This past Thursday I had my first follow-up appointment in Madison with Dr. Heise. Since my last update I have continued to improve and have finally been released into my own custody (as opposed to forced convalescence with my family). So the appointment was pretty short and sweet. Everyone said that I looked good. This isn't saying much as their only basis for comparison was me unbathed in an open-backed hospital gown with messy hair and assorted tubes coming out of me. I took the compliment either way. We ran through the next couple of months and what they were expected to entail. Basically, it goes like this: in 2-3 weeks I go back for a flexible sigmoidoscopy (flex sig) in order for them to examine my new pouch and see how it is doing. For anyone that hasn't had the pleasure of one of these guys, basically it is like a colonoscopy, but they don't go as far and there is no sedation. In my past experiences this procedure has largely involved me swearing at the medical staff and calling them sadists.
If everything looks good in the flex sig, then a couple of weeks later we do that fun barium test thing. I have never done it before, but I have heard that the barium tastes horrible. Which brings me to my next point. I asked Dr. Heise how that test would work as I currently have a bypass and the barium wouldn't be able to make it to my pouch. The answer to this had already occurred to me before he answered. The inevitable barium enema was explained. Good times. At least I don't have to taste it. If that test looks good, then we schedule my takedown (hooking everything back up and getting rid of the ostomy) a couple of weeks after that.
That is about all of the excitement for now. Things are pretty status quo. I am getting more comfortable with changing my appliance everyday. I also feel a little better and have more energy each day that I get up. I had heard from multiple sources how they felt better immediately after the surgery because their diseased colon was gone. I thought that they were crazy, but now I have to agree. There is a lot that I feel like I can do that I haven't been able to in a long while. Unfortunately, things are still healing and I have to take it slow, but overall I am beginning to feel pretty good.
Friday, June 20, 2008
Thursday, June 12, 2008
Settling in
I am not going to lie and say that I was 100% comfortable with everything when I left the hospital. I don't think that I ever would have been, no matter how long I stayed. At some point though, you have to leave the proverbial nest and survive on your own. It is a big change to go from having a nurse available 24/7 to attend to any problem you may have with a pharmacy of medications at their disposal to taking care of yourself with limited support. With this in mind, I settled into my Middleton hotel room which would serve as home for the next few days. My biggest concern by far was the fact that I hadn't made it 24 hours in the hospital without having to put a new appliance (ostomy bag) on. I held out little hope that anything would be different once I left.
The next few days passed with little excitement. My appliance never leaked (thank goodness) and I had a couple of visits from Home Health Care nurses. The first nurse weighed me, which hadn't been done since before I checked into the hospital. Apparently I had lost about 13 pounds over my hospital stay. It may have been more because I hadn't weighed myself after my gorging episodes several days before the surgery, but I guess that this question is lost to history. The second nurse and I changed my appliance, which I am becoming uncomfortably comfortable with. When the day arrives that the sight of my intestines sticking out of my abdomen doesn't phase me, it will truly be a disturbing day. Other than that, not too much else happened. I busied myself with various daytime television programs, but one can only watch so much syndicated programming, and I am afraid that I simply cannot stomach much of what network television has to offer before 3:00 PM.
On Wednesday, I begrudgingly headed up to the Twin Cities. Although I firmly held to the idea that I could take care of myself in La Crosse, the overwhelming tide of conflicting views that came from everyone I knew eventually wore me down. So for at least the next week or so, I will be staying in The Cities and then going to my follow-up appointment in Madison on June 19th. After that, I plan on staying on my own in La Crosse. One can convalesce for only so long. Until then, I will continue to recuperate (and improve) and hopefully receive some visits from those few individuals who could not make the trek to Madison.
