“The great thing in the world is not so much where we stand, as in what direction we are moving.” -- Oliver Wendell Holmes
Day 6 AS
Yesterday was a red letter day -- not only could I actually get up all by myself, but I could wipe my own ass!! Again, something we truly under-rate until we can't do it!
I finally exceeded 40 oz. of fluid in the 24 hour period and consequently didn't have a dry mouth by the end of the day yesterday. The lower back pain that had been interfering with my sleep left also -- progress -- step by step. I managed to stay awake more than half of the day also. The other milestone -- feet, ankles, toes and calves that look like my very own!! Oh -- and one more -- I finally found something that tasted good -- sugar free orange jello.
Progress continues today -- although the outing to the doctor's office was exhausting I confess. I'm glad we saw her -- there are a couple of things she's concerned about so we can work on fixing those now. The biggest one is my excessive belching and urping -- the latter shouldn't be happening. So she's added another med (thankfully a small enough one to swallow without cutting up) -- reglan. That's seemed to help a lot -- no urping after 2 doses -- she wants me on it a month 4 times/day. The downside of it is that it makes me a little dizzy, so I may not be able to drive next week as I'd hoped -- we'll see. Not happy with my infrequent farts either -- I still have a ton of abdominal gas that just won't come out. So I'll keep on walking and try to wake that darn colon of mine back up. Another issue is skin breakdown around the drain site -- I think it just stayed too wet too long. I'll be trying some OTC hydrocortisone cream on that.
Some good news -- my blood pressure is great! It's usually good -- but rarely great! Not sure what to think about my blood sugar -- I have a call in to my endocrinologist to consult with him. I'd cut my insulin way down -- and I still had a low last night, so didn't take any. Pretty low this morning too, so again passed. I guess when you're taking in almost zero carbs and less than 100 calories a day there's not a big need to worry about it once the surgery shock wears off -- and seemingly it's starting to wear off. I had awful numbers in the hospital -- glad those days are past.
I have survived 6 hours alone this afternoon -- woohoo! John helped set me up nicely before he went to work -- what a wonderful man he is. He's on his way home now and is going to try to find me some more sugar free orange jello. Who could ask for more???
Monday, September 28, 2009
I'm grateful for a mature spouse! :)
“I would say that the surest measure of a man's or a woman's maturity is the harmony, style, joy, and dignity he creates in his marriage, and the pleasure and inspiration he provides for his spouse” -- Benjamin Spock
Day 4 AS Saturday, September 26
Hallelujah -- the drainage is slowing down to a very manageable level. I had been wearing an abdominal binder to add some additional support, but tried going without it today and finally feel better without it -- so away binder!!
My day is moving into a boring but consistent pattern. Force fluids, force tiny cut up pills down, sit up, belch and burp to relieve some pressure -- try to avoid the dreaded hiccups. Walk to the bathroom. Fart (if I'm lucky), poop, pee -- generally in that order. After this the abdominal pressure's released enough that I can comfortably walk -- I'm up to five loops of the upper level of the house now. Sit down, force some more fluids and pill fragments down, fall asleep out of exhaustion for around an hour or so -- repeat cycle every 3 hours.
We were looking forward to USC reinstating themselves again Saturday night and thankfully they did. I think I made it through about half the game -- not bad.
I still can't concentrate enough to read -- or long enough to even use a round of energy up in Mafia Wars or Vampire Wars on Facebook -- shocking! ;) I can almost make it through a one hour TV show. Glad there are a lot of new shows on the DVR from season starts last week.
John heads back to work Monday afternoon. I can't say enough times how great he's been. There's no way I could have done this without him. I'm truly grateful for the Lab's FMLA policy and his wonderful co-workers that put up with him missing most of last week to help me. He will be driving me to the surgeon's office Monday morning.
I'm praying I can take care of myself by then...
The very best part of the day -- a shower. Wow. It was heaven.
Day 4 AS Saturday, September 26
Hallelujah -- the drainage is slowing down to a very manageable level. I had been wearing an abdominal binder to add some additional support, but tried going without it today and finally feel better without it -- so away binder!!
My day is moving into a boring but consistent pattern. Force fluids, force tiny cut up pills down, sit up, belch and burp to relieve some pressure -- try to avoid the dreaded hiccups. Walk to the bathroom. Fart (if I'm lucky), poop, pee -- generally in that order. After this the abdominal pressure's released enough that I can comfortably walk -- I'm up to five loops of the upper level of the house now. Sit down, force some more fluids and pill fragments down, fall asleep out of exhaustion for around an hour or so -- repeat cycle every 3 hours.
We were looking forward to USC reinstating themselves again Saturday night and thankfully they did. I think I made it through about half the game -- not bad.
I still can't concentrate enough to read -- or long enough to even use a round of energy up in Mafia Wars or Vampire Wars on Facebook -- shocking! ;) I can almost make it through a one hour TV show. Glad there are a lot of new shows on the DVR from season starts last week.
John heads back to work Monday afternoon. I can't say enough times how great he's been. There's no way I could have done this without him. I'm truly grateful for the Lab's FMLA policy and his wonderful co-workers that put up with him missing most of last week to help me. He will be driving me to the surgeon's office Monday morning.
I'm praying I can take care of myself by then...
The very best part of the day -- a shower. Wow. It was heaven.
Sunday, September 27, 2009
“Digestion is one of the most delicately balanced of all human and perhaps angelic functions.”
“Digestion is one of the most delicately balanced of all human and perhaps angelic functions.” -- M.F.K. Fisher
Day 3 AS - Friday, September 25
I finally wake up nausea free and almost feel like myself. My temperature was under control and I was starting to recognize my feet, toes and ankles again. Nothing is going to keep me there another day!!
Thankfully my surgeon concurred, because although I hate to admit it, I know her vote was the only one that counted. She was really pleased with my overnight improvement and ordered my discharge. I finally was able to consume all 3 oz. of breakfast too.
The day charge nurse came by to commiserate over the loss of chair -- it turned out she was the one who had ordered these and had the procedure herself 3 years ago. She spent about half an hour with me. I was discouraged that I was still in pain and she reminded me everyone has different pain tolerance and different physiology. She herself lost her pain when the JP drain was removed. We all recover in our own time -- and we do all recover.
John returned shortly after that followed by my day RN who removed my IV. Wow, was that thing ever taped on good! She did a wonderful job minimizing the pain as best she could. She provided us with bunches of supples to help with the drainage site collection and butt wiping and skin pain I had developed (likely from sitting in that awful wheelchair).
John hauled all my gear down to the car, made sure my seat was all the way up and set back. The day CNA came by and helped me clean up once again, then wheeled me down to John and freedom.
How great it is to be home! I was still exhausted -- it was all I could do to try to keep up with my fluid goals in between sleeping -- still difficult to concentrate for more than a few minutes at a time. I was cleared for a shower but as much as I wanted it I simply could not muster up enough energy.
It's great to have chairs that are soft and fit again! Great also to have my own toilet. I hate that I still can't quite get up by myself on Friday or wipe myself on Friday -- but am incredbily grateful for a soul mate that would do anything possible to help with my comfort in John.
No nausea, but awful painful gas, belches, burps and hiccups.
It literally took me hours to consume my night meds after breaking them up into small enough pieces to swallow without risking their getting stuck. One of the pill fragments the night before had been too big and did stick for about 20 minutes -- painful. I definitely don't want to experience that again.
I am hating the continuing gas and digestive issues -- tons of reflux while I sleep in spite of a pretty high dose of meltable Prevacid. Hopefully this will all calm down in a few weeks. Trust me colleagues -- you definitely don't want me back in the office yet -- between all the noises and awful smells it's truly gross -- even to me. Trust me on this. :)
Day 3 AS - Friday, September 25
I finally wake up nausea free and almost feel like myself. My temperature was under control and I was starting to recognize my feet, toes and ankles again. Nothing is going to keep me there another day!!
Thankfully my surgeon concurred, because although I hate to admit it, I know her vote was the only one that counted. She was really pleased with my overnight improvement and ordered my discharge. I finally was able to consume all 3 oz. of breakfast too.
