The Patient Who Lost His Patience

I surely must be in the midst of a nightmare. It is 1:45 a.m. and was just woken up by a nurse requesting that I “sit up” and “sign a consent form for surgery.” Oh, and while I am at, I also need to complete a “risk assessment for anesthesiology.” This couldn’t wait until sunrise for me to complete?

I am having surgery today. This will be my third procedure in a week. I have osteomyelitis, which is an infection in my bone. This past Wednesday I had a surgery to remove some infected bone from my left foot. Yesterday, I had a procedure to close the wound on my foot. This morning I will have one to put a port in my chest, through which I will receive IV antibiotics for the next 6 weeks.

Don’t let anyone fool you. Hospitals are not a place where one goes to rest. I actually have had very little of that since Wednesday.

I am quite certain I didn’t really need to fill out a risk assessment for anesthesiology. Especially, since I have done two of these with an anesthesiologist in the past week. However, I was too tired to argue. I could have asked to speak to a supervisor, but it is too early for me to put up a struggle. So, I signed the consent and completed the assessment.

I wonder if nurses are even made to play the patient while they are in school? If not, perhaps they should be. For the most part I’ve had very empathetic nurses this past week. However, there have been a few who could learn some things about patient care.

Having been in and out of the hospital quite a lot over my 45 years, I have seen it all. Perhaps, I should start a side hustle as a “professional patient.” I could consult with hospitals as to the quality of the care they are providing.

However, for now my patience as a patient has petered out. I am actually looking forward to surgery. Maybe I will get some sleep in the operating room. If not, I might need to conduct my own “risk assessment” with the anesthesiologist.

One Little Victory

I am a fan of the Canadian rock band, Rush. One of the last albums they made before disbanding was an album called “Vapor Trails.” Perhaps, my favorite song from this album is “One Little Victory.” The material on this album deals largely with the healing process their drummer went through after some very dramatic losses in his personal life.

For example, the song “One Little Victory” addresses how hard it can be even living from moment to moment when you are experiencing periods of grief. In my struggle with depression over the last few years one verse from this particular song often comes to mind:

Celebrate the moment as it turns into one more/Another chance at victory, another chance to score/The measure of the moment is a difference of degrees/Just one little victory, a spirit breaking free

Sometimes it is difficult to see the forest for the trees, especially when your mind is clouded with the doubts of depression. Oftentimes, the only thing worth celebrating is a particular moment. Its these “little victories” that enables one to keep moving forward when the “big picture” cannot be seen.

I have been in the hospital for the last four days. Laying in a hospital bed for nearly a week can cause you to lose focus on the positives. Therefore, I have been looking for the “little victories” each day that will spur me on to getting back home.

For instance, tonight I learned that I no longer have to be hooked up to my IV unless the nurse is specifically running medications through for me. My veins, my kidneys, and my bladder are all thankful for the rest! It will be heavenly to go to sleep tonight not having to worry about accidently ripping a needle out of my arm! These “little victories” can feel huge at times.

Hopefully, within the next few days I can return home. I miss Amanda and our boys. Being separated from them is the hardest part of this ordeal. However, I am going to wake up tomorrow and look for at least one “little victory.” There is sure to be at least one.

Doctoring in the Time of COVID

Going to the doctor in 2020 feels more like how going to the airport used to feel when we still went places. You check in and are “wanded” across the forehead so that your temperature can be checked. Fortunately, mine has been holding steady at 98.7 degrees or so. You are then “interrogated” about your health, with whom you’ve been in contact, if you experienced body aches or chills recently, and then you are allowed to pass through to your “gate.”

I think I might just get a t-shirt made that has my full name and date of birth printed on it so that I can just point to the front as they take me in for yet another test. Today, it was an ultrasound on my neck and arm to check for a blood clot. The area around the entrance to the PICC line that I had inserted into my arm a few weeks ago looked suspicious to my home nurse as she visited today. Therefore, I was sent to see my doctor, who at first thought I had an infection in the line. However, as noted above, it turned out to be a blood clot. Fortunately, it is was not a clot that tends to cause any problems.

