There and back again...

So I'm here, sans ostomy, and feeling great. But how did I get to this point? Well, lets go over the last 24 hours or so. We (my mother and I) arrived in Madison yesterday at about 6:30 yesterday evening. After checking into the hotel (the process of which involved my saying "what a production" to my mother several times in exasperation), I decided to take in some of the local cinema. As I had not eaten since lunch, and would not eat anytime in the foreseeable future, I decided that it would be a good idea to distract myself. Once I returned from the 2 1/2 hour epic of The Dark Knight, I began the next stage of my preparations for today (the first of which was self-imposed starvation). Earlier that day I purchased from Walgreens what looked like something that you would find in the supply closet of a doctor's office in California recently after the Louisiana Purchase. It was a sizeable bottle of grape-flavored, carbonated laxative called Magnesium Citrate. When I returned to the hotel, I consumed the entire bottle with a water chaser, and waited. The idea of using a laxative is slightly disturbing for me normally, but now I was using one to hurry things along in a rather non-traditional way. Within a half-hour, my ostomy bag began filling at a break-neck pace. Much more than the equivalent of the bottle's contents passed through me, which would come into play the next day. As I was looking forward to being free of the bondage of the ostomy, I let my guard down and the little bugger got the best of me one last time. I don't know if any of you have tried to empty a bag filled with liquid and attached to your body at 2:00 AM, but trust me when I say to maintain your diligence in such cases. I took for granted the fact that I was a veteran with such tasks, and failed to notice the rather large gap in between the toilet seat, and toilet bowl at the hotel. I figured that once I cleared the seat, I was home-free. Unfortunately, this was not the case. As I opened my ostomy bag for what would be one of the last times, a torrential flood of my remaining fecal matter came pouring through the aforementioned gap. My old nemesis was apparently not letting me go without a fight. While such an event would have been a source of frustration two months ago, now as I was so close to being relieved of my omnipresent burden, it was nothing more than an annoyance and slightly comical.

The remainder of that night was spent without incident. I awoke this morning, eager to get to the hospital. We arrived at 7:40 AM and were told to check in at admissions. After giving my name to the hospital worker, I was offered the information that I was at the wrong facility. I say 'offered' because I replied with, "No, you are wrong lady." She said that I was wrong (big mistake) and that I had an appointment on the other side of town at a non-surgical facility with a doctor who wasn't a surgeon. I replied with, "Well, I am having surgery, and it is not happening there. So thanks, but no thanks." I immediately left and went to the office where I knew my surgeon worked out of. I asked a woman there to look up my appointment and admit me. Shortly after this, the previously mentioned ignoramous came chasing after me and telling me that she found the appointment for today. The other appointment that she was looking at was scheduled for January of 2009. Way to instill me with confidence. If they can't even find the right appointment, how would they find the right body part to operate on? Fortunately, I have the utmost confidence in my surgical staff. Nonetheless, I did double check several times that they would be performing the correct procedure.

I then checked in for my surgery and was quickly ushered off to my prep room. After dispensing with the regular pleasantries, we jumped right into sticking me with as many needles as possible. First, we needed to get some baseline blood tests. Normally, not an issue. Remember the high output in my ostomy bag the night before, well apparently that resulted in me being pretty well dehydrated. Unknown to me, a side-effect of dehydration is that your veins are not very full, and don't really put out much blood. We arrived at this conclusion after attempting twice in vain to get some blood out of me. Then another old friend arrived to welcome me, the heparin shot. The nurse wasted no time in reaquainting us. We were then down to the IV. This is also not a big deal normally these days as I have received more than I can remember. The IV went in without a hitch. However (there is always a however), the anesthesiologist who put it in must have found the one good vein left in my body, and it resulted in my blood leaking all over myself, the bed, and the floor. I chose not to observe these events, but I would imagine that it would look something like a butcher shop counter right before the Fourth of July. After cleaning up my blood with what I believe was a spill kit normally intended for jack-knifed tankers on the interstate, I was given my IV cocktail to relax me and then was whisked off to the operating room.

After receiving my cocktail, they could have done anything to me. But they just operated. The last thing that I remember is being told to breath four times with a mask over my mouth. I made it to about 2 1/2.

I woke up in the recovery room feeling pretty good. The procedure took under two hours. I was pretty sleepy, but I was excited to be rid of the ostomy, so I didn't sleep too much. I hung out down there with a bunch of really ornery patients. I overheard many patients complaining, and many doctors trying to satiate them. One of my favorite lines was delivered very deadpan from a doctor. He said, "We can't give you that much pain killer. It would result in death." Needless to say, the doctors and nurses were sorry to see me go.

