Hospital Course

I know I'm running a few days in arears but we will be all caught up soon. My first night in the hospital was really uneventful. I got my precious dilaudid and zofran on a scheduled basis + phenergan in between. I can handle pain but nausea I cannot. The bulk of my discomfort was from the bloating left behind from the laparscopic procedure itself. Awesome intervention the laperscopic procedure provides but the huge down-side of it is they have to blow you full of air to visualize what they are doing. Apparently they do not "burp" you afterwards because it was certainly all left inside of me with pain in my belly and neck. The only means of relief, I'm sorry to say, is to "pass the gas". Well, as unattractive as that sounds, I would have paid some good money to pass some gas but couldn't. I was out of the bed within 2 hours to go to the bathroom...the other part of that is that moving around decreases your risk for blood clots and I had NO intentions of a blood clot complication so up I came. I also wore inflatable balloons on both legs to prevent clots. I still had my IV as they were infusing bag after bag of fluids plus some antibiotics...flagyl and avelox. I was pleased with this selection because I too had no intentions of getting an infection.

Ok, so onto some humor. Natzi nurse came on duty at 7:00 Friday morning and I immediately new that I did not like her. She asked me about my pain and I told here it was primarily the bloating pain, she immediately went into a full sermon about walking and that was the only way to get past the bloating. She wanted to see me up and moving all day long. She checked my drainage tube and showed me how to "strip it". She said she wanted me to be stripping it...no thanks. Then came the administration of my effexor. I cannot have capsules, for that matter no tablets larger than the size of an aspirin. She hands me my effexor XR and I remind her tha t I cannot have a capsule...she looks at me like she has never encountered such a predicament in her career. I ask about putting it in apple-sauce but my diet does not allow apple sauce yet. She commences to tell me I will have to swallow the granules plain...ok, well that will take some mental preparation and at that very moment I needed to potty, BAD. I'm trying to get up and Cayce had just walked in. He's trying to get settled, I'm on a mission, and all she is worried about was that effexor dose which she had now mixed into some water and was panicking they were going to dissolve into mush. I had already snapped at Cayce, sorry honey, and curtly told her I would take the effexor after I used the bathroom but she would not let it go. I'm not even kidding she brought me the slurry of effexor + water to take while sitting on the potty. Wow, I knew it would be a rough day. On her way out I'm sure she reminded me I needed to go walk.

The day goes on and she comes to check my drainage bag asking if I had stripped it...no and am I'm not going to. No other nurse had asked me to strip it myself so I'm pretty sure it is not on my list of patient responsibilities. At one point she fussed at me before giving me some Lortab saying she didn't want to give me pain meds for bloating pain....I needed to walk to get rid of that (I got my lortab by the way). Thankfully she was not overly attentive so I did not see her too much through the day but then she came in for hand-off to the next nurse. The next nurse was the sweetest thing. She was indian with a slight accent AND a southern drawl that I loved! But until we got started, I had to endure the hand-off from natzi nurse. She was going through the list of my care and came to the CPAP. Can you believe we are back to the CPAP after coming so far? They had told Cayce to take the CPAP back to the car before my surgery so he didn't have to carry it all over the hospital. Granted he was supposed to bring it back and didn't but still, come on. She blew a gasket about me not having my CPAP so I called Cayce to see if he had left yet. He was in the parking lot heading out...he brought the CPAP back.

My sweet nurse helped me set it up me knowing all along I had no intentions of using it. I asked if I still have dilaudid on my profile b/c I was having some trouble choking down the lortab. I doubted it was still on board but someone messed up and it was!!! She brought my cocktail of dilaudid and zofran and off I went. I woke up to go to the bathroom and she came in. She asked about the CPAP, considering the mask was on my belly. I told her apparently I had not put it on before I went to sleep. Got more zofran...back to sleep. Later in the morning the nursing assistant came in for vitals...why do they need my vitals in the middle of the night when they have been 100% wonderful the whole time. None-the-less, she checked my vitals which were again, perfect. She helped me up and fixed my bed-head. No one else had fixed my bed-head which Cayce pointed out made me look like E so I was tickled she did. I had planned to go walk a few laps before settling back in but then I realized that she was a smoker. Geez-louise. Bionic nose kicks in and nausea starts. Her uniform and hands smelled like a smoker and now it was stuck in my nose. No laps, please bring me some phenergan as it was not time for zofran. Sweet nurse brought the med and asked if I was ok, I told her yes that I thought the assistant may be a smoker and it had made me sick. She confirmed what my nose had already told me and bless her heart, they did not sent her back to help me the rest of the morning. I would not want to hurt her feelings for anything but seriously, the smell made me some kind of SICK! Sweet nurse said that i had not worn the CPAP all night but she had monitored me and I was not ever in any distress, no gasping, no snoring, no apnea. See, this is what I've been trying to tell them...my disease is super mild.

So this brings us to Friday morning and nurse Tina. Of note, sweet nurse had stripped my drain tube all night without any need for my assistance. I was confirming hours before that natzi nurse would NOT be back. Here we go with the effexor again. She hands me my capsule in a cup. I remind her I cannot have the capsule and again get the deer in the headlights look. I ask for some apple sauce since my diet had been advanced. Not even kidding....she brought me a teaspoon of apple sauce with the capsule laying on top. Kind of like a cherry on top. Bless her heart. I asked her to open the capsule and sprinkle the contents into the apple sauce and she commences to tell me it was controlled release...yah, da, da, da. I finally pulled the I'm a pharmacist card, I'm not going to chew the granules and we got past that. I made a mental note at that very moment that while my surgeon practices in a nat'l center of excellence, the post-op nursing staff is not necessarily part of the program having been offered a capsule twice and carbonated beverage, both of which are 100% no-no's for the sleeve patient. I will have to alert the bariatric program coodinator of these issues and I bet there will be some posters hung on the 6th floor by the end of the week.

Enough for today, we will be all caught up by tomorrow but not sure I will ever be able to beat the cherry on the top presentation of my effexor dose.