The next few days passed with little excitement. My appliance never leaked (thank goodness) and I had a couple of visits from Home Health Care nurses. The first nurse weighed me, which hadn't been done since before I checked into the hospital. Apparently I had lost about 13 pounds over my hospital stay. It may have been more because I hadn't weighed myself after my gorging episodes several days before the surgery, but I guess that this question is lost to history. The second nurse and I changed my appliance, which I am becoming uncomfortably comfortable with. When the day arrives that the sight of my intestines sticking out of my abdomen doesn't phase me, it will truly be a disturbing day. Other than that, not too much else happened. I busied myself with various daytime television programs, but one can only watch so much syndicated programming, and I am afraid that I simply cannot stomach much of what network television has to offer before 3:00 PM.
On Wednesday, I begrudgingly headed up to the Twin Cities. Although I firmly held to the idea that I could take care of myself in La Crosse, the overwhelming tide of conflicting views that came from everyone I knew eventually wore me down. So for at least the next week or so, I will be staying in The Cities and then going to my follow-up appointment in Madison on June 19th. After that, I plan on staying on my own in La Crosse. One can convalesce for only so long. Until then, I will continue to recuperate (and improve) and hopefully receive some visits from those few individuals who could not make the trek to Madison.
Sunday, June 8, 2008
Filling in a few blanks
I know that it has been a few days, but I assure you that they have been action packed. Let's jump right into the gory details. So Thursday started out great, but ended mostl
y with me being covered in assorted bodily fluids at semi-regular intervals. The main culprit this time was my JP tube, which is a tube used to drain fluid from a surgery site I guess. It just continued to leak no matter how many times we changed the dressings. I think that there must have been some ostomy leakage interspersed in there, but it has been a few days and I can't recall as vividly. Much of this clean-up/laundry duty fell on the unlucky nurse assigned to me that evening, Amanda (pictured obviously much before I became a pain). She was quite the trooper that evening, even as my returning sarcasm became sharper and more haphazard. We must have changed my sheets and gown half a dozen times. The remainder of that day passed without too much more excitement, other than I was beginning to feel much, much better.
The next day (Friday) began with a rude awakening (as my surgeon, Dr. Heise had forecasted). We began the "no epidural" experiment this morning at about 6:00. We replaced the epidural with oxycodone. I have heard that people supposedly abuse this stuff, but after trying two doses, I really don't get it. It basically completely wiped me out and made me want to vomit all morning. At this point I was getting a bit frustrated. It did not seem like I would ever get out of the hospital. Shortly after my horrific morning, we decided to stop using the oxycodone. I told them that I never wanted that garbage again. They made a note in my file. After my deto
x, I began feeling much better and even had my first solid meal since Saturday, a grilled cheese sandwich and some mashed potatoes. I was also graced by a visit from my brother Derek, and his wife Sheryl. Their aid was indispensable in running interference with my mother. Unfortunately, my excitement over my returning energy and new visitors was short-lived as we still had the task of removing my remaining tubes. First was the JP tube, which if you don't remember was a decent-sized tube sticking out of my abdomen for drainage. I had expressed some concern over getting this removed to Amanda, she said that it wouldn't be bad except for it has a fish-hook like thing on the end. I had to think for a moment before I realized that she was joking. Hilarious. So to take the JP tube out, one of the ever-sensitive residents came in and basically said roll to the side a little bit, and then just started pulling it out like she was Mary Poppins unpacking her luggage. I didn't look, but Derek said he thought that it was three feet long. It kind of felt like someone was pulling my guts out. Good stuff. Once that one was done we still had the epidural and catheter. The epidural itself wasn't bad, but it was affixed to my body basically by tape all over my entire back, the good surgical stuff. On the plus side, I got a free back wax. So then just the catheter was left. That wasn't so bad, but it did burn a bit. Thank goodness it wasn't as long as the JP tube. That would have been bad news. I was left with the task of urinating under my own power within the next six hours with the threat of reinserting a catheter if I didn't. This was not as easy as one would think after not having done so for five days. With much patience and fluids, that task was accomplished and I faded off to sleep...but wait! I wasn't about to get off that easy. Once before the day was done I was awakened by yet another bag leakage, and a night nurse who wasn't as patient as those saintly day nurses. We made it through though, and I eventually got to sleep.
