Organ Donation Chronicle - D plus 4 (2)

Through The Looking Glass – Life In The Hospital

My very limited and unscientific sample of hospitals has led me to believe that an awful lot of them are big bureaucratic machines. But my negative feelings about Hartford Hospital during all the months prior to the surgery were confirmed in spades when I was placed in its bowels for recovery following the surgery.

I briefly posted on Friday about the pain once surgery was complete. I can’t say that I wasn’t warned by a number of people. But as I’ve commented when you willing yourself through such an experience, you are putting your mental energies into visualizing your fully successful outcome, you just don’t focus on the negative. And you are focusing on getting to the finish line (the operation) so detailed thoughts of what exactly was implied by having gone through this act were not fully on the agenda either.

So starting Wed night in my hospital room the full implications of my decision in terms of my person were hitting me like a ton of bricks. I can honestly say that I’ve never been in such a constant level of pain for such an extended period. Of course I’ve lived a charmed life and there millions maybe billions of people who daily are going through incredible levels of pain. I can describe the pain as fitting into four categories:

➢ Pain from the operation – this includes the incision and the resulting trauma to tissue in the body and around the area where work was done

➢ Pain from gas – the gas the system generates from working out the anesthesia they put into you

➢ Pain from being in bed – Being bedridden causes it own set of problems with aching and soreness and is exacerbated by whatever you bring along such as my arthritic hips and shoulders

➢ Pain from the hospital system – I include in this all the physical stuff such as tubes sticking in you and out of you, blood being taken, etc. plus the psychological aspects of the hospital routine that seems to an outsider as specifically designed to keep one disjointed, frustrated and as discombobulated as possible.

I may be being very unfair to the people who were working in the unit I was at. There may have been some extenuating situations. And there were some really wonderful people who really did their jobs with caring. But the majority were just going through the motions; doing as little as they could to get through the day.

There are these horribly annoying IV dispensing machines. You are given a metal pole on set of wheels. On this goes your IV bags (you could have several for hydration/nutrition, medicines, other drugs), the dispensing machines, and your urine collection bag (you are almost certainly have a catheter in you. In fact the cognoscenti quickly figure out that urine production and the optical clarity of your urine are very, very important. One of my roommates and I would give each other pats on our back about the volume and good looking nature of our urine).

The pole is your symbol that you are indeed a patient worthy of being in the hospital. Once your input and output tubes come out, the system will be looking to eject you as soon as it can (modified for maximum final frustration). The dispensing machines are very sensitive. If by rolling over your block one of your tubes (really easy to do when you’re drugged up and in pain), it sets off an alarm. It sets off an alarm when one of your bags is getting empty. If it is on battery there is an alarm for it getting low. When the alarm goes off, it goes beep beep, pause, beep beep, on and on and on and on until someone comes and fixes the problem and resets the machine. Until you become a cognoscenti like during the first 12 hours when you are racked with pain and in an anesthetic haze, you don’t even realize what is causing the beep. No orientation is given when they wheel you in the room. Your consciousness just becomes aware of the beeping that continue and continues and continues with ever deeper annoyance. You finally learn that you are supposed to call for help which almost never comes right away and can take as long as 40 minutes. Not only that, you can hear the beeping of other people’s machines. You can hear their calls into the central desk. You can hear the page for the appropriate Nurse or Care Assistant to go to the room. You can hear the beeping continuing and continuing. You can hear the second request. So if I can hear other people’s beeping from around floor, can’t the staff here it? If they do, there must be some sort of work rule that says you can’t initiate any action until the patient actually requests it because they never did with me or anyone else that I could determine.

It almost never mattered what you requested because it was going to take awhile to get. Sometimes you could hear that there was something critical going on in the floor – lot’s of calls for help at once, a critical patient being wheeled in, etc. – however other times I would see (as I was getting better and walking around a lot) that the staff was just chatting away while the calls for assistance came and went. The body language of a lot of the staff was so demonstrative – “I really don’t want to do any work and I’m going to do as little as I can get away with”.

Within a short period of time, a day or so, you can hear totally what’s happening. That’s a problem itself because trying to get any quiet or darkness to rest is really difficult. Then there are the routines that must, must, must happen. You must get your vital signs (temperature, pulse and blood pressure) three times a day and you must get your blood taken once a day. And all your urine must be measured. Most of these are scheduled for when you finally doze off to sleep.

You are encouraged to get your lazy ass out of bed and get walking around. This of course is a good thing because it is what you need to get out. However, there is that slight problem of getting anyone to actually help you during those first few times. I was lucky that my care assistant in the beginning was one of the best I had. Then you go through the learning curve of how to unplug your device so your pole was mobile and how to use the pole for support while navigating with the device plus input and output bags and tubing.

Then there is pain medication. The whole thing related to pain medication is very bizarre. Along with our device, they include a narcotic pain reliever. You get another button (brown to distinguish it from the red ‘pretend someone is going to respond to your call for help’ button. They want you to use your brown button - sort of. You can push it as much as you want. The device will regulate things so you can never overdose yourself. And the official posture is that they do not want you in pain. You should not be in pain. You should take your pain medication.

Now some of us are sensitive to narcotics and don’t react well. They send me into all kinds of dark dreams and I feel like I’m on the verge of asphyxiating. So after the first night, I’m saying to myself, “I may be in agony from the pain but I think the narcotic effect is worse so I’ll just deal with the pain.” The system doesn’t like this. When the doctors and nurses come in they ask how your pain is from 1 to 10 with 10 being the worse pain you’ve ever had. So you tell them and they say, “but you’re not using your pain meds; if you’re in pain you need to use your pain meds!). So you insist that you hate the pain meds and you’d rather just deal with the pain. Finally they relent and let you take a much smaller dose by mouth that dilutes the effects substantially.

Additionally the narcotics slow down the body’s digestive and elimination system. This is the second big rite of passage to getting out of the hospital…you have to poop. No going means not going. So the more you use the painkillers the more you’re slowing your system.

Since I’m pretty much a paranoid individual, I’m convinced they want everybody drugged up as much as possible. If they’re drugged they won’t ask for so much pesky help that interferes with standing around the nurses station, chatting, being in the break room and surfing the Internet.