Reflections on Recovery: the Hospital Experience

O.K. folks, sorry it has been so long since my last post. Honestly I had fully expected to wake up from my surgery, maybe spend a few days on happy-meds, then be up, around and back to my normal self.

Brother, I have been wrong about things in my life before, but the presumption of a quick recovery has been the biggest error in judgement I think I have ever made. To put it simply, if someone tells you that you are having major abdominal surgery -- expect the worst.

That being said, and before I move into some more humorous anecdotes about life after surgery, I want to say that, if you ever NEED major surgery, then the Cleveland Clinic is the ONLY place to go. The title of 'world-class-hospital' is well deserved and any comments that follow are related to my own personal experience and observations and NOT meant to criticize the care I received!

So, here we go. To review, for those coming late to the game. Almost a month a go I was admitted to Cleveland Clinic to have a fairly large colon tumor removed. After arriving in Cleveland the day before surgery, accompanied by my wife and our best friends, Tim and Cyn, we made all kinds of humorous jokes about my pending surgery, such as how, after words, I would no longer be 'full-of-shit' anymore, or how while I was under they should just go ahead and do liposuction, a tummy tuck and a penile extension just for fun... It has always been comforting for me to have such good people around me when the going gets tough.

The hope that the surgeons there could pluck it out, reconnect my innards so that I would be left with, uh, 'normal-stool-passing-functions'. That was the plan. Plans change. Going into the surgery, I knew that there was a possibility that they would start digging around and find that things weren't in good enough shape to salvage my sphincter - hmmm... 'Salvage My Sphincter' almost seems like a cool name for a punk band - but, anyhow, I digress.

So, with good luck wishes, hugs, hand shakes a few kisses, off to surgery land I was wheeled. Being wheeled into the operating room - already slightly drugged up - is always kind of cool to me. I have always enjoyed all the technology related to medical treatment, and appreciate the times we live in that make so many wonderful things possible, so I didn't have much of a 'fear-factor' as I lay there being prepped, of course the dose of Demerol and Versed coursing through my veins helped wonders!

I tried to maintain my usual level of banter with the nurses and techs as they hustled and bustled around the room getting ready for my surgery - the only bad thing I remember at this point is that they were all talking about what they were going to have for lunch - and here I was nearly 24 hours past my last meal and I was freaking starving!!! I told them to cut it out or at least to go get me a Starbucks before I went under!!! But, alas, no Starbucks appeared, instead the anesthesiologist appeared, lowered a mask on my face and said, "Breathe deeply and count backwards from 10..". I started, "Ten, nine, eig......"

If you have never had major surgery before, what follows will hopefully give you some insight into the whole process of 're-entering' the world of the regular - the world of normal - the post-surgical world in which the rest of the world lives. Now, I fully realize that each person will experience this process in their own way, for some the process IS simple, quick and pain free, for others the process is agonizing, drawn-out, fraught with post-surgical complications and lengthy. I think my experience falls some where in the middle. The problem I faced is that I had always THOUGHT that I was on the 'quick-recovery' end of the spectrum, but am discovering - even today, nearly a month after the surgery - that this is not quite the case. Looking back on my experience recovering in the hospital, I will try to summarize by making a list entitled, "Things I Learned About Surgical Recovery". The list appears in random order, as I reflect on some notes I made during my recovery...

1) ICE-CHIPS are the NECTAR OF THE GODS!!! - Upon waking from surgery, you must remember that at this point nothing had passed my lips in nearly 36 hours, so I was thirsty, hungry, tired and in pain. The I.V. Dilaudid took care of most of the initial pain, and when I awoke, my wife was there, and when she placed a few chips of ice in my mouth, I truly thought I had entered another world. The simple pleasure of cooling relief, moisture, and a little something to chew on is almost too hard to explain. At that particular moment, after one mouthful of ice chips, I could have died and gone on to meet my maker and been no happier! It's weird that after a major event, the simplest things are often times the most pleasurable.

2) NEXT LEVEL OF NIRVANA - POPSICLES!!! - alright, I have just mentioned how awesome the ice-chip experience was, but later that day, or perhaps the next, I don't remember, a nurse entered my room bearing frozen nirvana on a wooden stick - a banana popsicle - as I sat there, watching the Food Network on the television, I began to sample the frozen treat... Almost like the heavens opening up above me, the cool banana sensation melting, entering my system almost like it was another narcotic, designed to bring me back one step closer to the normal world. Granted this may indeed have been a combination of watching what ever they were cooking up on the Food Network show at the time, coupled with the narcotics already coursing through my veins, but I think I made that popsicle last about an hour. What came next was even more amazing... the Nurse said I could have one WHENEVER I WANTED!!! Talk about a near orgasmic experience!!!! I was tempted to tell her to just wheel the freezer into my room and let me have at it... but, alas, nurses are wiser than that. I DID get to have two popsicles, then I drifted off into a narcotic induced nap.

