My Staycation in Anchorage, Part 10, Barnacles and Vitals Thieves

Barnacles and Vitals Thieves

 

And yet another nurse arrives beside my hospital bed and says, “May I take your vitals?”

I reply, “If you girls keep “taking” my vitals, soon I won’t have any left.”   That one took a moment, but she got it.

All my smart-mouth joking serves a purpose.  Not only does it keep me on the bright side, but it also lets me know that everything is okay cognitively.  I continue to monitor myself assiduously for any signs of anesthesia-related cognitive decline.   That was my worst fear about surgery.

Later on, two nurses arrive for checks, and this time they want to see my five laparoscopic incisions.  I pull up my gown and they count the four near my waistline.

When she hesitates after counting four, I say, “The last one is up here near the barnacles.”   I am referring to the brown seborrheic keratosis that dot my torso and back.  They are caused by many factors like age, genetics, and exposure to sun, and are common in the elderly.

 

This time, all three of us started giggling and it took a while before the ladies could continue their exam.   They left smiling.  Score! I said to myself.   

 

Diane arrives with a bouquet of flowers.   They are a replacement for a previous bouquet sent by Diane’s daughter and two sons and were to contain specific flowers with specific meanings.   The daughter was not happy with the first lovely bouquet as it did not contain lavender, which symbolizes purity, silence, devotion, serenity, grace, and calmness. 

First flowers

Neither did the second bouquet—purple stocks.   Nonetheless, it’s the thought that counts and the flowers are lovely. 

Second flowers

Once again, I am wheeled down to the Ultra Sound lab where a tech locates and pinpoints the spot for another tech to drain the pleural effusion around my left lung.   This time, the half-liter of fluid is not milky and is a brighter red.   My “limousine driver” wheels me back up to the third floor and I get back in bed.  

Altogether, they have drained 1.8 liters of fluid from around my lungs.  Picture almost two Nalgene bottles of fluid, or close to four lbs.!

 If all goes well, I can expect to be discharged tomorrow.

Tomorrow arrives.   Another X-ray reveals only a residual amount of fluid around the right lung.  Not enough to worry about as long as I am breathing well.   

As I pack up to leave the hospital, I ask Diane what she thinks about giving the second bouquet to my roommate.   She approves.  We call the woman’s husband and give him the flowers.    He gives them to his wife and she is happy.

He says, “They put my single rose to shame.”

Ah, my.   So often my good intentions have unintended consequences.

Back at the hotel, we are in a new room as we had to change rooms when our original reservation expired.    

I climb into a sofa bed with an array of pillows that prop me semi-upright, per instructions.  

Then, I start to make plans to go home.  It’s now Saturday.  We canceled Diane’s original Friday flight home and rescheduled it for Monday night.  I get in touch with my friend Julie, who lives in an apartment on my property.  She is returning Sunday from vacation and I will get a ride with her.   Diane will have use of the pickup until Monday.  

Neighbors volunteer to go to Anchorage to get my truck and bring it to Moose Pass for me.   All is set and by Sunday late afternoon, a week after first going to Anchorage, I am home.

Then begins the at-home recovery process.  It will be marked by successes and setbacks, but no more hospital visits.

My Staycation in Anchorage, Part 9, "Hello? Grub Hub."

“Hello?   Grub Hub?”

 

Mounted on the wall near the foot of my hospital bed was a medium-sized dry-erase board.  On it was written the date, name of the nurse on duty, the diet I’m allowed (“full liquid”), and at the bottom is the number of the hospital extension where I could order food.  

I was only mildly concerned about my cup of missing meds that a nurse had given me an hour before, but I was pretty sure I wasn’t going to be deprived of them for long and I would need something to help with swallowing them.

I dialed the phone number and someone answered.

“Hello,”   I said.   “Is this Providence Grub Hub?”   (Grub Hub is a business that picks up and delivers take-out food.)

A long silence and then a voice full of laughter said, “Why, it sure is.   Would you like to place an order?”

“Yes, I’ll start with a thick rib eye steak, cooked rare…….  No, scratch that.   I’m on a full liquid diet.   I would like chicken broth and some cranberry juice.”

“You got it.   Forty-five minutes.”  I never again ordered food, but two containers of Ensure arrived three times daily.   The dietician, explained the nurse.

When a nurse came in, I mentioned the missing meds.   “We are bound by rules and can only leave them out for so long,” she explained.   “I’ll get you some new ones. “  

That left me pondering what they did with the meds they confiscated.   Do they dispose of them?   What a waste.

I told her I was sorry I’d not taken them but I was trying to get some sleep while it was quiet, indicated my roommate with a slight nod of my head in that direction.   She replied that she understood and was sorry.  

“No, problem,” I whispered.   “She’s pretty frightened and disoriented.”

