Saturday, February 24, 2007
Post-Op
I should begin by noting that this was my very first surgery as an adult. I vaguely remember my tonsil surgery when I was six, but that's limited to recalling an unpleasant odor as they put me under, a sense of some sort of consciousness at some point during the procedure, and vomiting bloody stuff after I awoke. So, I have no real base of comparison within my own experiences. My wife has been hospitalized a few times since we married: twice for the births of our sons, once for a laparoscopic procedure to remove endometirial material, and once for a hysterectomy. I thought the care she received from the staff after her surgery was fine, but of course I was not there all the time.
My first post-op evening started off pretty uneventfully. Coleen went home shortly after visiting hours were over, and I drifted off to sleep. I was on an IV for rehydration, and was getting some pain medication in it as well as a post-op antibiotic. These days, most hospitals are putting leg cuffs on patients when they are lying in bed; the cuffs massage your lower legs to promote blood flow and thus prevent any clots from forming. Of course, I also had a catheter that would still be with me when I left the hospital on Wednesday, and a surgical drain that went through one of the incision sites.
I was awakened about 12:30 am when a patient was brought into the room. There seemed to be a lot of room-swapping going on, having to do with gender issues. I was still somewhat out of it, so I'm not sure about all of it. I would learn later that my roommate's name was Bob. All I knew at the moment was that his operation was unsuccessful, that he had vomited during the procedure, that his legs did not work at all, that he couldn't eat, and that he desperately wanted to just get up on his feet and go to the toilet. I would also later learn that he was a heroin addict trying to kick his addiction, and that people were smuggling methadone into the room since the hospital staff was giving him none. And, of course, I saw none of this, since the curtains were drawn. It was all a little scary.
And noisy. I could hear IV alarms going off, nurses talking in the halls, and other distant noises. It was not a restful place.
The next morning, I was able to have a liquid breakfast. My appetite was beginning to return, and I think that the resident (whose name I cannot recall) was anticipating that I would be released that day. I wanted to be able to have at least one bowel movement before I left, just to make sure that I knew what to expect -- the literature hinted at the possibility of a 'discharge,' an unsettling word.
I also met my student nurse. Sophie was studying for her LPN certification in a two-year program at a nearby college, and was part of a team of five student nurses that came on the post-op ward that day. I have a number of nursing majors in my statistics courses at my college, so I had some feeling for who Sophie was and what to expect from her. I suspect that the hospitals depend on the student nurses fulfilling a couple of needs: 1) student nurses are a source of cheap labor; and 2) student nurses are fresh, and do not transmit to the patients any hint of jadedness.
And Sophie was very nice, and full of good humor. When she had to give me a suppository or help me hook up my catheter we spoke about the glamor of medicine. When she would help me walk around the post-op ward, she'd introduce me to the other student nurses, and we' discuss their educational progress. She will be a fine nurse one day.
But I do worry that nurses get worn down by their job. My surgery and recovery were entirely routine -- to them. That I was unfamiliar with either seemed to be of no importance. Around noon, just after a very nice lunch of a chicken Kiev and roasted potatoes, I felt a bowel movement coming on, and rang to be unhooked so that I could get to the restroom. Only the head nurse was available, and she seemed to be very uncomfortable dealing with me. But, she did unplug my IV pump and undo my leg massagers, and my wife helped me to the toilet.
That's, of course, when I found out what the 'discharge' was all about. Every bit of pressure I put into pooping actually pushed a bloody mess out around the catheter. It terrified me, and I stopped my attempt. Later, the nurses would tell me that it was all normal and that I shouldn't be so scared of it -- they are no doubt right, but it still seemed callous on their part. I was walking gingerly in the afternoon, and one nurse mocked the way I was walking. That seemed just downright unprofessional -- and I didn't care that she was the spitting image of the beautiful doctor Neela from ER.