So, tonight I find a pressure bandage around my right arm. Warm compresses will be used as I climb into bed. Then tomorrow another PICC line will be placed in the opposite arm so that I can continue to receive my daily dose of antibiotics. I sometimes wonder if all of this is real. Each week of 2020 just seems to get more odd.

Amanda got a flat tire this past Friday. I layed on my glasses last night in bed, which bent the frame and popped out a lens, then news of a blood clot in my arm today just seemed to be the icing on the cake.

I think tomorrow when I go in for my procedure, I’ll pretend like I truly am at the airport. I’ll check my bags, and ask for a glass of champagne as I take my seat in first class, then I’ll recline my seat and drift off to sleep. Perhaps, when I wake up it will be 2021. Then again, I’ll probably just be asked, “what is your full name and date of birth?”

He Said, She Said!

It appears I will be going home today, I think. Modern, American medicine is something that I am still struggling to understand. I have had a doctor called a “hospitalist.” To my knowledge, this doctor is supposed to coordinate the treatment being carried out by a team of doctors. In my case, I have an infectious disease doctor and a podiatrist. To me the lines of communication between all three doctors should be open and collaborative. However, my observations have shown me otherwise.

The entire time I have been hospitalized, podiatry has just walked in whenever they feel like it and does what it needs to do. Infectious disease has been the same way. The hospitalist, on the other hand, doesn’t really seem to know what is happening with either department. I seem to be the middle man between them all. This is apparent when each asks me what the other has said. Isn’t this what a hospitalist is being paid to do? If so, I’d like my first paycheck by next Friday.

This is frustrating when all you want to do is go home. For instance, the hospitalist was in today and said he needed to check on whether antibiotics would be administed at home or if I would need to come in to the hospital each day to have this done. This is infuriating, seeing as how the hospital social worker told me yesterday that home nursing would be by tomorrow to administer my first home dose and then teach Amanda and I how to run it from there.

This all leads me to believe the hospitalist has read none of the notes in my chart, as there is an order in for me to be discharged. Plus, I am positive there is information about the establishment of home nursing care. Fortunately, I have a feisty nurse today that knows what she is doing and has read the notes in my chart. I still can’t figure out why a doctor who is supposed to be coordinating my care has not. Maybe, he just has chosen not to take the time.

I expect a standard of care when I am being treated for an illness. My nursing staff has been exceptional. The doctors on the other hand all have seemed to have checked out on me, which doesn’t instill a lot of confidence. I wish I could say this is my only experience like this, but it isn’t. If a generalist is going to be on staff then they need to have a firmer grasp on the information being provided to the patient. The patient should never have to play a game of “he said, she said” with the doctors. To me that is unacceptable.

It is nearly 1:00 p.m. and I am still waiting to go home, despite the fact that my daily dose of antibiotics have been administered. I’m not ordering any lunch, as I refuse to eat another meal here. I understand the discharge process can take a while. I am trying to be patient. However, as I have noted in past blog posts I am not the most patient of patients. However, am I really the patient anymore when I am being asked to provide the services of a “go-between” with my doctors?

Please Shut the Door Behind You

I wish someone could explain to me what sense it makes to wake someone up who is in the hospital every three hours to take their vitals. If someone is critically ill, yes, I can see keeping a close watch on their blood pressure, temperature, and pulse rate. However, for a patient who is stable, and has been since their admission then why the need? Rest to me seems as if it should take precedent over anything else.

If a body needs healing, rest seems to be one of the best ways to promote that. I get horrible sleep in the hospital. It is more like a series of cat naps I take at night. This is because I know that if I try to fall asleep for real, I’ll have someone in asking to check my blood pressure, my temperature, and my pulse rate. This is despite the fact all of those numbers have been consistent for days!

I’m a quiet person who generally doesn’t summon the nurse or an aide for anything, unless I need to use the bathroom. Then I ask for help getting to and from there. Once that is done I expect to climb back into bed and be left to my own devices. If I have my phone and iPad within reach that is all I need. I like my door to be shut and to not be bothered.

