Friday, November 20, 2009

Goldie Locks & the Three Chairs

This is an entry that I started a month ago and I am finally just now ending it. Mid October, Dad went into the hospital to have an abdominal aortic aneurysm repaired. The aneurysm was quite large, 10cm, and we were warned that the surgery would be as difficult, if not more so, than Dad’s triple by-pass surgery of two years ago. About a week and a half after the surgery, still not recovering as he should be, Dad’s surgeon placed a nasal gastric tube into his stomach to remove the fluid and air that had built up there. In the following days, Dad continued to grow even sicker from an unknown source of infection (all x-rays were coming back clean), until (about twelve days after the initial surgery) a team of doctors opened him back up for exploratory surgery. They removed a very dead and gangrenous gall bladder, and placed him in SICU. There he remained for another eleven days of close observation. He moved back on the eighth floor for over a week, improving a little more each day. We were finally able to spring him from the joint Wednesday. It was a glorious morning yesterday when I saw Dad emerge from his bedroom while I was drinking my coffee. It is too mild of a statement to say that I am glad he is home.

Here are a couple of the more humorous entries from Dad’s hospital stay, or the time that we like to refer to as Dr. Ferguson’s Science Experiment:

22 October 2009 Day Three in the hospital with Dad.
Massive abdominal aortic aneurysm, 10cm. Planned surgery. Just got him from the ICU, and he’s adjusting to the room. He’s had difficulty breathing since last night, and is just now getting his oxygen levels back to where they need to be. We were schooled on how Dad is supposed to get himself up. He does it the right way when hospital staff are looking, and his own way when they are not. Had a moment with him earlier when he decided that he wanted to get back into the bed because it could be adjusted up into recliner form. He found the bed to be unsatisfactory after sitting there for all of two seconds, and decided that he wanted to sit in the real recliner across the room. Now the room is not very big, so this shouldn’t have been an issue, but FOR REALS this is the most cramped room ever, and when a drug-hazed Dad says he wants to do something, he starts moving, and asks questions later. It is just like a NY apartment, five rooms of furniture crammed into one room. I warned dad that the chair he was interested in moving to was a rolling chair, and that it sat no straighter than the bed. He wanted in it anyway. Had to move him out the other side of the bed, make him stand there while I moved his IV and fluids, put pads down on the chair and finally let him sit. He sat for about five seconds before declaring the chair to not be as comfortable as the first chair. Alright, Goldie Locks…

23 Oct 2009 Zapruder Tape, Part II, Take I
Off the IV for half a day now, and they are not giving him fluids. In fact, they gave him another diuretic to take off any excess fluid. He is dry now. Moved to a larger room. Bought Dad a small cactus garden to brighten up his little postage stamp of the hospital. On the card I write “Treat this plant like they are treating you…give it very little water. Love, your girls.” In addition, I thought a nice football shaped balloon with ALABAMA across the belly would be a pleasant touch to his accommodations, considering the Alabama Tennessee game tomorrow. Dad is catching some shut-eye, and I am enjoying a chapter of The Secret Garden when all of a sudden a gun-shot goes off in the room. I bolt upright, gasping for breath while looking around for Lee Harvey Oswald, and see no assassin, no gun, just the ALABAMA balloon falling flaccidly to the ground, gaping wound from over-inflation…I look across the room to the sleeping trucker, and he’s no longer asleep. His eyes are wide open and he’s looking at me. “Did you have the big one?” he asks. I stammer a moment, say something about the balloon exploding, and then ask him if he’s okay, does he feel lightheaded? He gives me a weak but almost conspiratorial smile and says that it didn’t bother him a bit, but wants to know if I’m okay. After I put my head between my legs, and breathe deeply, I am okay.

Dad’s doctors are an eclectic team, each with his own distinct personality and style. Dr. Ferguson is like a strangely confident and intelligent Kramer from Seinfeld, bursting through the door (almost skidding to a halt) with uncontained medical enthusiasm. Fergie, as my Dad calls him, always shoots it to you with the bad case scenario first just so that when things go blindingly well, you are thrilled to find that you are still alive. Dr. Vipul Amin, Dad’s GI man, is a spiritual yogi of a doctor who promised to not hurt him, and then didn’t hurt him as he re-inserted an NG tube back down Dad’s nose and into his stomach. “LOOK at me, Mr. Roark,” Dr. Amin commanded in his steady voice. “I will not hurt you.” He pushed the tube in. “That is the only discomfort you will feel. Look at me and focus on my eyes…” And finally, there is Dr. Alberto Echeverri, whose demeanor is so soothing, so calming, that you believe everything will be okay if he says it will be so. Dr. Echeverri is the type of doctor who will be walking with his colleagues, see you across the lobby and call out to you so that he can find out how you are doing and how you feel your patient is doing. He always takes time to talk about the surgical and healing processes, and he always wants to know how you as the caregiver are holding up.

And Dad’s nurses are like a major weather front of medical care. In SICU there is the thunder storm of charge nurses, Janie, who runs a tight, orderly and informative ship. Then there is LeeAnn, Dad’s heartbreakingly caring SICU nurse, who is married to the equally heartbreakingly caring Sid. Dad was fortunate enough to have seven days of care from LeeAnn, while receiving seven nights of care from Sid. The two of them together are a tornado of extra special nursing. On the eighth floor there is Joy, Candace, Kayla, and a plethora of other nurses who are like a full-on tropical storm of NG tubes, Jackson Pratts, catheters, IVs and spirometers. And then there are hurricanes Susan and Cindy. If not for the persistence of Susan and Cindy in the weeks following the first surgery, the second exploratory surgery may not have happened when it did. All of these nurses took such a personal interest in my Dad’s care, that they began to see him as family, and acted accordingly. They have been the truest good stewards of my Dad’s health. And for that, I will be eternally grateful.

Now, in addition to Dad being down and out, Kansas Slim has had a bit of a run of bad luck, too. Last Sunday while warming up for a cyclocross race at Sloss Furnace, he took a spill and hurt his wrist. He was unable to compete in the race, and by the time he had driven home, the wrist had swollen to an unnatural size. His doctor didn’t have an opening until Tuesday, at which time it was determined that Slim’s wrist was probably broken. A visit to an orthopedist confirmed that yes, indeed, the wrist was broken…so broken as to require surgery. There were two options: apply an external fixator, or open it up for a plate and screws. Neither of the options sat too well with Slim, but there was simply no choice on his part. Surgery came and went on Thursday with the latter of the two options being the choicest for the injury. So, Slim, with a new set of internal hardware, is on his way to recovery. Things have gone well so far, but the pain has recently taken on a new dimension. I’ve never broken a bone, nor have I ever had anything screwed into one of my bones, but I would imagine that eventually a person who has had either of those things happen to them would experience a kind of pain that emanates from the bone in such a way as to make them want to bite that part of their body off. Slim looks as though he is ready to start chewing at his wrist any moment now…

I part with some words from Frances Hodgson Burnett’s The Secret Garden that I shared with Dad recently.
“When new beautiful thoughts began to push out the old hideous ones, life began to come back to him, his blood ran healthily through his veins and strength poured into him like a flood…His scientific experiment was quite practical and simple…Much more surprising things can happen to any one who, when a disagreeable or discouraged thought comes into his mind, just has the sense to remember in time and push it out by putting in a n agreeable determinedly courageous one. Two things cannot be in one place.
‘Where you tend a rose, my lad,
A thistle cannot grow.’”