Wednesday, March 26, 2008

Complications, Complcations All Around

I have spent the last week and a half dealing with, and meditating on, the "small problems" which sometimes accompany surgery. I had one (a small problem) a week and a half ago that sent me by ambulance first to my local hospital, then later in the day, again by ambulance, to Yale New-Haven Hospital where I had my original surgery done Feb 28th.

I had figured I'd already had my "small problem" when same day surgery turned into a four day stay in the hospital, with the addition of four units of blood transfusion. (And, thank you, one and all, who donate blood. I really do appreciate "the gift of life.") I had returned home, lived carefully through the next week or so, had my two week check up with Dr. God, the plastic surgeon, and returned home exhausted but thinking I was healing.

(Now if you are really squeamish about blood and gore, either skip or skim the rest of this.)

The next day I woke up in a large pool of my own blood and gore. Luckily the Visiting Nurse was due soon, so I sat, keeping pressure on both sides of my wound until she arrived. And she quietly panicked, even while she efficiently took over. She cleaned me up, put pressure bandages on me, called the ambulance and promised to put out extra food for Roxy as they wheeled me away.

Emergency Rooms are very boring-hurry up and wait alone-and I had not had the wherewith of mind to grab a book. Four hours later the ER doc at my local hospital told me the obvious-I needed to go to Yale-and eventually another ambulance came to take me away. I was still bleeding, but quite well bandaged by then, thanks to a passing nurse. Yale ER is much crazier than my local hospital. I waited 2 hours for their ER doc, even though my surgeon's residents knew I had arrived. They turned up two hours after the ER doc and gave me the lie that "this is just one form of a normal problem, don't worry, it'll stop by tomorrow morning" then disappeared, after sticking gloved fingers into the three holes out of which I was bleeding. Two hours after that I finally got the pain med the ER doc had ordered, and was moved out into the hall to wait for a room.

I was actually one of the lucky ones because an hour later a bed opened on the surgical ward, and they put my name on it. By the time I was wheeled up to it, the hospital was full, leaving many others to spend the night down in the ER. Unfortunately, I arrived at the change of shift, so I spent two more hours, lying in my own blood and clots, desperately needing a bedpan. Help finally arrived at 1:00 AM, in the form of a horrified nurse, who cleaned me up, called for the on-call doc, demanded something be done, and (when told this was a variation of normal and they wanted me to pass the clots) said (to me) no way was this normal, nor was I going to bleed out on her time. She put on pressure dressings (not what the resident doc had wanted), and handed me heavy pain meds. Bless her, her name was Melissa, and I am deeply grateful to her.

The next morning, the whole pantheon of residents and interns and hangers-on appeared at my bedside to reiterate the lie, this is all part of normal, as they again tried to pull clots out my holes with gloved fingers. I needed to be lightly dressed to draw the clots out, they said, not to worry they had it all in hand...while I, going on no sleep at all, tried to form intelligent questions about all the blood I was losing along with the blood clots. They hushed me, placating me until I felt stupid, and left while I was still trying to explain about the amount of blood I was losing.

Twenty minutes later, it was clear their light dressing were not a good solution, for once again I was passing a huge amount of bright red blood along with gigantic clots. Luckily, I am not squeamish. I rang for my (new) nurse, demanding that she call them back. She freaked a bit at the amount I'd bled in 20 minutes, cleaned me up, called them back, then left the room to have a heated argument outside my door, explaining that at the very least I'd need two units of blood to make up for what I'd just lost. Two residents returned half an hour later, when I had once again bled through the pressure bandages, and the chief resident said, quietly, "Oh, I didn't realize it was bleeding this much, this isn't normal at all, in fact it's almost unheard of for someone to bleed two full weeks after surgery." This out of the mouth that had been assuring me (lying to me) about "variations of normal" for 15 hours!

I was enraged, and said so. Four units of transfused blood and nearly eight hours later, the word came down from on high (my surgeon, Dr. God, who did not put in an appearance until three days later) that they would not do surgery, hoping that packing me would staunch the bleeding, but not stop the clots, which needed to drain out. That was Friday morning.

By Monday I was threatening to die of terminal boredom, so they sent me home Tuesday, feeling as weak as I did when they sent me home the first time. I did manage to keep a happy front up to Meg, and all the rest of the family because my mother, poor woman, was back in the hospital in Littleton, CO, due to "confusion caused by her meds" and uncontrollable diarrhea. She ended up having back surgery the day I came home, to fix a couple of her ruptured discs, in hopes this might help with her other problems. The family has been all riled up over her situation, so I downplayed mine.

And, indeed, mine is no longer acute. I have a visiting nurse come daily to put in a drain in one bad hole (I can do a lot of medical things to myself and others, but simply cannot use a sterile Q-tip thingy to stick a couple of inches of gauze drain into a hole in my side) Today I go back to Dr. God, who will look down his patrician nose at me as assure me (as he did the day before I started bleeding) that all is well, and I am on my way towards healing.

Yeah, in rereading this, I can see how angry I was, and still am, although it has dissipated some with time and less pain. I am no less susceptible to post-surgical problems than anyone else, but part of my rage was at their inability to understand that I was really in trouble, though several nurses backed my story up. These residents and interns will soon be out there as full fledged doctors, not listening to their own patients. And Dr. God only got second hand reports during the time I was really bleeding. He turned up the day before I left to inform me they had it all under control now. (Duh, I could have told him that.)

I did have several wonderful nurses, who took on the docs for me, demanding they get back up to see me, right now!, and others who just took really good care of me. My first 18 hours there were pretty scary; I was discounted and placated and lied to and ignored (nobody should lie bleeding heavily for two hours, despite speaking twice to a nurse and ringing the bell several times, and I did make a formal complaint about it). The scary thing is that we have one of the best medical systems in the world, and I am grateful to live here. I am also thankful to have good insurance and a fair amount of "consumer savvy" due to the number of surgeries I've had. (Too many!)

Whine, whine, piss, piss, moan, moan. I actually am quite grateful to be through the worst of all this, and though I am still exhausted and in pain, I am beginning to perk up and take a small bit of interest in the world of J-Land again. I'll be around a bit more, and am looking forward to reading journals again.

Blessings, Margo

1 comment:

Becky said...

Oh Margo...this is horrible! I think you are like me. Too nice. There is something to be said for how some of my friends are. They are labled "bitch" because they don't tollerate any nonsense, shoddy workmanship, badly prepared food, or doctors/nurses who don't pay attention. Me? I never send food back. If I get something mail order that has a flaw, invariably I'll just keep and try to fix it as best I can. I don't make waves. I don't want to cause a flap. I don't want to inconvenience people, even when *I* am being inconvenienced. We make great patients, because we resist ringing the buzzer and we rarely complain. But it's at the expense of our own health and well being. There is something to be said for being a "bitch". I hope you start feeling better soon.