Erik MH:

blog entry

In which I detail my recent sur­gery, praise health pro­fes­sion­als, & cas­tig­ate the health industry

date2024-06-30 00:52 utc
topicshealth; family

Well, that’s done. Here’s a rough timeline of events:

Monday

  • diet: only clear-ish liquids

Tuesday

  • diet: only clear-ish liquids
  • shower with special antibacterial soap, clean clothes and sheets

Wednesday

  • 4:00: rise
  • 4:15: black espresso
  • 4:30: drive to Hanover, NH
  • 6:00: check in
  • 6:30: in my gown, lying down, the questions begin:
    • Did you bathe with the special antibacterial soap? See above.
    • When did you last eat? See above.
    • When did you last drink? See above.
    • etc.
    • If your heart stops beating, do you want us to restart it? Yes.
    • If you stop breathing, do you want us to restart your breathing? Yes.
    • Why are you here? Well, philosophers have debated that question… To have my colon removed from my thorax and restored to its native abdominal environment, preferably with a good talking-to first.
    • [And repeatedly] What is your name?
    • What is your quest? What is your date of birth?
    • 7:00: get wheeled off to pre-op, hoist myself from the first gurney to the gurney cum procedural chair cum convalescing bed.
      A pro­ced­ur­al “chair” made by “Cham­pi­on”; notice that it’s many things, but not a hos­pit­al bed. Not exactly what was used, but close.
      Chat with doctors briefly until suddenly…
    • ~11:15: … I’m in a different room surrounded by entirely different people; no opportunity to say “But it wasn't a dream. It was a place, and you and you and you … and you were there.… But you couldn't have been, could you?” Because they weren’t there!

But the next seven or eight hours, frankly, are pretty hazy. Karen was there with bounteous amounts of emotional and logistical support. Abigail the nurse was friendly and helpful and gentle.

And I got the unexpected and extraordinarily welcome news that I was welcome to eat anything I felt I could tolerate — no enforced liquid diet!!

  • ~17:30: I order cottage cheese and macaroni and cheese — soft and comforting.
  • ~18:00: Food arrives! But I’m told that I cannot use the digestive enzymes I’d brought with me (even the ones prescribed by the very surgeon who’d just operated on me) because of policy. So we had to order enzymes. The pancreatic enzymes came quickly, because I do have a prescription; the lactase (to digest the lactose in both the cottage cheese and the mac and cheese) took much longer — yes, we’re talking the exact same enzyme that’s in Lactaid, Lacteeze, and LactoJoy!
  • Over the ensuing three hours I surreptitiously take some of my own enzymes and eat food.
  • ~21:00: One Lactaid tablet arrives. I finish the remainder of the very warm cottage cheese.
  • ~22:30: Karen leaves for a well-deserved rest at the house of nearby friends.

The keenly observant reader will have noted that there was no mention of my being moved from the post-op ward into any kind of overnight area or private (or double or triple) room — or, indeed, of being moved off of the aforementioned surgical chair. The omission was entirely intentional.

They did dim some lights, and from time to time it was clear that the nurses, at least, were making an effort to talk more quietly. But there was a constant din of beeps, and all the 18 or so other patients were of course making their own noises. And nurses came and went to collect fluids and measurements and such.

Thursday

If you’re at all squeamish or sensitive, you may want to skip the next bit. I’ll put it behind an HTML DETAILS tag:

← Click or tap the triangle if you want to read the somewhat-graphic bit

So, I hadn’t been drinking a lot on Wednesday. I remembered from previous surgeries that I have what they call a very shy bladder and that it can take a while for me to get … erm, going … again. So I’d thought I was buying myself some time by drinking less.

I’d managed to spend a (small) penny — OK, more of a farthing, really — at some point in the evening, and figured I was off the hook. But at around 1:30 they checked my bladder via ultrasound and were concerned that it was void, considering how little I’d produced.

The nurse said he’d be required to insert a Foley catheter.

The mere mention of such a device will make the bravest and brawniest man break into a nervous sweat and start looking for exits.

I am neither the bravest nor the brawniest. Further, I’d had rather direct experience with this torture device during my convalescence after the Big Surgery of 2017. And so I did what any other man would do under the circumstances.