The day charge nurse came by to commiserate over the loss of chair -- it turned out she was the one who had ordered these and had the procedure herself 3 years ago. She spent about half an hour with me. I was discouraged that I was still in pain and she reminded me everyone has different pain tolerance and different physiology. She herself lost her pain when the JP drain was removed. We all recover in our own time -- and we do all recover.
John returned shortly after that followed by my day RN who removed my IV. Wow, was that thing ever taped on good! She did a wonderful job minimizing the pain as best she could. She provided us with bunches of supples to help with the drainage site collection and butt wiping and skin pain I had developed (likely from sitting in that awful wheelchair).
John hauled all my gear down to the car, made sure my seat was all the way up and set back. The day CNA came by and helped me clean up once again, then wheeled me down to John and freedom.
How great it is to be home! I was still exhausted -- it was all I could do to try to keep up with my fluid goals in between sleeping -- still difficult to concentrate for more than a few minutes at a time. I was cleared for a shower but as much as I wanted it I simply could not muster up enough energy.
It's great to have chairs that are soft and fit again! Great also to have my own toilet. I hate that I still can't quite get up by myself on Friday or wipe myself on Friday -- but am incredbily grateful for a soul mate that would do anything possible to help with my comfort in John.
No nausea, but awful painful gas, belches, burps and hiccups.
It literally took me hours to consume my night meds after breaking them up into small enough pieces to swallow without risking their getting stuck. One of the pill fragments the night before had been too big and did stick for about 20 minutes -- painful. I definitely don't want to experience that again.
I am hating the continuing gas and digestive issues -- tons of reflux while I sleep in spite of a pretty high dose of meltable Prevacid. Hopefully this will all calm down in a few weeks. Trust me colleagues -- you definitely don't want me back in the office yet -- between all the noises and awful smells it's truly gross -- even to me. Trust me on this. :)
“Hospitals are only an intermediate stage of civilization”
“Hospitals are only an intermediate stage of civilization” -- Florence Nightingale
Day 2 AS - Thursday, September 23
This was probably the most discouraging day of my stay -- I remember asking my surgeon why on earth I had done this when she came by to visit me. I had the highest fever of my stay, was the most swollen, was leaking gobs from the drain site and just overall felt crappy. She sidestepped my question and gave me the expected bad news that all these symptoms were leading me to at least one more day in the hospital -- to be reviewed each day, one day at a time. I bitched about the chair situation.
Her response was as you'd expect very measured -- let's see what we can do to fix all this. Gave me some heavy duty Tylenol with hydrodone liquid to bring down my temperature and help relieve the pain. Ordered IV Lasik to make me pee -- and boy did that every work. I lost more than 10 pounds of fluids that day! I finally farted and better yet started to have diarrhea. Kind of gross I know, but what an incredible relief to the abdominal pain did just that prove to be!!
After that I started my quest for a decent chair with the day RN. For hours she looked to no avail -- so engaged her charge nurse in the quest. Unbeknownst to me at the time that charge nurse had had this procedure herself 3 years ago (and looks fabulous I might add!) and was instrumental in the ordering of the 2 whole bariatric chairs the hosptal had. Pleasantonians must be a lot smaller than Oaklandians -- I remember there they had several suites dedicated to bariatric patients with appropriate beds, toilets and chairs as required for COE certification.
Several hours later -- success! She found one of her chairs in the ICU waiting room and stole it back. Crazy, isn't it? Got it aounrd 4 PM -- and although a bit low to the ground it was a blessed relief to the too big wheelchair.
Early that morning I met the biggest ray of sunshine in the hospital -- my CNA was fabulous. She probably spent 1/3 of her shift with me, cheering and encouraging me every step along the way.
Without presenting to graphic of a picture -- once my bowels restarted there's been no stopping them! I could not bend in the middle yet, hence I could not clean myself. She very matter of factly handled the issue for me every time I needed her -- and later came back to administer a blessed sponge bath.
I also told her my fear of getting back in bed and potentially getting Nurse Ratched again that night. She said not to worry -- she'd make sure that didn't happen, and sure enough she did! My day RN came in and asked me about her -- told me she'd talk to the charge nurse and did. She came back and let me know we were "safe" that night and that I could rest assured if I spent any others there I wouldn't see either Nurse Ratched or the lazy CNA. The RNs and CNAs circled their wagons it seemed to make sure nothing like that happened again while I was there.
3 of the RNs on the floor have had this same procedure performed, and the lovely CNA shared their success stories -- very sweet.
John had to leave for a few hours around 3 to hand off Tasters Guild materials to Jerry for the Guild's dinner that night. What wonderful friends we have in that group! Carol, Jerry, David, and Ray all went beyond the call of duty to make sure the group had a good night without either of us and so John could come back and be with me. I can't begin to tell you what an incredible champion/help mate John has been. I am truly blessed in my partner. You definitely need an advocate in the hospital, and he was with me every tiny step along the way helping to make me as comfortable as possible.
The lovely CNA started negotiating with me to go back to bed -- I really did need to elevate my feet. I totally trusted her, so with her help went back to bed -- she turned off the light, put the call bell right next to my hand and promised to come back to help me up before her shift ended at 7. And sure enough she did.
The only down side was when John got back she had closed my door, so we didn't want to disturb me not knowing what was going on behind that closed door. He ate his dinner in the hall, and then she came by to help me up and we spent a few more hours together.
The night RN had too big of a patient load that night as the hospital filled up -- 5 patients including 2 new admissions. The night charge nurse came by and chatted about Nurse Ratched -- told me I should definitely have complained and that I should spread the gospel that even if it's just a personality conflict as patients we have rights to care we're comfortable with.
Given the RN was so busy, the charge nurse personally took me on! :) She helped me in and out of bed that night, as well as found a new bed that worked and traded it out in the middle of the night -- there's a program that helps prevent pressure sores and the one on my bed had crapped out.
The only negtive that night was that a different RN came by to "borrow" my good chair for another patient. Wanting to help him, I said sure, but I needed it back at 5 AM. Suffice it to say I never did get it back -- sigh,
Day 2 AS - Thursday, September 23
This was probably the most discouraging day of my stay -- I remember asking my surgeon why on earth I had done this when she came by to visit me. I had the highest fever of my stay, was the most swollen, was leaking gobs from the drain site and just overall felt crappy. She sidestepped my question and gave me the expected bad news that all these symptoms were leading me to at least one more day in the hospital -- to be reviewed each day, one day at a time. I bitched about the chair situation.
Her response was as you'd expect very measured -- let's see what we can do to fix all this. Gave me some heavy duty Tylenol with hydrodone liquid to bring down my temperature and help relieve the pain. Ordered IV Lasik to make me pee -- and boy did that every work. I lost more than 10 pounds of fluids that day! I finally farted and better yet started to have diarrhea. Kind of gross I know, but what an incredible relief to the abdominal pain did just that prove to be!!
After that I started my quest for a decent chair with the day RN. For hours she looked to no avail -- so engaged her charge nurse in the quest. Unbeknownst to me at the time that charge nurse had had this procedure herself 3 years ago (and looks fabulous I might add!) and was instrumental in the ordering of the 2 whole bariatric chairs the hosptal had. Pleasantonians must be a lot smaller than Oaklandians -- I remember there they had several suites dedicated to bariatric patients with appropriate beds, toilets and chairs as required for COE certification.
Several hours later -- success! She found one of her chairs in the ICU waiting room and stole it back. Crazy, isn't it? Got it aounrd 4 PM -- and although a bit low to the ground it was a blessed relief to the too big wheelchair.
Early that morning I met the biggest ray of sunshine in the hospital -- my CNA was fabulous. She probably spent 1/3 of her shift with me, cheering and encouraging me every step along the way.
Without presenting to graphic of a picture -- once my bowels restarted there's been no stopping them! I could not bend in the middle yet, hence I could not clean myself. She very matter of factly handled the issue for me every time I needed her -- and later came back to administer a blessed sponge bath.
I also told her my fear of getting back in bed and potentially getting Nurse Ratched again that night. She said not to worry -- she'd make sure that didn't happen, and sure enough she did! My day RN came in and asked me about her -- told me she'd talk to the charge nurse and did. She came back and let me know we were "safe" that night and that I could rest assured if I spent any others there I wouldn't see either Nurse Ratched or the lazy CNA. The RNs and CNAs circled their wagons it seemed to make sure nothing like that happened again while I was there.
