When you're sitting in the surgical waiting room for the third time, it's like no time has passed in between. I remember that stain in the carpet in front of the middle chair in the third seating area on the left. I know where the coffee is, and where they keep the extra tissues. I know how to watch the large screen schedule monitor that displays the current status of each operating room in a coded color with the patient's six digit tracking number that is updated every 45 seconds and tells you absolutely nothing.
I know how to make pleasant small talk with other people who are watching the same tracking number I'm connected to.
I am a professional.
I arrived at Rich's bedside at 05:45 this am because surgery was scheduled for 08:00 and … I am a professional. His room was a flurry of activity because pre-surg was on their way and they were packing up his belongings and getting ready to transport him. Rich and his nurse were so relieved that I got there in time to see him before they took him away. Once we get him ready to go—no easy task with 5 different IV drips through two IV pumps, and a cardiac monitor and four bags of stuff. Where did the stuff come from? He was admitted a week ago with nothing except the clothes on his back and now I'm schlepping four bags of stuff.
We had some quality time together once he was packed up and we waited for them to come for him. And waited. At 08:00 the anesthesiology team was wheeling him down the hall and I was sent packing. At the elevator I saw his surgeon in suit and tie, coffee in hand. He was actually glad to see me because he couldn't find Rich. Someone forgot to tell Dr A. that Rich couldn't go to pre-surg (where the doctor likes to talk to him before they are both prepped for surgery) because he's on a cardizem drip so he had to go straight from his room to the OR.
There was a time that such lack of organization and communication would have made my face pop off, but not any more. I am a professional. And knowing that Dr A is in charge leaves nothing to worry.
At 09:30 our beeper buzzed and I'll admit to a flash of panic. It seemed too damn soon for Mission Accomplished. I'm no doctor but how the hell do you disconnect the stomach from the duodenum, re-route the small intestine and make a brand new connection to the stomach in 90 minutes including prep and close?!?!?! I did not voice these thoughts however because I am a professional.
So we gathered in Conference Room #3 and in less than a minute Dr A was there and informed us immediately that all went exactly as planned. He drew the whole procedure on the dry-erase board in front of us and told us what happens next and answered my questions. I knew what questions to ask, and what not to ask because those questions don't have answers. I am a professional.
At 11:30 I went to the info desk because the large screen schedule monitor shows that Rich's tracking number has turned green, which means “Discharged from OR” for over half an hour now. Last time he had surgery no one told us he was back in his room for over two hours and there he sat waiting for us. So I ask at the desk and they tell me they're getting ready to transport him. Maybe getting out of surgery takes as long as getting into surgery.
It's now Noon. Leaving surgery has now taken almost twice as long as the surgery itself.
I'm just hoping I'm not the first one to tell him that he's not getting anything to eat real soon. He has not had food in over five days. He's not had a beverage in four days and they took away his water and ice chips over 48 hours ago. All he's had is mouth swabs and mouthwash and that's contingent on his solemn word that he will not swallow. There's a really good joke there, but I'm too tired to flesh it out.
Once the vomiting stopped he started getting pretty hungry. He said he dreamt about food all night. He's too hungry to worry about the surgery. He told me this morning that “if someone were to bring me a tray of food right now, I'd get an erection.”
Really. Good to know.
Personally, I would like a nap right about now. I was not ready for my 04:00 wake up. The act of sitting and waiting is not what I would call invigorating. The ideal situation would have been for me to crawl into his bed when he left for surgery and then I'd be right there waiting for him when he got back.
In my head (where the voices stay when we're not in the van) I keep replaying Dr A's words. There is no cancer in the stomach. The tumor just grew and squeezed the opening between the stomach and the duodenum. Eventually the opening was completely shut off and there was nowhere for anything to go except back the way it came. Which created an ulcer at the top of the stomach near the esophagus. And this didn't all just happen in the past week since the vomiting started. It's been quite some time in the works. First noticeable a few months ago when he was popping TUMS a dozen times or more through the night. I would blame myself but no one else caught the problem and THEY were looking at the CAT scan. I don't blame them either. It just is what it is. With what magical insight do you go from reasonable symptoms of cancer, to maybe it's a stomach virus, to wholly shit, the plumbing is totally plugged.
