Wednesday, April 2, 2008

A Blog Entry That May Be Too Long to Read

The setting is Lancaster, Pennsylvania. Visualize Amish farms, horse and buggy rides, antique stores, quilt shops, bed and breakfast inns, and smorgasbords. Now erase that image. Picture a hospital in Lancaster, Pennsylvania. Somewhere downtown. It could just as easily be a hospital in downtown Scranton. What I observed is that the rich culture of the surrounding area does not seem to penetrate the hospital walls. The bottom line is that I thought that the food would have been better! Actually, I doubt that the likes of Emeril Lagasse and Rachel Ray could have come up with a meal that would have tasted good to me after the surgery.

This week’s main event was surgery: removal of a cancerous section of the right tibia, replacement with an allograft from a non-objecting donor cadaver, and reinforcement with a steel rod. Take two. We tried this the week before, but the wrong cadaver bone was sent. This week, the correct bone was sent, with an apology and two conciliatory gift certificates. This may be the reason why we waited an extra week!

The morning of the surgery (March 28th) was like déjà vu all over again. Same procedures, but new personnel - except for the surgeon and his assistant. I fell asleep in the pre-op staging area while the anesthesiologist was drawing on my buttocks to determine placement of a catheter for a femoral nerve block. When I woke up, about six or seven hours later, I was being wheeled into my private room on the fifth floor.

The surgeon told me that everything and, from what he could tell, all of the cancer had been removed. [We now have to wait for the pathology report, which will take at least three weeks. This will show us what percent of the cancer cells were actually killed by the chemotherapy. Depending on that percentage, radiation treatments may be necessary. In any case, chemotherapy will resume in two or three weeks.] There was only one snag in the surgery – a screw snapped in half and the surgery was halted for fifteen minutes while someone went out (presumably to the hardware store) to get a device to reverse the screw.

On Monday morning, the surgeon removed the dressings and was pleased with the way that the incision looked. It is always good when the surgeon smiles and is pleased with his work.

This is the first major surgery I have had as an adult. I had my wisdom teeth removed when I was 18 and my appendix removed when I was 21. This is the only time I know of that I have been hooked up to IV fluids (via my vascular port), had a femoral block (via a catheter inserted into my lower back), had a drain coming out near my surgical incision, had a breathing tube inserted into my trachea, and had a urinary catheter. The IV was no problem. I am getting accustomed to that. The breathing tube was inserted and removed while I was under general anesthesia. The others were all inserted while I was sedated. But the doctors and nurses found no problems with removing them while I am awake!

Before the anesthesiologist removed the catheter for the femoral block, I asked him if it was going to hurt. He said, “Not a bit. I’ve done it hundreds of times and I’ve never felt any pain.” It was only a bit painful.

The surgeon removed the drain tube when he changed the dressing on my incision. It did not really hurt, but felt like a worm crawling out from under my skin.

The one I feared the most was the removal of the urinary catheter. If I had known that the surgery was going to require such a thing, I may have elected to not have the surgery. That is why some things are better left unknown. But once the thing is in there, (The words are vague, but you know exactly what I am talking about. Some of you may be reliving this traumatic experience from your past. I am sorry.) it has to be removed. I asked the nurse if I could be put out for this. She laughed, as if to say, “Men are such wimps.” We are. I am. I am so grateful that my wife bore our children. The nurse removed the air from the balloon. Apparently, once this thing is inserted into the bladder, a small balloon is inflated so that it does not pull out. While the nurse was describing this fact to me, she told me about a patient who insisted on doing it himself. I cannot even begin to imagine that kind of bravery. She said that she got the OK from her nursing supervisor to allow the man to remove his own catheter, but that she would be required to deflate the balloon. This is a detail that should not, must not, be overlooked. We are finally ready to remove this thing and she tells me to remember to breathe. She began to pull and I forgot to breathe. The nurse and my wife are both telling me, “Breathe, breathe.” Without any additional details, I will say that it was the strangest feeling I have ever felt. I hope never to feel it again.

A necessary part of my post-surgery care was physical therapy. It was not extensive, since my right leg cannot bear weight for several months. On Sunday, the therapist got me out of bed, and had me use a walker to move to the door and back to a chair, where I sat for an hour. That took a lot of energy. It was such a simple task that I have taken for granted my whole life. On Monday, I did the same thing with using a pair of crutches, plus a few leg lifts –with the help of the therapist. It was a little easier and less painful than the day before. On Tuesday, I walked part way down the hall and tried to climb a single step. It did not happen. But I learned my limitations. I think that is a vital part of the maturing process - learning our limitations.

One of the most interesting aspects of my hospital stay was the presence of student nurses. On Monday afternoon and evening, I had a student nurse assigned to care for me. She was young, confident, calm, and kind. The kind of attribute mix you want in a nurse, but do not always find. My wife enjoyed conversing with her – hearing about her training and her aspirations. On Tuesday, a young male student with the same mix of attributes was assigned to me. He meticulously changed my dressing on my incision and helped with the details of my discharge from the hospital. When the duty nurse came in to de-access my port (remove the IV needle), a group of eight or ten nurses came into the room to observe. It was great to be a part of the students’ training. It was nice to see the interaction between the students and their instructors. Of course, it reminded me of what I am missing by being away from my students. And, if these students are representative, the future of the nursing profession is in good hands.

I enjoyed observing the communications dynamics this weekend. Between hospitals. Between doctors. Between nurses. Between nurses and doctors. As an undergraduate anthropology major I took several courses in medical anthropology, and I have always been interested in the roles and interactions involved in the medical field. I was reminded, as I observed both good and bad examples of communication, of the importance of good communication in any relationship or organization. We need to learn our limitations when it comes to remembering things. And how it is OK to write things down right away, so that details are not overlooked. When communication is good, everything else in an organization or relationship is better.

It is good to be home again. I always say that. I always mean that. There is always special about coming home.

My life for the next two weeks consists of elevating and icing my leg to keep the swelling down, and trying to avoid infection.

Our younger son kept me company today. He gave me a lot of hugs, talked to me, and played some games with me. He observed as the home health nurse changed my dressings and drew blood from my arm. He asked a lot of questions, and we assured him that God is using all of this in the process of taking care of Daddy’s cancer.

My wife is still my best friend and my greatest encourager. She has a strength that can only be explained by the presence of God’s Spirit within her. She is an amazing woman and I am blessed.

Our God is an awesome God. I know that this phrase is overused and could be labeled as cliché, but it is always true. As His child, I can say that when things are going well and when they are not. He is in control. And our decision is as firm as ever: We choose to please Him in all things. May God be glorified.


NursePenny said...

Dear Mr. Bond,
I'm glad you have not lost your sense of humor! I miss being in your class and I can just picture you telling us your experiences and making us all laugh!

Love, Mandie Schreck

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