y with me being covered in assorted bodily fluids at semi-regular intervals. The main culprit this time was my JP tube, which is a tube used to drain fluid from a surgery site I guess. It just continued to leak no matter how many times we changed the dressings. I think that there must have been some ostomy leakage interspersed in there, but it has been a few days and I can't recall as vividly. Much of this clean-up/laundry duty fell on the unlucky nurse assigned to me that evening, Amanda (pictured obviously much before I became a pain). She was quite the trooper that evening, even as my returning sarcasm became sharper and more haphazard. We must have changed my sheets and gown half a dozen times. The remainder of that day passed without too much more excitement, other than I was beginning to feel much, much better. 
The next day (Friday) began with a rude awakening (as my surgeon, Dr. Heise had forecasted). We began the "no epidural" experiment this morning at about 6:00. We replaced the epidural with oxycodone. I have heard that people supposedly abuse this stuff, but after trying two doses, I really don't get it. It basically completely wiped me out and made me want to vomit all morning. At this point I was getting a bit frustrated. It did not seem like I would ever get out of the hospital. Shortly after my horrific morning, we decided to stop using the oxycodone. I told them that I never wanted that garbage again. They made a note in my file. After my deto
x, I began feeling much better and even had my first solid meal since Saturday, a grilled cheese sandwich and some mashed potatoes. I was also graced by a visit from my brother Derek, and his wife Sheryl. Their aid was indispensable in running interference with my mother. Unfortunately, my excitement over my returning energy and new visitors was short-lived as we still had the task of removing my remaining tubes. First was the JP tube, which if you don't remember was a decent-sized tube sticking out of my abdomen for drainage. I had expressed some concern over getting this removed to Amanda, she said that it wouldn't be bad except for it has a fish-hook like thing on the end. I had to think for a moment before I realized that she was joking. Hilarious. So to take the JP tube out, one of the ever-sensitive residents came in and basically said roll to the side a little bit, and then just started pulling it out like she was Mary Poppins unpacking her luggage. I didn't look, but Derek said he thought that it was three feet long. It kind of felt like someone was pulling my guts out. Good stuff. Once that one was done we still had the epidural and catheter. The epidural itself wasn't bad, but it was affixed to my body basically by tape all over my entire back, the good surgical stuff. On the plus side, I got a free back wax. So then just the catheter was left. That wasn't so bad, but it did burn a bit. Thank goodness it wasn't as long as the JP tube. That would have been bad news. I was left with the task of urinating under my own power within the next six hours with the threat of reinserting a catheter if I didn't. This was not as easy as one would think after not having done so for five days. With much patience and fluids, that task was accomplished and I faded off to sleep...but wait! I wasn't about to get off that easy. Once before the day was done I was awakened by yet another bag leakage, and a night nurse who wasn't as patient as those saintly day nurses. We made it through though, and I eventually got to sleep.Saturday I woke up feeling pretty good. One of the well-polished residents greeted me this morning with, "How you would like to go home today?" I thought that she was kind of nuts. It seemed like I hadn't felt decent for two days in a row, so inevitably this day would turn. Once Robyn and I talked about it, we decided that there really was no reason for me to stay other than to continue to be a pain in the butt to the staff and to have someone to change my ostomy stuff. After an early morning visit from my brother Jason, his girlfriend A
bby, my uncle Ron, and his wife Jean, we began the discharge process. Robyn walked me through changing my ostomy. Once again she was infinitely patient. The change was a success with a few added modifications, including a sporty new belt. Newly fitted with my hospital issued pajama bottom type pants and Obama '08 t-shirt, Jason wheeled me down the hallway and out of the hospital. All in all, it was a pretty decent stay for a pretty crappy procedure (pun only sort of intended, the adjective definitely applies). The nurses for the most part where excellent, even if they did not demonstrate mastery of the English language all of the time, which as a future English educator I take as a personal affront. If any of the nurses happen to be reading this (as I am sure they have much more free time now that I have been discharged and my mother was sure to give everyone the blog address with the zest of a door-to-door encyclopedia salesperson), I just wanted to say thanks for putting up with all of my complaining, whining, pissing, and moaning (well, not so much pissing, that was largely taken care of by the aforementioned catheter), but nonetheless they did an excellent job. That is it for the hospital stay for now (I hope). I would love to update further, but I have a date with a couple of vicodin.