I fled I said, “no.”

This started an interesting chain of events, in which various people were called (at 2:00 a.m.). The nurse finally consulted telephonically with the resident-in-charge, who apparently concurred that it was “hospital policy.”

I begged. I pleaded. I managed to get the nurse to call the resident again, to explain about my very shy bladder and also about my previous experience with a Foley catheter. He succeeded in getting her to come visit me in person.

I again pled my case. She was firm. But because she also let on that literally the only reason for the catheter was to precisely measure the amount of excreted urine, I continued — because that was just absurd; they don’t need more precision than a graduated cylinder would provide. But fatally, she uttered the magical words herself, “Well, ultimately it’s your choice.”

Around 6:15, I managed to spend an entire shilling. Thank the gods! When the nurse came in, I pointed to it. “Excellent!” he said. “You know your own body better than anyone else does.”

OK, so enough of those details! To continue with Thursday morning:

  • 6:45: Dr. F’s team came by to tell me what a good job they’d done to see how I was doing and to see whether I had any questions. The surgery had apparently gone very smoothly — but it had taken the full 3+ hours allotted because my entire intestine was in my chest. Not just the small intestine this time, but the entire thing. Sheesh! So it took quite a while to snake the whole thing back down into the abdomen, and then to patch up the hiatus in such a way that further migrations would be discouraged. They were pleased by what I’d eaten the previous evening, but still said I’d be released either Thursday or Friday.
  • 6:50: One of the team members said they’d heard about my standing up to the resident-in-charge the night before. “Nice!” he said. 😊
  • 7:00: Karen arrived, fresh and perky despite her own restorative sleep having been interrupted by my frantic 2:30 texting.
  • 7:30: Hospital eggs, home fries, and sausage weren’t, of course, as good as they’d sounded — but they were a whole lot better than the thin cream-of-rice porridge I’d been expecting. I had small amounts, carefully chewed. I was in heaven!
  • 8:00: Some of Dr. F’s team returned to say they’d seen recent test results and that all looked really good, and they were very pleased at how much I’d eaten. My nurse then said that “the speed-of-light scenario is that all the paperwork will be done mid-afternoon, and then we’ll be able to let you go.” Speed-of-light, indeed.
  • 9:00: I ordered boiling (well, nearly) water and two cups and bonded with the LNA over espresso machines as I showed her my COFFEEJack.
    COF­FEE­Jack: Very decent port­able espresso. It doesn’t steam milk, though.
    It was pretty durned good!
  • 9:30: My nurse came back to say that the impossible had happened, and that Dr. F’s team said that I was to be discharged as soon as she could process everything, which she pledged to do right then.
  • 10:00: And she did! Against all expectation, Karen and I left the ward at the stroke of 10:00, and before 11:00 we were dining (lightly) al fresco in Hanover with friends.

The car ride home was somewhat challenging, but Karen kept it all as smooth as it could be. I spent the afternoon dozing on the couch, mostly. My night’s sleep was better than expected, and both Friday and today I’ve been able to keep productive with the stupid busywork that doesn’t require much brain but that keeps one’s life operating relatively smoothly (that is, I’ve been organizing my 300,000 e-mail messages and discovering all the people whom I owe replies to: Hi, Jeff! Hi, Monica!)

So now I’ll simply ease back into full portions of regular food, and head back to the RehabGYM to keep my core strength up over the next six weeks, whilst I’m not allowed to lift more than 10 pounds.

The health care at Dartmouth-Hitchcock has been truly excellent; honestly, among the best in the world. A nurse told me that I (like others) was in the post-op ward for the entire stay not because they didn’t have enough rooms, but because of insufficient staff. I know there’s a shortage of medical professionals nationwide, but the nurse absolutely implied that their staffing shortage was due to policy — financial policy, perhaps scheduling policy, benefits.… It was also policy that delayed my enzymes for hours, and policy that nearly caused a very painful, unnecessary ordeal [outlined in the hidden details above]. They always send surveys afterwards; I will fill it out appropriately — including the uniformly excellent doctors and nurses.

All-in-all, this was no picnic in the park — but it obviously was nowhere near as bad as my 2017 Trip to Mordor. With any luck, this will be the last “health” post from me for a long, long time.