SCIENCE hospital part deux

By SCIENCE

SCIENCE’s Hospital Saga, Part Dieux
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As you all know by now, I had to go back to the hospital. What follows is a long-winded description of what happened and why. But first I want to that all of you who visited me, called me, and prayed for me. All those things were highly appreciated. I may play fast and loose with my religion, and I can be snippy about those who force their religion on people, but I’m not quite as far gone as Mark and I do care that people prayed.

Sir? I don’t think that everything is quite right here…
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I had returned from four nights in the Morgantown WV hospital on Monday 9/14. Each day my ribs hurt a teense bit less, and I had a follow-up visit with my own primary care physician to beg for more pain meds on Friday 9/18. He saw me and noticed nothing abnormal. I had a very active weekend, and was even driving around and running errands on Monday morning (9/21). I did a lot of work from home at my laptop through early afternoon, but at some point I felt really whipped so I reclined the chair to rest. I sat there for maybe 30 minutes, but rest did not happen. In fact, I was feeling like I was winded. Panting, trying to breath deeply. It was not working. It’s like I could breath in about 1/3 of a full breath and then my lungs just… stopped. Maybe a little like having the wind knocked out of you.

Stupid thoughts go through your head at times like this. Stupid thoughts like “stop being a whiner” and “if you call your doctor he’ll just schedule an appointment a week out.” Eventually I shook these off and I called my doctor. The secretary answered, and I started with the usual lines “This is Mike Pagan I’m one of Dr. XXXX’s patients. He saw me last friday for broken ribs, but I’m having trouble breathing…”

“Call 911 NOW!” the secretary snapped, with authority.

OK. That was my permission. Knowing that when you call 911 in my town you WILL get a personal visit from the police, I stood up to go and open the front door while making the call.

I made it 3 steps and blacked out. Like Holyfuckingshit this is SERIOUS blacking out. Hit the floor, didn’t even feel pain in the ribs.

I recovered, made the 911 call from the floor. I know I sounded like a wreck. I realized at this point I could only speak in single word gasps.

I gulped as much air as I could and stood up shakily, more or less supporitng myself on furniture to get the front door opened. By the time I got there, the police were already in my driveway. I beckoned them into the house and explained the situation. For all we complain about “The Man,” these guys were on the scene in seconds and calm and helpful and perfectly coordinated. They had paramedics there in no time. The paramedics wanted me on a transport chair, and I blacked out again climging in, but once in the chair they gave me oxygen which definitely helped..

I was hauled out of my house and into the ambulance at around 3:20 PM. Exactly when every schoolchild in my town passes directly in front of my house. My kids were going to hear about this in the morning, I though. The paramedics were friendly, calming, and professional and got me to the hospital in under 10 minutes. I went straight into my own room in the ER.

I see no other choice. We’re gonna just chop the leg off
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As luck would have it, the guy in the next room over was a 73 year old man who had just been in a motorcycle accident. He and his wife had gotten t-boned by a Porsche (why did the doctors always add that detail when conveing the information? They all mentioned the make of the car). I got to hear much of his saga while I had my own. Oddly, it went a long way to making me feel more fortunate.

I got X-rays and CAT scans again, very quickly. Then I got to talk to Dr. John Adams (“like the president”), Thoracic Trauma Surgeon. Dr. Adams explained what had happened. He started with “You don’t have a pulmonary embolism. That’s the first this we checked, and that would have been VERY bad.” Thank you doctor for reassuring me by freaking me out. He went on: “Your right lung is being crushed by blood which has been leaking into the pleural sack, probably slowly ever since your accident. Do you know how many ribs you broke?”

Me: “Uh… they told me I broke one, maybe more.”

Dr. Adams: “Pffft! I’ll say! I stopped counting at five, and of those some are broken in two places which gives you a condition called ‘flail chest.” That’s a lot worse than a simple broken rib. It means the side of your chest gets sucked in every time you breath. It must hurt like hell! What kind of pain killers are you on?””

Me: “Well, Advil during the day…”

Dr. Adams: “Advil? ADVIL? Why, when I get my hands on your doctor… Advil is a blood thinner that has probably contributed to your condition. You should be on much more powerful pain relief.”

