Sunday, September 11, 2011

Guts, guts, got no guts and stitches don’t help at all

As I begin this blog post, I’m sitting in yet another waiting room of yet another hospital—this time, Heartland Spine & Specialty Hospital, in Overland Park, KS. I have been here all day, and even finished all my homework for the weekend, waiting as Patrick undergoes surgery for bilateral hernias.
In some ways, I think this has been one of the most uncomfortable, inconvenient healthcare experiences I’ve ever had, and that’s saying something, especially when you consider I spent a fairish amount of time in Truman Medical Centers’ charity wards in the 80s.
However, the hassle began well before we set foot on these premises.
It started back in July, when we discovered that Patrick had hernias. As I mentioned in a previous post, this is a common complication for peritoneal dialysis. The treatments erode the peritoneal cavity until it eventually gives out altogether. The maximum one can expect to do PD is ten years. We’re hoping to have a kidney before then, of course.
Our primary care doctor gave us a list of referrals for surgery and we began going down the list. We had to go through three surgeons before we found one who could perform the operation relatively soon (less than a month out). There is some urgency because the longer we let it go, the more risk it poses in dislodging Patrick’s dialysis catheter; more importantly, it could interfere with transplant surgery.
We specifically asked if the hernia operation would be at Research Hospital—where the renal ward and transplant center is located. The surgeon assured us that it was.
Yet here we are. After the consultation, the doctor’s scheduler informed us that it would not be at Research as this was an outpatient procedure, and all outpatient procedures are performed at Heartland.
I’d never even heard of this damn place. We are incredibly nervous about doing the surgery somewhere without a trained dialysis unit.
The last time Patrick had surgery was his catheter placement back in 2009. He wound up with an infection that put him in the hospital for a month. You can understand our trepidation.
Then, on Thursday, the day before surgery, Patrick’s nephrologist called to inform him that she strongly recommended that he go on hemo dialysis while he heals up from surgery, which would mean putting in a temporary neck catheter.
Really, doc? Just . . . really? You’re really calling and springing this on us THE DAY BEFORE THE SURGERY?
First of all, thanks for giving us ample time to consider this and make an informed decision.
Second, Patrick’s had a neck catheter before. It’s as awful as it sounds. Third, hemo sucks. And finally, it would be a logistical nightmare, as hemo would mean going to the dialysis clinic three times a week and we only have one car.
So thanks, doc, but no thanks. Pass on the neck tube.
On Friday morning, we arrived at the hospital. The receptionist handed me a pager—like one of those light-up pagers the hostess would give you at Outback Steakhouse. They were going to take Patrick up to prep for surgery, then page me to notify me when I could go up to see him, page me when he woke up in recovery, etc. I was like, are you fucking kidding me?
The waiting room was crowded and filled with the most uncomfortable chairs I’ve ever seen—except those fiberglass chairs from the 70s that were bolted together in rows at Truman. Ah, memories.
What I’m trying to say is, I hated the place. I hated the place instantly, deeply, passionately. Even more than I hate most medical establishments. My therapist has helped me to recognize that my default emotion is rage and that is not healthy, but dude-- a PAGER? I am not waiting for a booth so I can order a margarita and a bloomin’ onion here.
As I waited, I went to the dining area over lunch, where I found out they only accepted cash. The cafeteria ladies took pity on me and gave me a free meal. Just when you think that a situation is irredeemable.
After weeks of fretting and difficulty, though, the operation itself went perfectly. The surgeon told me he closed the dual incisions with cosmetic stitches, adding proudly, “When he heals up, he could model swim trunks if he wants.”
We’re home now, though I’m sorry to say that Patrick’s in a great deal of pain. He needs assistance getting up and can’t bend down at all, so I have to help him to the bathroom, fix him his meals, help him hook up to the dialysis machine, etc. He’s also sleeping a lot, and recovery looks like it’s going to be a long, slow road. I’m not sure at this point if I’ll be back at the office Monday.
So. Nothing to do but chin up and remember to be grateful for the tuna sandwiches of compassion.

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