bby, my uncle Ron, and his wife Jean, we began the discharge process. Robyn walked me through changing my ostomy. Once again she was infinitely patient. The change was a success with a few added modifications, including a sporty new belt. Newly fitted with my hospital issued pajama bottom type pants and Obama '08 t-shirt, Jason wheeled me down the hallway and out of the hospital. All in all, it was a pretty decent stay for a pretty crappy procedure (pun only sort of intended, the adjective definitely applies). The nurses for the most part where excellent, even if they did not demonstrate mastery of the English language all of the time, which as a future English educator I take as a personal affront. If any of the nurses happen to be reading this (as I am sure they have much more free time now that I have been discharged and my mother was sure to give everyone the blog address with the zest of a door-to-door encyclopedia salesperson), I just wanted to say thanks for putting up with all of my complaining, whining, pissing, and moaning (well, not so much pissing, that was largely taken care of by the aforementioned catheter), but nonetheless they did an excellent job. That is it for the hospital stay for now (I hope). I would love to update further, but I have a date with a couple of vicodin.Thursday, June 5, 2008
The post-colon era
Creating suspense! That's exactly what I have been trying to do. It is exactly how I have learned it from the great Hollywood producers of yester-year. You build, and build, and build, and then nothing. For a bit. So obviously, I am alive. The surgery went for about 8 1/2 hours for everyone in the real world. It was about one minute for me. It went pretty well I think. I'll run down what I can recall. First we checked in at the First Day Surgery department at 5:30 AM. Shortly after, I was whisked away to a curtained area where I proceeded to get my gown and robe mixed up and put them on backwards. A word of advice, the gown has snaps, the robe doesn't. Otherwise they are exactly the same. Both equally sexy. After meeting with the various teams that would be working on me (I like the idea of a team, like when somebody makes an error in baseball someone is there to fix their mistake). The anesthesiologists were very pleasant. They brought me first to "cocktail hour" where they doped me up on something that allowed them to stick an epidural in my spine. I would imagine that would have been a bit uncomfortable without the initial pain killer. They had to wiggle around for a while to find the right spot. It did start working almost immediately though. That was pretty good. They then wheeled me into the OR where I scooted onto the operating table. It was a pretty cold, white room with a lot of lights and cameras. After moving onto the table the next thing that I remember is waking up in a haze and not really knowing what was going on. 
To the right is a picture of me looking pretty doped up and chubby right after surgery. Certainly not the most flattering of pictures, but it kind of sums up how I felt. The nurses appeared to have a bit more energy. There are some even less appealing pictures if you can believe that. I don't remember the first day too well. I basically laid on a bed in my room and drifted in and out of consciousness. I couldn't really drink or eat anything yet, not that I was very interested in that. Doctors and residents stopped by and checked on me, and I eventually fell asleep for a few hours at a time that night. I ran a fever of 103 for most of that evening and night, but we eventually got it under control.