It's been less than a year since Dr A cleaned the abscess out of his liver, so I have total confidence when he tells me that “the tumors haven't gotten much bigger”. And he said the unaffected side of the liver looks VERY healthy. I detected a note of amazement in his voice as he detailed everything that looked good. Apparently I do not have a “poker face” because he quickly, albeit gently, reminded me that “you do understand we will reach a point when we can no longer fix it.”
“Absolutely,” I nodded. “But TODAY you did.”
The he smiled. “You know,” he said, “Rich is my longest living pancreatic cancer patient. No one else even close. If I can get another year for him I'll be thrilled.”
I wish I could convey to you how incredibly humble he looked and sounded as he said those words. Not many people know this, but Dr A's father was a brilliant and beloved surgeon in this area. I don't know if it's true or not, but someone told me his dad died of pancreatic cancer.
This was Dr A's third journey into my husband's viscera. It's become an annual event. I think he saw the difference in me today compared to the first time. Even the second time. He didn't seem cautious with his words to me. He was frank and I was tearless. We were like two seasoned soldiers discussing the latest battle of the war.
At 12:30 we went to the desk again. Rich left recovery an hour ago and is in his room.
Really? Good to know.
The man is in tremendous pain, and he's not a complainer. In fact he does everything he can to stifle his moans. I know he's in pain because I know him. On a scale of 1-10 I would call it 7, leaning on 8. Considering it's 45 minutes after his morphine, I need to take action. Luckily the internist comes in to check him because being present in the room for a minimum of 45 seconds is a prerequisite for the $250 bill we'll be getting. She listens to his heart (he's on a heart a monitor) and asks him how he's doing. His knuckles are white and he manages to mumble "...hurts..." She nods like she gets it only I'm not thinking she gets it. I ask with honey dripping from my mouth if she would be ever so kind and change him from morphine, which has never worked for him, to dilaudid which works perfectly, ending my request with an oath of undying gratitude and a hint of future donations to her favorite charity. I was ready to genuflect before her, but she quickly assured me the med change would not be a problem. Why, you may ask.....? Because I am a professional.
An hour of blissful dilaudid delirium.... he's no longer writhing, guarding or moaning. He's drifting peacefully in and out, no longer complaining about the pain or asking them to remove the catheter and the nasal tube draining his stomach. Perhaps he's visiting his friends, the Hedgehog People. Anytime now he may burst into song and I will have Christmas in June, or be introduced yet again to everyone in his third grade class.
I've learned from experience that I just need to get him through these first twenty-four hours post-op and then he'll begin the most amazing rally his nurses have ever seen.
I have shined it on for all necessary parties, orders are in place, and he's in excellent care. I could even go home and take a nap. In truth I'm reaching the point where I just need to leave so I can have my BIG Cry. Not a big cry, or a Big Cry...this will be the BIG Cry that follows every miracle we get, all in preparation for THE BIG CRY. So I will drive home with the Voices and have my post miracle BIG Cry, after which I will be exhausted but unable to sleep because of feeling guilty about leaving his bedside.
Seriously.
I'm a professional.
Friday, June 17, 2011
Monday, June 13, 2011
It's Summer, McGee is on Vacation, so Rich is in the hospital....
That's how THAT works.
The bad news is that nothing has changed in his condition. The good news is that he has the BEST doctors on it.
He's been vomiting since admission, nothing is staying down, and that's on a phenergan drip!! But his surgeon has “a feeling” that the tumor is pressing on the area where the stomach dumps into the small intestine so his stomach isn't draining properly and backing up. They're going to do a test that can confirm this. Waiting for that. Then Dr A. can go in and re-route the stomach to the small intestine. If anyone knows' Rich's viscera, it's Dr A. This will be his third time in.