3 of the RNs on the floor have had this same procedure performed, and the lovely CNA shared their success stories -- very sweet.
John had to leave for a few hours around 3 to hand off Tasters Guild materials to Jerry for the Guild's dinner that night. What wonderful friends we have in that group! Carol, Jerry, David, and Ray all went beyond the call of duty to make sure the group had a good night without either of us and so John could come back and be with me. I can't begin to tell you what an incredible champion/help mate John has been. I am truly blessed in my partner. You definitely need an advocate in the hospital, and he was with me every tiny step along the way helping to make me as comfortable as possible.
The lovely CNA started negotiating with me to go back to bed -- I really did need to elevate my feet. I totally trusted her, so with her help went back to bed -- she turned off the light, put the call bell right next to my hand and promised to come back to help me up before her shift ended at 7. And sure enough she did.
The only down side was when John got back she had closed my door, so we didn't want to disturb me not knowing what was going on behind that closed door. He ate his dinner in the hall, and then she came by to help me up and we spent a few more hours together.
The night RN had too big of a patient load that night as the hospital filled up -- 5 patients including 2 new admissions. The night charge nurse came by and chatted about Nurse Ratched -- told me I should definitely have complained and that I should spread the gospel that even if it's just a personality conflict as patients we have rights to care we're comfortable with.
Given the RN was so busy, the charge nurse personally took me on! :) She helped me in and out of bed that night, as well as found a new bed that worked and traded it out in the middle of the night -- there's a program that helps prevent pressure sores and the one on my bed had crapped out.
The only negtive that night was that a different RN came by to "borrow" my good chair for another patient. Wanting to help him, I said sure, but I needed it back at 5 AM. Suffice it to say I never did get it back -- sigh,
"Pain is temporary"
“Pain is temporary. It may last a minute, or an hour, or a day, or a year, but eventually it will subside and something else will take its place. If I quit, however, it lasts forever.” -- Lance Armstrong
Day 1 AS (after surgery) Wednesday, September 23
Boy, do they ever want to do all they can to move you in, through and out of the hospital as fast as they possibly can. Luckily this matched my own agenda! :)
The day RN came by around 9 to let me know that someone would be by soon to take me to imaging for the swallow test and a chest x-ray. I had developed a fever and there was concern naturally about the source as it could have been caused by a number of things -- and none of them good. It turned out in this case that my lungs were pretty compromised -- no doubt accounting for the fact that I could barely take a few steps without wheezing and a few more without wanting my inhaler. Consequently I was unable to walk enough -- I tried every 3 hours (4 at night) but was very challenged. Coughing hurt like heck too, as did using the incentive spirometer, but again it was good knowing ahead of time that all of the above needed to be done to reduce the pneumonia and blood clot risk. By the end of this day I came to appreciate how toughing it out through the pain meant some nice rewards on the other side of some pain reduction after doing these things.
The swallow test was thankfully perfect -- no leaks anywhere. A warning to anyone that ever has to do this -- the contrast fluid tastes nasty! As much as my poor dry mouth wanted the liquid, it was all I could do to keep it down in wee tiny sips. In between sips and various images they let me sip a little water -- that was the best tasting water I ever had! :)
The xray tech was great. Her brother had been through this procedure about 6 months ago, so like many other people I've run into along this path, she was highly compassionate and went out of her way to carefully explain everything that was being done step by step so I knew what to expect.
Apparently there were a number of emergency needs for radiologists that morning and none were available to work with me. This is a "live" radiology procedure -- the radiologist was literally standing on the other side of the imaging machine and me reading results as I swallowed. A very kind female radiologist came in a couple of hours before her shift to help me -- wow. I'm truly amazed by this because the one thing I've learned through this experience is that everyone in the hospital seems to work their ass off (with the notable exception of Nurse Ratched and the lazy CNA -- more to come on this). I found everyone else at the hospital to be truly committed to their work and to being as helpful and as encouraging as they could be.
When finished, I'm wheeled back to my room where the day RN pours me a lovely carafe of ice water. How wonderful it was! I still (day 5 PS as I am typing) can only tolerate ice cold or warm water, so I'm grateful she knew that would be the case.
It was a little scary drinking at first, and incredibly difficult to get to my current goal of 20-30 ounces of liquid in a 24 hour period on day 1 PS. I ordered my first "meal" -- an ounce of herbal tea, an ounce of broth and an ounce of sugar free gelatin. These made me incredibly nauseous, but again this was seemingly expected as there was a standing order for some serious anti-nausea medicine that helped a lot and was needed both days 1 and 2 AS.
After that the RN gave me the bad news that the morphine needed to be removed. Holy crap! I asked if that meant the JP drain was coming out too, and she said no, not until later that afternoon. I did some swift negotiating and played on what we'd learning in class, that being that it would help with the pain of the drain removal if you took a couple of doses of morphine just before. You could tell she was feeling my pain, so I agreed to not use the morphine until the JP drain removal and rely on the lighter weight darvoset IV injections. She finally agreed.
She came back a few hours later to say it was time to pump up the morphine -- gave me enough time for 2 doses, and then blessedly removed that medieval torture device. She also removed the Foley catheter, so it became a little easier to walk on my own.
Both of those removals brought on their own sets of challenges too though. For the JP drain, we had to start using a ton of gauze to collect the fluid that now leaked directly out of me. Kind of gross -- on day 5 AS it is down to a slow ooze, but there were times it gushed those first couple of days. Ugh.
Removing the Foley presented some challenges too -- I now had to use the toilet myself. This is where the lack of appropriate bariatric equipment began to make itself very apparent -- shocking frankly for a nationally certified Bariatric Surgery Center of Excellence. Surprisingly, the toilet was very low -- and there was no way my incredibly distended abdomen was going to bend enough to let me sit that low. So the RN found a booster that worked -- until we found out that the surgeon wanted all the fluid outputs captured and measured because I was so incredibly swollen. They were worried about blood clots now because my feet and ankles were so swollen and hot.
They had me climb on the scale and I had gained more than 10 pounds in IV fluid retention. Yikes! In just a little more than a day!
Abdominal gurgling and belching and burping and urping started early this evening. I would have killed to have been able to fart but that wasn't in the cards this day.
By now the night shift assignments had been posted and John comes back to me with the less-than-good news that Nurse Ratched and the lazy CNA are assigned to me. I think about asking the Charge Nurse for a reassignment, but decide it takes 2 to tango, so perhaps if I try to be a better communicator all will be well. After all it's the night shift and I'll be sleeping a lot and not need much, right? Boy was I wrong!
The one good thing she did for me was found a porta pottie that actually worked for me. She could not find any chair I could sit in -- although I doubt she looked very hard. The day RN had provided me with a wheelchair that was too big and too hard for me as a stop gap measure.
I dreaded going to bed that night -- I'm such a control freak (no........ me? :) ) that it was making me crazy that I still needed help getting in and out of bed. By now my ankles and knees didn't bend at all either which didn't help matters any. So I rang for assistance and Nurse Ratched and her CNA showed up together. The RN stood back and didn't do a damn thing to try to help -- clearly I was beneath her dignity. The CNA did the least she could -- and finally I was there. Uncomfortable at best, unable to move sideways or to scoot up or down, but at least I was there.
I woke up a few hours later burning up -- turned out to have close to a 104 degree temperature. I tried lying there but couldn't. So called for help again and God forbid, but this time Nurse Ratched shows up alone. I should have known I was in trouble. She watched me struggle for at least 5 minutes telling me I really should be able to this by myself by now and then finally acknowledged that maybe I couldn't. Lying there like a beached whale in front of a stranger is not exactly my idea of a good time. So she condescended to push the button to raise my head and torso a little. Waited a few more minutes and then further condescended to help with my legs, shaking her head in disgust the whole time. It was at best annoying. I vowed then and there that I would not get into bed again -- now way was I going to deal with that awfulness.
I asked here again about a chair and not surprisingly she said there wasn't one so I suffered in silence in the uncomfortable wheel chair -- but at least I could get in and out of it by myself.
What a crappy night!
