The Hospital Stay

Dear Reader…

I have been remiss in maintaining the blog, I know. But these last few weeks have been very difficult and each time I have sat myself down and tried to unleash, it just hasn’t happened. I will explain more about this as I catch up, but here, for the time being is a report on my post-operative hospital stay. Bear with me…

Dec. 16^th, 2010

I wake up in the recuperation ward with a nurse named Laura a few inches from my face, shaking my arm and saying Mr. Truss… Mr. Truss… Please, such formality. Call me Mr. Spaceman.

I think that maybe I smiled at her and she said something else and then asked me how I felt. I responded positively, in so much as I felt nothing, and then looked around the room. It seemed vast and endless and lined with thousands of beds; each bed containing a person in some state of discomposure. I remember that it was the chance of not getting into one of these beds that almost canceled my appointment. I guess it was a good day in the operating theatres as no bed lay ominously empty.

I fall back into a black sleep.

Sometime later I wake up in my superior-grade, private room on the 6^th floor of the hospital. I have an I.V. in one arm, an oxygen line in my nose and a sharp pain in my stomach. I move my head to one side and notice that there is a tube attached to a sack coming out of either side of the bed. I suppose one to be the catheter. Could there be two catheters? No, that doesn’t make sense. Pain stops me from twisting to get a better view.

Figure 1: A Room with a View

The light coming in through my window (that later I find out looks out onto University Ave.) is bright and starting to hurt my eyes. A nurse named Delma comes in with a warm smile and in a soft, Caribbean voice murmurs “Ahh, you’re with us.” “I think so,” I reply.

I’m a bit hazy now about the events of the next short while, but she explained a couple of things to me and then gave me a cup with some ice to suck. No liquids for a bit, she tells me.

Then Brooke comes in. Brooke, who has spent the afternoon in what I can only imagine to be a hell of its own particular bent, and now comes in with a broad smile and moves to my side and kisses my cheek. The smile that she has on offers a thousand words. I had imagined that if things had gone well and she had been informed of it, that this would be the kind of smile she would have on. Not the sort of empty-encouragement smile that I felt I had plastered on most of the time when I visited with my dying father, despite all attempts to be sincerely upbeat.

She confirms this. Sitting in the family waiting area with her sister Lisa, Dr. Fleshner (who I still haven’t seen in person to this point) arrived in scrubs and, towering above them in his six-foot-something frame, told her that the operation went very well and that he was optimistic that the removed prostate contained all the nasty bits. Also, the nerve-sparing went well. This will be important to the expectation of manly action later on. He told her this and then, apparently, got changed and flew to Paris. I guess I won’t be seeing the great man anytime soon.

I can’t remember now exactly how long Brooke stayed but it must have been a few hours. The pain is stark but manageable, assuaged by the steady drip, drip, drip of the morphine. Ah… morphine.

After Brooke leaves I am visited by the ‘team’. I suppose because Fleshner is now in France sucking back oysters on the Champs D’Elysees, Weebly is now in charge and together with a team of four or five blue-clad interns, he pokes me a bit, tells me that everything looks good and a swift recovery looks promising. He also tells me not to let anyone (by ‘anyone’ I imagine he means the nurses unless he expects someone to wander in off the street) put anything into or take anything out of my catheter tube connection. I am happy to comply. Later I find out that some doctors (but not all) consider flushing the catheter tube too risky to have done by a nurse. I have yet to have the courage to actually look down there at it. Dr. Weebly also remarks that I appear to be one of the lucky ones who have neither a terrific sore throat from the surgical breathing tube that was jammed down my gullet nor sore and swollen lower legs. (I never did find out why I would have that.)

He also explains the mystery tube. It is the Jackson-Pratt tube, named after either two doctors named Jackson and Pratt, or one doctor from an Ivy League school. The JP tube (as it is known to my caregivers) is a drainage tube to take poisonous bile away from my incision area. I am told that this is working well and soon the sack would have to be replaced. Many sacks and bags will be drained in the next few weeks.

The team moves on and as he passes the bed Dr. Weebly gives me a pat of encouragement on my big toe. He is somewhat awkward about it. I like Dr. Weebly. He seems to know his stuff and his bravura pre-op and now with his teaching group, belies, I think a certain insecurity that makes him seem more human to me than the others who seem more like a herd of deer on the Trans Canada, caught mid-headlight, when they actually have to tell me something or give me attention. They (the student doctors) are all about keeping up with the A-team doctors and impressing them with their keen thirst for knowledge and attention to detail. Understandable, this hesitation, I suppose. I sense the game that all these people must play with each other on a daily basis and that has been the fodder for so many day-time soaps and medical series. I really do have confidence in them… though I suppose I have little choice there.

