Wednesday, July 2, 2008

The Bitch is Back

I got my central line placed at Duke yesterday. The surgeon was incredibly sweet and thorough; he went to great lengths to find a small line that was a good fit for my petite frame. We have finally learned to insist that I be treated like the pediatric sized patient that I am and this surgeon was incredibly accomodating.

The day surgery suite is always a complete zoo. The sea of humanity bursting out the waiting room and into the halls down all the way to the elevator makes it look like someone is giving away free gas cards or something equaling enticing.

My case was schedule for 4:45 but I was told to come at 1:45. I showed up dutifully on time and waited only about a half hour to be called into the preoperative area. There I prepared for my surgery by donning a gown sized for a 400 lb person and some very uncomfortable slip-free socks (I eventually ditched them and hid them under the sheets so I wouldn't get in trouble). Then, looking fashionable, I sauntered over to my gurney where I would spend the next four hours practicing the virtue patience.

The nurse came over and asked me what I was there for. I love this question. I always want to be a smart-ass and say, "I don't know, I was hoping you knew that." But knowing that this person is about to stick me with a 20-gauge IV needle, I answer as pleasantly as possible. She cozied me up with a large supply of warm blankets and I settled in for a long afternoon.

Initially my gurney was the center of a whirlwind of activity: blood pressure cuffs were attached, temperatures taken, pulse oximeters put in place. The surgeon came by and explained the procedure and showed me the answer to my prayers, a tiny central line for a tiny person who hopes to become bigger (at least wider, taller is clearly beyond hope) through said line. Then the nurse placed my IV line. I hate IVs; I always have. When I had my appendix out as a kid I ripped two separate IVs out in my sleep. When I had my wisdom teeth out I woke up from the anesthesia, still out of it, and told the nurse, "Get this f***ing thing out of my arm." Nice. I have learned to accept IV lines now that I have had dozens of them, but I still hate them.

Then the flurry of activity around me died down. There was nothing for Bill and I to do but look at each other. We'd just spent two whole days together in the car. I spent the entire car ride from Charleston telling him dating stories from my early 20s. I was involved in some very messed up relationships during that period of my life so those tales pretty much filled up the car ride. Relating these tales to Bill and reliving this period made me realize how far I had come. "I'm glad I didn't meet you before then," Bill said when I said I had pretty much normalized shortly before he met me. "Me, too."

Then we spent the last hour talking about the reality that "people cannot give you what they don't have." I realize this now because I have so many limitations on what I can give. It was a long conversation about forgiving the people in our lives who don't seem to understand the crisis that we are currently experiencing or doctors who had been unhelpful or unsympathetic along the way. Fortunately, there aren't many of these people in our lives, and most everyone we know has gone far above and beyond the call of duty to help. I tried to tell Bill that we need to both let go of any anger we have towards those who have disappointed us because perhaps they don't understand or their plates are simply too full or they simply cannot bear the pain of watching a friend/family member suffer this way. People cannot give you time, sympathy, support, etc. if they do not have it to give. The disregard or obliviousness or whatever you want to call it is nothing personal and it's not worth the energy required to feed the anger it inspires. It was a much needed conversation for both of us and we walked around all day Monday repeating to each other, "People cannot give you what they don't have."

So, after the prior two days, Bill and I were out of things to talk about. So we just sat there and waited. And then we waited some more. At one point a nurse anesthetist came over and introduced herself, looked in my chart and then disappeared never to be seen again. Another 40 minutes went by and I was in serious need of pain medication for one of my finger wounds. The nurse was finally able to get an anesthesiologist who did an assessment an ordered me some hydromorphone. She gave me enough to take the edge off the pain and I went back to waiting. Later the anesthesiologist let me know that another doctor would be taking over my case. When I needed more hydromorphone, the newest anesthesiologist come over. He started to give me the medicine without cleaning the port first. "Can you clean that first?" I asked, summoning my inner bitch. "It has a cap on it," he responded. I started to debate with him and then I stopped, "I don't want to argue with you. Just clean it. It's a simple request." The bitch is back. He did as I asked and then actually stayed and chatted a bit. Apparently he likes bitchy girls the way some of my old boyfriends did.

More time went by. Then another anesthesiologist came over and began looking through my paperwork. Once I let the bitch out, it can be tough to rein her in, "I'm sorry who are you?" I asked. Too many cooks spoil the soup; too many docs kill people. I guess I scared him because he introduced himself and, when we told him we thought there was already someone for my case, he set off to find him. Finally we setttled on anesthesiologist number 2. He explained his plan for conscious sedation and introduced me to the nurse anesthestist. He took off and she and I agreed that I had no interest in being remotely awake and aware during the procedure (I was awake during my second feeding tube placement and it was not fun, especially when they were having problems and I was awake to hear the whole drama).

I woke up on my way to recovery and after a brief period was allowed to finally go home at 8:30. We stopped off for a bite to eat, called our parents, and headed upstairs for some much needed rest. We woke and spent the morning with the the infusion nurse. She drew labs and I told her that she wasn't wiping the hubs for the recommended 15 seconds before access the ports. It's my line and my life so I am going to need to get pretty bossy about sterile technique. People are going to hate me. Oh well. The infusion nurse's teaching touched off many memories of nursing school and my brief career as a floor nurse. I am glad that I have that knowledge and experience to call upon. It makes me less fearful and more empowered.

So today is day one in that long journey toward recovery, at least on the nutrition front. We figure it will take 12 months to gain 20 lbs. So I have plenty of time to master my inner bitch, ensuring that she does her job without scaring everybody away.


Marie Coppola said...

Welcome back, bitch! Was glad to get the update on yesterday went. Hope we will be able to talk soon.


albischof said...

never been so happy to call a friend a bitch! Glad you are back

Karen & Stuart said...

We're also glad that The Bitch in you back! That must be a good sign!

Karen and Stuart