Day 1 AS (after surgery) Wednesday, September 23
Boy, do they ever want to do all they can to move you in, through and out of the hospital as fast as they possibly can. Luckily this matched my own agenda! :)
The day RN came by around 9 to let me know that someone would be by soon to take me to imaging for the swallow test and a chest x-ray. I had developed a fever and there was concern naturally about the source as it could have been caused by a number of things -- and none of them good. It turned out in this case that my lungs were pretty compromised -- no doubt accounting for the fact that I could barely take a few steps without wheezing and a few more without wanting my inhaler. Consequently I was unable to walk enough -- I tried every 3 hours (4 at night) but was very challenged. Coughing hurt like heck too, as did using the incentive spirometer, but again it was good knowing ahead of time that all of the above needed to be done to reduce the pneumonia and blood clot risk. By the end of this day I came to appreciate how toughing it out through the pain meant some nice rewards on the other side of some pain reduction after doing these things.
The swallow test was thankfully perfect -- no leaks anywhere. A warning to anyone that ever has to do this -- the contrast fluid tastes nasty! As much as my poor dry mouth wanted the liquid, it was all I could do to keep it down in wee tiny sips. In between sips and various images they let me sip a little water -- that was the best tasting water I ever had! :)
The xray tech was great. Her brother had been through this procedure about 6 months ago, so like many other people I've run into along this path, she was highly compassionate and went out of her way to carefully explain everything that was being done step by step so I knew what to expect.
Apparently there were a number of emergency needs for radiologists that morning and none were available to work with me. This is a "live" radiology procedure -- the radiologist was literally standing on the other side of the imaging machine and me reading results as I swallowed. A very kind female radiologist came in a couple of hours before her shift to help me -- wow. I'm truly amazed by this because the one thing I've learned through this experience is that everyone in the hospital seems to work their ass off (with the notable exception of Nurse Ratched and the lazy CNA -- more to come on this). I found everyone else at the hospital to be truly committed to their work and to being as helpful and as encouraging as they could be.
When finished, I'm wheeled back to my room where the day RN pours me a lovely carafe of ice water. How wonderful it was! I still (day 5 PS as I am typing) can only tolerate ice cold or warm water, so I'm grateful she knew that would be the case.
It was a little scary drinking at first, and incredibly difficult to get to my current goal of 20-30 ounces of liquid in a 24 hour period on day 1 PS. I ordered my first "meal" -- an ounce of herbal tea, an ounce of broth and an ounce of sugar free gelatin. These made me incredibly nauseous, but again this was seemingly expected as there was a standing order for some serious anti-nausea medicine that helped a lot and was needed both days 1 and 2 AS.
After that the RN gave me the bad news that the morphine needed to be removed. Holy crap! I asked if that meant the JP drain was coming out too, and she said no, not until later that afternoon. I did some swift negotiating and played on what we'd learning in class, that being that it would help with the pain of the drain removal if you took a couple of doses of morphine just before. You could tell she was feeling my pain, so I agreed to not use the morphine until the JP drain removal and rely on the lighter weight darvoset IV injections. She finally agreed.
She came back a few hours later to say it was time to pump up the morphine -- gave me enough time for 2 doses, and then blessedly removed that medieval torture device. She also removed the Foley catheter, so it became a little easier to walk on my own.
Both of those removals brought on their own sets of challenges too though. For the JP drain, we had to start using a ton of gauze to collect the fluid that now leaked directly out of me. Kind of gross -- on day 5 AS it is down to a slow ooze, but there were times it gushed those first couple of days. Ugh.
Removing the Foley presented some challenges too -- I now had to use the toilet myself. This is where the lack of appropriate bariatric equipment began to make itself very apparent -- shocking frankly for a nationally certified Bariatric Surgery Center of Excellence. Surprisingly, the toilet was very low -- and there was no way my incredibly distended abdomen was going to bend enough to let me sit that low. So the RN found a booster that worked -- until we found out that the surgeon wanted all the fluid outputs captured and measured because I was so incredibly swollen. They were worried about blood clots now because my feet and ankles were so swollen and hot.
They had me climb on the scale and I had gained more than 10 pounds in IV fluid retention. Yikes! In just a little more than a day!
Abdominal gurgling and belching and burping and urping started early this evening. I would have killed to have been able to fart but that wasn't in the cards this day.
By now the night shift assignments had been posted and John comes back to me with the less-than-good news that Nurse Ratched and the lazy CNA are assigned to me. I think about asking the Charge Nurse for a reassignment, but decide it takes 2 to tango, so perhaps if I try to be a better communicator all will be well. After all it's the night shift and I'll be sleeping a lot and not need much, right? Boy was I wrong!
The one good thing she did for me was found a porta pottie that actually worked for me. She could not find any chair I could sit in -- although I doubt she looked very hard. The day RN had provided me with a wheelchair that was too big and too hard for me as a stop gap measure.
I dreaded going to bed that night -- I'm such a control freak (no........ me? :) ) that it was making me crazy that I still needed help getting in and out of bed. By now my ankles and knees didn't bend at all either which didn't help matters any. So I rang for assistance and Nurse Ratched and her CNA showed up together. The RN stood back and didn't do a damn thing to try to help -- clearly I was beneath her dignity. The CNA did the least she could -- and finally I was there. Uncomfortable at best, unable to move sideways or to scoot up or down, but at least I was there.
I woke up a few hours later burning up -- turned out to have close to a 104 degree temperature. I tried lying there but couldn't. So called for help again and God forbid, but this time Nurse Ratched shows up alone. I should have known I was in trouble. She watched me struggle for at least 5 minutes telling me I really should be able to this by myself by now and then finally acknowledged that maybe I couldn't. Lying there like a beached whale in front of a stranger is not exactly my idea of a good time. So she condescended to push the button to raise my head and torso a little. Waited a few more minutes and then further condescended to help with my legs, shaking her head in disgust the whole time. It was at best annoying. I vowed then and there that I would not get into bed again -- now way was I going to deal with that awfulness.
I asked here again about a chair and not surprisingly she said there wasn't one so I suffered in silence in the uncomfortable wheel chair -- but at least I could get in and out of it by myself.
What a crappy night!
"...let us all be thankful"
"Let us rise up and be thankful, for if we didn't learn a lot today, at least we learned a little, and if we didn't learn a little, at least we didn't get sick, and if we got sick, at least we didn't die; so, let us all be thankful." - Buddha
Day 0 - Surgery (Tuesday, September 22)
Thank God for great surgeons, anesthesiologists, and admissions nurses -- and at the very top of the list a husband with the patience of Job. Let's finish that list with the wonders of Versed.
The admissions RN had a very pragmatic matter about her and a somewhat dry wit -- a perfect match for me. After changing into the chic (hypoallergenic in my case) hospital gown and booties I was freezing. She turn on a groovy hot air filled blanket for me that had me toasty warm in a heartbeat. After signing a million more release forms (and yes, Fern, I took your advice -- I didn't read ANY of them -- after all, I already knew the major risks), she took my BP and it was a little high -- what a shocker. :)
The anesthesiologist had called me the night before and had given me "permission" to have him paged an hour before surgery if I felt the need for any anxiety reduction assistance. He told me I had to see the OR RN too before any chemical help would be available to I asked the admissions RN to get the OR RN and then to page the anesthesiologist.
The OR RN came in and was again nicely compassionate, clear and direct -- love that type of RN! She very nicely distracted me with yet more paperwork while the admissions RN inserted the IV. Yay, it worked the first time. I have awful veins so this was a very good thing.
In the interim the anesthesiologist answered the page and the admissions RN administered a small dose of Versed. I love Versed -- almost instant relaxation and no memory at all of anything after the 2nd dose about half an hour later.
The admissions RN also added a sticky to the anesthesiologist's paperwork asking him to help me visualize pink, purple and white lights as he put me under, as Jayne so kindly suggested. I remember discussing this with him in between Versed doses and he noted lots of people have requests like this and lots to play visualization and relaxation tapes. Kinda cool.
I loved the anesthesiologist, but both John and I can't help but wonder if he's tried any of his own meds along the way. Talk about Dr. Mellow! If he were any more laid back he'd be asleep!