Many more nurses come and go. In fact, during the two and a half days that I will be in here, I never see the same nurse twice. About ten different nurses have charge of me for different shifts over that period. Some, but not all, of their names are Evelyn, Claudine, Iris and Melissa. They all vary in warmth and connectedness, all have different approaches to pain-killing and all have different instructions on doing similar things. By this I mean, catheter cleaning for instance. One would tell me what to do and how to organize the equipment and then the next nurse would come in, look down at it, cluck and say “Who did this to you? I see you have done such and such. You must never do this again. It is very dangerous.” Only once did I bother telling the nurse that I was doing such and such because the previous nurse told me to do it this way. It seemed pointless after a while. (On a side note: I found this behaviour extended to the nurse in my home-care situation as well.) But, again, I have to say they took care of me pretty well with minor exceptions.

A word on pain-killing… Dear Hospital, (should you ever read this blog) here is my advice on pain-killing. After morphine drips have ended, don’t start further medication with the smallest, least-effective pill available. The first nurse, who gave me something after the morphine, came in carrying a small, red Motrin tablet. This was absurd. I could have eaten a bowl of them to no effect and it was only after much button-pushing and complaining that I eventually worked my way back up to something adequate. When it comes to pain… give me the best you’ve got and we can work our way down from there. I’ll tell you later if it was more than I needed. I don’t have time to work my way up the pharmaceutical ladder. Stop the pain now! Just saying…

Friday, Dec. 17^th, 2010

This is my first full day in hospital. I have spent a not too bad night. Every couple of hours someone enters, usually with a flashlight but not always, and wakes me up to give me something or change my catheter bag or bile sack.

I have progressed to juices now and even had a little broth earlier. Oh yes, and a mistake had been made earlier. Around 7 pm the previous evening a candy-striper had shown up with a complete meal. I couldn’t really muster the enthusiasm to eat it right then so I told her to leave it on the table and I’d try later on. This apparently saved my life as I was, under no circumstances, to try to eat anything solid. The nurse who discovered it on my table almost had a heart attack.

Anyway the night passed away. There was some pretty intense pain along the way but I still managed to sleep for bits of time.

Brooke returns the next day and we pass some time. I have to get up and start moving about, the nurses tell me. I have been putting it off, not feeling very confident about the whole thing. I have decided on my own to remove the oxygen tube from my nose. It doesn’t seem necessary as I am breathing fine and seem energized to some degree. I have been given a funny device to exercise my breathing so that fluid doesn’t collect in my lungs. It resembles a bong from my younger, wilder days. (For those who don’t know, a bong is a thing that looks like a large pipe, usually made from plastic or glass and is used to smoke illegal substances with the aid of water and sometimes ice. The effect is to cool the smoke.) I feel ridiculous using it so I opt for breathing exercises that I learned in theatre school. Finally, a use for them…

Figure 2: The Hospital Bong

Eventually, we try to move around a bit. I have to be mindful of all the tubes and, of course, my bare ass hanging out. We cover that bit with a reversed hospital gown so that no one in the halls will be nonplussed. Getting the legs over the edge of the bed takes forever and smarts quite a bit. But finally we do get that done, I stand into slippers that Brooke has provided, and I stutter around the room pulling my I.V. stand with me and holding my JP sack close to my hip. I am moving, but very slowly.

In total I will get up and walk about three times this day. On the second attempt Brooke walks me around ‘the circuit’ that is a path down the hall, around the nurses stations and back up to the room. As we slowly make our way along we pass others doing the same thing. One guy, around 55 or so, hurtles by with a proud smile on his face. “This makes 30 circuits for me.” Braggart… I’ll show you, I think, and increase my speed to .015 MPH. I make it around once and that’s it. Brooke is wary of my pale face and shaking limbs.

Figure 3: Hospital Boy on The Circuit

Brooke goes away for a while with the promise to be back around 4 pm. I have progressed now to some solid foods and that goes down well. There is absolutely no indication of bowel movements and, in fact, there won’t be any for an ominously long time. Just as well really, for negotiating that with all this paraphernalia would be daunting if not impossible without humiliating help.

When Brooke does return it is with some sobering news. She has just run into our mutual friend, actress Lindsay Leese, in the hallway. Lindsay and Brooke exchange pleasantries along the lines of “Gosh, are you visiting someone here?” “Yes. Are you?” “Yes…” There is hesitation and then they move on not having actually said who it is either is visiting. This is the protocol of the cancer ward, I suppose… don’t ask, don’t tell. However, Lindsay has probably figured it out as she knows of my connection to Brooke. Brooke finds out by other means that Lindsay is in fact visiting Gina Wilkinson who is just down the hall and is another actress that we both know. Gina has cervical cancer which was discovered in November. When I leave tomorrow, Gina will be in the process of marrying her partner Tom at bedside. By mid-January she will be dead. That is the wall that we face.

After Brooke has left for the day I read for a bit, try to use the small laptop I brought with me and listen to a couple of tunes on our I-pod. None of these things last very long though as the medications I am taking leave me drowsy and I keep falling asleep. I have determined that unless I really can’t do it I am going to go home tomorrow. The two days I have spent here seem like an eternity and I am ready to get into my own bed. Besides, tomorrow is Sunday and there’s football to watch.

