The Hospital

Alta Bates hospital in Berkeley is its own little city. Even while I was doped up, I could tell the many layers of work that kept the place going, thriving. I was always amazed.

Every morning and every night someone would come in and write the name of the RN for that shift on the board in front of me. Simple math tells me that they probably had three registered nurses for each patient, but I can only remember the names of two, the same two I would see day after day. If there's sunlight, Kristi was coming in, followed by her nurse intern, Rachelle. If it was night, Sylvia would come in, print her name in big, bold letters on the erasable board, and give me a little lecture about what was to be expected of me. I began hoping I could avoid the next Sylvia shift as time went on.

Below the RN we had many types of nurses and physician assistants. Some did some things, while others did others. Although at night I noticed that fewer people were on staff. Maybe that's why I noticed Sylvia more.

And every shift had its responsibilities. My vital signs had to be taken four times a day. Blood had to be taken, but I'm not sure when -- maybe every couple of days? Nurses would write on my bandage as to when the last shunt or IV was put into my vein; every four days that had to be replaced.

When you're trying to get an hour's worth of sleep and someone is waking you up every 10 minutes (or so it seems), their health care seems counterintuitive. Still, I'm sure I was getting plenty of sleep, as much as I needed. I just didn't like to be awakened.

As Ruth tells me, though, she would see assistants turn around when they saw that I was asleep, promising to come back later.

I probably saw at least four doctors a day. This is quite different from when I had my colon re-sectioned 10 years ago; I only saw one doctor once that I remember, -- Dr. Wright, my surgeon -- and I'm sure I was wrong. There was probably another doctor or two who would check in on me, but I just didn't recognize them.
Dr. Poddatoori was there at least three times during my 5-day stay.
Stephanie, Dr. Stern's assistant, is also a doctor, and she was there about 3 times, maybe more.
Dr. Richter subbed for Dr. Laura Miller of Lifelong Medical, and she would fill me in on things, bringing the whole picture together for me as to where I was.
Dr. Stern was there twice. I was lucky that I was delayed checking out on Tuesday, as he was able to give me a summary of the pathologist's report.
I believe there was another hospital-based doctor in there somewhere as well.

I was taken care of so well. Even Sylvia, the one I was trying to avoid, was telling me exactly what I needed to do to get better and to check out of Hotel California Med: Walk, pass gas, eat solid food, breathe into the thingamabob so that I would eventually take deep breaths. I tried to be a very good patient. They were all very good health givers.

Babysitting After Surgery

Ruth is still a little nervous about leaving me alone even when today counts the seventh day from which I had surgery!

So, she's looking for people to look in on me. Today, our friend Dawn stepped up. Dawn even brought little tri-cornered hats of Hamentaschen - SUGAR FREE! Of course, they still had butter, so they were delicious! That's apricot filling. And the hamentaschen is one of our signposts that Passover is straight ahead.

And tonight, Jim and Marisa came over and made us dinner, a stir fried feast of chicken and vegetables. There were lots of wok jokes, including ones I haven't used since the seventies. Hey, this drug-addled memory is good for something!

Why I Stayed in the Hospital So Long

One note about why I stayed in 5 days and not the 2 days Dr. Poddatoori said I'd be experiencing.

1. She said "2 days" before the results of the PET CT Scan and the pathologist's report (during the actual surgery) were in. A small, laparoscopic surgical incision just wasn't in the cards for me.

2. One of the anesthesias was making me nauseous. It was either the stuff they gave me, a general anesthesia, during surgery, which took some time to work its way out of my system, or it was the drip they had me on in the hospital room. They put me on dilaudid instead of morphine for the first few days in the room. The RN and doctors figured out eventually that that choice made me nauseous. They had obviously made the choice to give me more pain relief after such heavy-duty surgery, as dialudid is seven times stronger than morphine.

I threw up on the 2nd day of hospitalization, and was in danger of doing so the next two days after that. Once the switch was made to morphine, it took a full day to bring me back. But that nausea meant I couldn't eat and I couldn't even have liquids or ice chips. That will certainly slow down the normalcy of your stomach and intestines.

It's alimentary, my dear Watson.

A Strong Dose of She's Right, I'm Wrong

We finally figured out what pain med dosage will work best for me. It's I listen to Ruth, who set up a system that actually works, and I stop trying to thwart her.

She has worked the Vicodin and Motrin so that I take it all at once during the time limits. We don't have to think about, okay, Motrin here during this two-hour time period when I was starting to hurt.

Why did I give her such a hard time about it? I think it's because I'm worried about running out. It's less to do with getting addicted. I'm certainly not close to that yet.

And one thing I suspect is working here is that I'm on medication, which makes it hard to think about what I should properly do about medication. I need a second party to help me monitor it.

