The first call from the hospital was to get my medical history and a list of all my medications. I have had all of my surgeries (in the double digits) done at this hospital chain, with the most recent surgery less than a year ago, so they already had all of my history and medications. But they had to get all of the information again. And they couldn't just verify what they had was correct. They had to get all of the information from me. It's a good thing that I had it all written down.
The next call was to inform me what time my appointment was. It was set for 9:30 am, which is a good time. Not too early, so I don't have to get up early in order to get to the hospital just in time to wait for the doctors. Not too late, so I don't have to go all day and all night without food or water before the operation. It was the ideal time.
The third call was to give me instructions, which Deanna gives to patients all the time. Nothing to eat of drink after midnight, including chewing gum, mints, throat lozenges, etc. I was told which medications I could take before I left for the hospital, and was told to wear something comfortable, that I could fold up and store until I was read to go home. There is only one part of these instructions that I have a problem with. They don't tell you "...nothing to eat or drink for 6 hours before the operation", but rather they tell you "...nothing to eat or drink after midnight". Now if you are the first person scheduled to be operated on, at 6:00 am then that is fine. But what if you are scheduled to be operated on at 2:00 pm? That means that you have nothing to eat or drink for 14 hours, while the person who is operated on at 6:00 am only has to go 6 hours with nothing to eat or drink. Not fair! Doesn't make sense. But then they say that they could call you in early, but if you have eaten they couldn't. But I speak from experience. From the time that they know that you are going to come in early, it takes at least 6 hours to get for them everything ready (in my opinion). First you have to travel to the hospital. Then you have to wait to register. Then you have to change your clothes. Then you have to get an initial exam. Then you have to wait for someone to come and get you. Then you have to wait for the room. There is no way that they will do all that in less than 6 hours. So if they need you to come in early, they call and say come in now and don't eat anything. By the time you get there, and get all set up, and get to the operating room it will be six hours. But wait! If they do it that way, there is a small, slight, minimal chance that the doctor may have to wait for 30 minutes, or heaven forbid an hour. Much better to have every single patient starve for part of a day so that the doctor doesn't have to wait. Because if he has to wait, he's not making money. And of course, there is nothing else he could be doing to keep himself busy while they are getting you ready for an operation.
We get to the hospital 5 minutes early because we don't want to make anyone wait for us. They have a registration kiosk that is pretty efficient - if you know that it's there. Since I have been there many times, I know what to look for. It's touch screen (don't worry, they have disinfectant and wipes available), and all you have to do is enter your first name, last name, and the number of the electronic beeper that is sitting on a table next to the kiosk. It's similar to one of the beepers you are given when you sign in at at busy restaurant. When they have a table ready for you, the bells, lights, and whistles go off. So we take our beeper and sit down to wait. After about 20 minutes we get beeped. We go to the front desk. There they have all of our information, already filled out by the person who made the first call to gather information. But it seems they didn't send me a form to fill out like they promised, so Deanna had to fill it out. Since she fills out these forms all day, it didn't take her long to fill it out. When it's all filled out we take it back up to the desk again, and we are told that the next time we are beeped we need to go down this hall to the right, then turn left, and someone will help us.
We didn't have to wait long before the beeper was beeping. We found where we were supposed to go, and were shown into the dressing/exam room. Blood pressure, weight, and temperature were taken. I was given a wonderful hospital gown to change into. Now I've been in and out of hospitals for the last 50 years, and while the hospitals may have changed, and the procedures have changed, the doctors and nurses have changed, there is one thing that has not changed - the hospital gown. Since at least the 1960's every gown I have worn has basically been the same. A very nondescript blue pattern, short sleeves with snaps to open and close the sleeve, and with a tie in back of the neck and on the side. I don't remember when, but it was quite a few years ago that they began to give you pants to wear with the gown. Before then, all you got was a single (ICU - I see you) gown.