I'm going to give you all a break and spare you the medical details of what we're dealing with and how we got here. Bottom line....it's summer, McGee was on vacation last week so.... Seriously. Just a few weeks ago, you may recall, Rich had a CAT scan and saw each of his doctors and they said "I'll see you in September." That was a great song from the Sixties but it's not working for me so much.
I think I need McGee's vacation schedule. Not trying to invade his personal space, I would just really appreciate a clue as to when the cancer is going to rear it's ugly head. Apparently, McGee is such an amazing oncologist that his mere presence keeps the evil cancer bastard at bay. Wow. Do I know how to pick the right doctors or what?!
I have a plan. It involves five gallons of gasoline and the same paving material used for high school running tracks. For the third summer in a row I'm facing a huge mound of mulch in my front yard and a crop of weeds that have almost completely taken over the flower beds and paths in the back yard, and all work to bring the two together has once again come to a screeching halt before it really began because Rich is looking at surgery. Rich is assuring me, between morphine injections, that he'll have the garden under control in no time.
Right.
For the third year in a row I can pretty much guarantee that it will be November before the mulch pile has oozed its way to the backyard, the weeds will have mutated five generations into a massive green Hulk and I will be looking forward to a blanket of snow. I'm good.
I say let's level it and pave it. Not only will the maintenance level reach a manageable level, the grand kids will LOVE the Big Wheeling potential.
I need to gradually ease Rich into the concept. Obama's got his campaign, I've got mine. Equally daunting. So I casually, in a joking tone, serve this dream to Rich this evening. Cuz, when you've got a morphine IV push for gravy, you can serve black top for dinner. Oh wait...he's not keeping anything down.
I know I'm not gonna win out of the gate—I've got several primaries, secondaries, and at least one tertiary to campaign my way through. But his response did blind side me. He said...because I can't make this shit up..... “We can't do that...it would ruin the resale value of the house.”
Dude. Are you fucking kidding me?!?!?! In what possible state of mind is the resale of our house a factor of ANYTHING? Oh, and yeah, the incredible creeping green Hulk in the backyard is going to give the real estate agent a woody.
Luckily, in MY state of mind I can keep it real. Focused on Rich's beloved garden slipping further into the valley of despair, feeling that the weeds aren't just strangling the peonies, they're strangling me as well. I know I'm not going to win this campaign, I'm just tired of the weeds.
The bad news is that nothing has changed in his condition. The good news is that he has the BEST doctors on it.
He's been vomiting since admission, nothing is staying down, and that's on a phenergan drip!! But his surgeon has “a feeling” that the tumor is pressing on the area where the stomach dumps into the small intestine so his stomach isn't draining properly and backing up. They're going to do a test that can confirm this. Waiting for that. Then Dr A. can go in and re-route the stomach to the small intestine. If anyone knows' Rich's viscera, it's Dr A. This will be his third time in.
I'm going to give you all a break and spare you the medical details of what we're dealing with and how we got here. Bottom line....it's summer, McGee was on vacation last week so.... Seriously. Just a few weeks ago, you may recall, Rich had a CAT scan and saw each of his doctors and they said "I'll see you in September." That was a great song from the Sixties but it's not working for me so much.
I think I need McGee's vacation schedule. Not trying to invade his personal space, I would just really appreciate a clue as to when the cancer is going to rear it's ugly head. Apparently, McGee is such an amazing oncologist that his mere presence keeps the evil cancer bastard at bay. Wow. Do I know how to pick the right doctors or what?!