I asked John to describe my pre-op demeanor to me. I was surprisingly a whole lot more relaxed than either of us expected the night before and the morning of -- up until I climbed up onto that gurney. Then panic started to set in until that first dose of Versed came. After the 2nd dose of Versed John reports I was almost as relaxed as Dr. Mellow. :)
They wheeled me into the OR around 8:45 and around 11:10 my surgeon came out to talk to John. She said everything came out great and the laparoscopic surgery was much easier than she expected -- likely due to the more than 60 pound weight loss I had before the procedure.
Apparently they kept me in recovery a lot longer than the anticipated. 1 hour At first there was an issue with what room I was going to be moved to and as soon as that was resolved my blood pressure became unstable.
About 2.5 hours later I was stable and taken to 2428. Fortunately I had a private room -- I understand they try to do that for all of the patients going through this procedure because of food issues. The smell of real food today, even the thought of it, (and I'm typing this 5 days after surgery from home) makes me instantly nauseous.
John reports my spending the rest of the time he was with me (until around 9 PM) as in and out of sleep. God bless morphine. The clock rapidly became my best friend -- every 10 minutes I religiously pushed that button.
One of the biggest things I remember is being incredibly dry-mouthed. I knew I wouldn't be allowed any fluids until the leak test was performed the day after surgery. It was great having John there and being prepared for this so knew to ask for some mouth swabs. He kindly got me some and they provided great relief. The RN came in a few hours later and gave me some really tart lemon-lime flavored ones that helped even more. She also brought me some heavenly lip moisturizer.
The other thing I remember was the pain. My abdomen was incredibly distended from all the gas they'd pumped me up with (still somewhat uncomfortably distended 5 days later) and my shoulders hurt a lot. I was really grateful for Sue's email reminding me that was also a side-affect of all the gases. The main pain was where the JP drain was installed. Ugh. Apparently it was necessary because I swear at least a liter of fluid was extracted over those first two days, but just imagine a foot or two of plastic tubing under your skin on top of the stomach that had just been cut up and you'll get a sense of what it felt like.
Nurse Ratched was assigned to me on the night shift -- although I didn't connect fully with this analogy until I ended up with her a second night the next night -- more on that later. She didn't seem to understand a word I spoke to her. I remember looking over to John several times silently asking if I was speaking English or Greek and seeing the commiseration in his eyes over her seeming stupidity. Her CNA was also by far the laziest one I met. Smarter than her RN, and smart enough to do just enough to get by.
Thankfully I still had my morphine and after affects of anesthesia so recall sleeping pretty solidly that night.
Day 0 - Surgery (Tuesday, September 22)
Thank God for great surgeons, anesthesiologists, and admissions nurses -- and at the very top of the list a husband with the patience of Job. Let's finish that list with the wonders of Versed.
The admissions RN had a very pragmatic matter about her and a somewhat dry wit -- a perfect match for me. After changing into the chic (hypoallergenic in my case) hospital gown and booties I was freezing. She turn on a groovy hot air filled blanket for me that had me toasty warm in a heartbeat. After signing a million more release forms (and yes, Fern, I took your advice -- I didn't read ANY of them -- after all, I already knew the major risks), she took my BP and it was a little high -- what a shocker. :)
The anesthesiologist had called me the night before and had given me "permission" to have him paged an hour before surgery if I felt the need for any anxiety reduction assistance. He told me I had to see the OR RN too before any chemical help would be available to I asked the admissions RN to get the OR RN and then to page the anesthesiologist.
The OR RN came in and was again nicely compassionate, clear and direct -- love that type of RN! She very nicely distracted me with yet more paperwork while the admissions RN inserted the IV. Yay, it worked the first time. I have awful veins so this was a very good thing.
In the interim the anesthesiologist answered the page and the admissions RN administered a small dose of Versed. I love Versed -- almost instant relaxation and no memory at all of anything after the 2nd dose about half an hour later.
The admissions RN also added a sticky to the anesthesiologist's paperwork asking him to help me visualize pink, purple and white lights as he put me under, as Jayne so kindly suggested. I remember discussing this with him in between Versed doses and he noted lots of people have requests like this and lots to play visualization and relaxation tapes. Kinda cool.
I loved the anesthesiologist, but both John and I can't help but wonder if he's tried any of his own meds along the way. Talk about Dr. Mellow! If he were any more laid back he'd be asleep!
I asked John to describe my pre-op demeanor to me. I was surprisingly a whole lot more relaxed than either of us expected the night before and the morning of -- up until I climbed up onto that gurney. Then panic started to set in until that first dose of Versed came. After the 2nd dose of Versed John reports I was almost as relaxed as Dr. Mellow. :)
They wheeled me into the OR around 8:45 and around 11:10 my surgeon came out to talk to John. She said everything came out great and the laparoscopic surgery was much easier than she expected -- likely due to the more than 60 pound weight loss I had before the procedure.
Apparently they kept me in recovery a lot longer than the anticipated. 1 hour At first there was an issue with what room I was going to be moved to and as soon as that was resolved my blood pressure became unstable.
About 2.5 hours later I was stable and taken to 2428. Fortunately I had a private room -- I understand they try to do that for all of the patients going through this procedure because of food issues. The smell of real food today, even the thought of it, (and I'm typing this 5 days after surgery from home) makes me instantly nauseous.
John reports my spending the rest of the time he was with me (until around 9 PM) as in and out of sleep. God bless morphine. The clock rapidly became my best friend -- every 10 minutes I religiously pushed that button.
One of the biggest things I remember is being incredibly dry-mouthed. I knew I wouldn't be allowed any fluids until the leak test was performed the day after surgery. It was great having John there and being prepared for this so knew to ask for some mouth swabs. He kindly got me some and they provided great relief. The RN came in a few hours later and gave me some really tart lemon-lime flavored ones that helped even more. She also brought me some heavenly lip moisturizer.
The other thing I remember was the pain. My abdomen was incredibly distended from all the gas they'd pumped me up with (still somewhat uncomfortably distended 5 days later) and my shoulders hurt a lot. I was really grateful for Sue's email reminding me that was also a side-affect of all the gases. The main pain was where the JP drain was installed. Ugh. Apparently it was necessary because I swear at least a liter of fluid was extracted over those first two days, but just imagine a foot or two of plastic tubing under your skin on top of the stomach that had just been cut up and you'll get a sense of what it felt like.
Nurse Ratched was assigned to me on the night shift -- although I didn't connect fully with this analogy until I ended up with her a second night the next night -- more on that later. She didn't seem to understand a word I spoke to her. I remember looking over to John several times silently asking if I was speaking English or Greek and seeing the commiseration in his eyes over her seeming stupidity. Her CNA was also by far the laziest one I met. Smarter than her RN, and smart enough to do just enough to get by.
Thankfully I still had my morphine and after affects of anesthesia so recall sleeping pretty solidly that night.
Saturday, September 19, 2009
"Your courage will guide your future"
"Land of the Free" by Harry Chen
"Your courage will guide your future" -- Fortune Cookie Saying
Day 137
An auspicious saying I think in the cookie that accompanied my "last supper" tonight. Knowing that the GI cleansing starts tomorrow I wanted to be sure to eat lightly today. I did not feel like cooking, and John is enjoying an evening with the Pompous Twits wine group tonight, so he kindly picked up some yummy hot and sour soup from our favorite local Chinese restaurant for my supper. It was delicious, and the saying rather fits how I feel about all this.
I do feel courageous for me. I know the next couple of months are not going to be easy, but I am willing to bet it is going to buy me a few extra years of life in better health and less physical pain that I have today. What is a few months compared to that?
I spent a somewhat frustrating five hours doing pre-op junk at the hospital Wednesday; frustrating because surely it should not have taken more than two hours and I had an awful lot of things waiting for me to do at work. I sure wish I was going to be at a different facility. I really do not like the facility in Pleasanton compared to San Ramon or Oakland. I am definitely hoping that all goes wrinkle-free and I am only there two nights. The admissions nurse had never heard of hypo-allergenic linens. I learned 12 years ago that I am allergic to the harsh detergents hospitals generally use, so this is a must. She said she would do some research -- hopefully they will figure it out! More blood-work and urinalysis performed -- you would think I had been poked enough already. And yet another image -- this time a chest x-ray. I am really glad everyone is being so careful, but I cannot help but wonder how much all of this is costing... and how much is too much? I will have to add up all the insurance statements one of these days -- but not today.