3) OF BAD NEWS & CATHETERS - with the help of ice-chips and nirvanistic-popsicles, I had slowly started to re-enter the regular world, some time during post surgery day 2. And as with many things, this is the time when the doctors come by to begin to hand you the news - the good and the bad. In my case it was a typically mixed bag. They stared with the bad news. The surgery took longer than planned - about 6 hours, rather than the 2 or 3 they had hoped. The reason was that the cancerous part of the colon was much more 'involved' - I never did get a good explanation of that one though - and they could not save the sphincter and get enough surrounding marginal tissue to ensure complete removal of the tumor. So, the main reason for coming to Cleveland Clinic in the first place - sphincter 'conservation' ended up not being possible anyhow, I guess I could have done the procedure in Toledo, and saved many people lots of time and money driving back and forth, I will always regret that at some level. So, I am now left with no colon, a permanent ileostomy, will have to catch my poop in a bag for the rest of my life - great, fan-freakin-tastic. At 48, I am a 'near-invalid' - at least that is how I feel. The rest of my life will revolve around this stupid bag on my belly. How will I work? How will I play? How will I be able to enjoy anything, any more? All questions now swimming around in my head. So, after a pause for them to let this new info sink into my narcotic addled brain, they told me the good news - the cancer was completely removed by taking the colon, surrounding tissues and closing the sphincter, leaving, no possibility of recurrent colon cancer (duh!) and that there was NO indication that any cancer had spread to other organs, a sigh of relief in that regard.
Trying hard not to cry in front of the cadre of doctors, interns, nurses and my wife, I was also informed that they had to insert a catheter and it would need to be in place for several days until my insides woke back up from surgery and started to heal... Great. Well, at LEAST I got to suffer that indignity while I was under anesthesia in the operating room! So, after the room cleared, I sat there trying to absorb all that had been laid in front of me: no sphincter, no near-normal bodily functions salvaged, stuck with a permanent bag, but as the cheerful people around kept saying (and at times I am really sick of it) "Well, at least you're alive!" - yeah, YOU SAY. Do any of you want to trade places? .......silence. On we go I guess.

4) TIME IS PUNCTUATED BY PUNCTURES - back to something a little lighter, again for those who have not experienced this, when you are in a hospital recovering from surgery, time does not flow, nor is it measured the same way it is in the normal world. First, the clock moves, but not much else does. Television shows roll by, songs on the MP3 player scroll by, and then someone appears in at my bed side announcing that it is time for 'blood-work'. Depending on the tech, this is a quick process, or one that requires some digging around to find a vein - keep in mind that I have been dehydrated for 3 days and normally easy to find veins are now hard to find - OUCH! Blood drawn, needle removed, cotton ball tapped down to my arm. This particular time-punctuating process is repeated 3 times a day, around 8 am, around 4 pm and then around 11 pm. This is followed a few hours later by blood sugar readings, again; poke, squeeze, sample, cotton ball, band aid. Somewhere in between the blood draws and sugar readings, there are other punctures; anti-clotting meds, insulin, pain relievers, antacids. So as you can guess I am being punctured, pierced or monitored at least every other hour, around the clock, so, you can guess what kind of sleep I get....very little, unless they dose me with pain meds after dinner, then I seem to be able to get nearly 3 hours in, before the next series of pokes and prods...