The evening meal was okay: beef tips that were a little tough. My wife and father-in-law walked with me around the ward a few more times, and then left for the evening. I was going to stay a second night. The resident doctor seemed to be unconcerned about my lack of bowel movement, but I did not want to leave without having had at least one. He ordered a second suppository, which never came.
I don't know how I feel about the night nurse. She closed the door to our room, and I'm not sure why. I do know that the door was not a very good sound barrier to the outside, and I learned a lot about the nurses' private lives that they probably did not intend. My roommates alarms went off several times during the night, and he or I would have to ring to get someone to attend to them. Sometimes, she would come in, turn off the alarm, and leave right away.
My own alarm went off at 3am. My IV was in my left hand, and the hand was slightly swollen. She decided to switch it to my right hand. It seemed to take a long time; maybe 25 minutes. She seemed irritated that she had to do this. She also seemed annoyed when I asked her whether my leg massagers should be switched on, since they were cuffing me but were not massaging.
The resident came in to see me about 6:30 am, spoke with me for a minute or so, and left the light on when he left. It stayed that way until the surgeon's PA came in shortly before 8 am to let me know that they were clearing me to go home that day. I would return to the clinic side to have the catheter removed in a week.
Breakfast came along at that point. It was dreadful; eggs, bacon, home fries and toast, under a metal lid with a slice of pineapple?! Everything tasted of the pineapple! I could not eat it.
I did finally have a bowel movement, as I had hoped. I would just have to get used to the discharge, though I would break out in a cold sweat with every bathroom visit for the next week. (More on that later.) Sophie got me a washcloth and towel, and I took a shower -- that felt so refreshing. Sophie and her instructor brought in a 'goodie' bag consisting of several leg collection bags that I would need until the catheter was removed, alcohol swabs, lubricants, a spare bedside collection bag, gauze pads, and some other stuff. They went over the catheter care with me -- I'll write about the catheter some more in my next entry. They also helped me get the leg bag on, and get dressed. My father-in-law arrived with the car, and Sophie escorted me out. I was now in the care of my in-laws at their home for a week, until the catheter came out.
The surgery went well, but the post-op care in the hospital just seemed substandard to me. But I do not know. As I wrote at the beginning of this, I have had no first-hand experience with post-op care as an adult, so maybe it was great.
My first post-op evening started off pretty uneventfully. Coleen went home shortly after visiting hours were over, and I drifted off to sleep. I was on an IV for rehydration, and was getting some pain medication in it as well as a post-op antibiotic. These days, most hospitals are putting leg cuffs on patients when they are lying in bed; the cuffs massage your lower legs to promote blood flow and thus prevent any clots from forming. Of course, I also had a catheter that would still be with me when I left the hospital on Wednesday, and a surgical drain that went through one of the incision sites.
I was awakened about 12:30 am when a patient was brought into the room. There seemed to be a lot of room-swapping going on, having to do with gender issues. I was still somewhat out of it, so I'm not sure about all of it. I would learn later that my roommate's name was Bob. All I knew at the moment was that his operation was unsuccessful, that he had vomited during the procedure, that his legs did not work at all, that he couldn't eat, and that he desperately wanted to just get up on his feet and go to the toilet. I would also later learn that he was a heroin addict trying to kick his addiction, and that people were smuggling methadone into the room since the hospital staff was giving him none. And, of course, I saw none of this, since the curtains were drawn. It was all a little scary.
And noisy. I could hear IV alarms going off, nurses talking in the halls, and other distant noises. It was not a restful place.
The next morning, I was able to have a liquid breakfast. My appetite was beginning to return, and I think that the resident (whose name I cannot recall) was anticipating that I would be released that day. I wanted to be able to have at least one bowel movement before I left, just to make sure that I knew what to expect -- the literature hinted at the possibility of a 'discharge,' an unsettling word.