I have officially started my leave of absence from work. The first stop on the pre-op visit trail was with the surgeon. She did a great job going through in painstaking detail the procedure and risks again. Her colleague will be assisting -- it is nice to know two surgeons who have both done this many, many times will be in the operating room. The anesthesiologist is more involved than I had realized also. He or she will be inserting a tube with a small balloon into the upper area of my stomach -- essentially to measure off what will become the new pouch. The surgeon has kind of a groovy machine (if you think of this as something being done to someone else :) ) that will simultaneously insert two rows of staples in the stomach and cut between them. Amazing. The largest of the 5 or 6 incisions she will be making is expected to be about half an inch wide. I love laparoscopy. She cautioned me again that she may have to open me all the way -- I am truly hoping this will not happen. She has not had to open anyone all the way up in a few years and I really do not want to break her record!!
I received my new medic alert bracelet yesterday. The RN for the program gave me a brochure for this online vendor and I like their stuff -- they are on the web at http://www.laurenshope.com/ if you are looking for anything along these lines. They engrave a plate and attach clasps on either side so you can change out the bracelet you use with it to match your wardrobe -- kinda fun. For my first one I got purple (what else?) and clear Swarovski crystals. I hope I never need anyone to use it -- but if I do I know I will be glad I have it!
Anyone that knows me well knows that I would not be satisfied with a "last supper" of hot and sour soup. After four months of protein drinks for breakfast and lunch and small dinners, I confess to three lovely splurges this week.
The first was a nice lunch with my colleagues kindly coordinated by Harry. Speaking of Harry, I am going to use my blog to shamelessly ask you to vote for his work. Harry's an amazing photographer. He created the wonderful image at the beginning of this blog entry. He is a finalist in the Aaron Brothers'"Show Us Your America" contest at: http://www.showusyouramerica.com/votes/n
The next was a lovely meal was dinner with my friend Belinda. What a wonderful evening! We started at her beautiful home visiting with her Bella -- a terrific cockapoo I freely admit to coveting greatly. We shared a fine feast at an Italian restaurant -- starting with Scoozi and some spicy sausage stuffed mushrooms before splitting some Prawns in Vodka-cream sauce over pasta and finishing with some incredible chocolate thing with vanilla ice cream. We couldn't finish it all but certainly enjoyed what we could.
The final splurge was last night -- a pastrami reuben sandwich. It was hard to choose between french fries or part of an eclair, but I finally settled for a salad instead of the fries and went for the share of the eclair. Surprisingly enough to me, my ability to eat all that comfortably has already changed... but the tastes were delicious. :)
I am finding myself surprising less apprehensive than I expected at this point -- but note there are still a couple of days left to stress out in. I am certain part of the reason is all of the support my friends and family have been providing. I think I am one of the luckiest people in the world! My Jewish friends said prayers for me at Temple as they welcomed the new year; my Christian friends are lighting candles as they say prayers for me at Church, and my alternate-spirituality friends are sending me great ideas for visualizing white, purple and pink light to bathe myself in love as I go under... who could ever ask for more? I am indeed truly blessed by all of you -- thank you.
Monday, September 14, 2009
"Godspeed your love to me"
Day 132
As Belinda so aptly put it when I got "THE" date a couple of hours ago: "Holy CRAP!" A week from tomorrow, Tuesday, 9/22 at 8:30 AM PDT start sending good vibes my way as that's when they'll wheel me into the surgical suite to start the next phase of this journey.
I'm really excited and a wee bit apprehensive now. This is an irreversible decision once I go under. At the pre-op prep class last week they had us sign the surgery authorization with all of the warnings including the big D (death) thing and the reminder that you will not be able to consume the same same size meals as you can today. Three 1-3 ounce meals at first, and then three 3 ounce meals for a long time -- eventually 1-1.5 cups depending on the individual after a year or two. Considering that's part of my objective, the latter is a good thing. We're rooting for a pass on the first thing.
This week is going to be crazy -- an insane work load at the office; several hours doing pre-op stuff Wednesday and I bet a couple more things later in the week. After all these months of waiting it truly is now going to be rush rush rush. I suspect this is part of the strategy to keep people from changing their minds -- keep them too busy to worry too much.
I just heard the news that Patrick Swayze lost his battle with pancreatic cancer and am saddened by his passing. I have always had a bit of a crush on him... who could resist him in "Dirty Dancing" or "Ghost?" Remember this one?
Unchained Melody
Composed by Alex North with lyrics by Hy Zaret
Oh, my love
my darling
I've hungered for your touch
a long lonely time
and time goes by so slowly
and time can do so much
are you still mine?
I need your love
I need your love
Godspeed your love to me
Lonely rivers flow to the sea,
to the sea
to the open arms of the sea
lonely rivers sigh 'wait for me, wait for me'
I'll be coming home wait for me
Oh, my love
my darling
I've hungered for your touch
a long lonely time
and time goes by so slowly
and time can do so much
are you still mine?
I need your love
I need your love
Godspeed your love to me
Please Godspeed your love and good thoughts to me next week! You know I send them back a hundred-fold.
The Righteous Brothers perform 'Unchained Melody' (YouTube video)
As Belinda so aptly put it when I got "THE" date a couple of hours ago: "Holy CRAP!" A week from tomorrow, Tuesday, 9/22 at 8:30 AM PDT start sending good vibes my way as that's when they'll wheel me into the surgical suite to start the next phase of this journey.
I'm really excited and a wee bit apprehensive now. This is an irreversible decision once I go under. At the pre-op prep class last week they had us sign the surgery authorization with all of the warnings including the big D (death) thing and the reminder that you will not be able to consume the same same size meals as you can today. Three 1-3 ounce meals at first, and then three 3 ounce meals for a long time -- eventually 1-1.5 cups depending on the individual after a year or two. Considering that's part of my objective, the latter is a good thing. We're rooting for a pass on the first thing.
This week is going to be crazy -- an insane work load at the office; several hours doing pre-op stuff Wednesday and I bet a couple more things later in the week. After all these months of waiting it truly is now going to be rush rush rush. I suspect this is part of the strategy to keep people from changing their minds -- keep them too busy to worry too much.
I just heard the news that Patrick Swayze lost his battle with pancreatic cancer and am saddened by his passing. I have always had a bit of a crush on him... who could resist him in "Dirty Dancing" or "Ghost?" Remember this one?
Unchained Melody
Composed by Alex North with lyrics by Hy Zaret
Oh, my love
my darling
I've hungered for your touch
a long lonely time
and time goes by so slowly
and time can do so much
are you still mine?
I need your love
I need your love
Godspeed your love to me
Lonely rivers flow to the sea,
to the sea
to the open arms of the sea
lonely rivers sigh 'wait for me, wait for me'
I'll be coming home wait for me
Oh, my love
my darling
I've hungered for your touch
a long lonely time
and time goes by so slowly
and time can do so much
are you still mine?
I need your love
I need your love
Godspeed your love to me
Please Godspeed your love and good thoughts to me next week! You know I send them back a hundred-fold.
The Righteous Brothers perform 'Unchained Melody' (YouTube video)
Saturday, September 12, 2009
I need to set the kitchen timer...
“My recipe for dealing with anger and frustration: set the kitchen timer for twenty minutes, cry, rant, and rave, and at the sound of the bell, simmer down and go about business as usual” - Phyllis Diller
Day 130
I definitely need an attitude adjustment today -- we'll have to work on that!
It has started off the perfect way to go with my mood -- a crazy, and very unusual for here, LOUD thunderstorm woke me up. I had really hoped for some extra sleep this morning as my work day started at 6 AM yesterday and we all know what a morning person I am NOT. I worked a very frustrating 13 hours and didn't accomplish half of what I needed to do so am looking forward to a lot more tedious work this weekend to try to get at least half way caught up for some critical Monday deadlines. Yuck yuck yuck.
I should be elated -- I received insurance authorization for my surgery late yesterday afternoon. Perhaps I am ungrateful, but what a pain it was to get it!! I spoke with my surgeon's office Thursday and was told basically to go away and they'd let me know when they receive approval -- you know how that would not work for me. So I called the insurance company and was able to sleuth out my case manager. Good thing I did...
