Tales from the Crypt ~ Part 1

 INCARCERATION   HOSPITALIZATION  ~

Arrival - We drive through streets I've traveled daily for over 30 years.  They look odd.  Too cheery.  Too dull.  Surreal.  We park in the asphalt labyrinth of marked spaces that surrounds the hospital.  Lights are flashing at every entrance. A constant, loud and grating, "BAH BAH BAH!" echos.  Once at the appropriate registration desk, a nice lady with a slightly Irish gnome appearance reassures us they are having but a drill as we shout to hear each other...reviewing my name, rank, serial number and funding.  "Okay.  So that will be $6,000.00.  How did you want to pay?" BAH, BAH, BAH! "I'm not." BAH, BAH, BAH! "What?  Didn't the financial office call you?" BAH, BAH, BAH! "Yes, they did." BAH, BAH, BAH! "Well, this is the calculation they made based on your insurance and...." BAH, BAH, BAH! "The deductible I will owe you for a surgical procedure per my insurance company is $500.00.  That is what I will pay you today." BAH, BAH, BAH!  "Oh, okay."  Transaction completed, I am rolled off to the surgical area - lights flashing.  BAH, BAH, BAH!

Pain - I expect it and it is there.  Waves.  Luckily, the marinol anesthesia gave me in pre-op really did prevent post anesthesia vomiting for the first time ever!  So...I can do this!  Eat they say.  I try.  It hurts.  Horrible things are excreted.  I capitulate.  Drugs.  Requisite nausea.  Requiring zofran and phenergan with every dose.  I try.  To think.  To make sense.  To have some sense of self.  Some sense of decorum.  Walk they say.  I do.  I can do this.  What is pain?

Loss of Control - There is no rest.  Knock, knock, knock. Followed by immediate entry.  Respiratory.  Knock, knock.  Food service.  Knock, knock, knock.  "I'm turning on the lights! Here to get your vital signs." Lab.  IV team.  Nursing.  CNA's.  We both lose focus.  We can't think.  We can't hear.  The nights are endless trips to the bathroom with foley and pole and pain.  The human body rebels at allowing the expulsion of it's innards while clenched in pain.  So one must try to relax.  Somehow.  B cradles my head, supports my weight, and rubs my back as I hold on to his pants leg.  The ventilating system (????) is incredibly, constantly, loudly roaring - no matter the setting.  I drive Brent crazy.  I am too hot.  I am freezing.  Pain and nausea drive my inner thermostat.  Every night, I hear singing as I watch the clock and various papers and bulletins float along the wall.  It comes from the rafters at the top right corner of the room, from my bed's perspective.  Sort of like a men's choir singing the Russian anthem crossed with Mannheim Steamroller.  I look forward to hearing it.  I know I am insane.  My arms and body seem to twitch.  I can't tell if I just feel it or if I really am jerking my limbs in clonic movements.  Then, as I try to drift off, both my arms strike the over bed table, startling me.  Oh.  So, it is real.  I shove my hands under my bottom to try to keep them still so that I can rest.  B can no longer hear or understand me.  Part of that is me.  Part of that is his utter exhaustion.  He calls in the troops.  But, even in my delirium, I know he has been unclear.  He has to call Ruthie back.  "Yes, I mean come NOW."

I rally - Ruthie arrives.  Her bright smile and sanity bring us strength.  She and B alternate the night shifts.  With even that small modicum of rest, B regains his hearing and faculties.  My adverse reaction to the phenergan and zofran with the jerking and drawing of my face are called dyskinesia.  A known reaction to these drugs, though I had never experienced them before.  So...no more of that.  Days are required to diminish the effect.  Toradol becomes my friend.  Though docs are cagey about how many total doses I'm allowed due to the potential for adverse effects on my kidneys.  I am determined.  I try to eat more.  Walk more.  Ruthie gets me.  As we walk I say, "I feel bad for that woman!"  Her face clouds, probably thinking - 'Okay, dokie.  Here she goes again!'  But, rapidly she brightens and replies, "No, shit.  It's really bad!  She's probably our age!"  We stop.  Looking at a print (a photo?) in the ward's hall, of a worn and weary woman, wearing a rather 'Little House on the Prairie' style bonnet, standing in front of quilts that seem to be hanging in the sun.  She stares hard back at us.  She doesn't appear happy to have been captured in this moment (in her life?) and I am certain that she would have been horrified to know she has been forced to hang in this fetid back hall of a hospital's abdominal ward for years.

Nursing - What happened to nursing?  Some nurses are nice.  Some are competent.  Some are frightening.  Some are cold.  But, are any of them nursing?  I have been scanned - repeatedly.  I have been required to give my name and date of birth - repeatedly.  Have I been nursed?  Have I been assessed?  Has my pain been evaluated in anything other than a number descriptor that I am forced to provide?  Have any interventions been discussed with me or my caretakers that might make my stay better?  My health return faster?  No.  I am rarely touched.  At all.  Probably a story for another time.  But - really?