5) OLD BEDS & FALSE RECOVERY - well, after a day or two, I have become PAINFULLY aware of several things. First, I think I have a bed that harkens back to the Korean War. It seems that there is not a position it can be moved into that allows me to get comfortable for more than an hour or two at a time... Please keep in mid that in addition to the new bag on my belly, the incision with 21 staples, abdominal pump washing out my innards, the catheter, and the draining operative area on my bottom, and it should come as no surprise that it would be nearly impossible to find a way to recline comfortably for very long. To combat that - and to keep me from developing clots - the nurses and docs want me to be up and walking at least 3-5 times a day. The process is arduous. Push the call button...wait....wait...wait. The nurse arrives. She unhooks all the gizmos attached to me, hanging them on the IV pole. Next, I veeeerrryyyy, gently get myself to a sitting position (again remember all the stuff still attached to, the, um, sitting area), I hoist myself to a standing position. If I am lucky nothing icky comes gushing from anywhere before I start my walk. If I'm not lucky it becomes 'clean-up in room 19' before I can go anywhere - embarrassing. I have to have a gown change, a dressing change, just to leave my room. Then I venture out on my first walk. My first walk took me about 20 steps from my door to the edge of the nursing station. Exhausted, with the effort I had to turn around and go back to bed. Jesus, I never felt so tired with just a few steps. A long nap followed, then later I tried a couple more times that day. Not too bad. The next day I ventured much longer walks, laps around the floor, two or three at a time, thinking, "Yea, I'll be back home, back to work and back to regular in no time!" Then I nearly collapsed in the hallway before getting back to my room -- too much, too soon. This recovery is going to be a bitch.

6) OLFACTORY NIGHTMARES - another aspect of hospital stays are the array of, odors that can have both good and deleterious effects on patients trying to recover. Let's look at a few of them. We can start with the simple. Alcohol swabs - get used to this one, they are the precursor to every needle stick, they waft through the air, then they are gone. Medicines - these are weird ones because while most are injected, many leave awful tastes in your mouth after they are administered. For me the ostomy bag - I have to dump the dang thing about every hour or so, as my insides wake up and my diet shifts from liquid to solid, this is not a pleasant experience. Janitorial Solutions - the cleaning staff uses a wide variety of odiferous solutions to clean floors (citrus), toilets (bleech), counters (lemon), beds (some floral soapy concoction). Again, these odors come at weird times, and make for some nausea and head aches for me, at least. Next we move on to the nurses, doctors and visitors in the hallways. There seems to be some kind of strange olfactory competition going on to see who can wear the strongest, most pungent perfume, aftershave, deoderant, hair spray or what ever on the floor. My walks are punctuated by pungent smacks in the nostrils at every turn on the floor. A few times I almost barfed as I passed by the nursing station! Jesus people... enough is enough!

7) BAIT & SWITCH - CHECKING OUT? NO YOU'RE NOT! - alright, after 13 days in hospital it is WELL beyond time that I want to go home. Nothing new seems to be happening, I have watched as much Food Network, History Channel, House and Sports Center than I can handle. The bed is awful, the food is repetitive, the schedule of pokes and prods is really getting on my nerves. I JUST WANT  TO GO HOME! For the final few days of my stay, each day I was 'assured' that I would be, "...going home today or tomorrow, really!" Each day I would get excited, then each day a doctor would come in and say, "Well, you know, we are really concerned that you had a fever for a while yesterday." or, "Well, the wound is not healing quite as fast as we had hoped." or, "Well, in the morning we will do another CT scan, then you can go home for sure!". So, each day I would happily text family and friends about my soon to be freedom from the hospital. And each evening I would have to RE-TEXT them and tell them, no...there is another delay. Finally, I just told my wife, "Just wait until I REALLY get papers signed saying that I can go, then I will call you and you can come pick me up." It was on the evening of Monday, March 15th - the Ides of March - that I was finally released. I packed up my gear, dressed in real street clothes, bundled up with my bathrobe, and pillows, got comfy in the Jeep and headed for home. One side note. For the last few days my appetite had started to return, and on the way home we stopped at Buger King - not usually my fave restaurant - and my wife bought me one of their new chicken breast on flatbread sandwhiches and once again I was in heaven... It tasted SOOOO good. I could only eat half, but man was it awesome! Some real food with real seasonings... I napped a while in the Jeep, and we were home.

Now, today marks a little over two weeks of being at home - dealing with a whole new set of adventures, and dealing with the glacial pace that recovery will evidently take, even though I am free of the hospital. But, alas, I have written enough for this post. I will share the trials of home recovery with you later. Right now, a nap is in store....

On The Way In...

Alright, folks. The day has arrived. In a few short hours I go into surgery. In a few hours after that I will come out, lighter one colon and with a 'loop-ileostomy', which if all goes well should be temporary as the rest of me heals.

I just wanted to take a moment to mention that I have all the faith in the world in the medical community, and even more in my friends and family. I have come to realize that there are times in our lives that we have to simply open our arms  and accept that there are things we can't control, and that there are times when we need to depend on the love and support of others -- because, we have all done the same for them at times.

Another key element to my healthy recovery is, I believe humor. I think that man evolved humor and laughter as a way to deal with times like these... We have to have SOME kind of response to situations that are simply beyond our control, some way to deal with pain and suffering that keeps us all from running, lemming style, over the end of a cliff every time we encounter something in our lives that seems insurmountable.

