"Take Down" Surgery Day

Jason is in 6831, Ward 68 General Surgery.
His room phone is 202 782 8891
Jason is in pain and is on a dilaudid pump with an 8 minute lock-out for bolis which he controls with a left hand held button. I requested they bring Jason the right elbow-powered RN call button as his left wrist is still recovering from surgery.

Please no calls Saturday.
I will let you know how Jason is doing Saturday evening.

Jason had a difficult time going to sleep as he had taken the prescription to clean out his bowels. "Every 5 Minutes!"(If you have had to prep for a colonoscopy, I know you can identify with him 100%) He finally turned the TV off at midnight. I passed on to Jason the telephone calls for best wishes for surgery from Martha and Bill and Vira Sisolak, cards, emails and blog entries. Jason's dad should arrive while Jason is in surgery.

One of the things Jason has said, "After this surgery I am going to take as many showers as I want to each day."

Jason was to be at the hospital at 9:30 AM. So he said, "Wake me at 8 AM. I will take a shower and head over." Jason got up a little early and took a shower. Good planning. At 8:15 AM "ring, ring" the phone and it is "Jason, Dr. Golarz for you." One of Dr G's surgeries has cancelled, "Come as quick as you can. You are now scheduled 2nd, not third."

So off to ward 68 to wait a while, down to OR where the anesthetist began to hook up tubes to the left arm. This made me wince as it is not in anyway healed and the broken "post operative blisters" look horrible. Each one looks like Jason has been burned by a cigarette. I thought I had better let the RN's and MD's know because I sure didn't want Jason's stomach looking like his arm. So I asked every medical, "Jason just had surgery and had a reaction to something. What do you think it is and how can we keep it from happening with today's surgery?" The consensus was that it was probably Benzoid, I understand it is a type of glue that is used to keep the serri strips in place. As it follows the incision made sense to me. The consensus was "We don't have to use it." One of the RN's wanted to check the medical record, not sure if she did before surgery. I left Jason at about 10:15 with the operating staff.

Down to the fourth floor OR waiting room, oh so familiar now filled with lots of family members and the Red Cross volunteer at the desk. About noon I decide I should get something to eat as I don't know how long surgery will take. I go down to the mess hall and get carry out plus some juice to drink as I know Jason will be very dehydrated when he gets to his room.

I am eating lunch in the OR waiting room and in pops Dr. Golarz at 12:45 "What did I tell you about time?" Obviously very proud of himself. Dr. G had said 2 hours and I am sure that is what it was, not bad for a chief resident who will be deployed to Iraq soon. Dr. G says, "Everything was right on. Very minimal lesions, we found everything where it should be. Didn't use the silk except for one stitch. Everything went really well. Jason is a healthy young man and had healed very well." Jason's stoma had looked irritated to me. "Don't worry, we cut that off." Ouch, now I know where the pain will come from-an added site. Jason had been cut open along the old scar, the stapled ends of the intestine where cut off and sewn together (the way Dr. G described it like a running stitch), the hole in the fascia was stitched. However, I am not sure how this works the stoma hole is not closed but will heal from the inside?

Doc G reiterated two potential problems, infection and the 1% possiblility of leakage from the intestine. Again he said, "We have to watch closely for the next three to four days." Dr. G left and shortly after Dow arrived from Chicago. He looked tired from the trip and the stress. Jennifer, making the documentary stopped by, she had hoped to catch Jason today, but missed him. She will see Jason next Friday. We spent sometime talking with the spouse of another patient who is retiring from the military and was having some corrective surgery done. He was retired military and we talked about options for his 19 year old son "who wasn't ready for college."

Jason took sometime in recovery as they were trying to bring his pain under control before they let him go up to the floor. I think I called shortly before 4 PM and the RN said, "He's on his way out, you can meet him at the corner." Dow and I headed out and found Jason in the hall. He was out of it but could tell us, "I am in a lot of pain." The RN said, "We are going to go slow," and she slowly rolled Jason to the elevator to the 6th floor. We went to his room, the RN hooked Jason to the pumps and Jason slumbered, woke, gave himself a bolis (a beep tells you what he has done), fell asleep and repeated the cycle as we sat quietly by his bedside.

Dr Golarz and his team of 4 students stopped, reviewed the post-op situation with Jason and said, "Looks like we will need you around here for about 6 weeks to make sure you are healed." Jason wanted a list of "dos and don'ts for PT" for Kyla the PT. Dr. G said he would be glad to create the list, "No lifting is part of the PT regime for a while. It is go easy."

"What do you need from the room?" "My bluetooth headset." "Okay, I can go get that for you," thinking he is in no shape to do anything even talk on the phone. Dow stayed with Jason and I headed to the room. I needed to rest awhile as waiting through a surgery is always stressful and this one in particular as Jason is counting on it so much, "My life is on hold till the colostomy is reversed." Before I got back, the Air Force visited: a mechanic and dispatcher for Air Force One. Dow said that Jason had a good conversation with them. Dow went to get supper while I stayed with Jason. He was really using the bolis, watching the clock for the passage of 8 minutes, and his face began to itch. RN Zack, from 65 was Jason's nurse this evening. I was really glad as he knows Jason well and Jason respects and really likes Zack. The perfect RN for a night of discomfort to come.

Zack got Jason some benedryl for the itch, he thought it was probably caused by the narcotics as Jason said one of the dermatologists proposed on their consult when Jason was first at WR. So Zack gave Jason the benedryl which I hope will also make him drowsy so he can get more than 5 minutes sleep at a time (between bolis). Dow told Jason about his trip out west to see his sisters and Jason and he traded blonde jokes for a couple of rounds. But about 9:30 Jason said, "You can go now." And so we went. The floor seemed very quiet which is good for after surgery rest.

Please keep Jason's pain control in your thoughts and prayers.
Let us pray that he does not get any infections.