Parting Is Such Sweet … Ah, Forget It – Let’s Just Go Home

It is 1340 and I am just now getting a chance to write anything.  Busy morning.

That morning started early.  Deb was up at 0100 for a trip to the restroom and a lap around the ward.  Then we did it again at 0530.  She ordered breakfast for us both at 0630, but it took about 30-45 minutes (they say to allow them that long, so that wasn’t unexpected).  PA Jackie showed up at around 0700 and said she would put in the order to let Deb leave.  She also looked Deb over once again and was happy with the results of both surgeries.  We will go see one of the nurses in their office for a recheck on Monday and hopefully remove at least a couple of Deb’s drains. 

Nurse Chelsea then turned us over to Nurse Jan for the day shift.  She got started on the paperwork and we were hopeful to leave just after 1100 but before 1400.  Why that window?  Well, the I-5 express lanes switch from southbound to northbound at 1100 or a little after which would speed our exit from downtown a bit.  But if Deb had still been there at 1400 she would have gotten another Heparin injection, which she didn’t want.

Deb was allowed (and even encouraged) to shower this morning, so Jan and I assisted with that as much as we could.  I went ahead and helped Deb put on her ‘going home’ clothes (and old button up shirt and pair of scrub pants of mine) to help get her ready to leave as soon as notice of discharge and transport came through.

Not long after that was when Jackie P. arrived for a visit (the PA is Jackie L.).  Deb had taken a painkiller after the shower, but was able to be alert while Jackie was there.  Jackie left somewhere around 1100 when Jan showed up with the homecare instruction and said discharge was imminent.  I finished packing up our stuff and grabbed the prescription sheets while Jan left to call for Transport.  At that point I figured I had just enough time to stop at the hospital pharmacy (the prescriptions had actually been faxed the night before), get to the car in the sublevels of Dante’s Garage, and get up to the patient pick-up area.  I got there, but no Deb.  So I pulled aside and waited*.  And waited.  And waited.  And waited some more. I finally called the hospital switchboard, got connected to the 11SW nurses station, and asked Jan (who’d been the one to answer) if Deb was still up there waiting for something else or if she was somewhere on her way down.

Jan had gotten distracted by another patient and had forgotten to call for Transport.

Profuse apologies to me followed (and apparently where given personally to Deb as well), so at least there’s that.

We left the hospital around noon or so and made the trip home without too much discomfort for Deb.  I have since gotten her to the restroom, fed, and into the succubus-like embrace of the sofa where she is currently dozing.  And I’m doing this.  And now I’m going to stop doing this and take a nap.

Zzzzz

*Turns out I was parked in a spot that was posted "No Parking Or Waiting", but I didn't see the sign until the car parked in front of it moved.

Moonlight Over Seattle

I have performed my dog walking/feeding duties for the evening and got back to the hospital at around 2230 or so, only to find Deb – with the help of Chelsea, the night nurse – coming back out of the restroom and ready for another walk around the 11SW ward (which is where we are tonight, and there’s a really good view of the southwest end of downtown/SoDo from the room’s window).  Deb took her third lap around the longer course for the evening and plans to go for maybe one more sometime during the night.  The slippers I brought from home should be more comfortable than the textured socks that hospitals like to give out.

I left this evening for home at around 1920 since I wanted to wait until the handoff between the day nurse, Susan, and Chelsea.  That way Chelsea would at least recognize me when I got back and not wonder who that strange guy is walking into Deb’s room.  Deb had already had her dinner (which looked very good, by the way – some kind of cod preparation) and Jackie had been by one more time to try to work with that one problematic surgical drain (I think she got it this time).

Deb was just nodding off into la-la-land when I left, and reportedly had remained there almost up to the time I got back.  That’s a good thing, but she noted that she had stiffened up a good bit due to lack of movement during her last walk around the ward.

Here’s a current report on Deb’s condition overall:

-        - She’s off the IV and onto oral meds now except for the occasional shot of Heparin they put into her leg (which apparently stings a good bit).

-        - The recovery of the right side (the one they went back into yesterday) appears to by improving, though Jackie will evaluate it again in the morning.

-        - Her kidneys are working quite well, thank you, as evidenced by the regular trips to the restroom.

-        - Her navel area still looks like it is a bit angry, so Jackie will be looking at that again tomorrow morning as well.

-        - We expect to be sent home tomorrow morning, though the time it takes to be discharged can vary wildly.  I’m hopeful that we can leave soon after 1100 (since that will be one of the best times traffic-wise to head home with the least delays).