This seems to unnerve some nurses and aides. I am a low-maintenance patient who loves to be in the quiet of my own space. That is not to say I don’t appreciate their kindness and their helpfulness, but in all honesty, I’d rather just enjoy the solitude. Maybe in hopitals there needs to be a side of the floor for those who need the extra care and support, and a side for those who just want peace and quiet.

In reality, I am pretty certain none of this will ever change. however, if I am in a hospital to rest then let me do it. I know my body and it enjoys its rest. Let me sleep and I will be gone much quicker out of your care. Yes, I know I sound like an old man who is growling through clenched teeth for medical staff to “get off my lawn!” Nonetheless, I do appreciate what they do. They just need to do it more in someone else’s room. I am fine, I will be fine, and I know when I need to call for help.

What is There to Fear?

If you read my last blog post you know I have been struggling physically the last few days. I thought things were looking up until I went for a follow up with primary care doctor today. The infection in my foot appeared to be getting better. However, upon closer examination the wound on my foot had a sneaky, little hole that was leading down to my bone. Through this hole poured some of the infection. What this means is yet another surgery tomorrow.

As I have gotten older I have begun to question just how much more my body can withstand. I’ve had over 30 procedures done in the 43 years I have been alive. It seems there isn’t a part of my body that has been left unscathed by a surgeon’s scalpel. I have seen large chunks of flesh removed from my body, my head has been shaved bald, and I’ve had muscles removed from one part of my body and transferred to another spot.

I’ve had some great doctors. I have also had some fairly incompetent ones. The nurses, on the other hand, have all been terrific. They are the ones who really know what is happening. I’ll ask a nurse something before I ask any doctor. A nurse, even if they don’t know the answer, can usually do some investigative work and get you the information you need. Plus, they clean up all of the messes!

I don’t mind having surgery. It is nothing that scares me. I’m confident in the doctor who is performing the surgery, so I know I am in capable hands. There are great nurses around as well. Likewise, I know prayers are already being spoken for me. Therefore, it is in God’s hands. What is there to fear? I just hope they ask me what kind of music I want to listen to as I drift off to sleep!

P.S. I had my first test for COVID-19 today. It felt like someone shot onion juice up into my sinuses, as my nostrils begin to sting and my eyes began to water! After that I feel like I can face anything.

Saturday Night Fever

One of the most difficult things about having spina bifida, at least for me, is the lack of sensation that I have below my knees. Along with this lack of sensation is also decreased circulation. Having no feeling in your feet can’t present various problems. The decreased citculation can magnify those problems.

For instance, I have to wear leg braces to keep my feet from flopping around aimlessly. Likewise, I can easily cut my foot and not even feel it. I’ve actually had a chronic wound on my foot for several years now. Unfortunately, this past weekend, my wound got infected. This is despite always keeping it clean and dressed with a bandage and antibacterial ointment.

Friday afternoon I began to feel a bit feverish. Likewise, chills also began to rack my body. At first, I thought this was perhaps just some dehydration, as I had drank a lot of coffee and very little water throughout the day. I woke up Saturday morning feeling a little better. However, that was not too last.

I thought as the fever and chills continued throughout the day on Saturday that I might have contracted a UTI. This can be a fairly common issue for those with spinal cord injuries as well. Therefore, I started drinking lots of water and cranberry juice. I then went to bed and slept all afternoon and night.

On Sunday morning when I woke up I was feeling a little better again. However, I think the Tylenol that I had taken the night before was merely masking my symptoms. As I looked at my foot as I do every morning. It looked angry. It was very red, streaky, and warm. I now knew the real cause of my agony. The wound on my foot was infected.

It looked fine on Saturday morning, but I now knew I needed to get the emergency room. Amanda dropped me off there around 9:30 yesterday morning. They drew blood, swabbed the wound for cultures, and ran two different IV antibiotics. I was then sent home six hours later with a prescription for two different oral antibiotics, which I am happy to say, seem to be working well. Today, I feel like my body has gone a few rounds with Mike Tyson in his prime.

My foot does look a lot less angry. I haven’t had any chills since last evening. In addition, I don’t have a fever at the moment. I am not sure I am out of the woods there yet, as it seems like once the Tylenol wears off the fever slowly creeps back up above normal.