At various time in my life I have had the opportunity to travel to areas of our world that do not share our standard of living, and those experiences have had a profound impact on me. Looking closer at those times and images I made as a photographer then, one thing remained clear. In spite of all human suffering, in spite of the worst of human conditions, in spite of all cultural, religious and political differences two things remain universal. The ability of humans to smile and laugh, and the importance of the simple gesture of holding another persons hand or wrapping them in a hug that reassures that we are all in this process together, that in the worst of times, there are always people around we can count on, sometimes, in despite of ourselves.

I will see you on the other side....
Love to all of you.

"The New Adventures of : 'The Flush' " - a special kind of hero

O. K. folks, by this time Friday I will be either uncomfortably waking up, or comfortably medicated to get rest after my surgery. Since tomorrow is to be filled with travel, pre-opp appointments, consultations, lab work, I thought I would take some time to examine, in a different way the life of someone I hope will go away after the surgery.

In an earlier post I examined the relationship between the cancer patient and the superhero. I explored the 'reluctant' nature of the relationship, and the futility, at times in trying to ignore or accept our destiny, as seen by others. So, for this post I want to go back to the superhero / cancer patient relationship, but to look at the dynamic in a different way.

'The Flush' - who is he? 'The Flush' - how did he get his abilities? 'The Flush' - who is the man-behind that all too familiar bathroom noise? 'The Flush' - a force for evil or good... You decide.

One evening, a man, sharply dressed, walks into a restaurant with an equally stunning woman on his arm. "Table for two, please." he whispers to the maitre' de.
The maitre' de looks at the man, recognizing him imediately, "Why yes, sir, your table is ready. Right this way."
The man, walks cooly, like James Bond, his date ahead of him. He watches her walk, expecting a wonderful evening of dinner, dancing and more, the maitre' de turns to seat them. "Here is your ta..."
The puzzled look on the maitre' des face makes the woman turn. The man is gone.

"Damn it! Where does he GO?" the woman whispers under her breath. The maitre' de stands as if waiting for instructions...or an explanation from the woman.
A bit louder, but not to draw attention to her self, she thanks the maitre' de who seats her professionally and she sits, hands folded neatly waiting at the table, again, for the man to return.
She waits.
She sips some water.
She waits some more.

Suddenly, out of the corner of her eye she notices the man has returned, seemingly out of no where and is standing at her side. "Sorry for the delay, dear. I had to attend to a business matter. I'm starved. Shall we start with wine and a salad?"

In those few moments, what the woman and the maitre' de did NOT see was the near instantaneous emergence of The Flush. Unlike other superheros, there is no sudden rending away of the clothing to reveal a neon colored spandex outfit, there is no spinning in circles, or twisting of a ring, or flash of light to make his presence known to everyone. That is not the way The Flush makes his appearance. No, it is not that flashy. When 'the change' comes over the man, it turns him nearly insane with the real, physical and emotional need to find the nearest restroom - public or private.

In the brief moments when they weren't looking the man turned, possessed, scanning in a split second, the architecture of the restaurant. The Flush has the ability to instantaneously locate in space and time the nearest route to the bathroom, and to plot the most direct course to get there -- without being noticed.

If there were hi-speed cameras present, they MAY have been able to see The Flush deftly moving between the tables, spinning around waiters carrying trays of food, dodging other customers who stood or moved unexpectedly. He moves with the speed and grace of a humming bird, finally reaching his destination. Flinging open the door, he makes the final dash to the stall.

Now he spins, carefully removing and hanging his jacket on the back of the door. He takes his position,  just in time. Once again, The Flush has reached his destination without 'incident'. When the relief passes, so does The Flush. Suddenly, the man finds himself again, in an all too familiar place, not quite sure how he got there, again. Hypnotically he reaches down, grabs the handle.... FLUSHHHHHH!

He tucks his clothes, dons his dinner jacket, washes up and heads back to the table. Since this has happened many times before, he knows just how to avoid the searching eyes of the maitre' de and his date. With an air of practiced repetition he slides up behind her at the table...."Sorry for the delay, dear. I had to attend to a business matter. I'm starved. Shall we start with wine and a salad?"

As he sits down to eat, he knows that it is only a matter of time before he will be confronted with the emergence of The Flush. He just hopes it can wait until much later in the evening.

He hopes. But, he knows he has little control over the time or place at which his alter ego will transform him, once more into 'The Flush'.

STAY TUNED>>>>