid pill in the office, told me not to go to work that day and to e-mail him the next day with an update. I left the office, waited for paratransit, went to work for about an hour and then went home.
At this point, I started feeling a much more intense type of nausea than what I now think of as my "normal" GP-related nausea. I took a rescue of Zofran, which worked, and made a note to let Dr. Lungs know when I e-mailed him the next day.I tried to be as still and quiet as possible the rest of that day. I took my nightly meds and tried to sleep.
The next morning, Wednesday, I learned something critical about myself. I learned that taking a sick day requires just as much commitment from me as does a normal work day. I learned this after working five hours of what was supposed to be a sick day. I e-mailed Dr. Lungs and gave him an update at some point too. His response solidified my love for this doctor. He signed it with his first name. This guy is super cool! He asked me to bump up the steroid, add a regular liquid cough medicine, and e-mail him the next day. All good, I was still free! I let my boss know I would definitely be out the next day, settled in for the night.
The next morning I woke and immediately knew something was very wrong. I have been very hoarse for a very long time,but on this day, I had exactly no voice. Interesting. As the morning wore on I realized that Hadn't eaten or drank anything since the night before. Weird. Even more weird, I was totally fine with that situation. I also noticed a huge increase in cough. Awesome. I e-mailed Dr. Lungs around lunch. The e-mails first line was "I have no idea what's going on anymore." I then caught him up on what had happened. When I was finished composing this whiny laundry list of symptoms, I cautiously hit send, hoping that I could stay free. Because I'm a realist, I also packed an overnight bag.
Not 20 minutes later, I got a response. He asked which hospital of the two where he has privileges did I want to go to? The choice boiled down to the fact that I could be what's called a "direct admit" at one hospital because Dr. Lungs was on call there. Or, I could be admitted through the ER at the other hospital and have some stranger doctor take care of me. Not much of a choice really. After some back and forth about meds and things, I was ready to spend one more bad night at home, with the prospect of a couple of bad hospital nights creating many good nights at home. I was actually looking forward to the next morning. It would be Friday April 13....
Next Up: Hospital Days 1 and 2: APU,CTs and DVTs,
On Monday, I threw myself into work, hoping for a distraction from how badly I felt. It worked to a point. Around lunch, I called the office where I usually see Dr.Lungs to make an appointment. The office told me he wasn't going to be there for two weeks. The practice he's with has two offices and he was at the other one while on call at the hospital. I made an appointment to see him there the next afternoon., arranged for paratranist and let my boss know what was going on. Not that she needed much warning, my cough gave me away. The next morning, paratransit got me to the new office with plenty of time to spare. I drank my breakfast and finished up a book on my Kindle and then headed up to the appointment.
After checking in, a nurse brought me back to a do a mini Pulmonary Function Test called spirometry. This is the first thing I do at every visit to Dr. Lungs. The nurse puts an oh so attractive nose clip across my nose, and I have to breathe into a device hooked up to a computer. The test measures the amount of air you can inhale and exhale. Asthma is actually a disease that impacts how you exhale,. not inhale, even though it feels like the opposite. The test was particularly hard for me that day. Since last September when I began seeing a pulmonologist, we've known that I can't exhale for the required six seconds of the test. We've chalked that up to my positioning. On this day, I couldn't even do it for the second and a half that is my normal. We did the test three times. In the end the nurse handed me the nose clip and the mouthpiece to hang on to in case the doctor wanted to run the test again. I went back to the exam room and eventually Dr. Lungs came in. We talked for a few minutes, made longer by breaks for coughing. He advised that I start the Azithromocin and give steroids a try. He said that if the steroids didn't help, we might be looking on an admit to the hospital to get straightened out. He gave me the first steroid pill in the office, told me not to go to work that day and to e-mail him the next day with an update. I left the office, waited for paratransit, went to work for about an hour and then went home.
At this point, I started feeling a much more intense type of nausea than what I now think of as my "normal" GP-related nausea. I took a rescue of Zofran, which worked, and made a note to let Dr. Lungs know when I e-mailed him the next day.I tried to be as still and quiet as possible the rest of that day. I took my nightly meds and tried to sleep.
The next morning, Wednesday, I learned something critical about myself. I learned that taking a sick day requires just as much commitment from me as does a normal work day. I learned this after working five hours of what was supposed to be a sick day. I e-mailed Dr. Lungs and gave him an update at some point too. His response solidified my love for this doctor. He signed it with his first name. This guy is super cool! He asked me to bump up the steroid, add a regular liquid cough medicine, and e-mail him the next day. All good, I was still free! I let my boss know I would definitely be out the next day, settled in for the night.
The next morning I woke and immediately knew something was very wrong. I have been very hoarse for a very long time,but on this day, I had exactly no voice. Interesting. As the morning wore on I realized that Hadn't eaten or drank anything since the night before. Weird. Even more weird, I was totally fine with that situation. I also noticed a huge increase in cough. Awesome. I e-mailed Dr. Lungs around lunch. The e-mails first line was "I have no idea what's going on anymore." I then caught him up on what had happened. When I was finished composing this whiny laundry list of symptoms, I cautiously hit send, hoping that I could stay free. Because I'm a realist, I also packed an overnight bag.
Not 20 minutes later, I got a response. He asked which hospital of the two where he has privileges did I want to go to? The choice boiled down to the fact that I could be what's called a "direct admit" at one hospital because Dr. Lungs was on call there. Or, I could be admitted through the ER at the other hospital and have some stranger doctor take care of me. Not much of a choice really. After some back and forth about meds and things, I was ready to spend one more bad night at home, with the prospect of a couple of bad hospital nights creating many good nights at home. I was actually looking forward to the next morning. It would be Friday April 13....
Next Up: Hospital Days 1 and 2: APU,CTs and DVTs,
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