Later that afternoon, Diane said she was going to get me some broth.   “Get it from the ER,” I said.  “It’s much better than the broth from the cafeteria.”   That morning broth that I'd ordered was barely lukewarm, and the granules weren’t even dissolved.

Obviously, I didn’t have my wits about me because she returned with a large container of won-ton soup, minus the won-tons, from a Chinese restaurant.  She had me up and walking around the ward and past a pleasant seating area in an atrium.

When I was ready for the Chinese broth, I suggested we go to that seating area.   I got my broth and she had her Chinese take-out and we sat in the atrium area for a nice meal.

On the way back to my room and bed, we passed the nurses’ station and I told them we’d been out to dinner.   I am not sure they understood as the nurse had a momentary look of concern on her face.

Getting out of bed was becoming easier and easier. Though still being careful to not tear any internal stitches,  I seldom needed help.  Once in a while, I’d get myself into a position that required too many abdominal muscles to sit up.   That’s when I asked for help.

Hey, if you can't have a bit of fun in a hospital, well....   Fun is where you find it.

A Good-Bye to Missy

 Goodbye and Godspeed to you, Missy.   You will be missed.

My Staycation in Anchorage, Part 8, CALL THE COPS!!!

CALL THE COPS!!!

An hour after I was re-admitted to the hospital for pleural effusion following my surgery for large hiatal hernia repair, another patient was wheeled into my room. No more private room for me.

Imagine my entire stomach being above the diaphragm, interfering with my lungs and heart.   That's what my surgery was meant to correct.

“What are YOU doing back here?” asked my surgeon when he came to my new hospital room the next morning. I laughed.

“I told you so,” I replied, referring to my life-long history of non-standard reactions to meds and procedures. I like to breathe, I thought, and may or may not have said it aloud.

He then took great care to explain what was happening to me. I described the previous day’s activities: walking laps in the hotel corridor, sitting up and feeling fine all afternoon, and struggling to get enough air that night.

He picked up Diane’s partially full water bottle. When you’re sitting up, he continued, this is where the pleural fluid is. He pointed to the water in the bottom of the bottle. Then, he turned the bottle on its side, demonstrating how the fluid  now affected more of the lungs, rather than just the bottom.

It made perfect sense.

He then told me that the hospital would probably drain the other lung sac if the X-ray showed fluid build-up. As to the previous day’s liter and a third, he said they were concerned about its milky appearance tinged with blood. 

The lab is going to check it for lymph. “I am reasonably certain that the system that moves lymph was not nicked,” he said. “It’s a long way from where I was operating.”

If it were, he continued, they would install a drain and you would have to remain hospitalized for several weeks until it heals.

Oh, joy, I thought.

Again, he said, “I’m pretty sure that is not the case. “ I thanked him for coming by and off he went.

During the day, I went to the bathroom and on my way back to my bed, my roommate said loudly, “YOU! Who are you?” I said nothing, not knowing if she was dreaming or to whom she was talking.

She was a frail, elderly lady who had fallen and had some hairline fractures in her hip and back. English is her second language, and she apparently had trouble understanding why she was bedridden, where she was, and so on. I also think she had more than a touch of dementia.  Her husband stayed with her during visiting hours, explaining again and again what was happening.   

On another trip to the bathroom, I paused at an opening in the curtains to her area and said, “Hi. I’m Jeanne and I’ll be your roommate for the day.”

That broke the ice and Diane and I spoke with her husband frequently afterwards. It turned out we knew someone in common.

Diane was better able to hear what the lady was saying. She was having hallucinations and thought I was one of some intruders in her home. She wanted to call the police.

That night after her husband left, I heard her crying. Frequently a nurse would spend a long time with her, reassuring her, explaining her circumstances, and comforting her.

Nonetheless, we both had restless nights with little sleep.

Vitals, pills, checks, etc., continued on schedule. Finally, I was sleeping at 7 A.M. when a nurse brought me a cup with all my morning meds. She tried to get me to take them, but I said I would need to wake up a bit before I could.

I fell asleep again. When I awoke an hour later, the cup of meds was gone.

The Drill Sergeant

 

 

I called Diane my “nanny” rather than my “caregiver” when she came to Alaska to help me through my hiatal hernia repair surgery.   I figured, knowing my propensity for pushing the envelope, that she would restrain me from doing things too early in my recovery.

 

Instead, she turned into a drill sergeant.

 

“This afternoon,”  she declared, “I want you up doing laps in the hallway.”    Dang, I thought, all I want to do is lie in bed.  Plus, that’s a long hallway.  But, I consented.   I knew I was supposed to be moving around to prevent pneumonia.

So it came to be.  The worst of the pain was gone, I was sticking to my Tylenol schedule, and getting out of bed was—well, it wasn’t easy but it was doable.