To the right is a picture of me looking pretty doped up and chubby right after surgery. Certainly not the most flattering of pictures, but it kind of sums up how I felt. The nurses appeared to have a bit more energy. There are some even less appealing pictures if you can believe that. I don't remember the first day too well. I basically laid on a bed in my room and drifted in and out of consciousness. I couldn't really drink or eat anything yet, not that I was very interested in that. Doctors and residents stopped by and checked on me, and I eventually fell asleep for a few hours at a time that night. I ran a fever of 103 for most of that evening and night, but we eventually got it under control.The second day I started feeling quite a bit better. I managed to sit up a little bit and even walk a couple of times. I made it about 30 feet, which was pretty good I guess. At least according to the nurses. Much to the dismay of everyone around me, I also got my NG tube taken out. For those of you not familiar with such a device, it is about a two foot long piece of tubing (maybe 1/4 inch) that goes down your throat and into your stomach. The intention is to suck out various substances that can 
make you nauseous and perhaps vomit, which would not be comfortable for someone with recently made incisions in their stomach. Unfortunately for me, but fortunately for others, this tubing made it a bit difficult to talk. By the second day it was making my throat pretty sore. We decided that the output wasn't very high and that we would take it out. While pulling it out, I decided that the four seconds that my nurse was taking to perform this task was not enough and just pulled it out myself as fast as possible after about half a second of this lovely experience. Definitely not pleasant either way. The faster the better though. The end result was a slightly sore throat and a piece of tubing covered in mucus and snot. With my newly recovered vocal abilities, I returned to my usual abrasive and sarcastic self. Additional activities that I enjoyed this day include changing my ostomy bag and being bathed by an intimidating nursing assistant from South Africa.
make you nauseous and perhaps vomit, which would not be comfortable for someone with recently made incisions in their stomach. Unfortunately for me, but fortunately for others, this tubing made it a bit difficult to talk. By the second day it was making my throat pretty sore. We decided that the output wasn't very high and that we would take it out. While pulling it out, I decided that the four seconds that my nurse was taking to perform this task was not enough and just pulled it out myself as fast as possible after about half a second of this lovely experience. Definitely not pleasant either way. The faster the better though. The end result was a slightly sore throat and a piece of tubing covered in mucus and snot. With my newly recovered vocal abilities, I returned to my usual abrasive and sarcastic self. Additional activities that I enjoyed this day include changing my ostomy bag and being bathed by an intimidating nursing assistant from South Africa.The third day was filled with ups and downs. I was able to start sipping clear liquids. This was a nice change. I tried to get up that morning for a towel bath, but got very light-headed and ended up laying in bed for a bit. Unfortunately, my position made my ostomy connection begin to leak and within a few moments I was enjoying laying in a pool of my own waste material. Very comforting. Thank goodness for my nurse Robyn (right). She was very patient with cleani
ng everything multiple times that day and never complaining about it. It was truly repulsive. One thing that I have learned is to have no shame in terms of medical care. You really have to be open to whatever in order to get proper care. I basically took it easy the rest of the day. It was decided by a team of residents (much like you can imagine from any popular medical television show, i.e. ER, Scrubs, or House, but without the entertainment value) that my fluids were low which was making me light-headed. So we increased that and I began to feel much better.
ng everything multiple times that day and never complaining about it. It was truly repulsive. One thing that I have learned is to have no shame in terms of medical care. You really have to be open to whatever in order to get proper care. I basically took it easy the rest of the day. It was decided by a team of residents (much like you can imagine from any popular medical television show, i.e. ER, Scrubs, or House, but without the entertainment value) that my fluids were low which was making me light-headed. So we increased that and I began to feel much better. Today is the fourth day (Thursday). It has been a much better day today. I discussed with the anesthesiologists about making a new cocktail for my epidural yesterday. We started that last night and it has been working wonderfully. I went for two walks today, and even had some clear liquids. This is the first form of food that I have had since Saturday morning, but I fear that I did not loose as much weight on the famed starvation/take out an organ diet as I had hoped. We have begun discussing a discharge date, which still seems a bit sudden to me. I gauge how I am doing by how many apparatuses are attached to me. I still have the epidural, a catheter, a wound drainage device, and an IV. It seems that there is still a ways to go. We will see though. Perhaps late tomorrow or Monday. I am supposed to start on full liquids, which I believe are those that you cannot see through, later this evening. I am definitely looking forward to that. Anyway, now that I am a bit more mobile and coherent I will update more often and hopefully more entertainingly. Until then, thanks for all of the support.
