All The Gory Details

Thus did my week at Penn State resort begin. Forgive me if I ramble a bit, I'm still pretty doped from the few drops of Delotid they gave me yesterday (I'm such a lightweight). Hopefully some of these details will help someone else headed down the same path at some point. And I don't know about you, but it helps me to actually see pictures when someone's going through a medical thing so I have an idea of what is happening. Nothing here is really gory (unless you count the shirtless pic of me further down).

Christie was up a 6 to rally the boys, pack bags, and dig a trench to the van. It snowed A LOT this last week (with more to come) so shoveling has been a daily chore. Nothing is melting so we've got an ice-under-snow situation. While I finished packing my stuff for the week, she and Rich went to work digging the van out.

 We have a garage, but it has snowed so much that the alley 

behind the house to which it's attached is a solid sheet of ice with mud beneath.

Rich really does take it upon himself as much as he can, for which we're so grateful.

  

And this:

Christie and Rich have also been clearing our elderly neighbor's walk and drive while she's in the hospital, and she generously offered for us to use her driveway until the alley and garage pad melted.

And the house looked like this:

 

Though you can see that once out of the driveway and our street, the roads were pretty clear to the hospital:

When we arrive, I check in while Christie parks. The boys know the drill - they head to the waiting room and log onto the Penn State wi-fi to play Minecraft with friends, or play DS, or read a book. I'm usually the first cath of the day so the place is empty most of the time. 

First things first, I need a port for anesthesia, labs, etc. For this part, you want Matt. You do not want Bill. Matt is a good stick and knows exactly what he's doing. Bill, on the other hand, learned to place ports at the Helen Keller school for Medical Hopefuls. And he was in the remedial class. Bill couldn't find a vein with a Garmin handheld, a flashing runway, and an arrow tattoo saying "INSERT NEEDLE HERE." Bill, in short, sucks not only as a nurse, but at life in general. Bill blows veins. Bill pierces veins. Bill has to have someone else do the stick for him because Bill is incompetent. Not to put too fine a point on it, but Matt = good, Bill = shouldn't even apply for a job sticking straws through the X's on the plastic lids for Styrofoam cups. 

But eventually one of his colleagues (read:babysitters) manages to get the port in. They wheel me into the cath lab and make me woozy with a mix of Phentenol and Versed. Once this kicks in, it is typically a painless procedure with a little pressure on your neck at times. Yesterday, the doctor inserting the cath met with scar tissue from the last 3-5 caths I've had, and was forced to push really hard to get the sheath and wire in. The procedure is two-fold: first, a short, rubber sheath is inserted as a guide for the wire (or "cath" that will run down the artery and into my heart). The sheath is pliable and therefore if it meets with any resistance has to be forced aggressively into place, which is what happened yesterday. This caused a considerable amount of unexpected pain. However, the cath went in easily after that and I was returned to recovery.

In recovery, Lucy in the Sky with Diamonds playing in my head. I think I also talked about how cool my hand looks.

As the anesthesia from the procedure wears off, it begins to dawn on me that I've been stabbed in the neck, albeit by a group of well-meaning professionals. Where there should be a standing order for pain meds, I inform Bill that I will need some Tylennol (at least) because of the normal pain, not to mention the now throbbing tissue surrounding the the cath site where the doc had to man-handle the sheath to get it in. Thus commenced a 45 minute dance routine known as the "Hem-Haw" while Bill tried to suss out how the phone works. Or whatever. Matt = pain meds in 15 minutes from first request. Bill = discussion about pain meds 45 minutes after first request accompanied by multiple asinine questions about what "number" the pain is at. After explaining that on a scale of 1 to 10 mine was around Get Me Drugs or I'm Going To Tear Out Your Spleen With This Urinal, he finally trotted off to call the doc for pain meds.

Pre-narcotics

Post-narcotics. Have I mentioned how cool my hand looks?

You must know that Penn State is AWESOME. The doctors are brainiacs with incredible bedside manner, the nurses are sharp, pro-active, and compassionate, and even the people who clean the rooms are super-friendly. I love the place. Then there's Bill. But I digress. After a debacle involving a broken call button, a missing urinal, a sports car, and a barbershop quartet, I was taken up to my room (I'm making up zero of those things. Tune in next time for details).