Me; “Yea, tell me about it…”

We had a further discussion and explanation about what was wrong with me and what needed to be done. It turns out that since this blood filling my chest had been going on for some time, much of it had clotted and they couldn’t just drain it out with a tube. He highly recommended that I have a surgical procedure to physically remove all the goop filling my chest.

Mr. Pagan, you’re in luck…
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As it turns out, Morristown Memorial Hospital has a special Minimally Invasive Thoracic Surgery unit. Dr. Adams said he could do the procedure “the old fashioned way,” but that would FUck Me Up. It involved removing ribs. However, one Dr. Steiner was on his way to my bedside right now to offer me a procedure called VATS, for Video Assisted Thoracic Surgery. Think of it as arthroscopic surgery for the chest. They would cut small one-inch incisions in my chest wall and insert small TV cameras and instruments to do the job without major cutting.

Well SIGN ME UP!

By this time Terry and Angela had arrived, so they got to me Dr. Steiner. Let me say something about Dr. Steiner:

Aside from coming across as ultra-competent (you can almost *see* the Harvard med school degree sticking out of his coat pocket), the guy was… how can I put this… A hunk. I mean like TV doctor good looking. Flowing long hair like a male model. Terry confirmed my assesment, and Terry NEVER says anything about other men. I think she said something like “Did they find him in central casting under ‘young doctor leading man’?”

The Klingons would NOT approve
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Terry and Angela accompanied me as they admitted me to the hospital and took me to my room. Dr. Steiner also made a comment about “stone age pain medication policies” and told me that he was going to make sure I had “the good stuff, and lots of it.” I forgave him his perfection when he told me this.

Indeed they set me up with the Good Stuff. They immediately put me on a PCA – Patient Controlled Analgesic. The pain button, or more appropriately the anti-pain button. The polar opposite of the Klingon pain stick. The IV pump would give me a slow, low-level drip of dilaudit (morphine derivative), 1 milligram per hour I overheard. When I pushed the putton, it would blast me with TWO full milligrams of the stuff. And I could push the button again after 8 minutes. So I could push this like 7 times per hour and get 15 mg total of morphine. In Morgantown, they were giving me shots of the same stuff, 2 mg ever two hours, basically equivalent to the baseline drip that Dr. Steiner had prescribed.

I pledged to myself not to abuse my new powers.
What followed was the most comfortable sleep I’d had since the accident. Pneumatic hospital “smart bed” (it pumps up and down on it’s own to keep you comfortable). Pain meds that actually worked. It was great! And I counted. I used the button 4 times the whole night. I didn’t want to get high. Being pain free was blessing enough.

Shit, they offered me Ambien too. I refused because I was still kinda freaked out that I might just stop breathing in the night.

The rest of the night was the same hospital drill from Morgantown. Vital signs, blood sample, Resident Dr. visit every few hours. I was exahausted and relieved so I slept through most of it, waking only to pee and push the button.

A sugery virgin no longer
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The next day I met with Dr. Steiner and his team. He explained that I was scheduled for surgery at 3 PM but that was a worst case time. More likely the other surgeries before me would go quickly and I’d get in sooner. Terry planned to drive out and be with me for the 3 PM schedule.

It turned out the doctor was right and they called me in for surgery at 1 PM. I called Terry and she hurried out, just making it as I was in the pre-op prep room. Again I was pretty freaked out since I’ve never had surgery or a general anasthetic before. But blacking out from lack of lung capacity is a strong motivator, so I Cowboy’ed Up and didn’t whimper.

They took me in to the operating room, which was remarkably cluttered with things that looked like nothing special. Lights, gas cylinders, and other junk. However, Dr. Steiner was hunched in a garden-shed sized piece of Star Trek-looking equipment, which I take to be the VATS machine. THe anaesthesiologist chatted with me. I voiced my concern about post-operative nausea with busted ribs and…

…I was awake in post-op, cranky and hallucinating that Steve (my younger brother) was pinching me in the side. I was slightly uncomfortable, maybe a hair off in the stomach but I had no nausea. A quick check of the hydraulics also showed that I had no catheter (another one of my wussy fears). The surgery had taken just over an hour, and apparently all went well. Dr. Steinger visited me shortly and confirmed this. Terry was allowed in shortly to comfort me, and they wheeled me back to my room.