(Side note: Also, there is the hospital food. Now I realize that there is a long standing tradition of hospitals trying to kill patients with the food and that, if nothing else, it has provided fodder for a long line of stand-up comedians… but, holy smoke. It’s as if there is some competition to make the most taste-less, unsatisfying, ill-prepared food possible. Well, if there is such a competition, it’s hard to believe that Toronto General didn’t win it, hands down. Getting some reasonable sustenance is goal enough to endure the process of getting out of here.)

Saturday, Dec. 18^th, 2010

Going home day…

I am chomping at the bit, as they say, and have been awake from about 7 a.m. I have done a couple more circuits of the ward and am pretty confident about getting down to the truck.

I call home at around 9:30 to find out what state Brooke is in and when I can expect to be extracted. I must admit, I am somewhat disappointed to find out that it won’t happen until after noon for various reasons, but I guess that’s okay, it’s not like I have an appointment. Brooke has been preparing the home for my arrival and the cats are all dressed in clean fur and waiting by the door.

Some nurses come and go, including the woman whose job it will be to remove my JP tube. I’m not really thinking about this much although later it will prove to be intense. I’m watching a light snow fall outside and mentally imagining myself making my way out of this room, off the ward, down the elevator, through the main parking doors and into the truck. This seems to me right now like I might as well be taking part in the Iditarod. But bring it on, I say.

When Brooke comes to the hospital, I have already packed everything and am pretty much ready to go. The nurse who is on duty has me sign off on the quality of care statement and the “yes, they told me everything I need to know as I go home” form. The intern on duty has already stopped by to see me and has said she thinks I’m good to go. I wanted to thank her, and by extension, the whole medical team so I tried to form the right sentences on the fly but didn’t do a very good job. I can’t begin to express how impressed I am with the whole group and how grateful I am for this chance to further my existence. I will have cause in the near future to doubt myself regarding this procedure but I can’t fault them on the work. At least at this point…

One last bit of medical work. The removal of the JP tube... Now it seems the nurse to whom the chore fell of taking this tube out didn’t realize that she was meant to do it. She thought that it would be done at home by a home-care nurse. We corrected her about this and she went to seek the confirmation of a superior. She got this and returned with a slightly apprehensive look on her face. I don’t think she was comfortable with this particular procedure. She removed the dressing, took the collection bag off and removed the one small staple holding the tube in. “Don’t look if you don’t want to see this”, she said and I advise you, gentle reader not to look either. Grasping one end of the tube she tugged on it to get it moving and then with one strong pull ripped it out. I have always wondered what it would be like to be shot by a bullet. Well, this was kind of the reverse of that with the bullet coming out not going in. The portion of the tube that was inside me must have been about six inches long and it is like no feeling on earth to have something like that pulled from your stomach, let me tell you. You can feel every inch of it as it moves along under your skin. She patched up the hole, redressed it and nervously made off. Of all the pain I felt in the hospital, the pain of this extraction would become the most problematic for the next few days.

We do the finally getting ready. I put my coat on and, with my new catheter bag strapped firmly to my leg under my pants, we start the trek to the car. We pass down the empty hallway, past Gina’s closed door, past the nurse’s station. The nurses are scurrying. The life of the hospital continues as the endless stream of cancer patients moves in and out like ants to and from an anthill. Too many ants...

As I step from the lobby doors into the underground parking lot I get my first dose of reality as a cramp tightens up around the catheter and I have to balance against the wall while Brooke gets the truck.  She returns and I carefully get into the passenger seat. Brooke gets in on the driver’s side and we’re off.

Every bump and street car track vibrates through my poor old body, held together with stitches and tubes as Brooke slowly drives along, trying to avoid potholes and stoplights as much as humanly possible in a city such as ours. I am not looking forward to the two flights of stairs up to the apartment but when we do eventually pull up in front, I find that it isn’t too bad and, one step at a time, I mount to the summit.

Huxley the cat is the first at the door as per usual. BC the cat is asleep on the bed that I collapse onto as soon as I can and Hattie the cat is hiding somewhere as is her way. We get me out of my clothes and into some pajama things that Brooke has been so cute as to provide. The night-time sleeping urine drainage bag is attached and placed on the floor beside the bed. This wasn’t easy to accomplish and there was much swearing and cursing as first I alone, and then with Brooke, tried to get the main bag to work and drain properly. We finally find the culprit, a massive blood clot, which has blocked one end of the tube and is gumming up the works. We get the bag working and all settles down. I had forgotten the warning about blood clots that I will pass for the next few days.

I have been given Endocet, an opiate, for pain. I take one and drift off into sleep around 6 o’clock. Home… Today, as the posters from the 70’s explained more as a call to action than an acknowledgment of the obvious, is the first day of the rest of my life. What kind of life though? Only time will tell.