Monday, November 29, 2010

How to cope

with surgery, recuperation, the accumulation of heavy objects around the house that you can glare at for hours but not pick up?

My suggestion:marry my husband Randy. This, of course, is a path closed to the rest of you (and how) but I think Randy's due for at least a fraction of the gratitude due him. Since I've gotten home, he's:

fed dogs, let dogs out, taken care of dogs at 6 a.m. all day to 11 p.m.
made macaroni and cheese, hamburgers, eggs or whatever else I think my innards can take
shopped for groceries
done laundry
vacuumed
shoveled
done dishes
made beds -- you've never seen a neat bed until you've seen Randy's work
driven me to various appointments at various clinics
as I got better, driven me to department stores to go through clearance clothing.

At the hospital, he was attentive and positive while I was awake and perfectly happy to read while I wasn't. Not having to feel like I'm being entertained, and not having people feel responsible for entertaining me is my ideal for a hospital visitor, I must say.

Of course, Randy is my ideal for just about everything!

Saturday, November 20, 2010

My surgeon made me cry

Chrissy, a friend and former co-worker who's had two children, noted on e-mail that since I'd lost 20 pounds since the operation, I'd probably have to get a whole new wardrobe.

I'd hoped that perhaps I could get rid of some of the really big clothes, maybe the ones that made me feel huge, and gradually replace the rest.

But something about that e-mail made me go upstairs and pull out a couple tops and some pants.

It appeared during the 5 days I'd been gone, someone had stocked my closet with clown clothes.

Waking up in the hospital, I noticed immediately that my stomach fell down and away from my rib cage, instead of bulging up and out. By the fourth and fifth day, I was sitting up Indian-style in the bed, which I hadn't done since my early 30s. After that, apparently the kidneys had taken over, shutting down my breathing as they pushed up into my lungs.

I've written elsewhere about my size 10-12 hips and thighs and size-24 waist, but the fact I could now pull every shirt I owned out to 6 inches from my waist really brought the message home. What had disappeared had disappeared from my hips to my rib cage, leaving it concave instead of convex.

I forgot to measure my waist before I went in for surgery, but I'm sure it was over 50 inches.

But I guess I didn't realize how far I'd come until Randy took me to Target to see if there were anything on the clearance racks that came any closer to fitting me. I found a pair of leggings in medium -- an avenue closed to anyone shaped like I was.

With an armful of tops and sweaters -- seriously, who knew what size I might be at this point? -- I went into the fitting room. I was feeling shaky and lightheaded -- this was Saturday and certainly the most exercise I'd had since before surgery.

I pulled on a long, thigh-length sweater that clung too close to purchase. But what it clung to was an obvious waist. How many years had it been since I'd seen that? How long had I been wearing women's elastic-waist knit pants and men's T-shirts and sweatshirts I got at Goodwill? How frantic was I during the months it looked like they were going to leave my kidneys in? And for how many years before that had I blamed myself for being "fat"?

One of the things my surgeon told me right before the operation was "You'll feel so svelte!" Genius, procedure and technical capability put aside, she knew.

I certainly never expected to look svelte again, and it's a shock every time I look in the mirror. People at work say just seeing me walk by in the corners of their vision, they're not registering it's me.

So, apologies to Target shoppers on the afternoon of Saturday, Nov. 20. The woman bawling and clinging to her ever-understanding husband was me.

I know -- I've had my life saved and, on top of that, the quality of my life given back to me. This shouldn't matter so much.

But perhaps to a woman --and certainly to this one, it does.

Wednesday, November 17, 2010

First Morning Back

-- by Randy

So Holly slept in her own bed last night and it is a pretty happy day today. I'm happy. The Dog Fairies are happy. At some point we should begin to hear from the patient herself and her side of the experience.

We still haven't gotten any information about the kidneys so we have to wait a little longer on that. However, from the time she was weighed minutes before surgery to now, Holly's lost 15 pounds! That's a "so far" weight -- after spending days on continual IV fluids, her tissues will probably keep throwing off water for up to a week after she gets home.

-----------Holly, later--------

Getting home was so great. It's easy to forget when you're well that being able to sleep when you're tired, drink when you're thirsty and eat when you're hungry are so essential.

Yesterday, when I got home, I called my transplant coordinator, who admitted she'd panicked a little when she saw the call come in so soon after discharge. I just wanted to get clear with her on when I should have labs and where.

I then told her I'd only had a pain pill to nap that day. "I can't believe it," she said. "I just can't believe it."

Well, there's my theory that I heal like a dog -- a couple days down and then you've gotta keep up with the other predators. I've told several RNs this theory and not had any argument.

Meanwhile, I only found out tonight that, as Randy puts it, "they had to unzip your large intestine from your abdominal wall." No wonder it took from Wednesday night to Monday morning to be able to eat oatmeal!

I notice this when I've been "vertical" -- walking or sitting up -- for a while, then go to bed and try to lie on my side. I can feel things slowly sliding downhill in there. It's not painful, but unnerving enough that I switch to my back.