We went over the basics with the nurse, where she told us about what was going to happen next. We told her that we had a couple of questions for the doctor. Deanna remembered him telling us that they were going to operate on C4 - T1, but the papers the nurse had said they were going to be operating on C5 - T1. I also wanted to talk to the doctor to make sure that he understood that the reason for having the operation was to relieve the pain in my neck, not only to fix the nerve and muscle damage in my arm. The nurse said that the doctor never talks to the patients before the operation, which is quite unusual. The nurse even admitted that it is not the normal practice for most doctors, but that he will talk to Deanna immediately after the operation, and will come see both of us before we leave the hospital. She said she would share our concerns with him. Deanna asked who was going to mark the spot of the incision - it's a hospital policy to mark the spot of the surgery while the patient is still awake to make sure they don't operate on the wrong location. Doctors have been known to amputate the wrong arm or leg, so it's a very important policy. The nurse said she didn't know who would mark the spot. In reality it didn't matter because there wasn't a right or a left to mix up, and if the doctor got in there and found that the problem was on different discs I don't think he would be waking me to get my approval to make a change in the diagnosis.
Deanna gave me the IV.
After we were all ready, the nurse told us that the doctor had had an emergency earlier in the morning and was running a half hour late. So instead of leaving for the operating room at 11:15, we would have to wait until 11:45. I was glad to hear the 15 minute interval. That at least told us that the estimates were somewhat accurate. At 1:30 pm they finally came to wheel me up to the operating room.
As they were taking me up to the operating room, I realized something really scary. I recognized the hallways in the basement, from being there before - for a different operation in a different building. But they shared surgical services so I was going to the same part of the complex. When we got to the floor of the operating room I asked the nurse which floor we were on. She said the 14th floor. I later learned that it was a lie. Actually it was the 13th floor. But that brings up another hospital policy I don't quite understand. Why don't they number the 13th floor as 13? Isn't this an institute of higher learning and education? And if people are really superstitious about the 13th floor, do they really think that calling it the 14th floor will counteract the superstition? And why is a hospital perpetuating the myth? People with superstitions may find validation in the fact that even hospitals, with all the smart doctors, won't even name the 13th floor. Now as I see it, the only way to avoid the problem is to have a 13th floor, but just have it be storage and maintenance floor. But of course they couldn't do that because then they would always be having problems with maintenance - because it's on the 13th floor. So maybe they should just have a 13th floor and just have it be empty. But then a lot of prime patient room space, with great views, would be wasted simply due superstitions. Much better to just rename the floor - even though everyone knows it won't make any difference. That way people on the floors above will feel they are one floor higher, which we all know is better and more costly. But then again, if we go back to having an empty 13th floor, you could make it so that it wouldn't really cost that much. Just make the floor one foot tall. Give it a fake ceiling and a fake floor. It would technically still be the 13th floor. You could even give it a number on the elevator, but the elevator wouldn't stop there, and in the stairwell, you would only have a crawl space. But hey, that's too much work just for a superstition. So they compromise and give in the superstitious and just rename the 13th floor 14. After all, it's just a number. Right?
So they are wheeling me down the hall. For some reason this is one part of the procedure I always remember. Going down the hall, looking at the ceiling tiles, trying to figure out where we are and where we are going. We finally get to the operating room, and I am left in the hall while the cleaning crew finishes moping the floor and getting everything ready. They put me next to a wall of windows on the east side of the hospital, overlooking the helicopter pad, with a city park across the street. It's a dark gray out, even though it's the middle of the day, and it's snowing. I see the cars driving up and down the main street of the city, although there's not much traffic. I watch the snow flakes flutter past the window as they descend towards their final resting spot below. As I'm watching, someone wheels in a huge piece of medical equipment into my room. I have now claimed it as my room.
Then someone approaches from behind my head. He introduces himself. Of course I don't remember his name, but I do remember him. He was the anesthesiologist. I remember him because he was different. He was elderly, 50 - 60, and black. Being from Utah, that is rare. He must be really good, to be a minority, at his age, in a white state. He had my full confidence then and there. He said he was going to give me something to get me started before they took me into the room. I never saw what he did, if anything.