Upon arrival I'm greeted by Sara, one of my favorite nurses on the IMC ward. Most of them know me by name now and she was on top of the pain meds and getting the room settled before Bill got the bed out of the room. It was so good to see her - recovery was not fun yesterday. Now she runs around for about an hour making sure my numbers look good, getting my med schedule fixed so it doesn't keep me up all night, deals with the room temp, food, drink, blood work, and about a dozen other things.

This is actually from day two - note my laptop setup so I can entertain myself for hours by trolling people on Facebook. I mean, by watching movies. I watch movies.

 At this point I'm usually awake enough to start contemplating the placement and configuration of the swan cath in my neck and whether or not the dressing is going to last the week (it wasn't, so Sara and Johanna, another great nurse replaces it).

What you see here is the yellow cap on the end of the catheter - that's where the long, plastic wrapped yellow wire is coming from. This line is used to draw blood, administer some medications, and since the other end of it is in my heart cavity, it can measure cardiac output. So I only get stuck twice - once for the anethesia for the procedure, and then this other time in the neck. After that everything goes in and out through this tube. The part that looks like a gold ball is where it's actually going into my neck. The bandage around it is simply to keep it sterile and isolated - the one on my shoulder is just to keep the tube itself from flopping around. You would think this would be incredibly painful, but once the initial inflammation calms down, I can generally go the rest of the week without any pain meds at all.

This tube branches off into 9-10 other tubes that are used to administer heparin and saline drips, dopamine and delbutamine (the inotropic drugs that I am required to take to meet UNOS transplant criteria for "1A" status time), as well as several ports used to draw blood for labs and inject Bumex (my diuretic). The rat's nest of tubes and connectors all lead to here:

This is Dr. DooDaa. He follows me wherever I go. Each of the little boxes regulates the frequency and speed of the drips from the bags hanging from his hat so I don't get too much too fast or too little too slow. Or vice-versa. He also has a love handle in the middle that holds my phone, urinal, and the index fingers of nurses who don't get the stick the first time. 

I'm also hooked up to a heart monitor which allows the nurses to see my cardiac activity from four different points in the hall as well as at their station.

Meet Boing. So named because if one of those leads come off or he gets unplugged, he relentlessly boings at you until you put him back together. Like a car alarm except this one brings half the nursing staff running with paddles and Epinephrine injections.

Meet Four-Eyed Bob. Bob lives above my bad. He isn't very talkative but since I tend to dominate the conversation anyway, it works well for both of us. Bob may look like a four-eyed simpleton, but he and I have had some very deep conversations about things like stem cell research, artificial hearts, John Boener's freakishly orange skin, various mystery meats (he doesn't know what animal the jellied, gray patties come from either), and the meaning of life. Bob also doesn't like Bill very much, so we have that in common.

The other adventure here is the food, as I have made well-known to any who will listen. I'm supposed to be on a "low-sodium" diet and the cafeteria is apparently on a "low-cost" budget. They've solved their problem by serving sodium-laden, super-processed, and often unidentifyable food-like substances, but only giving the patients 1/3rd of a serving of said substances. While it probably keeps them under-budget, the patients are typically grossed-out and hungry, and I'm ashamed to admit, often so hungry I just eat the stuff anyway. I've tried fasting, food-strikes, and leaving helpful notes for the "chef" (my apologies for using this term to describe the individual responsible for this. You short order guys at McDonald's are heroes. Carry on). The hunger pangs eventually wear you down and you find yourself trying to decide if the marbled yellow meat tastes more like raccoon or kangaroo. Probably whichever is cheaper.

In order of appearance from left to right: Orange flavored corn juice, warm milk, egg "product" with reconstituted potatoes and some green things trying very hard to resemble chopped bell-peppers. Cold coffee, corn syrup molded in the shape and color of a blueberry muffin. Fruit cup with actual slices of honeydew melon. Salsa with what I'm sure is tomato paste and powdered onion as its base (since when does salsa taste like unsalted marinara sauce?) Oh! And the package of low-sodium. low-fat, low-gluten, all natural organic Mrs. Dash containing exactly 4 specks of pepper, a flake of oregano, and 3,000 mg of MSG. It makes your food taste exactly like it did before you sprinkled it on in great hopes that somehow it would increase the quality and flavor, when in actuality it only increased your chance of developing stomach cancer. Hoho, that Mrs. Dash is such a hoot!

How long can I sustain myself on saltines and Hershey kisses?