I still have some kind of echoing pain in my lower left back, from the place I assume that kidney was pressing on a nerve. But the regular dull ache is gone. It actually surprises me sometimes -- hey! No kidney pain!

As I left work, I told the folks there this should put a stop to the grunting and groaning coming from my chair at random times during the day. "That's good," my staff writer said. "When that happens, I always assume it's because you're reading one of my stories."

The fact it'll also stop my mutting "Damn kidneys" as I stop midstep and hop around on one foot as I pull the other knee to my chest should probably go unspoken.

Tuesday, November 16, 2010

Surprise

Imagine my surprise when I got a call this morning at 8:45. It was Holly, "It looks like I'm getting out at noon today."

She said that she forgot her "sleeping" pill so she got up at 4 a.m.ravenously hungry and started her Tuesday early. As in bumming an essential-to-life "clear-liquid breakfast" of Jello off a nurse. When you've been on clear liquids for 72 hours and fear melting and slipping through a floor drain if anyone turns up the heat, a half cup of Jello can beckon like a half-pound steak.

With that nutrition on board, it was then a question of taking a shower, sorting clothes and bedding and otherwise filling time until food service opened. At 6:30 a.m. she picked up the phone for food service and phoned down the order for oatmeal, 2 % on the side and brown sugar she'd been dreaming off and on for two days. What? No one had switched her to "semi-solid foods" and she couldn't get it yet? Have you people seen the fury of an ill-fed, sleep-deprived, somewhat-damp hospital patient? Yes, that's her over there in bed, but note how high she's got the top of that bed cranked.

Holly chased down a nurse who thought there "might" be a doctor around at that time and got the transaction completed. Within 45 minutes, that cherished bowl of grain was in its proper spot.

I got there and she was sitting up bed. We were talking about what she had been doing and she said "Is this what you meant by chirpy?" Later Holly's surgeon stopped by and they talked about the plans for their next meeting. Then after some paper work and a couple more consultations Holly got discharged.

So now we are home.


----------Holly, later---------

That 7 a.m. bowl of oatmeal was so good I ordered another for "lunch" at 10:30!

When the doctors made the rounds, one with a pronounced accent took the lead with me. He asked (I realize now) "Do you want to go home?"

I registered bafflement.

"Do you want to go home?"

Hoping to pin down what might be a crucial question, I dutifully repeated back, "Do you want to go home?"

The next sally came through loud and clear. "I asked you first!"

So there we were . I woke poor Randy up calling him -- it's incredibly enverating to sit at a bedside and alternately entertain yourself and a patient for hours on end. But I hoped I wouldn't be so demanding a patient at home that he couldn't continue to catch up on his rest!

And the idea of not spending another wakeful night at the U (Law & Order or no Law & Order) sounded, to quote my nurse, "lovely".

Monday, November 15, 2010

A plateau day

-- by Randy

Holly had had a shower by the time I got here today and was getting up and down slowly but on her own. It does look like napping is still a big part of the schedule.

I think the reason she is resting so well is the pain management has been worked out. This is probably why so far the bipedal jaunts are only jaunty with in the room but it's still early yet. The occupational therapist hasn't been in yet. I always thought of occupational therapist as being work, that is employment, related but I think now that the meaning is "to keep one occupied." Work is also a word for effort and keeping occupied at this stage is extra effort.

Mostly she looks better and is resting comfortably. Time and naps and healing. Thanks to everyone for the emails and the calls.

----------Holly, later--------

Last night (Sunday) I was alone in a two-person room. My "roommate" Melissa went home at six. She had donated a kidney to her father, who had suffered sudden-onset kidney failure. Both seemed to be doing great.

I had the most delightful nurse -- arrived with a sunny outlook and only got more positive from there. When I inform her of things like "I'm going to change gowns and then walk down the hall," she says "That sounds like a lovely plan!" as though I've just suggested a picnic.

Positivity helps. After two go-rounds, I think my body's response to surgery is to stay awake, since the last time it fell asleep something awful happened. After the transplant, I assumed the sleepless, thrashing, eye-watering hours awake were due to steroids.

This time around, I am on a much lower dose of steroids, plus have my usual sleeping pill in the evening. And I'm still up until midnight, up again at 2, up again at 4. Thank heavens there's a Law & Order marathon on.

Now that I've actually ventured out the door, I'm even more impressed with the nursing staff here. If you wander out at 4 a.m. to see if there's any juice or Jello in the area (this is assuming you're a person on a "clear liquids" diet for four days) the first person you ask will say "What flavor?" jump up and get it for you. It doesn't matter who they are or what they seem to be doing at the time; there's no "I'll call your nurse" or "I'll see if there's an aide around."

And when they stop in to check vitals or hang an IV bag, they never leave without asking "Is there anything else I can do for you?" And they mean it. When you can't even sit up in bed, adding an extra blanket or or putting your oxygen on again can be the difference between resting comfortably and staying miserably awake.

I'm so thankful to all of them. Especially the one who slipped and asked "Is there anything more I can do to you?"

That was delightful too!