I am sure I am in for a weekly visit with a wound care specialist now until my wound heals. At 43, despite having been a patient all of my life, I still don’t have the patience to be a patient. I think I might have prayed for patience one too many times. The only problem is, I still have not learned that skill. Perhaps, this will be the turning point. It is comforting to know that we live two doors down from the hospital. Especially, since I am there about every 6 months!

Postoperative

The past few days have put me through the ringer. It all started this past Sunday around 4 p.m. That unmistakeable knotting pain began to form just below my sternum. In the past I have had this pain, but it usually lasted just a few hours and it was gone. However, that was not be the case this time. I did not sleep at all on Sunday night as the tightness in my chest was relentless. It seemed like no matter what position I contorted myself into, nothing helped. I knew that I was having a gallbladder attack.

Fortunately, I was off work on Monday due to Veteran’s Day, as most of my time would be spent in the ER. I checked in there around 6 a.m. on Monday where they ran blood cultures, did x-rays, EKG’s, and then sent me home with a prescription for acid reflux medication. I was kind of dumbfounded. Here I was doubled over in pain and I was sent home with instructions to come back if I started feeling nauseated or feverish. At this point the doctor knew that I had gallstones, as the x-rays had shown. However, I was supposed to wait three days before seeing a general surgeon. Perhaps, I did not express succinctly enough just how much pain I was experiencing.

After stopping by the pharmacy and getting the prescription for acid reflux medication, a problem that I didn’t really have, I went home laid down and tried to get comfortable again. However, this was not to be. I did start to feel nauseated. So, just a little over an hour after leaving the ER, I went back and was not going to leave until my pain was addressed. Finally, I made some headway with the ER staff and I was was given some morphine. This allowed me to get some rest as I waited an inordinate amount of time to hear what was next on the docket for treatment. I was sent for more tests, and then it was finally decided that I would be admitted. That was with the caveat that I may or may not have surgery the next morning. I would be put be on the surgery schedule, but only tentatively. They’d get to me if they had an opening on the schedule.

I understand that my case was not critical. I also am aware that most surgeries are scheduled at least weeks in advance. Likewise, I don’t believe that my condition was critical. However, to have to “fly stand-by” while I was in so much pain was not a comforting feeling. It was also frustrating to know that I was truly not listened to the first time I visited the ER. I was having a gallbladder attack, not a problem with acid reflux!

Fortunately, as noted above, I was finally admitted and was kept comfortable throughout the night with morphine. However, I did not get much sleep, as I was connected to an IV, heart monitor, and an oxygen mask. I understand that since I was taking a very potent narcotic, the nurses were interested in keeping a close eye on my respiration. However, with no sleep on Sunday night and very little sleep Monday night, I was at my wits end. The only positive at this point was that the pain in my chest began to fade away early Monday morning. This is good because much of Monday was spent waiting to hear if they could “pencil me” in on the surgery schedule.

I will say that all of the nurses that I had were very caring and professional, but I found there to be a lot of disorganization throughout the whole process from the ER all the way up to the time of my surgery. Feeling that things were not being orchestrated very well behind the scenes produced some anxiety, which is never a great thing when you are in the hospital.

It was around 2:30 on Tuesday afternoon that I was finally wheeled into surgery. Having surgery is not something that scares me. I have had around 30 different procedures throughout my life. So, I know the process once an individual gets to the operating room (OR). The nurses have you transfer to the rock-hard OR table. They then drape warm blankets over you. These actually feel like a little bit of heaven, as the OR is usually the same temperature as a meat locker. I am sure this is to help negate the heat that radiates from the enormous lighting fixtures that are mounted over the OR table.

A mask is then usually placed over your face that is pumping oxygen. Then, in order to put you under for the the procedure, the general anesthetic is sent through the mask. This sends you into a euphoric state that quickly fades while you slide into unconsciousness. I do enjoy that euphoric feeling. It is just too bad that does not last for very long. It seems like almost no time has passed until you are once again awake. That is when the pain from the procedure sets in and seems to get worse before it gets better. That is where I am today.