Soon thereafter the doctor himself appears. This wasn't supposed to happen. He NEVER talks to his patients before the operation. But yet here he was. He asked how I was doing. I told him I was fine. He said he was told that I had some questions. I told him about our concerns and he reassured me that it was the C5-T1 that they would be operating on and that while nothing is guaranteed, that it should help relieve the shoulder pain. Or at least something to that effect. Then he was gone. I assume he went into the operating room, but things were a little hazy by that time.
The time finally arrived. Two of them came out to get me. I was outnumbered, and there was nowhere to run, so I just gave up and let them take me. Once inside the room I looked around, but don't remember much. I saw a couple of people getting the last of their operating scrubs on, and some were playing with equipment. They asked me to move off of the gurney and onto the operating table. Remember when I said some things have never changed - like gowns? Well, one of the biggest, and best improvements hospitals have made over the last couple of years is the operating table. I remember when it was a cold, hard, metal table. Now it is a firm, foam like surface that you just sink into. It's great! So, they had me slide onto the operating table. Now normally is when the anesthesiologists tells me he is going to put me to sleep. But not this time. After moving onto the table, I don't remember anything until I was waking up in the recovery room, and even that is a little hazy. I would have remembered more if I had written it down as I was waking up, but they didn't let me take my laptop with me.
I do remember that I didn't sleep at all that night. I just watched mindless TV the entire night. I wasn't in much pain at all. I'm not sure, but I think I had dinner, which was pretty good. I think it was fish and mashed potatoes. I remember adjusting the pillows a lot during the night. I did actually try to sleep for a couple of hours, but sleep just wasn't going to happen. But let me tell you about the TV. I've been in hospitals where the TVs looked like they had been purchased from DI, or Good Will. Not here. It was a new hospital, and they had new TVs. Not only TVs, but a HD, flat screen with Direct TV Satellite. And big! It was at least a 48" TV, mounted on the wall, and came with a remote. Unfortunately it wasn't until I was getting ready to leave that I found out there was a remote. I had been using the up and down buttons in the bedside controls. But the remote had everything. Combine the TV with the really great food in the hospitals, and it seems like people would check in just for the food, TV, and house keeping. I'm sure that if you made a study, you would find that people would opt to stay an extra day or two if they were given an option.
12/23/2009
The next morning Deanna wanted to be able to sleep in before coming to pick me up. But the nurse came in early and said that the doctor had written my discharge papers. So I called Deanna to come and pick me up (it was at 8:30 am). The nurse popped in and said that he had to take care of someone else, but that he would be back soon. I told him to take his time.
Deanna got there shortly before the nurse came back. She took out my IV, much to the delight of the nurse. He then went over the discharge instructions, including the pain medication I was going to be taking, with a description of what they were and all the information about them. They gave me a script for Carisoprodol (the same thing as Soma), 350mg tablet taken 3 times a day as needed for pain spasm. Tramadol (same thing as Ultram), 50mg tablet every 4 hours as needed for pain. He also had a prescription for Oxycodone, but since I already had some at home, I didn't take the prescription for it.
The discharge papers said to do the following:
1. Call and make a follow-up appointment 4-6 weeks from the date of the surgery.
2. Keep the incision clean. They said not to get it wet, not to take a bath where the moisture would rise and make it wet, I could take a shower if I covered the incision with a plastic bag and tapped it off. But in my experience, that process has never kept anything dry, so I just took sponge baths, or rather I had my private nurse give me a sponge bath.
3. The discharge papers said that my throat may be sore from the endotracheal tube which is part of general anesthesia. They also said that I should expect some muscle stiffness and overall body fatigue. Adequate rest and nutrition will contribute to the healing process.
4. Walk as much as you can! No lifting greater than 25lbs. Minimize twisting, bending, squatting, and stooping. Do only what it takes to get dressed. The cervical collar is optional; if I find that it provides support, then I should wear it when up and around or any other time if helpful.
5. I should be careful with the pain medications since they are habit forming. I should resume all pre-admission medications that I had been taking.
So it was finally time to go home. Here is where the nurse usually calls for a wheelchair. Even if you are able to walk, and have been walking in the hospital for some time, you still had to use a wheel chair - for "legal reasons". But to my surprise, when Deanna asked if I could walk out on my own, the nurse said yes - just check out at the desk. So I did. I just walked out.
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