The result of perfecting this system of how much to take and when means that I pretty much know when to take each dosage, because it never changes (it's just 6 hours in the future), and I feel so much better. I feel so much better at times that I have to remind myself that marathon running is not on the menu. Please understand that most of the time, I feel like there's this hot plate of spaghetti lying on my stomach. And that great fatigue can come swarming down upon me without warning.

My sleep time is better as well. I alternate between the living room blue chair and the bed. I am so worried the dogs are going to pummel my stomach, that I place a pillow on my stomach before I lie down. But there are other reasons the bed doesn't work as well: the transition between sitting and standing is rougher, it's harder to get comfortable, etc.

The blue chair gives me a little bit of the feel of a hospital bed. I hate the fact that I can't sleep on my side, but there's nothing to be done about that, and the chair ensures that I don't even bother to try. And at 2am, it's just the chair, me, my meds coming at 5, and Princess. Nice and quiet with a warm, woolen blanket over me.

Figuring out what the routine should be is what's helping. I'm beginning to relax a bit.

Tomorrow: I get a babysitter.

Counting the Minutes to the Vicodin

It's 4:30am on a Thursday morning. I'm due for Vicodin and a Motrin pill at 5am. If I can last until 6am, I'll be doing that much better by stretching my pain medication, making it last, and maybe eventually coming off the need for it.

But on the other hand, I don't want to be in pain. Research shows that (1) people heal more quickly if they're in less pain, and (2) I'm a bitch when I'm in pain.

So I think I will compromise and take a little less. But I will still take some at 5.

I was just reading about Kristen Johnston's new book about her addiction to Vicodin. She would take between 20 - 100 pills a day. Of Vicodin! Finally, she said, her stomach exploded. At the age of 36. Oh, we don't want to go there. And I certainly don't have residuals from 3rd Rock from the Sun to lean upon when something goes wrong.

It's good to have doctors' appointments (three different doctors) looming. To check on how you're doing. To check on other matters. (Other health matters have sprung up during the hospital stay; I'll get into that later.) And to keep you in check on the medication. This is serious stuff. Just ask

Staples Center

This photo of me lying in the hospital bed was taken on Saturday afternoon, I believe. Friday was the day of surgery, and is pretty much a blur. I have had a few people tell me that they stopped by and talked with me, and I have no memory. But thanks for doing that.

The images and language below may be upsetting to some people. If you are upset by the view of stitches, you may want to move on and visit another health blog. You know, something where they can do things by telekinesis, my preferred method of surgery. But if you have the stomach (!) for it, hang on in there.

I spent about five days in the hospital. Went in at 6:30am on Friday, and came out about 2pm on Tuesday afternoon. Thanks to major coordination and consolidation by Ruth and Jim, I was deposited in the middle of three lovesick poodles, who made me feel very loved. Ruth tried to keep their demonstrations to a minimum.

I haven't been able to sleep very well, and I guess I'm surprised that being home didn't make a difference. So, at about 3am, I moved my aching body out to the living room recliner, and slept there. Five minutes there, two minutes there, that kind of non-REM-producing sleep.

But today, the 6th day, I felt better. The belly still hurts, of course, but I'm able to sleep for 10 minutes, maybe 20, at a time.

I called today into Dr. Jeffrey Stern's office to make that appointment for next week. They could've brought me into his office in Berkeley this Thursday, but that would be tomorrow, and the thought of riding around, and then walking a lot, was very upsetting. So I was glad to get an appointment for next Tuesday morning, March 20th.

I'm hoping Dr. Stern will give me the full pathology report in which he says everything's clear, no radiation or chemo therapy needed. That's the short version I got as I was preparing to be discharged yesterday as he did his rounds.

And I am also hoping to get rid of these infernal staples.

A friend asked me on the phone what they were like. I didn't really want to look (although, frankly, that's the first thing I did when I got home: get in front of a full-length mirror), but I did. I thought they were nylon. Maybe plastic. They're metal! I would certainly set off a bevy of TSA x-ray machines right now! My hardware is kind of ominous.

The lengthy picture here is a section of my incision and the staples holding me back together. Believe me when I say "filet" is the operative word here. They fileted me like a fish. There is no other word for it. I am cut from around the pelvic bone up in a vertical slash to the belly button.

It only hurts when I move. It only really hurts when I don't use my oral medication, which is vicodin for the heavy-duty pain, and Motrin for the not-as-bad pain. I'm on a combination of both.

I have to go back to my reclining blue chair, as it's time for a nap, only because my body tells me so. More on the hospital visit -- which was fascinating -- later.

The other photo shows a close-up of one of the staples.

Getting Prepped Up

I just took my laxative. You know, this stuff is getting better. Oh, sure, it's no Grand Marnier, but this one was only 10 ounces and fizzy. I am to drink at least one glass of water after it, so that's what I'm doing right now. The surgery is tomorrow.

And, speaking of cleansing, I've been cleaning the outside of my abdomen with Hiblens daily. I had never heard of that before, where the patient is expected to get the area clean before the surgeons get their crack.