I have a plan. It involves five gallons of gasoline and the same paving material used for high school running tracks. For the third summer in a row I'm facing a huge mound of mulch in my front yard and a crop of weeds that have almost completely taken over the flower beds and paths in the back yard, and all work to bring the two together has once again come to a screeching halt before it really began because Rich is looking at surgery. Rich is assuring me, between morphine injections, that he'll have the garden under control in no time.
Right.
For the third year in a row I can pretty much guarantee that it will be November before the mulch pile has oozed its way to the backyard, the weeds will have mutated five generations into a massive green Hulk and I will be looking forward to a blanket of snow. I'm good.
I say let's level it and pave it. Not only will the maintenance level reach a manageable level, the grand kids will LOVE the Big Wheeling potential.
I need to gradually ease Rich into the concept. Obama's got his campaign, I've got mine. Equally daunting. So I casually, in a joking tone, serve this dream to Rich this evening. Cuz, when you've got a morphine IV push for gravy, you can serve black top for dinner. Oh wait...he's not keeping anything down.
I know I'm not gonna win out of the gate—I've got several primaries, secondaries, and at least one tertiary to campaign my way through. But his response did blind side me. He said...because I can't make this shit up..... “We can't do that...it would ruin the resale value of the house.”
Dude. Are you fucking kidding me?!?!?! In what possible state of mind is the resale of our house a factor of ANYTHING? Oh, and yeah, the incredible creeping green Hulk in the backyard is going to give the real estate agent a woody.
Luckily, in MY state of mind I can keep it real. Focused on Rich's beloved garden slipping further into the valley of despair, feeling that the weeds aren't just strangling the peonies, they're strangling me as well. I know I'm not going to win this campaign, I'm just tired of the weeds.
Sunday, June 12, 2011
Really?/?????
s Rich is in the hospital.
He's on the oncology floor of AGMC. It doesn't get any better than that if you have to be “there”.
It's the weekend so I can rest assured that “no harm will be done”. On the weekend, everything is in the hands of the nursing staff so I'm resting really easy. On Monday Dr McGee will be back. For reasons I cannot explain, I feel peaceful.
They are hanging phenargan drips and still he's battling with nausea/vomiting. When IV phenargan doesn't control nausea and vomiting...it's like something holey unearthly is at work. They are getting lab results and nothing is making sense. I chuckle. Welcome to my world. Hours prior to his admission his vital signs denied dehydration; only blood work done in office suggested “holy moly this guy is seriously dehydrated.”
I talked to Rich just a few minutes ago. He tells me that he felt like something was wrong with his heart, so he asked the nurse to take his pulse and it was 48, so staff jumps to high alert and they do an EKG and he's in sinus rhythm but his pulse is way too slow so they adjust meds. Yay Rich!!!! Now they have him on a cardiac monitor.
I've been talking to my peeps the past few days and they all express what I am thinking. He is puking up the cancer. I'm not sure what this means. What I do know is that the thought of going back to the hospital to see him makes me physically ill. He doesn't remember his last hospital stay. I remember it in excruciating detail. The thought of returning to that place ignites a major PTSD event that alarms me in spooky ways. I'm working mightily to deal with it and it ain't easy. I feel like I need to rely on Dr McGee and Dr Peiffer and trust that they both have traveled with us far and long enough to know what the next step should be.
Please know what the next step should be, because I sure don't. I'm just so fucking tired. If I have to kick it into high gear I will, but one of the voices keeps telling me that this is okay and I can coast through it because this is just a blip.
I lie. The voice isn't telling me this is just a blip.... the Voice is telling me that Rich is puking up the cancer. The voice is telling me that I need to back away and let him “Git 'er done” Absolutely NOTHING scientific validates the voice in my head and the message in my heart that this is okay....He is purging all the poison. I've been praying for so long for a miracle that maybe I'm just a bit too anxious to jump on this. Who will suffer from this delusion other than me?
But I talked with Rich today and he's laughing and joking with me about how confused and confounded the medical staff is by test result vs. symptoms.... nothing makes sense... no clues... and all I can think is please do no harm until Dr McGee is back and we can re-formulate reality according to Rich.