I also met my student nurse. Sophie was studying for her LPN certification in a two-year program at a nearby college, and was part of a team of five student nurses that came on the post-op ward that day. I have a number of nursing majors in my statistics courses at my college, so I had some feeling for who Sophie was and what to expect from her. I suspect that the hospitals depend on the student nurses fulfilling a couple of needs: 1) student nurses are a source of cheap labor; and 2) student nurses are fresh, and do not transmit to the patients any hint of jadedness.
And Sophie was very nice, and full of good humor. When she had to give me a suppository or help me hook up my catheter we spoke about the glamor of medicine. When she would help me walk around the post-op ward, she'd introduce me to the other student nurses, and we' discuss their educational progress. She will be a fine nurse one day.
But I do worry that nurses get worn down by their job. My surgery and recovery were entirely routine -- to them. That I was unfamiliar with either seemed to be of no importance. Around noon, just after a very nice lunch of a chicken Kiev and roasted potatoes, I felt a bowel movement coming on, and rang to be unhooked so that I could get to the restroom. Only the head nurse was available, and she seemed to be very uncomfortable dealing with me. But, she did unplug my IV pump and undo my leg massagers, and my wife helped me to the toilet.
That's, of course, when I found out what the 'discharge' was all about. Every bit of pressure I put into pooping actually pushed a bloody mess out around the catheter. It terrified me, and I stopped my attempt. Later, the nurses would tell me that it was all normal and that I shouldn't be so scared of it -- they are no doubt right, but it still seemed callous on their part. I was walking gingerly in the afternoon, and one nurse mocked the way I was walking. That seemed just downright unprofessional -- and I didn't care that she was the spitting image of the beautiful doctor Neela from ER.
The evening meal was okay: beef tips that were a little tough. My wife and father-in-law walked with me around the ward a few more times, and then left for the evening. I was going to stay a second night. The resident doctor seemed to be unconcerned about my lack of bowel movement, but I did not want to leave without having had at least one. He ordered a second suppository, which never came.
I don't know how I feel about the night nurse. She closed the door to our room, and I'm not sure why. I do know that the door was not a very good sound barrier to the outside, and I learned a lot about the nurses' private lives that they probably did not intend. My roommates alarms went off several times during the night, and he or I would have to ring to get someone to attend to them. Sometimes, she would come in, turn off the alarm, and leave right away.
My own alarm went off at 3am. My IV was in my left hand, and the hand was slightly swollen. She decided to switch it to my right hand. It seemed to take a long time; maybe 25 minutes. She seemed irritated that she had to do this. She also seemed annoyed when I asked her whether my leg massagers should be switched on, since they were cuffing me but were not massaging.
The resident came in to see me about 6:30 am, spoke with me for a minute or so, and left the light on when he left. It stayed that way until the surgeon's PA came in shortly before 8 am to let me know that they were clearing me to go home that day. I would return to the clinic side to have the catheter removed in a week.
Breakfast came along at that point. It was dreadful; eggs, bacon, home fries and toast, under a metal lid with a slice of pineapple?! Everything tasted of the pineapple! I could not eat it.
I did finally have a bowel movement, as I had hoped. I would just have to get used to the discharge, though I would break out in a cold sweat with every bathroom visit for the next week. (More on that later.) Sophie got me a washcloth and towel, and I took a shower -- that felt so refreshing. Sophie and her instructor brought in a 'goodie' bag consisting of several leg collection bags that I would need until the catheter was removed, alcohol swabs, lubricants, a spare bedside collection bag, gauze pads, and some other stuff. They went over the catheter care with me -- I'll write about the catheter some more in my next entry. They also helped me get the leg bag on, and get dressed. My father-in-law arrived with the car, and Sophie escorted me out. I was now in the care of my in-laws at their home for a week, until the catheter came out.
The surgery went well, but the post-op care in the hospital just seemed substandard to me. But I do not know. As I wrote at the beginning of this, I have had no first-hand experience with post-op care as an adult, so maybe it was great.
