My ticket to ride...the hospital train

I thought I would give a little more info on what happened during my hospitalization earlier this month, and resulting surgery.

It was a Tuesday morning (March 4th), and for whatever reason, I got up earlier than usual. No pain, nothing. Just was wide awake. Got up to go take a shower, but before I hit the shower, I took a little swig of water (morning dry mouth, you know!). Immediately, I felt that horrible epigastric pain start. Now, this was strange, because I would get one of the gallbladder attacks about an hour after eating - not right away, and never from just drinking a little bit of water.

So, hoping it will be transient, I get into the shower. The pain doesn't get any better, in fact, it feels worse. I take my morning meds, rather painfully, and head downstairs. Start up the coffeepot. Take the dog out for a quick walk. Bend over at the waist in agony from the horrible epigastric pain. Take 2 sips of coffee, then eat a few goldfish crackers, thinking, maybe it's an ulcer, and I need some food in my belly. It makes my pain even worse.

Now it's 9am, and I put a call in to the insurance adjuster for my car, get approval for repairs. Pain still there. Call my bariatric doctor's office, speak to the secretary, who passes my message on to the doctor in the office. I am now lying on the couch, in pain, when the office calls back 15 minutes later and they tell me to go right to the ER and I'll be evaluated by my gastric bypass surgeon there.

Of course, on the way to the ER, the pain is getting better. I have my boyfriend along with me, just in case I am sedated for any procedure. I'm thinking, at the most, I'll have another EGD to evaluate for an ulcer, and then be sent home. The pain is just a dull ache by the time we arrive in the ER.

After about 1 1/2 hrs of wait time in the ER, which is good, compared to the other hospital's ER wait time of 8+ hrs until being seen, I am taken back to a cubicle. Change into a lovely hospital gown, feeling like I should just go home, because the pain is barely there anymore. I'm feeling like an idiot for taking up their time in the ER, still thinking that this is nothing, since all of my gallbladder tests were normal.

The RN comes in, draws blood, starts an IV. She asks me if I want anything for pain or nausea, and I decline both. "What? You have no pain now?" she asks me. No, I tell her, it's just a dull ache now. I'm good.

About an hour goes by, and one of the surgical fellows comes in to evaluate me. He takes my history, does a quick belly check - and WOWSERS!!!!! That's what a positive Murphy's Sign is!! My belly lights up like it's on fire when he presses on the upper right quadrant and quickly releases his hand. OMG the freaking pain! Please don't touch me again Mr Doctor Man, but oh no, he does it once more for good measure. OWWWWWW!!!

"Ok," he says. "We'd like to go ahead and admit you. We're going to do an EGD sometime today, or tomorrow morning to rule out an ulcer. Then we'll keep you for a few days, possibly take out your gallbladder if your EGD is normal, or else get you started on a medication regime if we find an ulcer on the EGD. We'll get you admitted to a regular room and take it from there."

By this time, my boyfriend and our 4 year old daughter were both getting ansy to get out of the hospital, and since I was being admitted, I sent them both home, with a list of a few things I would need. I call my nurse-manager, let her know that I'm going to have to be on medical leave for at least 2 days, maybe more.

I sign the consent for the EGD, and within 5 minutes of my boyfriend leaving with our daughter, the fellow comes back and says that they're ready for my EGD. WOW! No time at all to process that. My heart starts racing as they wheel me back to the Endo Suite.

I start saying to everyone in the room, loudly, "LATEX ALLERGY!", because the one time I had an EGD, one of the over-eager residents snapped on latex gloves and was about to touch me before I just about flipped out on him for the latex. I really wish the hospital system had something in place that screams out to all providers "this patient has a latex allergy."

Dr V is my anesthesiologist, and she doesn't recognize me, but I recognize her. I remind her that I work in L&D, thus, that's how I know her. I ask her if she uses propofol for the EGD anesthesia, and she waves the magic milk of amnesia syringe in front of me. One of the nurses does a quick heart and lung auscultation, and comments on how rapid my heartbeat is. I tell her that I wasn't expecting to be back for the EGD so quickly! No mental time to prepare.

Propofol goes in, and I go out...................

I wake up in the recovery area of the Endo Suite, where an awesome nurse named Marti took care of me. It's the end of the day for them, by now, being that it's almost 3pm. I think there is only one other patient in recovery. Propofol is so sweet, because you wake up so quickly afterwards, and don't remember a darn thing from injection until waking up in recovery. Marti helps me up to pee, while we're waiting on my inpatient room. The fellow comes by, tells me that I had no ulcer, and they were going to take my gallbladder out the next morning/early afternoon. I sign a consent for that.

It was a long wait until my inpatient room was ready, because it was change of shift. Marti tried to call report, or call on the room status several times, but kept getting pushed off. Now it's 4pm, and Marti is pissed. She heads upstairs to see what the fuss is, and finds that it's not even busy or even full on the med/surg floor. She points out a private room that's empty, and manages to get me transferred to that private room. Which was accomplished by her diplomacy, and also mentioning that I'm an L&D nurse! (Yeah, being "in the system" already helps pull some strings, I guess!)