This is where I float. I'm cleaning my house because that gives me comfort and a sense of control. I'm struggling between faith and “reality”. The two are becoming a liquid goo and between that and my battle with mosquitoes I'm navigating towards a hot shower.
This SUCKS, this BITES, this BLOWS!!!
When I close my eyes I meditate myself into a swing that Miss Elizabeth Bennett could lose herself in waiting for Mr Darcy. I swing between magic and reality, and I want to keep swinging because I am so terrified of where I will land when the swing finishes it's dancing arc.
If only I had the music of Melanie Safka as I did in my ancient teen years to comfort me through this. I refuse to relinquish my blind faith that Richard and I are moving deeper into the Mystery.
It's all I have right now. Thankfully, it is enough.
He's on the oncology floor of AGMC. It doesn't get any better than that if you have to be “there”.
It's the weekend so I can rest assured that “no harm will be done”. On the weekend, everything is in the hands of the nursing staff so I'm resting really easy. On Monday Dr McGee will be back. For reasons I cannot explain, I feel peaceful.
They are hanging phenargan drips and still he's battling with nausea/vomiting. When IV phenargan doesn't control nausea and vomiting...it's like something holey unearthly is at work. They are getting lab results and nothing is making sense. I chuckle. Welcome to my world. Hours prior to his admission his vital signs denied dehydration; only blood work done in office suggested “holy moly this guy is seriously dehydrated.”
I talked to Rich just a few minutes ago. He tells me that he felt like something was wrong with his heart, so he asked the nurse to take his pulse and it was 48, so staff jumps to high alert and they do an EKG and he's in sinus rhythm but his pulse is way too slow so they adjust meds. Yay Rich!!!! Now they have him on a cardiac monitor.
I've been talking to my peeps the past few days and they all express what I am thinking. He is puking up the cancer. I'm not sure what this means. What I do know is that the thought of going back to the hospital to see him makes me physically ill. He doesn't remember his last hospital stay. I remember it in excruciating detail. The thought of returning to that place ignites a major PTSD event that alarms me in spooky ways. I'm working mightily to deal with it and it ain't easy. I feel like I need to rely on Dr McGee and Dr Peiffer and trust that they both have traveled with us far and long enough to know what the next step should be.
Please know what the next step should be, because I sure don't. I'm just so fucking tired. If I have to kick it into high gear I will, but one of the voices keeps telling me that this is okay and I can coast through it because this is just a blip.
I lie. The voice isn't telling me this is just a blip.... the Voice is telling me that Rich is puking up the cancer. The voice is telling me that I need to back away and let him “Git 'er done” Absolutely NOTHING scientific validates the voice in my head and the message in my heart that this is okay....He is purging all the poison. I've been praying for so long for a miracle that maybe I'm just a bit too anxious to jump on this. Who will suffer from this delusion other than me?
But I talked with Rich today and he's laughing and joking with me about how confused and confounded the medical staff is by test result vs. symptoms.... nothing makes sense... no clues... and all I can think is please do no harm until Dr McGee is back and we can re-formulate reality according to Rich.
This is where I float. I'm cleaning my house because that gives me comfort and a sense of control. I'm struggling between faith and “reality”. The two are becoming a liquid goo and between that and my battle with mosquitoes I'm navigating towards a hot shower.
This SUCKS, this BITES, this BLOWS!!!
When I close my eyes I meditate myself into a swing that Miss Elizabeth Bennett could lose herself in waiting for Mr Darcy. I swing between magic and reality, and I want to keep swinging because I am so terrified of where I will land when the swing finishes it's dancing arc.
If only I had the music of Melanie Safka as I did in my ancient teen years to comfort me through this. I refuse to relinquish my blind faith that Richard and I are moving deeper into the Mystery.
It's all I have right now. Thankfully, it is enough.
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