"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!