She started the conversation off with a we have until Friday to get back to your surgeon within our service level agreements. I said great, that's tomorrow -- how's it going. She paused, and then agreed to do some more research. Came back on the line a couple of minutes later with a whole new attitude -- a most apologetic one. She had forgotten to assign me for review. Sigh. So had I not called, who knows when this would have finally been done. She promised my surgeon would hear from them the next day (yesterday) and we parted ways.
3 PM comes and goes yesterday so I called the surgeon's office and they still hadn't heard. Called the insurance company and actually got the case manager on the first try (took a dozen attempts Thursday -- you know I wasn't going to leave a voice mail message for her to call me back). Went through the whole thing again -- then remembered me apparently from the day before -- put me on hold, came back with congratulations -- you've been approved. Like I'd won the lotto or something. Said surgeon would be called before end of day (which was rapidly approaching). Also said she showed an admission date of October 3 (a Saturday -- seems a bit odd) and discharge date of October 5. I told her I expected it to be earlier and she said no problem, just let her know the new dates to update the file.
Called the surgeon's office and they said they couldn't do anything without something in writing from the insurance company. Sigh again. No one trusts or believes anyone, do they?
While we were chatting my cell phone rang. Put the surgeon's office on hold and it was the coordinator from the Valley Care program saying they'd just heard from the surgeon's office and I'd been authorized for surgery. Apparently the ladies at the surgeon's office don't speak to one another!! I thanked the coordinator, got back on the line with the surgeon's office and was told they were having a bad day and that since the other lady knew what was going on she would have to call me back Monday and couldn't schedule anything until then.
Oh well, what's one more weekend of waiting? A lot to me, I'll admit. Today is 130 days since I started this and it seems absurd that I still don't have a definitive date. It is so difficult to plan anything, but I'm doing the best I can. I ordered my cough buddy and my first medic alert bracelet (purple of course!) so two more things off that prep list. Still a bunch to do.
Fingers crossed that Monday I'll be able to post a definitive surgery date... and hopefully one in September. I find it difficult to think the surgeon would schedule a Saturday procedure!
Day 130
I definitely need an attitude adjustment today -- we'll have to work on that!
It has started off the perfect way to go with my mood -- a crazy, and very unusual for here, LOUD thunderstorm woke me up. I had really hoped for some extra sleep this morning as my work day started at 6 AM yesterday and we all know what a morning person I am NOT. I worked a very frustrating 13 hours and didn't accomplish half of what I needed to do so am looking forward to a lot more tedious work this weekend to try to get at least half way caught up for some critical Monday deadlines. Yuck yuck yuck.
I should be elated -- I received insurance authorization for my surgery late yesterday afternoon. Perhaps I am ungrateful, but what a pain it was to get it!! I spoke with my surgeon's office Thursday and was told basically to go away and they'd let me know when they receive approval -- you know how that would not work for me. So I called the insurance company and was able to sleuth out my case manager. Good thing I did...
She started the conversation off with a we have until Friday to get back to your surgeon within our service level agreements. I said great, that's tomorrow -- how's it going. She paused, and then agreed to do some more research. Came back on the line a couple of minutes later with a whole new attitude -- a most apologetic one. She had forgotten to assign me for review. Sigh. So had I not called, who knows when this would have finally been done. She promised my surgeon would hear from them the next day (yesterday) and we parted ways.
3 PM comes and goes yesterday so I called the surgeon's office and they still hadn't heard. Called the insurance company and actually got the case manager on the first try (took a dozen attempts Thursday -- you know I wasn't going to leave a voice mail message for her to call me back). Went through the whole thing again -- then remembered me apparently from the day before -- put me on hold, came back with congratulations -- you've been approved. Like I'd won the lotto or something. Said surgeon would be called before end of day (which was rapidly approaching). Also said she showed an admission date of October 3 (a Saturday -- seems a bit odd) and discharge date of October 5. I told her I expected it to be earlier and she said no problem, just let her know the new dates to update the file.
Called the surgeon's office and they said they couldn't do anything without something in writing from the insurance company. Sigh again. No one trusts or believes anyone, do they?
While we were chatting my cell phone rang. Put the surgeon's office on hold and it was the coordinator from the Valley Care program saying they'd just heard from the surgeon's office and I'd been authorized for surgery. Apparently the ladies at the surgeon's office don't speak to one another!! I thanked the coordinator, got back on the line with the surgeon's office and was told they were having a bad day and that since the other lady knew what was going on she would have to call me back Monday and couldn't schedule anything until then.
Oh well, what's one more weekend of waiting? A lot to me, I'll admit. Today is 130 days since I started this and it seems absurd that I still don't have a definitive date. It is so difficult to plan anything, but I'm doing the best I can. I ordered my cough buddy and my first medic alert bracelet (purple of course!) so two more things off that prep list. Still a bunch to do.
Fingers crossed that Monday I'll be able to post a definitive surgery date... and hopefully one in September. I find it difficult to think the surgeon would schedule a Saturday procedure!
Wednesday, September 9, 2009
“Unbeknownst to most historians, Einstein started down the road of professional basketball before an ankle injury diverted him to science”
“Unbeknownst to most historians, Einstein started down the road of professional basketball before an ankle injury diverted him to science” -- Gary Larson
Day 127
What an awful weekend I had! Thankfully I feel great today and hopefully this "incident" will soon be behind me. It doesn't really fit the journey per se, other than to record why I'm a week of exercise, but does go to show life doesn't always go the way we plan once again.
It would have to start on the first day of a three-day weekend when the only way to see the doctor is to go to the ER (and I was so not going to the ER on a holiday weekend unless I was literally dying!). At first there was irritating, but minor pain on the side of my left foot -- within a few hours it zipped up to excruciating -- I'd call it a 9 on the 1-1o scale. We had some leftover #3 Tylenol with codeines so those got me through the night. I spoke to the on call doctor Sunday who said effectively suck it up or go to the ER -- as expected.
Kept it elevated and periodically iced until I could get into my great new PCP yesterday morning. She took me in as her first patient. John was (as you'd expect) great through all of this else I don't know how I would have survived -- I literally could not even get out of my chair without help and had to use a walking stick to hobble around. Stairs were fun -- John on one side and the stick on the other.
Anyway, my PCP said there was a possibility of a stress fracture as I've increased my walking in the last few weeks, but likely it was either a recurrence of gout or some other inflammation. Plan was to xray it to rule out the former and to take 3 days of prednisone (since I can't take any anti-inflammatories this close to surgery) in case of the latter.
So next stop was the hospital. I love SRRMC -- everyone there is great. Lots of teasing for John and I thanks to my walking stick -- hey lady, did you kick him instead of using the stick stuff. As I dreaded, I had to climb up onto an awfully high xray table and put my foot into all kinds of unbearable positions for xrays. I looked at the scrawny tech who offered to help me up and kindly laughed at him. Put my hand on the footstool and said out loud "just suck it up and do it." He was awesome -- said his wife would kill him if he said that. Finally managed to get through it all and with his help sit back up and get back down and then hobble back to the car with John's help.
Next stop was the pharmacy. I know prednisone's side affects are awful, but OMG, I understand now why so many people become addicted to it and why my doctor only gave me a 3-day supply. Other than some hobbling (walking-stick free I might add) today, I feel like I'm in my 20's again. My shoulder that's hurt for almost 2 years now feels great! No wonder athletes love steroids. I feel like I can do almost anything (other than clean the outside of my house -- Fern, you've got to be kidding!).
Thankfully my PCP warned me the prednisone would play havoc with my blood sugar. I have it under really good control and generally have fasting numbers under 100. This morning it was 201 -- yikes! It hasn't been that high in over a decade. So I shot a little extra insulin this morning -- and then an hour later crashed. What a pain -- it dropped to 42 (should be above 60). So I rescued myself and called my (wonderful) endocrinologist. He told me not to worry -- let it go (as long as it stays under 300) and by Friday it should be back to normal. Although not optimal, it won't hurt for just a few days.