We made two complete laps of the long hallway and I felt pretty good.   Later, Diane went out to get food and I made one lap.   After her return, we started on another two laps and I noticed, when we paused at the end of the hall, that I was somewhat out of breath and we took a longer break before moving on.

I was again out of breath when we returned to the room, so I sat down.

I was awakened during the night, very short of breath and struggling to get enough air.   My respiration rate was quite high, and I was aware of having to take every breath, one right after the next.

I sat up as far as I could and struggled.   

Fifteen years ago, I fulfilled a lifelong dream and traveled to Tibet.  Three hours after arrival, I had a massive migraine headache.   During the night, I found myself lacking air.

With that experience in mind, I knew what was happening.  The extreme altitude (10,000 to 11,000 ft) meant there was a lot less oxygen in the air than my usual sea-level air.   Now, the cause was different but the feeling was similar.

Diane stirred and I told her we would need to go to the ER in the morning.   I don’t think she slept after that and early morning found us heading back to the hospital.  She lay awake listening to my breathing.

Test after test after even more tests.  I can tell you, though, that the chicken broth a nurse prepared for me in ER was far better than from the hospital cafeteria.

It was ten hours before I was admitted and put in a room.  During that time, I had 1.3^rd liters of fluid drained from the capsule around my right lung and I could breathe easier.  The tech who did the procedure was astonished at the amount.

 

The blood-tinged fluid was sent to the lab for tests.

  

The next day, a half-liter of fluid was drained from my left lung area, so 1.8 liters in total.   I told the techs in the ultrasound room where the pleural effusion was drained that I was supposed to lose up to 20 lbs. from the hiatal hernia surgery and that I was coming back for refund if I didn’t.  

 

We had done some quick conversions from liters to quarts and I remarked, “You just accounted for four pounds of that.”   It wasn’t, however, the weight I hoped to lose.

Finally, near 10 P.M., I was wheeled into a two-person hospital room, admitted until further tests showed I was okay. 

  I was hoping for a good night’s sleep after last night’s sleepless one, but an hour later they wheeled in a roommate, and that was the end of sleep.

 

 

 

 

 

 

 

 

 

 

 

My Staycation in Anchorage, Part Six, May I Take Your Vitals?

May I Take Your Vitals?

 

    Sleeping propped up in a hospital bed post-surgery presented some challenges.   Yes, I’ve fallen asleep while sitting up before, but this was different.   I had to be propped up all night.   I artfully arranged some pillows and found a position I thought I could maintain all night.

    “All night.”   What a laugh that was.

2 A.M.:   A nurse wakes me and asks if she can take my vitals.

4 A.M.:  Another nurse wakes me and gives me two Tylenol.

5 A.M.:  A nurse wakes me for another check, including incisions.

6 A.M.:   A nurse wakes me and asks if she can take my vitals.

 

    And so it went all day and all night.  How does anyone get any rest in a hospital?    Vitals every four hours.

    One advantage was that I was in a private room post-op.   I don’t know how that happened.  It might just have been happenstance.

 

    I was restricted to a liquid diet for the first week. On the minimal hospital menu were listed Ensure, Muscle Mile protein drinks, beef or chicken broth, popsicles, and Jello.  I asked the nurse how to get something, she told me how, and then she kindly ordered what I wanted.   Chicken broth and Muscle Milk that turned out to be a protein drink like the kind you can buy at Costco.

 

    The broth was insipid, just like the bone broths I bought and had to drink before surgery.   Only a large dose of salt would bring out any flavor.

   

 I wasn’t hungry at all but knew I had to consume something.  I drank what was delivered over a period of a couple of hours, then failed to order anything else during the day.  Somehow, Ensure was delivered.

    The surgeon stopped by to check and we had a great conversation.

   Diane was there, so she, too, stayed informed.   The surgery, he said, lasted three hours.   In addition to saying the herniated hiatus opening was FOUR inches instead of the size of a quarter, he also went through the post-op dietary restrictions.   He said he wanted me to have at least 300 calories a day.   Two protein shakes would cover that.

    I was discharged the following day and, after stopping at the in-hospital pharmacy and leaving with a bag full of six new prescriptions, Diane and I returned to the hotel room

    I changed and got into bed—propped up as required.   Maybe now I could get some uninterrupted sleep.   I remembered that eight hours had passed since my last Tylenol.  I got out the sheaf of discharge papers and tried to decipher the nurse's  handwriting.  I couldn’t and neither could Diane at that time.

Salmon for you, little one, but not for me.

    So, I took one Tylenol and went to sleep.

    I woke late afternoon to a fresh new hell!   I tried to roll over to get out of bed and a searing, over-whelming pain enveloped the entire side of my right back—shoulder blades to waistline.  It was like a giant spasm or cramp and it took away my breath.