I was then brought up to the familiar confines of the F4 section of the hospital. This is the same area that I stayed in before. I got checked in, met the new residents, said hi to some of my old nurses, and began to settle in. Before long, I was visited by yet another old friend, the familiar feeling of liquid leaking from my ostomy site. "That is impossible," I thought, "I no longer have an ostomy." To my relief, if was merely blood leaking from my dressing. Oddly enough, that is much less distressing than fecal matter. Well, maybe not too oddly. The blood continued to be a problem, but with an absurd amount of gauze taped to my belly, we got it under control. I guess that it is supposed to drain a little bit. Shortly after we stopped all of my bleeding, I was finally visited by my surgeon, Dr. Heise. He was pleased with how the operation went, but was pretty annoyed when he noticed what appeared to be a hematoma in my incision site.

Quick medical lesson. A hematoma can be caused by many things, one of these is an infection in part of your body. Apparently, there may be a little infected area under my skin, but over my muscle. The body seals this little infected area off, and then it needs to be opened up and drained at some point. I inquired as to how this is performed. Dr. Heise said that I would just come in to the clinic and they just slice it open, not really much anesthesia. So that should be fun. He did say that if we could get it to bleed out, then it would be okay. I would have to apply a lot of pressure to my incision site though. All of this after finally getting it to stop bleeding. I'll probably opt for the under-sedated slicing.

The remainder of my evening was spent attempting to urinate under the threat of having a catheter inserted (I didn't have ANY tubes coming out of me when I woke up this time) and ambulating. I think that nurses always use the catheter as a threat in order to scare the pee out of me. I went for a pretty long walk with my nursing assistant. We walked all around the floor. Upon return to my room, I noticed a slight, but increasing pain in my right side. She said that it was gas that had moved from when I was walking. I guess that I never realized it before, but trapped gas can be extremely painful. On the frowning face scale of pain, it was definitely a frown with some water come out of its eyes. I explained this to my NA, who responded with a look that seemed to say, "Are you serious? What a wuss." After continuing to complain of what must have felt like a heart attack, she supplied me with some heating pads which were supposed to help. The pain receded after a few minutes, and now I am fine, but man, it was no fun for a little bit.

Anyway, I am getting tired, and that is probably more than anyone wants to read anyway. I'll provide another update in the morrow.

69 days down, 5 to go

I know, it has been so long and you have all been met with disappointment upon each viewing of my blog that results in yet another updateless day. Well, half of that is correct anyway. "What have I been up to?" You ask. I would be happy to fill you in on all of the exciting details of my life over the past several weeks. This should take about three sentences (but I do tend to be a bit long-winded, even while typing). Basically, I have felt excellent since my last update. I have been biking and exercising any day that I have had time to. Also, everyone kind of came through for me when I said that I was insanely bored. Over the past several weeks, I have spent probably about 36 combined hours in La Crosse because friends in either the Dells or The Cities have provided me with assorted means to stay occupied. I have only had maybe one or two mornings to my self over this period of time. I have been pretty busy painting, working on the Dells house, catching up with old friends, making new ones, and of course eating/drinking on the patio at Salut.

But enough catching up, lets get down to the proverbial brass tacks (does anyone even know what that means?). A few weeks ago I had my barium test. It wasn't nearly as bad as I expected. The tube was not very large at all, and it only had one mishap when it shot out of where it was supposed to stay put and sprayed barium everywhere. While I would LOVE to describe this in every offensive detail that I can muster, I am attempting to keep this thing PG, or maybe PG-13, so just use your imaginations. Anyway, it was a pretty interesting procedure. I even watched on the monitor as the barium slowly crept up my new "colon" and then spilled out into my ostomy bag like the spring flood waters reaching the Mississippi River Delta. Also during this procedure, I stumbled upon the perfect joke for any procedure involving anything being inserted into an individual's rectum. I have tried many one-liners in an attempt to make the medical staff more uncomfortable than I. After all, why should I be completely at their mercy? You are all free to use this one. So the younger doctor that was overseeing the test tried to sympathize and say that all of these procedures must be pretty uncomfortable for me. I replied with, "Yea, this whole experience would be a lot more enjoyable if I were some sort of sexual deviant." The uncomfortable laughter that this was met with was pure beauty.