She wheels me up to my room, where I get settled in. I'm clear liquids only until midnight, then I'm NPO until after surgery. I'm on call as an add on for surgery for the next day. Still didn't need any meds for pain or nausea, as I just had a dull, vague ache.

The next day, Wednesday, operation day! I sit around in my bed, feeling rather blah as being NPO sucks big time, and being bored by the TV watching. Wait, wait, wait. See the surgical resident bright and early, who thinks I'll be done around noon. See another surgical resident later in the morning -- just how many residents does it take to round on preop patients?

Get my FMLA papers from the volunteer who comes around, fill those out, send them inter-office mail to the HR department. Give the medical certification form to my nurse, who clips it to my chart for the MD to fill out. Call nurse-manager for my unit, and let her know now that I'm going into surgery soon, you should be getting my FMLA papers, and I'll be off for at least 1 1/2 weeks, perhaps more, depending on what they find in surgery. Take a nap.

Finally, around 2pm, the transport guys come to bring me to OR holding. Of course, by now, my contact lenses are out, so I can't see a darn thing. My nurse comes in to give my heparin shot to me. Down in holding, all by myself - gosh it's lonely down here - I see a blur of blue scrubs - it's one of the new anesthesiologists, Dr B. He's ok, not much personality, and I've met him before on L&D. He tells me we're taking you back in a few minutes, reviews my history, I ask for some versed, por favor. God I love that shit. Makes you forget. Love it, love it. Got some versed, and away we go!! Weeeeeeeee!

Now I'm in the OR, and I'm feeling the love, man. Did I mention how much I love good drugs? Oooh groovy baby. Everyone is dolled up in their OR attire, and I do another "yo! Latex allergy here!" to let them all know. I don't remember moving from the bed to the OR table, but I must have done it myself. The big oxygen mask descends, Dr B tells me to take big breaths, and nighty night world! I'm outta here..............

Wake up to agony in my belly in recovery. Not as bad as my gastric bypass surgery, but bad enough. I get morphine several times. Sweet stuff. Send me back to oblivion baby. I ask for more, get more. Still hurts, but I don't give a damn. SCD's are in place, inflating, deflating. They were actually put on the night of my admission, so they're a comfort actually. Nice and rhythmic.

I'm back up to my room around 5pm-ish. My boyfriend got there while I was in the OR, and waited for me - I think. It's kinda fuzzy still, my memories. But I do know he was there that evening for a bit, before he headed back home. I was still getting morphine - but no PCA like last time - I have to ask for pain meds to get it. I'm also terribly nauseous, so I get zofran several times as well.

The nurse sits me up at the bedside, because I have to pee something fierce - no foley in place, you see. Big time pain and nausea, but I hobble to the bathroom anyway. Try to pee. Nothing. Go back to bed with assistance. Try bedpan. Nothing. Dang man, I gotta pee so bad now, my bladder is spasming up. I beg for a catheter, because of the spasms, and explain how this happened after I had bladder surgery once, on post op day 3, and needed catheterized in the ER. Blessed catheter is placed, and stays in for the night. Ahhhhh!! Sweet.

Later in the evening - no clue of the time - I start having chest pains and palpitations fierce. I thought I was having heart attack at the age of 34!! Call out for the nurse. They get a 12 lead EKG, which I'm assuming is fine, since I'm not placed on telemetry. Fade out....shoulder blades hurting....must be the CO2 gas used during surgery. Get more morphine. Manage to make it through the night unscathed, except for needing pain meds and more zofran.

The next morning, I start on vicodin for pain, still using IV zofran for nausea. Shoulder blades hurting. Get order for simethicone to break up the gas. Eat 2 bites of nasty egg, and two bites of nasty cream of wheat for breakfast. Beg for half a cup of coffee....get it, and barely drink a few sips. Absolutely no appetite, but I know I need to get some protein in.

Thursday passes in a haze. My boyfriend visits in the morning, and a friend comes by mid-morning, as well as again in the evening. Towards evening, I'm feeling better. Doc wants to send me home in the evening, but I'm worried about dehydration issues, since I've barely had 1 1/2 cups of water during the entire day. He's ok with me staying one more night, and I get bolused with IV fluids to help bolster my hydration status. Surgeon tells me how my surgery went, and tells me my gallbladder was huge! He fixed a hernia in the small bowel, and one in the mesentery. Oh yeah, foley was taken out in the early morning, so I'm going to the bathroom every 30 minutes to pee - all day and all night long. Doesn't allow for much sleep, but I do manage to sleep off and on.

Friday morning now.....more nasty breakfast. Blech. Not so bad lunch, but still only ate a few bites. Finally get sent home once my boyfriend comes to take me home, about 1pm or so. IV pulled out - weeee!! Vicodin script in hand, I add some Gas-X to my boyfriend's list of "get me these things at the store when you fill my script please", and home I go.

And that, folks, was my 4 day trip to the hospital. Not as much fun as a vacation, but at least I got some good drugs.