-        - Deb will likely spend most of the first week at home on the first floor of our house due to the challenges presented by stairs at this point.  I still haven’t quite figured out how to get her up the two stairs to our front porch without causing abdominal strain.  But I will … I will.  Nonetheless, the sofa and her reclining chair are ready for her.

Look for another update sometime tomorrow.  If I have time between the morning assessment and actual discharge I will post something then.  If not, I will do so sometime after we get home and get Deb settled in.

Progression

After spending some time at home with the dog and getting cleaned up and grabbing Deb’s slippers and buying a walker and getting lunch to go from Citizen, I finally made it back to the hospital slightly after 1300 (including another wonderful time spiraling s-l-o-w-l-y into Hell Dante’s Parking Garage – I wonder if that Lincoln in front of me will ever make it back out).  Deb has left ICU behind and placed in a nearly penthouse room on the 11^th floor.

Jackie was with Deb when I came in the room, trying to figure out if and where there was a leak in one of Deb’s surgical drains (near the bulb).  She was using bandage tape to try to cover where she thinks it is, but that’s not the best kind of tape for that.  I promised to grab some electrician’s tape when I go home again this evening (which is probably the right kind of tape).  Jackie is the best.  I mean that.  She has been around to see Deb often and even came in last night while I was gone when the night nurse in ICU had called her to ask a question.  Really, most people I know would have just tried to explain things over the phone, but Jackie came in from home just to make sure that everything was explained and understood.  I know she doesn’t live very far away, but that’s still outstanding dedication in my book.

Since I have been here I have met Deb’s day nurses on the floor and helped Deb get to the restroom and then take a much longer walk than any she has done yet.  I think it wore her out, though, so she’s lying back now and dozing lightly.  That’s likely for the best anyway.

Deb has now gotten to eat twice today.  I don’t think she enjoyed her breakfast all that much since it arrived while they were doing checks on her and by the time she actually got it everything was cold (which was fine for the yogurt but not for the eggs, et cetera).  She seems to have enjoyed the BLT she had for lunch, though.

Deb is also off of the IV fluids and painkillers now too.  She’s getting oral painkillers from now until maybe two or three weeks out (though the space between them will start to increase in a week or so).

And the spirometer has arrived today.  She really doesn’t like that thing (or that I nag her to use it).

--- UPDATE ---

Since I wrote the above Deb has gotten back up to go to the restroom again and has taken another walk out on the floor.  While I was proud of her progression on previous walks, this time she knocked my socks off by increasing her distance at least an order of magnitude (and increased her speed somewhat as well).  She plans to take two more walks of at least equal distance tonight.  Her only complaint is that she still can’t stand up very straight, but that is quite understandable given the nature of the abdominal disturbance she has undergone.

Up Down Up Down ...

I don't know how, but I think Deb and I actually got  little more sleep last night. We still had the every-30-minute intrusion for monitoring by the night nurse, but I think Deb was able to remain semi-asleep/semi-awake for most of those.  I know I didn't wake up for all of them.

Jackie (surgeon's PA) showed up early at around 0630 and looked Deb over.  While Deb's Doppler sounds and capillary refill are good, there is a little concern that the color is still a little pinker than the other side.  She left to file her report notes to Dr. Paige.

Dr. Paige showed up at about 0715 to have a look.  He noted the same things, but didn't think it warrants another surgery.  This time it's going to be a 'wait-and-watch' approach.  I think he feels that this will work itself out across the day (and I think he also feels that going back in again now might cause potential issues for no gain).  Still, he felt encouraged enough that Deb's dietary restriction is over.  She gets to eat!  Seeing as how she hasn't eaten since Sunday evening at 2130, she's ravenous (I've been careful not to mention food around her before now). I think his larger concern right now is around her navel which is right in line with the abdominal incision, but that's just something else to watch for now.  Dr. Beshlian came by a few minutes later and also thought things looked promising (he seemed more willing to show outward confidence today).

Deb will also begin the process of transitioning from ICU into a regular room.  Sometimes that happens quickly, sometimes it happens slowly, so I don't know exactly when we get to wave 'bye-bye' to ICU.  Maybe by the time I go back.

I've come back to the house this morning to take care of the dog and to get a shower and wash dishes and set up the sofa for Deb's homecoming and find a place to buy a walker and ... but enough about me.  Let's talk about Deb.

Deb has now made three excursions from the bed.  Twice she's been out into the hall (further the second time) and once to the bathroom.  She feels a bit weak right now, but thinks that is in large part due to lack of food (she was calling in her order to Food Services when I left, so that should get better).  It's painful - to no surprise - to get up and move around, but she's doing it and showing improvements.