Sunday, June 1, 2008
The colon's swan song
It is Sunday evening. I don't think that my colon is expecting anything. It has put up relatively little resistance thus far. We may succeed at this surprise attack yet. I finished the initial stages of my bowel cleanse. All that is left is an enema in the morning. Well, at least I have something left to look forward to. As anyone in this family will attest to, the lack of regular feedings of any member of the Bettini clan results in irritability at a much higher level than normal (hard to believe I know). In order to prep for the surgery, I had to stop eating after breakfast yesterday. This has had the expected result. I tried to plan for the expected physical and mental effects. I thought, "Where could I go that would not only leave me feeling full, but also not wanting to eat again for the foreseeable future?" The only possible answer was the Old Country Buffet. While the food there is only moderately sub-par, the clientele leaves something to be desired. I think that I officially finished my meal shortly after I observed a woman in line for a made-to-order omelet who apparently could not wait to return to her seat before devouring a fried chicken leg. Did I mention that this lady did not appear to need the extra fried chicken leg too badly or that it was 10:30 in the morning? Who eats fried chicken for breakfast? While in line for more breakfast? The image of that slovenly member of society has helped to keep the hunger at bay.
Seeing as this will be the last day for a while that I can foresee having much energy or patience, I thought that I would briefly go over a few more appetizing details concerning the procedure. So the big change over the next few months will be the introduction of an ostomy into my daily life. What's an ostomy you say? Well has anyone seen the opening scenes "Saving Private Ryan" with the Allied troops landing at Normandy? There is one gentleman in particular who is hit by mortar or some other explosive device and is holding his intestines inside his body. Well it is kind of like that except for the fact that I am overdramatic to a fault. Basically, I will have this new "colon" which is newly put together and full of sutures and doesn't know what to do. So while that is healing up, the doctors divert part of my ileum(part of the small intestines) so that it sticks out of my abdomen and then the waste comes out of there into what is essentially a zip-lock bag attached to my stomach with caulk. I know you are thinking, "How can I get one of these?" So that should be fun. After two or three months, I go in for surgery again at which point the doctors hook up my new colon and take out the ileostomy. My summer will largely be spent dealing with this new appliance as they call it. It's not a dishwasher. I think that they need a new term.
Right now it is about seven hours until I need to check in. I should probably get some sleep. I will try to post with an update whenever I am up for it. If anyone is worried in the meantime, you can feel free to call my Mom. Actually, it would probably help to keep her occupied. Her cell is 612-384-9190. Feel free to call for updates. Otherwise, I will see you cats on the flipside.
Seeing as this will be the last day for a while that I can foresee having much energy or patience, I thought that I would briefly go over a few more appetizing details concerning the procedure. So the big change over the next few months will be the introduction of an ostomy into my daily life. What's an ostomy you say? Well has anyone seen the opening scenes "Saving Private Ryan" with the Allied troops landing at Normandy? There is one gentleman in particular who is hit by mortar or some other explosive device and is holding his intestines inside his body. Well it is kind of like that except for the fact that I am overdramatic to a fault. Basically, I will have this new "colon" which is newly put together and full of sutures and doesn't know what to do. So while that is healing up, the doctors divert part of my ileum(part of the small intestines) so that it sticks out of my abdomen and then the waste comes out of there into what is essentially a zip-lock bag attached to my stomach with caulk. I know you are thinking, "How can I get one of these?" So that should be fun. After two or three months, I go in for surgery again at which point the doctors hook up my new colon and take out the ileostomy. My summer will largely be spent dealing with this new appliance as they call it. It's not a dishwasher. I think that they need a new term.
Right now it is about seven hours until I need to check in. I should probably get some sleep. I will try to post with an update whenever I am up for it. If anyone is worried in the meantime, you can feel free to call my Mom. Actually, it would probably help to keep her occupied. Her cell is 612-384-9190. Feel free to call for updates. Otherwise, I will see you cats on the flipside.
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