Monday, June 27, 2011

"The patient experience/POD3/Tylenol 3 blues/sore belly"

i was going to work more on this... but i think i will just post it, and leave it to rest here on this page. there is more to write, less to include, but let this be a document from a moment of reflection.

The patient experience/pod3/Tylenol 3 blues/sore belly:

I’m sitting on my own couch after being in the safety and solace of my parents’ home for the past 3 nights since my “laprascopic excision of endometriosis”. It must have been the cumulative effect of T3’s, but when I arrived back home, mom left, and suddenly I was crying my eyes out for no particular reason. It wasn’t surgical pain, it wasn’t fear- it is post op day 3 and the codeine is getting to me. A sense of loneliness and isolation came over me, and I didn’t know what to do. The boy didn’t know what to say over the phone, even though I know he’s trying his best, and mom wasn’t answering her cell… Finally after the wave passed over, with the help of a shower and reassuring words from the mother, I settled into bed for a sleep that would hopefully wash this sudden sense of misery all away.

I’ve been anticipating this surgery for a few months now, and before that, wondering what step to take since the stabbing pains still visited me although the Mirena IUD was in situ and working wonderfully. As the date drew closer, I became more and more interested in the patient experience I was about to embark on. I deal with post op surgical patients every day, and although I’ve only been working for less than a year, I sometimes find myself desensitized to their experience. Is it a self-preservation thing, a time thing, or a culture thing? So from the moment I put the hospital gown on, and gave up my clothing to a white “belongings” bag, I knew this would be one of those experiences that I am going to hold with me with every nurse-patient interaction I have from now on. It seems small. A tiny little day surgery. But any journey through the system is significant- especially for those of us that deal with “the other side” daily.

The iv went in smoothly, the fluids were a relief after being NPO for almost 12 hours at this point. I had a headache- which I attribute to the low amounts of sodium in the past 24 hours. And the fact that I had an intensive "bowel prep" for the whole previous day. In sum: electrolytes were a bit off!

Finally it’s time to walk into the OR. I climb up on the bed, lift my arm so the nurse can put little heart probes on their specific spots, and take a blood pressure and other vitals. Then there is a face mask that is over my face and I’m asked to take deep breaths. They said it was oxygen- really? It’s all a blur at this point, as then the anesthetist said that I had received the medicine that would make me sleep and that it might make me cough- if I cough it’s about 20 seconds til I’m asleep. I’m not coughing. He says, or you might just go to sleep. I’m awake and i look at the clock- 1.40pm. then the room is sucked away from me and I fall deep into a drug induced sleep.

The next thing I know I’m in recovery and another nurse is waking me up telling me to breathe deep and get my lungs going. She explains how my surgery went, and I have no idea what she’s talking about. I don’t want to wake up. It feels so good. I’m so sleepy. Then I start shivering and my teeth are chattering. I ask for a warm blanket. And then another since I can’t remember if I already asked for one or not. The nurse just chats and chats, I try to contribute to the conversation, but my words are jumbled. I’m trying to doze, but she just keeps talking to her colleague! Then she says I’ve been here almost an hour and it’s time to go to day care. She has given me some delightful fentanyl and some oxy and my pain is limited. I’m wheeled into the next room and introduced to the new nursing staff as “another nursing sister”, which makes me smile. Then my mom is there, and I’m getting ginger ale and it tastes so good. Another 30 minutes are spent here, reading about my surgery, me getting to be more awake, mom texting dad and the boy, and then I get the feeling that they want me out of there. So I tenderly put my clothes on, trying to stand and lift one leg then the other. It goes ok. But as we walk out, I realize that I can’t walk and that there is a porter with a wheelchair who is there just for us. I gratefully sit down in the chair and am wheeled out into the sunshine. Dad arrives after a while. We’ve been talking to the porter about the jazz fest, and give him a brochure and point out good shows. To remember this sounds ridiculous right now. My mind was such a fog I don’t even know what exactly I was promoting.

Get in the car, shuttled home and then off to bed for a little while… what a delightful snooze I have! That night I eat congee, the boy comes over with flowers and coconut bars, and I am in a stupor.

The next couple of days are pain meds, sleep, eating soft food, feeling full, feeling hungry, no poop, reading book, watching movies. The pain is different than I anticipated. It isn’t crampy like I thought. It is very surgical. The incisions hurt the most the first day, then it felt like I did a thousand sit ups and my abdominal muscles had been moved apart and jostled around. The gas in my abdomen from the surgery moved up to my shoulder that first night, and below my diaphragm. That sensation has subsided, luckily.

POD4

The lasting sensations of this surgery are different than I anticipated. I have this lightheadedness and a sense of confusion that I thought was from the lack of food I’ve had over the past number of days… Then I start to think about how the very core of my being was opened up (albeit through a tiny hole), looked at with a camera and bits of it were sliced off. No wonder my equilibrium is still off. Give the body credit for the probing it endured. I have this pass for the jazz festival, and one part of me wants to push myself and head out to see some shows, but then the thought of walking more than 3 blocks at this point makes me lightheaded and weary, so I think I’ll listen to my body, breathe into my body and let the balance re enter. Gently. Be gentle.

Even though my head is foggy, and I am GRATEFUL that I have another whole week off- (I can’t imagine returning to work with a clear mind at this point), I have a little bit of perspective on the surgical and patient experience. It’s hard to fully express how this will affect my nursing practice, but I knew it would, and it will.

Monday, June 13, 2011

Sunday, June 5, 2011

weekend on the coast

a few weekends ago, we drove up the coast to powell... spending the weekend reading, lounging, walking, eating, laughing, sleeping... all good things. not many photos were taken, but p&c started a good little bonfire in the pit, and we gathered round the warmth as the darkness came... i didn't want to leave that morning we packed up, reminding me that i need to make the trip more often. too much time had passed. i'll be back soon, point.