    All I could do was freeze and wait for it to diminish. Though it probably took several seconds, it felt like an eternity.  That continued off and on during the night.   By now, Diane has deciphered the nurse’s handwriting to mean two Tylenol every eight hours, so we stuck to it religiously.

I    n the morning, Diane was trying to help me get out of bed and the pain was the worst ever and lasted the longest  She jumped back with a horrified look on her face, her hands outspread, as I let loose with a LOUD “AHHHHHHHHHHHH!”   (Payback to the guests in the room upstairs who must have been moving furniture all night.)

"Laparoscopic browsing"

    I took care of my morning ablutions and went back to bed.   When I awakened near noon, that horrific pain was gone and never returned.   I found I could get out of bed with minimal assistance, but that depended on my starting position.  Sometimes I got stuck and needed a hand on my arm and one on my back.   Eventually, that lessened to just a hand.

    Diane went out to get some take-out for herself and brought back some soup broth from a Chinese restaurant for me.   She said she thought I was eating because I had to and not because I wanted to. 

    That was true, as I had no appetite.    The broth was DELICIOUS.   After that, I never again drank the tasteless broth from the boxes.

It was not piraña broth.   Or maybe it was.

 

Then came Wednesday night and the fright of not being able to breathe.

 

 

My Staycation in Anchorage, Part Five, All the Gory Details (NOT)

 

ALL THE GORY DETAILS (NOT)

The closer the date of my surgery came, the more stressed I was.   I knew it wasn’t doing me any good, but with my history of unusual reactions to procedures and certain medications, I thought I was right to worry. 

One day, I thought, I might not make it through another reaction.

An all-text post is boring so here's a nice photo that has nothing at all to do with the post subject:

This was the view from my loft windows at sunset.

Then, I came up with a semi-solution.   I lay in bed at night and imagined every step of the events right up to being wheeled into the surgical suite.   It worked, even though my imagined steps didn’t occur in real life, my repeated imagined scenarios calmed down my nerves.

The day before the big event, Diane and I went to Anchorage and checked into our hotel room.   The layout of the suite was perfect, affording me a place to rest quietly and Diane a separate area to work on her craft items or read.

I had a suitcase with cartons of bone broth, Gatorade, and protein shakes that I would consume on my restricted “clear liquids only” diet post-surgery.

All went well on the big day.  Check-in was amazing, the three pre-op tests the surgeon required were done easily and at my bedside, and I was wheeled into the surgical suite.   I’d had a chance to speak with the anesthesiologist beforehand so he was ready for me.

The nurse relieved me of my dentures and I said I wasn’t speaking or answering questions anymore.   That drew some chuckles.

A mask went over my face and I was soon in lala-land.  

The next thing I knew, it was the middle of the afternoon. A nurse awakened me in recovery and said she would keep me a little longer until my blood pressure stabilized.

The surgery lasted three hours.   Five small incisions were made so the surgeon could insert and manipulate the laparoscopic tools—three near my waist, one off to the right side, and the fifth in the center of my midriff.

Having watched an online video of a similar procedure, I knew the surgeon had a long job ahead of him as once the stomach herniated through the diaphragm, connective tissues grew on it and the esophagus to hold them in place.

When he freed them, he pulled the stomach into place below the diaphragm—the site of its initial installation at birth—and stitched the hiatus (the opening through the diaphragm) back to a smaller size.

I found out later that the hiatus, where food in the esophagus empties into the stomach, is normally the size of a U.S. quarter.  Mine was FOUR INCHES!!   That doesn’t mean the tissue was torn, but that the muscles had separated.   Still!!  No wonder I hurt.

Then came a procedure called a fundoplication.    I searched the internet for a video that described the procedure I had and came up with this one.   It isn’t exact, as my surgeon tightened the hiatal opening, and I think did only a quarter or half-wrap of the stomach.

Plus, this is an animated video so it’s not really gory.

 

The difference in the video to my situation was that my entire stomach had slipped through the diaphragm and was above it.

Why am I going into so much detail about my medical situation? Because of the estimated number of people in the U.S. suffer from hiatal hernias.

Here's the chart: 

 

The prevalence of hiatal hernias increases with age. It is estimated that: 

• 10-20% of adults have a hiatal hernia
• 50-60% of adults over 50 have a hiatal hernia
• 70-80% of adults over 70 have a hiatal hernia 

"Gastroesophageal reflux disease is a condition in which stomach acid repeatedly flows back up into the tube connecting the mouth and stomach, called the esophagus. It's often called GERD for short. This backwash is known as acid reflux, and it can irritate the lining of the esophagus.”

That acid irritation can lead to BIG problems, including cancer.

 

 

You’re welcome.