Currently, I feel as if I have gone a few rounds with Muhammad Ali while he was still in his prime. To have laparoscopic surgery where your gallbladder is removed through your bellybutton is an unusual thing. I don’t like to have my bellybutton poked, much less to have it cut open. I am sure that this too shall pass, as the pain from other surgeries have. It just always seems when your body is healing that it will never get back to the state where it was before. I am ready to be able to move again without pain. No more surgery for me for a while. I have had my share.

Rollin’ Stone

I love blues music, especially the style that originated in the Mississippi Delta region of the United States in the 1920’s and 1930’s. This music is about life, especially the hardships experienced by those who invented this musical form. Robert Johnson was perhaps the best musician to emerge from the Mississippi Delta in the 1930’s. Despite the fact that he recorded only 29 songs, he is considered to be the master of the Delta blues. Several of his recordings have a haunting quality, especially those where he sings about selling his soul to the devil for his musical prowess.

The legend has it that he met the devil late one night where Highways 49 and 61 cross each other in the town of Clarksdale, Mississippi. It was at these crossroads where Johnson made a pact with the devil to become a master of his craft. This is a story that has been passed down through the years. No one knows for sure if he truly sold his soul to the devil for his musical abilities. However, it does add a mystique to his songs.

Upon a close listen to his recordings, Robert appears to play both lead and rhythm guitar at the same time. This is one thing that makes these songs truly great. He was virtually a one-man show on the guitar. Robert died at the age of 27 under mysterious circumstances, but he left behind a legacy that would influence other musicians that came after him. There are some spiritual truths in his music that are quite profound if you truly listen.

The Delta blues eventually made its way north to cities such as Chicago, Detroit, and Boston. This occurred during the 1940’s and 1950’s, as poor, black sharecroppers moved to the industrial centers of the north to find jobs in factories. Shortly after travelling north, the Delta blues became electrified by the likes of Muddy Waters, Howlin’ Wolf, John Lee Hooker, and various other musicians. It is this style of electrified blues that gave birth to rock and roll in the 1950’s.

Perhaps what I like best about the blues is the honesty of it. Life can indeed be difficult, but we can all find ways to rise above. To me this music also has a very spiritual quality to it. It is music that speaks of sin, despair, and oftentimes redemption. Despite the themes of the blues, it is often uplifting. I think that is because much of speaks to the soul of a person. In the most difficult of circumstances there is always a light that shines through the darkness.

Life is indeed difficult at times. We have all been dealt different challenges. However, we can rise above those difficulties. Music is one thing that really speaks to my soul and helps me to rise to the various challenges I have faced in life.

If you have been a regular reader of this blog, you know that I often find myself in the hospital. In fact, as I write this I am laying in yet another hospital bed waiting to be discharged.

I had my gallbladder removed yesterday, as there was no longer any blood flow to it. This is due to the fact that I had three, fairly large gallstones which had formed. These stones blocked the normal functioning of the gallbladder and it shut down.

This is just another curveball that life has thrown my way. However, I have learned to hit the curveballs head on as they come. My faith plays a large part in this, despite the fact that it is often hard to have faith when things go wrong. Ultimately, I know God has a plan and it is my responsibility to look to Him for guidance.

One of my favorite blues muscians is Muddy Waters. As noted above, he is one of those who brought the Delta blues north. A well known song of his is “Rollin’ Stone.” This title was taken from the old proverb which says that a “rolling stone gathers no moss.” I think this means we must all remain active or we will go stagnant.

I certainly have gone stagnant in many areas of my life. For instance, I used to be a fairly healthy person. However, over the last few years I have become someone who has neglected my health. I have eaten poorly and have put on weight. This weight is not healthy for several reasons, especially due to my spina bifida, as it adds extra stress on my hips and legs.

My poor diet is something that I am sure contributed to the problems that I have had with my gallbladder. I plan to learn from this experience and once again become a “Rollin Stone.” My body can’t handle the moss that has gathered on it. If you are a praying person, please pray for strength for me to keep rolling. My gallstones have motivated me to become a “Rollin Stone.”

If you like the blues these recordings are some of the best ever.

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