Sunday, November 14, 2010

Later on Sunday

-- by Randy

So after an exciting morning of showers and bathroom breaks and talking to surgeons Holly is spending the afternoon resting. The I.V. being back in seems to have resolved the discomfort.

It is not easy for Holly to get out of bed but I am actually amazed at how she is doing with that. Cringing and wincing -- but not feeling uncomfortable enough to stop her trying. Maybe tomorrow she will get a lap or two in the hall. Holly says "I hope to make it okay through the night and have oatmeal in the morning." Now there's a name for a boomer rock band: "OAT MEAL IN THE MORNING."

I am checking the hollys2ndlife@gmail.com email so if you want to send her a message there so I can share them with her.

Sunday-a brand new day

-- by Randy

Last night I left as we were waiting for the doctors to come by on rounds. It was getting later and I had heard that the Transplant teams were pretty busy this weekend. There do seem to be a lot of patients on the floor. It looked like Holly was in for a rough night. During the day she was making visible progress. At that point I think there was some attempt to adjust her pain management. I assumed that when she was seen by a doctor that she would get a better setup. When I left she was not comfortable.

That being said imagine my surprise when as I walked into the room Holly was walking toward me on the way to the bathroom. There was a doctor there and he said that about eight last night they adjusted her pain medication. The nurse came in a little later and asked why Holly didn't have her I.V. in. Holly said she accidentally pulled it out when ( wait for it...) she was taking a shower.

So the I.V. will be returned but Holly is free of most other tubes which have brought to light some minor non-surgical issues. Mostly though she is way more herself and participating in her recovery.

-------Holly, later-------

I woke up this morning and whiled away a few hours before getting a "breakfast" of clear liquids. Broth, Jello, water, apple juice. It may not sound like much to anyone on a regular diet, but to someone who hadn't eaten since 11 p.m. Wednesday, the juice and a little Jello were a lifesaver.

I napped for a while and then woke up before my surgeon stopped by. She was on her own so sat down to chat. She saw my stomach tube wasn't working well so she took it apart, flushed it and got it going again. The tube's used to draw out excess fluids, so I don't get nauseated. It's also used to administer some meds. "I'll leave it on 'intermittent' -- don't want the nurses to get mad at me!" she said.

After she left, I thought "Man, it would feel good to have a shower, and it would be nice to get one before Randy arrives."

So did I call a nurse? Did I take the extra four steps past the bathroom door to poke my head out the door and ask someone to send my nurse's aide along? Did I even wait for Randy to help me?

No, of course not. With my newfound knowledge of how to uncouple my stomach tube, I undid that. I took the oxygen loop off my head and hung it on the bed rail. I removed the catheter collection bag from the lower rail and hung it on my IV pole. Then, except for the IV pole, I was free! And that pole has five wheels for a reason, right?

After nearly 3 days in bed, it felt like the Great Escape.

Once I got to the bathroom I was a little surprised to find that my stomach tube had been clipped to the front of my gown, mainly to ease the weight of the tube inside my nose. Ouch! But I'd committed myself this far, and I was, of course, hardheaded enough to keep going.

With the IV and catheter tubes leading out of the shower, there was no good way to close the curtain, and for quite a while I thought the flood on the bathroom floor was my biggest problem.

As I used the handheld spray (couldn't figure out how to mount it up on the wall) the IV in the back of my right hand hurt more than my nose as it got pulled and bumped. However, I got done and did an extra rinse of my hair. The IV gave me one last pang and I looked down at it. . . there was a good reason for that. It had pulled completely out and there was blood slowly going splot, splot, splot on the floor.

I pulled the "emergency call" cord. Apparently what happens is the first person in the hall who sees it runs in. My rescuer was a middle-aged, practical woman with a sense of humor. She started cleaning off my hand and pressing the vein to stop the bleeding. (A valiant attempt, given that I'd been getting heparin blood-thinning shots since the operation.)

Hard on her heels came my nurse's aide, a 20-year-old kid named Denny. Denny stood on the other side of the threshold, taking in the tableau of me in the altogether, the IV pole, and the aide on her knees in front of me applying pressure bandages to my hand. However, he was taken by another aspect of the drama.

"There's blood all over!" he exclaimed. "There's blood everywhere!" He appeared ready to stand there and enlarge on this theme, except the nurse cut him short. "Denny! Get me some towels!"

There was certainly water everywhere, and every time a drop of blood landed in it, it spread quickly. The nurse was intent on cleaning every bit of blood off my arm and me, although I assured her it didn't bother me. After all, it was my blood.

"It'll bother somebody here," she said wryly. "You can depend on that."

So, she was still mopping at the blood when Denny returned with an armload of towels, washcloths, blankets and robes. They were mainly deployed on the floor, with a few left over for me.

Once his arms were emptied, Denny again had the opportunity to opine on the situation.

"There's blood all over!" he announced. "There's blood everywhere!"

Later, one of my fave nurses, who'd somehow missed all the excitement and the blood, looked at me agape when we told her the story. "You're the second patient today to do that!" she said.

Well, I was clean, I'd finally done something that qualified as "physical" and I had a (probably misplaced) feeling of accomplishment. Things were definitely getting better.