Lead Me To the Water

"He supposed that even in Hell people got an occasional sip of water , if only so they could appreciate the full horror of unrequited thirst when it set in again."  - Stephen King (Full Dark, No Stars)

Soldiers, service personnel, nurses, sports team members, and band members all develop a common bond over time that indelibly commits them one to another for a lifetime. In the hospital, regardless of whether the patient is a transplant recipient or TAH patient we are tied by a bond stronger than blood. Stronger than memories of war or impossible victories. The bond of which I speak is...thirst. Insatiable, soul sucking thirst. Much like this guy:

Many surgeries require the patient to be pumped full of saline, so when you hit recovery, you're generally carrying several pounds of fluid you didn't start with. If you were already fluid overloaded when you went in (and we all are), it compounds the problem of recovery. So the docs want to get the fluid out, and they want to do so aggressively. This means a fluid restriction. Typically in the realm of 1.5 to 2 liters per day. Imagine one and a half to two Gatorade bottles. I do. Often. Mmmmmm....Gatordade....let's all stop and consider the savory, wet, thirst quenching glory that is Gatorade while you ponder how little fluid that is in a day. 

Note all the cold, cold, wet ice that will melt into water. Water that someone could drink. Right. Out Of. The. Bucket.

So it's pretty easy to drink 3 liters or more in a day without even thinking about it. 2 liters is do-able until you consider that everything counts. Everything. Fluid used to swallow pills. Soup. Popsicles. Ice chips. Everything. If you split the fluid allowance into three parts, it's just enough for a decent drink at all three meals. Until you add all the pills in. Plus, most of us grab something between meals 3-4 times a day. 

I don't embrace much of Southern culture, but I'm from the South, ya'll. And in the South we drink tea. Lipton iced tea. Sweetened Lipton iced tea. And lots of it. If a restaurant in the south doesn't have sweet tea, it doesn't last long. Babies drink it in their bottles. Cold brewed, mounds of sugar, in a tall clear glass full up with ice cubes.

The agony of trying to get through a sleepless night without any fluid is one of my most difficult challenges. When I hang out with other heart patients these days, I guarantee thirst is pretty much the primary, and often only, topic of conversation. We've all learned which nurses will actually not count Freeze Pops as part of your intake. Let's stop for a moment and remeber the nostalgic, corn syrup based, fruit flavored icy pop that we all know and love. Think of the small bits of frozen tubular ice slowly melting on your tongue, running down the back of your throat. The burning sensation that often follows. I know I am. 

Orange and grape are the best, but any flavor will do really. They're all cold. They all melt. They are all glorious.

Some of you no doubt take the Fla-Vor-Ices in your life for granted. You just sit there in your house, with your freezer filled to the brim with all manner of ice cream, popcicles, and fruit pops. You grab one and chomp it down, casually disposing of the package, and go on with your oh-so-perfect lives. 

Not us. 

A Fla-Vor-Ice is a 120oz. treasure of fluid intake. We snap off 2 inch pieces, slowly, one at a time, and let it sit on the tongue, so there is a maximum amount of salivating and mouth wet-ness. Once the ice itself is gone, there is still some leftover juice in the package. Corn juice, but liquid nonetheless. We don't throw that away. We suck until our eyes are going to pop out, then inflate the wrapper by blowing into it, causing precious drops of fluid to run down the tube onto our parched tongue. When it is gone, we are sad. 

Next we turn to hard candy. We don't crunch it, we don't chew it. We tuck it into our cheek or under our tongue, trying to coax as much saliva out of our glands as possible with these little pieces of Jolly Rancher heaven. Let's stop to consider how sweet, how tangy, how wonderfully sour and juicy these little pleasure nuggets are. I know I will. 

Generally, nurses don't count candy as fluid, so we can go through a bag of these in a day. 

If we get a drink with ice in it, God help you if you dump the ice once the drink is gone. I've taken nurses to task over the 30 mls of ice in the bottom of my juice glass that better be credited back to me. I will count ice cubes if I have to. Don't push me. I'm thirsty. 

One of the best things to happen in the midst of this is that I realized I can drink a Mountain Dew without worrying about the caffeine any more. I'm having some blood sugar issues, so it's Diet, but Mountain Dew nonetheless. Let's pause for a moment and reflect on the orange-juicy, fizzy, un-natural green concoction that is Mountain Dew. Imagine the bouquet of orange-lime syrup, the burn of the chemical aberration on your tongue. The juicy, fruity long finish that lingers until the belching starts. I know I am. 

Note the frozen water gently cradling the sweating can of diabetes inducing goodness. Not only will the ice melt into drinkable water, but the sweat on the can indicates that the heavenly libation within is brain-freezing cold, the way God intended Mountain Dew to be consumed. If you drink it fast enough, you could even lick the lingering condensation from the can. And the nurses probably wouldn't even count it. I know the can is probably unspeakably dirty, but when you can feel each individual pore of your tongue stretching out for fluid like a bloodhound at the end of a leash, it really doesn't matter any more. 

The news of a raised or increased fluid restriction among the heart patient population spreads through the HVIC here quicker than strep throat at a daycare center. It is guaranteed to be the next topic of conversation when we see each other outside or in the halls. 

Patient A: "I heard they raised your fluid restriction! How much!"

Patient B: "250 mls! It's, like, the happiest day of my life!"

Patient A: "A whole 250! Wow! That's like one of those little apple juice cups - the whole thing!"

Patient B: "I know! I'm trying to decide if I want to blow it on some juice, or maybe half a can of Ginger Ale later this afternoon. I really want to savor it, ya know?" 

Patient A: "Congratulations, man. This day will be long remembered. Cherish it."

Patient B: "Oh, I'm going to take pictures."

My fluid restriction was raised Saturday from 1500 to 1750. There was much rejoicing. I splurged on a cherry Mountain Dew that I nursed for two whole days. 

I find myself waking up in the night to look up juicing recipes online, price Sonic style ice-makers, and ordering fruit infusion water pitchers and Popsicle molds on Amazon for when I get home (btw, Christie: there are some packages coming in the mail). I dream about my little box of assorted tea leaves and chai mixes. Tea brewing in the hot sun in a glass pitcher. I even lingered on a football game the other day in hopes someone would pour one of those big Gatorade coolers over the coaches head (a perfectly horrible and disgraceful waste of Gatorade that could be used to help thirsty people everywhere). 

That is 5 WHOLE GALLONS of Gatorade Citrus Cooler, a flavor that first appeared in 1995 alongside the traditional Lemon Lime and Orange flavors. It was discontinued in the mid 00's but was brought back earlier this year to celebrate Gatorade's 50th anniversary. I know because I looked it up at 3:30 am this morning while waiting for a nurse to bring back a lime Fla-Vor-Ice. The flavor is a mix of orange, lime, and diabetes and is delicious served warm or cold. Just so long as it's served, instead of poured on the ground. Morons.

So wherever you are today, whatever you are doing, take a moment to consider the ready availability of your bottled water, your artificially flavored fruit drink, your Frappicino, your Lemon Lime Sonic Slush that you snagged (or should have) during Happy Hour for 60 cents. Caress its container and savor each small sip. Regardless of your drinking preference, enjoy the wetness on your tongue. the revived brain function, and the immediate satisfaction that comes from living in a society where fluid is available at every retail store, gas station, and soccer game in copious amounts at a relatively low price. Enjoy every drop. And if...IF you just happen to have any left over - even a little watered down 20 ml in the bottom of your bottle or cup, please, please bring it to me in room 1100 in the HVIC of Penn State Hershey Med Center, 100 University Drive, Hershey PA. Don't let the nurses see you.