Annnnnd I just got a call from Teri (one of the ICU day nurses) to let me know that they have a room assignment for Deb and that she'll likely be moved there before I get back. I will go back in a few more hours once I complete everything else and I will try to provide another update this afternoon.

So maybe not completely out of the woods yet, but I think I can at least see the edges of suburbia now.

Putting Her Foot Down

A lot has happened today.  It's been hard to keep up at times.  I rewrote one post this morning four times because the information I was getting was being updated or revised so fast.  Things have calmed down a little now.

Deb did get back to the ICU room around 15 minutes after I did.  She immediately looked a lot better - more awake and aware - than she did yesterday, but she hadn't had as much of the 'magic button' painkiller yet.  Even after, she has been more lucid than she was overnight or this morning.

We got a visit late afternoon by Dr. Paige and PA Jackie.  They explained that when they went back in they discovered that one of the artery/vein pairs had somehow gotten moved around enough to cause a kink of sorts.  The blood was getting through the artery due to higher pressure in, but the vein wasn't draining effectively.  But they were able to rework everything and then close it back up, and the color and ultrasound Doppler indicated that flow was as it should be (we could hear that it wasn't quite right before).  I think I finally let out that breath I've been holding in all morning and half of the afternoon.

Jackie came back again later and we'll also see her in the morning, but Deb was alert enough to discuss a Greek restaurant in Jackie's neighborhood that she needs to try (and I might have mentioned Tavern Law as well).  I can tell that Jackie is more pleased with Deb's condition now, too.

But the post's title alludes to something that happened later.  Around 1800 Eileen (the day nurse in ICU) came in and started helping Deb get ready to move over to the chair for a while (which entailed Deb straightening up enough to stand!) followed another 15 or so minutes later by Deb actually getting up and walking (with a walker, of course) all the way out of the room and across the hall to the nurses' station and back.  That, my friends, is a huge step (even if taken - as it was - with baby-steps).  Not exactly a walk in the park, but at the high end of the medical team's expectations for her.  She returned to the chair for a while and was planning on getting back in the bed in 20 minutes when the nurses came for the next monitoring.  That was when I left to come home, though, so I missed that part, but I was there for the most important part.

I've finished my dinner and our dog Betty has finished hers, so now I owe her some walk and play time before I head back to the hospital for the night.  I won't post again tonight, but will post in the morning once we've seen Jackie (we may not see Dr. Paige tomorrow) and gotten a progress update.

But things are looking much better now than they did this morning.

[Whew]

Missed Connection

Deb is out of surgery and in recovery now, but not yet to a place I can see her.  And I apparently missed seeing Dr. Paige by a few minutes while spiraling through hell the hospital underground parking garage searching for a spot where a vehicle other than a bicycle or Smart Car might actually fit without bending the laws of science to create a local tesseract field. I'm a scientist, but I haven't figured out how to fold space yet.

A few minutes later I got a voice mail from him, so I must have been down in Dante's garage when he tried to call.  The message was that he thinks they've resolved the issue and that he'll see us when he gets done with the next surgery he was heading into.  That may be as late as 1900 or so, but at least Deb will be awake.

I'm eating lunch now, but I hope Deb will be getting back to her room in ICU soon after I get back.

That's all for now.  More to follow.

The Decision

Well, they are going back in for a look this morning.  I am hopeful that it is something that they can fix easily if there’s something actually amiss.  Jackie (one of the surgical PA’s) has been talking with us about the plan, and Dr. Paige told us he hopes it is a simple thing.  All that aside, I know that they will do everything they can to ensure the success of the surgery and that Deb’s overall health is paramount.

Pre-Surgery (initial anesthesia, etc) may started around 0830 or so when they wheeled her down to the same pre-surgical suite we were in yesterday. We met a new Anesthesiologist and CRNA and the girl taking Rebecca’s place on the surgical team, Darby.   Darby has my cell number and will be the one calling me from the OR to update me.

If they can fix it, great.  If not, they remove that side’s work, close up, and we regroup later to come up with another plan, be it taking tissue from another area or putting in an expander for a later implant or whatever.  That’s what I know right now.  Wish us luck for the first part of that rather than the latter part.

Deb went back to the OR at around 0900.  I then went and searched for my phone which I’d misplaced (it was back in ICU where I figured it might be, but I had to retrace my steps including finding the same elevator).  Now I’ve run home to feed the dog and let her out for a bit and I will head back to the hospital around 1100 or so.  I likely won’t see Deb until noon or 1300, but we will be back in the same room in ICU tonight. 

So it begins again …