So that test went well, and everything is on track. Just five days to go from today. It is all pretty crazy. While I would love to embark onto a retrospective diatribe concerning the ups and downs of the past 2+ months, I fear that I must save that for after the surgery sometime. I go in on the 15th for my takedown. I did get some excellent details on how this procedures is performed. I asked the doctors if they just shove everything back in and sew it up. Apparently it is not that simple. What they do is pull a portion of my intestines out of my body (I know, sweet), and then cut out the part that goes to the ostomy, then they sew the two ends back together and shove it all back in. I think that flux and solder are involved somehow, but I am not sure. I was hoping to get some sort of camouflage hospital gown and perhaps a WWII military surplus helmet in order to finally re-enact that beginning scene from Saving Private Ryan (how is that for foreshadowing? I only wish that I had planned it [see blog entry #2 if you are confused]) After that, I will basically be good to go. I will have to stay at the hospital until I have a bowel movement (the beauty never ends). This can range from two to perhaps nine days. It all depends when my GI track feels like waking up. So I will probably feel great for as long as I am there, which with any luck will only be two or three days. I foresee a very boring stay.

I guess that is about it for now. I will let everyone know how it goes on Friday as I will probably be up and about pretty quickly. It is only a 2 or 2 1/2 hour procedure. Until then, thanks for all of the support.

The end is in sight

So there are a couple of reasons for this sooner than planned for post. The first, and unfortunately mostly informational, is that the last two dates for my last two procedures have finally been determined. On July 25th, I will be get my barium test. I don't foresee too many problems with that one. The other procedure which is for my (drumroll please) takedown is scheduled for August 15th. That is a little later than I had hoped, but I am over halfway there. It is definitely a workable date. The best part is I will be back together for the state fair. Hopefully everything will be up and working for the biggest test ANY gastrointestinal track can face.

The other reason for this post is that a few people (as well as myself) have noticed a decreasing entertainment value in my blog. I will do my best for my fans. So lets see...I do have one story that I excluded from the previous post. I will set the stage. You know when you go to a grand opening at some crappy store or perhaps auto dealer and they serve grade "D" hot dogs, popcorn, and have brightly colored balloons filled with helium? Well, think about those balloons filling with air from the helium tank, but replace the helium tank with a long flexible tube with a camera on the end and the balloon with my ostomy bag, and then just sandwich me in the middle somewhere. That was basically the effect that my last flex sig had on my system. I guess that I was naive when I thought that gas only went one way through the human body. Apparently, if you really try, it can also go the opposite way of what we all think of as natural. And not only that, if you happen to have your intestines sticking out of your body with a hole in them, the gas will escape. So lets paint a picture of my ultimate indignity (well not quite, but bare with me anyway because we all know there have been worse). There I am in a room full of doctors and students with my pants down, a camera in my rear end, and what is essentially a balloon attached to me which is filling up more and more with each additional refreshing burst of air dispensed by said camera into my "colon." I don't know what was going on there, but I am pretty sure that every hole in my body was serving a purpose other than what was intended and was thoroughly confused in the process. Good times.

So that's the only other story that I have. I hoped that I juiced it up enough to hold people over until I get an element from the periodic table squirted into my rectum. With any luck there will be some great stories when I get to the takedown. We can only hope...

Its all downhill from here

I know that these updates are becoming few and far between. This is mainly for two reasons. One, I doubt the attention span of the vast majority of my audience can last for a continuous month. The other is that my activities have basically consisted of nothing. Oh, if only I was lying. As much as everyone complains about having too much work and not enough free time, it is actually much better than the alternative. The slow train to boredom and insanity has already left the station. Sure, I have tried to keep busy with assorted chores, but it certainly does not occupy 40 hours per week.

On to the main reason for this update. Last Thursday (the 3rd) I had my follow-up flex sig. I believe that we all recall my earlier explanation. It didn't go too badly. Unfortunately, I do not have the rapport with this particular surgeon that I have had with previous doctors, so I had to watch my language. As with any procedure that is performed on me, there was a small audience to observe this medical oddity. It wouldn't be the same if there wasn't. Dr. Heise tried to reassure me once I disrobed that they were there to look in my backside, not at it. This was not reassuring at all. I expect nothing less than to be ogled.

Once the camera was inside and past the staples, I ventured a peek at the monitor. It didn't look too bad compared to other pictures I have seen of my dearly departed diseased and ulcerated colon. He said that everything looked good and that we would schedule the next step (the barium test) in a couple of weeks. If everything looks good with that, I might have the takedown done by the end of July. That would be the last step, at least for a while. He also mentioned that things may need to be...stretched out down there. This process is similar to basically a colonoscopy, but with much more barbaric intentions. If that is the worst that I need to worry about though, I can handle it.

So to sum everything up, I am doing well (except for the boredom), and everything is on schedule and looking good. I will update again in a couple of weeks once the barium test is done and hopefully the takedown is scheduled.

Follow-up appointment #1

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.

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.

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 mostly 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 detox, 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 Abby, 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.