John and I attended the pre-op/post-up combined support group session last night again. As anticipated, more good info was shared. One of the pre-op patients asked about hair loss. I'm glad they did as it's a definite concern of mine. Unfortunately it was confirmed that most of the post-ops there did experience this problem. The facilitator noted 50% of people undergoing rapid weight loss do in spite of keeping their protein levels correct. This was a little disappointing to hear, but best to be forewarned. Thankfully it's usually just one growing cycle and comes back -- I recall this being a 3-6 month cycle. I suppose I can live with less hair for a few months for all of the other potential benefits.
Tomorrow's the pre-op prep class. Two hours -- shouldn't be too bad. Hopefully the exercise-nazi RN won't freak out too much over my non-existent exercise since Saturday or my likely weight gain from the prednisone (yes, I'm blowing up with fluid retention thanks to even this small course of treatment). I'm really glad now I've lost so much more weight pre-surgery than I was required to. We have our final weigh-in and review our exercise records as part of the session. Can't wait. Not. The rest I am looking forward to -- bowel prep (not! -- supposedly easier than a colonoscopy prep -- we'll see) instructions and post-op short-term expectations.
To close, I've never been particularly interested in basketball, but I have been in science. I wonder if this ankle thing will send me back to it? I'll have to ask Gary next time I see him. :)
Day 127
What an awful weekend I had! Thankfully I feel great today and hopefully this "incident" will soon be behind me. It doesn't really fit the journey per se, other than to record why I'm a week of exercise, but does go to show life doesn't always go the way we plan once again.
It would have to start on the first day of a three-day weekend when the only way to see the doctor is to go to the ER (and I was so not going to the ER on a holiday weekend unless I was literally dying!). At first there was irritating, but minor pain on the side of my left foot -- within a few hours it zipped up to excruciating -- I'd call it a 9 on the 1-1o scale. We had some leftover #3 Tylenol with codeines so those got me through the night. I spoke to the on call doctor Sunday who said effectively suck it up or go to the ER -- as expected.
Kept it elevated and periodically iced until I could get into my great new PCP yesterday morning. She took me in as her first patient. John was (as you'd expect) great through all of this else I don't know how I would have survived -- I literally could not even get out of my chair without help and had to use a walking stick to hobble around. Stairs were fun -- John on one side and the stick on the other.
Anyway, my PCP said there was a possibility of a stress fracture as I've increased my walking in the last few weeks, but likely it was either a recurrence of gout or some other inflammation. Plan was to xray it to rule out the former and to take 3 days of prednisone (since I can't take any anti-inflammatories this close to surgery) in case of the latter.
So next stop was the hospital. I love SRRMC -- everyone there is great. Lots of teasing for John and I thanks to my walking stick -- hey lady, did you kick him instead of using the stick stuff. As I dreaded, I had to climb up onto an awfully high xray table and put my foot into all kinds of unbearable positions for xrays. I looked at the scrawny tech who offered to help me up and kindly laughed at him. Put my hand on the footstool and said out loud "just suck it up and do it." He was awesome -- said his wife would kill him if he said that. Finally managed to get through it all and with his help sit back up and get back down and then hobble back to the car with John's help.
Next stop was the pharmacy. I know prednisone's side affects are awful, but OMG, I understand now why so many people become addicted to it and why my doctor only gave me a 3-day supply. Other than some hobbling (walking-stick free I might add) today, I feel like I'm in my 20's again. My shoulder that's hurt for almost 2 years now feels great! No wonder athletes love steroids. I feel like I can do almost anything (other than clean the outside of my house -- Fern, you've got to be kidding!).
Thankfully my PCP warned me the prednisone would play havoc with my blood sugar. I have it under really good control and generally have fasting numbers under 100. This morning it was 201 -- yikes! It hasn't been that high in over a decade. So I shot a little extra insulin this morning -- and then an hour later crashed. What a pain -- it dropped to 42 (should be above 60). So I rescued myself and called my (wonderful) endocrinologist. He told me not to worry -- let it go (as long as it stays under 300) and by Friday it should be back to normal. Although not optimal, it won't hurt for just a few days.
John and I attended the pre-op/post-up combined support group session last night again. As anticipated, more good info was shared. One of the pre-op patients asked about hair loss. I'm glad they did as it's a definite concern of mine. Unfortunately it was confirmed that most of the post-ops there did experience this problem. The facilitator noted 50% of people undergoing rapid weight loss do in spite of keeping their protein levels correct. This was a little disappointing to hear, but best to be forewarned. Thankfully it's usually just one growing cycle and comes back -- I recall this being a 3-6 month cycle. I suppose I can live with less hair for a few months for all of the other potential benefits.
Tomorrow's the pre-op prep class. Two hours -- shouldn't be too bad. Hopefully the exercise-nazi RN won't freak out too much over my non-existent exercise since Saturday or my likely weight gain from the prednisone (yes, I'm blowing up with fluid retention thanks to even this small course of treatment). I'm really glad now I've lost so much more weight pre-surgery than I was required to. We have our final weigh-in and review our exercise records as part of the session. Can't wait. Not. The rest I am looking forward to -- bowel prep (not! -- supposedly easier than a colonoscopy prep -- we'll see) instructions and post-op short-term expectations.
To close, I've never been particularly interested in basketball, but I have been in science. I wonder if this ankle thing will send me back to it? I'll have to ask Gary next time I see him. :)
Thursday, September 3, 2009
“For my part I know nothing with any certainty, but the sight of the stars makes me dream.”
"For my part I know nothing with any certainty, but the sight of the stars makes me dream." -- Vincent Van Gogh
Day 121
Well, it's official. That is, I'm officially in "pending" status. All of my surgical pre-requisites have been met from the program's perspective and they have indeed submitted the request for surgery approval to my insurance company. Best guess is that I'll have the procedure the week of 9/21; with some luck and speedy processing by insurance perhaps the week of 9/14.
I'll be going in next week for a 2 hour pre-op class, objectives of which are to learn more about preparing for the surgery and preparing for the first month afterwards. There's another support group next week too so I plan to go to that as well.
Yesterday I saw my sleep doctor and as much as I hate it, that darn machine makes me look statistically good now at least -- averaged only 3 stops to my breathing per hour on it vs. the old number that was around 90. The doctor thought the numbers were great, so I guess that's a good thing. He had tested some things through bloodwork that may have been causing some restless legs at night and all those tests came back pretty good too. The one "close" one was iron -- they recommend having a level of up to 50 and I'm at 53, so good enough, but he suggested it could be higher so I'll start some iron supplements now too.
I was successful in setting up the new wireless network at home over the weekend and the reception's great everywhere! Woohoo. I love technology when it works. Our new laptop is fabulous also -- really pleased with it. John built a groovy rolling laptop table for me last night, so I'm all set and can remain connected now when I get home from the hospital. Who could ask for more?
Anyway, keep your fingers crossed for the week of 9/14 -- that would be grand. Fingers crossed...
Day 121
Well, it's official. That is, I'm officially in "pending" status. All of my surgical pre-requisites have been met from the program's perspective and they have indeed submitted the request for surgery approval to my insurance company. Best guess is that I'll have the procedure the week of 9/21; with some luck and speedy processing by insurance perhaps the week of 9/14.
I'll be going in next week for a 2 hour pre-op class, objectives of which are to learn more about preparing for the surgery and preparing for the first month afterwards. There's another support group next week too so I plan to go to that as well.
Yesterday I saw my sleep doctor and as much as I hate it, that darn machine makes me look statistically good now at least -- averaged only 3 stops to my breathing per hour on it vs. the old number that was around 90. The doctor thought the numbers were great, so I guess that's a good thing. He had tested some things through bloodwork that may have been causing some restless legs at night and all those tests came back pretty good too. The one "close" one was iron -- they recommend having a level of up to 50 and I'm at 53, so good enough, but he suggested it could be higher so I'll start some iron supplements now too.
I was successful in setting up the new wireless network at home over the weekend and the reception's great everywhere! Woohoo. I love technology when it works. Our new laptop is fabulous also -- really pleased with it. John built a groovy rolling laptop table for me last night, so I'm all set and can remain connected now when I get home from the hospital. Who could ask for more?
Anyway, keep your fingers crossed for the week of 9/14 -- that would be grand. Fingers crossed...
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