On the mend
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The only problem now was that I had more or less taken a step back right to the accident in terms of healing. The post operative pain was maybe half what the initial accident was, but still I felt back to be back to square one, in effect.

Two days of hobbling around the ward, lung exercises, visits from family, phone calls, etc. followed. Boring stuff except when I had visitors or phone calls. I filled my time by experimenting to see how many consecutive hours of CNN I could watch before I could stand it no more (answer: about 50 – then I switched to the Food Network). I *did* leave the TV on 24×7 because A) I was up many times during the night due to the hospital routing, and B) It took my mind off things. I got to see the Qaddafi, Ahmedinajad, and Netanyahu speeches in their entirety. Twice. That was amusing.

Can we get Chevron in here?
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They said I might leave by Thursday afternoon, and Scrounger made plans to be there, help me order my company car (the deadline was Monday) and drive me home. Zig visited at the same time, which was way cool.

But there was one more leetle thing the doctors wanted. It turns out I had lost a lot of blood, and my hematocrit was low. They wanted to give me blood before I left At least two units. On top of this, my IVs had been in since Monday, and protocol called for them to be removed and replaced. More problems: I had been poked and jabbed a lot in the past two weeks, and I was stuffed full of saline every day yet my blood was anemic. Long story short: the easy veins were already used and needed a rest, and the other veins were getting hard to find.

Scrounger and Zig got to watch first one nurse (a n00b) try about 6 differend veins. Then they brought in an experienced vein-finder. She tried antoher 10 times. They kept jabbing and jabbing. I just sucked it up since there seemed to be no point in complaining. My guests seemed pretty skeezed out.

skeezout sidebar: Zig noticed that some patient down the hall would periodically bellow out in some inarticulate anguish. The rooms are pretty sound proof, but I had noticed this too. didn’t bother me too much, as I kept the TV on, but I did later ask the nurse. Apparenlty I was not the only one to ask, and the nurses were not happy about it. It was a patient with “mental impairment” who would do this every time someone tried to do antything to/for them. One more joy of staying in a hospital.

In any case, two more nurses tried to find a veing on and off through the afternoon. Finally they brought in the resident (doctor), and HE found two veins. He did because he was a doctor, dammit, and with that ‘spensive medical degree he was going to find a fuckin’ vein. He also found veins because unlike the nurses, he really did not care how much he hurt me. He dug and DUg and DUG on each try, probing left and right and up and down with the needle.

It was 6 PM by the time they got the catheters in. Then it takes and hour or two while the blood is prepped. So it was 9 PM by the time they put the blood in me. Blood goes in slow, and the catheter they finally used was narrow guage so it took over two hours to get a unit of blood into me. They put two in that night, and wanted to do one more the next day. That sealed the deal on another night’s stay in the hospital.

It’s like wearing someone else’s underwear
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That says it all. That is how I felt about receiving blood. Uncomfortable. Slightly wrong. I never thought I’d feel that way. A transfusion from a young boy did Mr. Burns a wolrd of good, and Archie took a black woman’s blood no problem. Still it made me feel off. Probably psychological.

Free at last
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Thursday it took FOREVER to line up the final transfusion. I was worried that the IV catheters in my arms were fragile, so I wouldn’t do much for the majority of the day. I did get my surgical drains (used to make sure no more blood was filling my chest) removed before lunch. The nurse had me lay on my side, adn then asked me if I’d ever seen the movie “The 40 Year Old Virgin.” I had, and then it dawned on me: There was a half acre of strong adhesive material holding those drains in place. It went from my armpit to my belt line, from the middle of my back halfway to my chest. This needed to be ripped off of my hairy body. Ouch. Still, pulling the darins tubes out and pulling the stitches tight hurt more. Worth it to not have those freaky things hanging out of my side.

They finally got me loaded up by 2:30 PM, done by 5, and released to Terry and the rest of my family by 6 PM.

I’ve been home since. The rib pain has abated continuously over the days, but the post-op pain was a week and a half behind on recovery. This whole escapade makes me worry that every twinge I get is yet ANOTHER complication. Still, once again I feel a little better every day.

Gottal be home alone on Monday with the kids. School is out for Yom Kippur, and Terry needs to be at work. Should be exciting 🙂