No better - Profuse excretions continue.  My back aches.  My body aches.  My stomach remains swollen and tight.  I eat...next to nothing. I can't.  Tests are needed.  I am zipped down to radiology, to see what is, or isn't, happening in my recalcitrant abdomen, by a consistently kind, human, and efficient group - the transporters.  I am surprised to be taken, in my little nifty, side opening wheelchair, to a human parking garage.  Big open room.  Literal parking spaces, outlined with little bumpers, just like at Wally World.  I am backed rapidly and efficiently in my space between two half dead appearing peeps in their big beds.  Just me.  A little nasty woman smelling of dirty butt, parked right up in between here.  An incredibly nice chocolate brown lady in chocolate brown scrubs is kind to me and talks to me as others in their big beds go off for their tests.  She ignores the stench I know I possess despite B and Ruthie's best efforts to tamp it down.  She is kind to every person who enters.  She likes bar-b-que stuffed potatoes.  Me too.  Or I used to.  When I liked food.  I help her remember the name of her best place.  Rib and Loin.  Time for my film.  Nice tech.  To lie flat is horrible.  First time I have done so since surgery.  She helps me.  For the upright, the leaves me flat, but tilts the entire table straight up. Slowly.  Like a child on a slide, she helps me glide down until I am upright and standing.  It is a little fun.

Ileus - An answer.  Part of my gut is still not feeling it.  Not working, causing nothing.  Therefore, causing a back log.  The cure - time.  And a tube - down my nose and esophagus, to my stomach, placed to suction.  It is a nightmare.  The girl placing it is a newly hired nurse.  I have also been new.  I have done all things "for the first time" to my patients.  I have done horrible things, many times, to my patients.  I am sorry, sweet Tarren.   I try to make it okay in my mind to be that patient.  She doesn't even know how to measure the tube.  She does have a smart mentor - who shows her.  They use the largest one.  Ramming and ramming.  It will not go...as Brent is frantically trying to tell them:  A) Don't use the right side.  She had melanoma to her right tonsil and had extensive surgery there causing secondary damage and scar tissue.  (That point is made..but....)  B) You cannot use that size, even on the left.  She has had problems with her turbinates...having to see an ENT...  Point not taken.  Until it is obvious.  Another size is chosen.  They begin again.  I am not in the proper position.  Which intellectually I know, but can't really grasp or act effectively upon.  B and Ruthie hold me up.  I gag and tears run.  My throat is raw.  Suction is applied.  I become a bit psycho crying and talking about Tarren.  Ruthie probably has no idea what to do...but she comforts me and treats me as though I am sane.  B seems to melt in dismay.  Not at me.  Just at the horror that has become our reality.  NPO, well maybe some ice chips.  I probably take too many.  But they are the only way I can tolerate the tube.  Liters and liters of disgusting material are removed from my gut.  I do feel better.  My ear hurts with referred pain from the NG.  That night I almost lose my mind with the pain and gagging.  I cannot place what is wrong.  B figures it out.  My NG has been slipping up and down.  He re-tapes it.  Holds my hand.  All night.  I rest.

Better??? - Ruthie and B have a system.  Unplug that.  Rev up suction, wrap in towel, disconnect and plug that.  Roll her and her crap to the crapper.  Over and over.  I have to have a scan.  Meaning lots of contrast down my tube.  As each syringe is pushed in, vomiting is practically certain.  Ruthie interprets my stop and go motions for the nurses.  I must do this.  I cannot vomit out this tube!   I can't do this.  I will do this.  She understands.  I cannot talk and prevent emesis at the same time.  Scan done.  Not much different.  Maybe better.  At some point the surgeon is flushing my tube.  I close my eyes to focus on my mantra:  I will not throw up.  I will not throw up!  As he flushes it, I startle and jump.  "You can feel that?" he asks with surprise.  "Yes, of course!  You poured cold water all over my arm."  "Oh," he says, chagrined.  The nurses laugh.

Homeward bound - I finally get rid of the tube.  I am to eat and get better.  Maybe home on Monday.  My surgeon is going to be out of town over the weekend.  Partner covering.  We carry on.  B and Ruthie are so incredibly sweet to me.  Ruthie washes me.  B shops for anything he thinks I might eat.  My stomach appears unchanged to me.  What do I know?  We have tried to be a little conservative in my diet...soft things.  I am anemic.  I am very weak.  Surgeon's partner - loud, overbearing, obnoxious, speaking more about himself than my care, tells me I'm good to go on Sunday.  "Eat what you like! Your gut will be fine.  Follow up next week."  But, what about this rare cancer (so categorized by the Institute of Rare Diseases, no less!!! ).  "Rare?  That's not rare.  I used to take out one or two a month."  Nothing to worry about.  Gotta go do more life saving surgery.  (Yep.  He said that.  I shit you not!!!)

After 11 days...I head home.

...to be continued... c