I would like to take the opportunity to thank everyone who has left a message for me on CaringBridge, wishing me well, sharing a private joke, giving me something in the future (like a trip to Disney World) to which to look forward. Thank you all very much. The outpouring is immensely helpful, and a little surprising. I mean, you don't know you have so many friends until you have to add them to a list for something.

I've been getting notes all week. Email. Facebook notes. Someone even sent me a note on the Words with Friends game we were sharing. I had three phone calls today. One from a dear friend, and two more from an ex girlfriend who wanted to leave a message in my mailbox that morning. While my mailbox should not be treated like the Western Wall, a depository for prayers, I will appreciate any and all that I get.

Back to drinking my water. I wish you all a good night.

Getting Ready for Friday

I'm feeling great. Thanks for asking.

Yesterday morning, we met with Kathleen, a nurse at Alta Bates hospital. Her job was to prepare me, verbally, for what's ahead on Friday. That, and send me to see Sam (again), who would take an ECG (electrocardiogram), a nasal swipe to look for staph infection, and four vials of blood.

Nobody took my blood pressure or A1C glucose level, but that will all take place Friday morning.

I signed a lot of paperwork: consent for hysterectomy, authorization for surgery (defined as "abdominal hysterectomy, bilateral salpungo orphorectomy, pelvic/aortic node dissection, possible pelvic reconstruction"), consent for blood transfusion (with two units ordered, just in case I need blood).

The orphorectomy indicates that the ovaries will be removed. (Oh, and I also had to sign paperwork which indicated that I knew I'd be sterile after this surgery. No kidding.) The pelvic mention is probably talking about the lymph nodes to be removed. And the "reconstruction" has to do with what Dr. Stern talked about, moving things around in the abdominal cavity to make sure that any future radiation treatments, if needed, will be successful.

Thankfully, my chest x-ray was cancelled after Kathleen confirmed that I had had one for the biopsy some two months ago.

Everybody was so nice. Kathleen was sympathetic that I couldn't bring a poodle into the OR. Damn rules.

The Soylent Green Connection

You may not remember the science fiction flick Soylent Green. There's a scene in the movie where Edward G. Robinson's character volunteers to die, and is "treated" to scenes of luscious green pastures and trees, what the Earth used to look like before we polluted our planet to death. Edward sees these scenes on the gigantic screen before him, and sobs.

I've been wondering what I would like to watch on Thursday night, the night before my surgery. And I think it's going to be Moneyball.

That scene where the Oakland A's can win their 20th game in a row and come back from the dead, where they're behind. 9th inning. 2 outs. And Scott Hatterberg steps to the plate. And hits a home run.

When I saw this in the theatre, tears of joy streamed down my face, because I had been there 10 years before, sitting in the stadium seat, but then jumping up, raising my arms, and cheering as loud as I could with 30,000 other rabid fans. Sheer happiness.

How Far the Cancer Has Spread

I had the PET CT Scan this morning. As Ruth suggested, the PET could've stood for Pretty Easy Test. It was much easier than the MRI.

First I met Pat, the nurse, who did a good job of explaining what would happen and what she needed from me. She stuck me and attached a gadget to control the flow, and started an IV; the water coming in would tell her whether the flow from my arm was good. She took some of the blood in the tube after the IV was established to test my blood glucose level. She said that, if it was 200 or over, we would say goodbye right then and there. Fortunately, it was 128.

Then she brought out the radioactive isotope (glucose), and put that into the IV tube. The only thing I had felt so far was the prick of the needle to start the IV. Then she left me for an hour, covering me with a heated blanket. "Don't talk on the phone," she told me, "but you can play games on your phone, anything like that." She then chatted with me about how she had gotten hooked on Angry Birds. During this long period of time left alone, I could've taken a nap, but she came back before I realized the time had gone by, and moved me to another room. I was urged to clear my bladder before I went in.

In the other room with the big, long MRI tube taking up most of it, I was told to partially undress (bra off, top still on, pants off, socks on) and slip into a gown. I then lay on the narrow plank, with my head on the pillow. She then placed a foam rubber pillow over my forehead, to keep it in place, I would guess.

"Your job," instructed Pat, "is to stay perfectly still. Don't hold your breath; breathe normally. This will take 21 minutes." This seemed easy enough until she placed my arms above my head, a most awkward way to relax.

And so I lay there as the machine moved me back and forth through one end and out the other, and back again. I noticed the whirring mechanism at one end, and so I assumed it was the business end.

This is the machine, the test, which will tell the doctors how much the cancer has spread. Whether it's reached the lymph nodes or not. Pretty important test. The insurance paper said the order was for "Pet Image with CT, Skull - Thigh." That's a pretty long scan.

20 minutes went by fairly quickly. I got out with her help, got dressed, saw the receptionist who offered me cookies. I don't turn down cookies, even for breakfast. Come to think of it, the radioactive isotope was breakfast. Helluva way to treat a diabetic, either way.