Daughters WhiteCoat are competing in two dance competitions and performing in two plays this weekend, so will be busy videotaping and taking pictures. Ergo, no posting.

However … I finally made a few tweets [?] on my Twitter account. If you are exceedingly bored, you can follow me at “WCintheED“. If I can figure out how to put a Twitter feed on the margin of the blog, I’ll try to do that next week.

The comments section is hereby open for anyone to post any questions, comments, or other medically-related esoterica. Just remember, no personal attacks.

I’ll try to answer posted questions/comments on Monday. Enjoy the weekend.

WC

And it didn’t even happen in the emergency department.

A staff member’s husband stops by Subway sandwich shop to get his wife some lunch. A couple people ahead of him in line is an elderly man in a John Deere baseball cap and overalls. When he gets up to the counter, the conversation goes something like this:

“Welcome to Subway. How can I help you?”
[Elderly man puts crumpled up Subway wrapper on counter]
“You better quit littering in my yard.”
“I’m sorry sir, I don’t understand.”
“This is the second time I’ve picked up your store’s litter in my yard.”
“But ….”
The elderly man was already getting flustered and several customers had gathered around and were apparently enjoying the interaction.
“You better stop treating my yard like some trash heap.”
“But sir, we put our garbage in a dumpster in the back. That is a wrapper from a sandwich that someone else purchased here and took out of the store.”
“Next time it happens, I’m going to bring my trash in here and dump it over your floor to see how you like it.”

If I happened to be personally standing in the store at that time, I would have begun running toward the exit in a serpentine pattern, waiting for the inevitable double barrel shotgun to be brandished.
Instead, everyone stood around smiling and giggling.
The elderly man pointed his finger at the young man behind the counter, said “last warning,” walked out the door, and drove away in his pickup truck.

If this were a medical facility, based on this interaction, the Subway shop’s Guess Praney rankings would plummet precipitously, and leave the store manager on the verge of losing his franchise.

Getting out of bed was much more difficult than I expected.

The pain of sitting up was one thing. I was able to help myself up to the side of the bed by pulling at the top of the bed railings, sitting the back of the bed as high up as it would go, and then using my arms to push myself up into a seated position. That only took about a minute to accomplish.

Standing was the easy part, although I did get a little head rush when I first stood up. Maybe I should give myself a fluid bolus? Hmmm. Urine in the Foley catheter bag is light yellow. I’m well hydrated. We’ll hold off on that one.

Trying to walk was a different story. No, I hadn’t forgotten how to do so. The problem was organizing all of the lines that were attached to my body. Like a marionette, when the IV line was stuck on the edge of the bed and became taught, my arm pulled backwards. I took a couple of steps and the Foley catheter gave me a gentle tug which stopped me in my tracks. There goes that Bic lighter sensation again.

So standing up to walk out of the room involved first making sure that all of the IV lines were free of obstruction. I looped them on top of the rolling IV pole to keep them out of the way. Once the IV lines were secured, then the Foley bag was hung on a hook on the bottom of the rolling IV pole. I looped the drainage tube once over the hook as well so I didn’t step on it while walking. Ooooh. I shuddered just thinking about that. Stepping on a shoelace has nothing on stepping on your Foley catheter.

Then I had to make sure that my gowns were properly positioned. If you only have one gown, either way you wear it, someone is getting an eyefull. Opening to the front is wrong position – especially for male patients with Foley cathethers. Not something most people want to look at. Opening to the back is also not a sight to behold, either. So the way to fix the problem is to wear one gown forward and another gown over it facing backward.
Last, but not least, you have to wear the non-slip booties. Not that I am worried about slipping quite as much, but I just have to wonder how often they disinfect the hallways in the hospitals. That’s stuff I just don’t want on my feet. So the booties go on when I step out of bed and off when I get back into bed.

(more…)

After actually spending almost a week as a patient in the hospital, I can’t figure out why people want to be patients in the hospital. Some people come to the emergency department with their suitcases in tow and are actually disappointed — if not downright mad — if the emergency physician has the audacity to discharge them. I just don’t get it.

Maybe there’s some good feeling about someone taking care of you. But try to get sleep. Just ain’t happening. I may have missed a couple of visits, but as best I can remember, my first night in the hospital went something like this:

11:30 PM. Nurse comes in and introduces herself. Makes sure I don’t need anything. We talk a little bit. I’m one of four patients she is taking care of that evening. I promise to try not to cause her any problems.
12:10 AM. Tech comes in the room to take my vital signs. Puts the pulse oximeter on my index finger and then takes the blood pressure on my same arm. When the blood pressure cuff pumps up high enough to cut off the blood flow to my arm, the pulse oximeter isn’t going to get a reading. So I switched the pulse oximeter to the other hand. Tech gives me a funny look. I just said “thanks” when he was done.
1:45 AM. Call light goes off in room next door. I can hear the entire conversation between patient and person at the nurse’s station through the wall. I have enough bowel troubles of my own, I don’t need to hear about someone else’s bowel trouble. Wait. Am I dreaming? Nope. Not dreaming. The patient then starts asking for more pain medication and the nurse is telling her it is 15 minutes too early. Wait. Maybe I really am dreaming. Then I start wondering if the other patient can hear me yelling when I start laughing. I must sound like a kook. Can only imagine what she’d write in a blog about me.
2:30 AM. My IV starts beeping. Time to change the bag of IV fluid.
5:00 AM. Lab tech comes in to draw blood. Blood needs to be drawn at 5:00 AM because the results need to be ready for the doctors who are getting ready to round.
6:30 AM. Surgical team comes in to examine me. They lay the bed flat. Still look like I have a beer belly which is ticking me off. Wounds are healing up just fine from 18 hours ago. Wait. Look at my body. My stomach has the shape of Homer Simpson. The hair is shaved from my pubes up to about 4 inches below my nipple line. I have a patch shaved on my leg where the grounding pad for the bovie was attached. I have a patch shaved on my other leg where the evil Foley catheter is still anchored. How the heck am I going to go swimming looking like this? I look like I passed out in some college frat house and they punished me with a razor.
“Are you using your incentive spirometer?”
“Trying my best.”
“Um … you aren’t taking very much pain medication. You have to hit the button if you’re having pain. You know that, right?”
“Affirmative.”
“Let us know when you begin to pass gas. Then you can start with a liquid diet.”
“Check.”

I was having a moral debate about whether I should tell them that I pass gas before I really do pass gas. The sooner I pass gas, the sooner I get out of the hospital. But if I don’t pass gas and end up getting an ileus or bowel obstruction, I’ll be there longer. We’ll wait and see on that one.

When the resident sat the bed back up, I had slid down in the bed. As I tried to sit up to get in a better position, I learned something else about abdominal surgery: Regardless of how many sit-ups you can do in a row before surgery, the number of sit-ups you can do the day after someone fillets open your abdomen with a sharp instrument equals no more than “one-half.” That’s .5 for all you numerical types. Notice that there was no “leading zero” on that number. JCAHO can go pound sand.

Mrs. WhiteCoat arrived about 10:30 AM after getting all of the kids off to school. She brought me cards that the kids had made the night before. My oldest daughter made a little poem for me.

Dad,

To me you mean a lot
You’re probably reading this on a cot

You’re the best dad
If someone tried to argue, it would make me mad

You’ll be missed a ton
But we will see you when your surgery is done

We know you love us so much
You show us that with one little touch

So I just wanted to say
How much I have loved you until this day

We will be waiting at the door the day you get home to give you a big fat hug!

I started laughing at the second verse, which made my stomach start hurting. So I’d laugh, then I’d yell in pain. Almost as bad as trying to do a sit up. Then I’d think about the irony of having pain when I laugh and I would laugh more and yell louder. “You have to put that thing away, honey. I’m going to bust a gut … literally.” She taped it on the wall behind me — out of my reach.

Then Mrs. WhiteCoat pulled a chair up alongside the bed and we watched TV for a while.

About an hour or so later a shadow passed through the doorway. At first it looked like one of those caricatures from “Where the Wild Things Are” – with extra snaggle teeth. I blinked a couple of times and saw that it had scrubs on. Was it the guy that I work with who spills food on his clothing all the time? No. No stains. And no food in his mustache. I blinked a couple of more times. OH! It’s Jennifer – one of the other docs I worked with in the emergency department. She had a wry grin and was holding her iPhone just waiting to get a picture of my six-pack now that it had been severed by the extra-long scalpel blade they had to use to get through all the muscle. She brought a picture of a bunch of other people standing in the emergency department holding a sign – the contents of which I cannot disclose in a public forum – and wishing me a speedy recovery.  We talked and we laughed. More pain, dammit. Once she discovered she could cause pain by making me laugh, it became a contest. Then she and Mrs. WhiteCoat ganged up on me. I tried to fight the good fight, but quickly conceded. I was told that I pushed the button on the PCA pump, but don’t remember doing so. All I remember is waking up holding Mrs. WhiteCoat’s hand — and that the scrubmonster had vanished.

The nurse came into the room to check on me.
“You’re awake!”
“Kind of dozed off there. Catching up on sleep from last night.”
“You haven’t gotten up to the chair yet. You know the quicker you get up and move about, the quicker that you’ll get out of here.”
“No … I didn’t know that.”

I don’t know how I’m going to get out of this damn bed, yet, but honey … we’re going for a walk.

Here are links to the other parts in case you get lost:
Part 1, Part 2, Part 3, Part 4, Part 5, Part 6