Heme/Onc (blood and cancer) fellowships are competitive. As far as medicine subspecialities go, they are one of the harder programs to get into. I still remember how relieved I was the day I "matched" into Heme/Onc in Little Rock. I thought it was exactly what I wanted. And, that was the last time I can remember being excited about my career choice. I've never loved this fellowship. But, medical training is not meant to be fun so I have just trudged along feeling like it's probably the training and not the content that I don't like. From the start, I have talked about leaving but I was scared to walk away from such valuable training. Before I got sick I was just starting to get into a little groove and feeling like maybe it wasn't so bad...this Heme/Onc thing...I could do it and it would be fine.
But, then I got sick. I'm learning that such a life changing experience is, well, life changing. Fine is not how I want to describe my work life. I'm not the same person and I'm definately not the same doctor. I thought that after the fear of thinking I might not ever get the priviledge of being a doctor, I would relish coming back to fellowship. I mean, this time last year I was PRAYING to be able to complete my training. At one point while I was out there was a question that I might have to completely redo my fellowship because I had missed so many months in a row. I had decided that I would quit if that was the case. When my program director called to tell me that I wouldn't have to start over and could pick up where I left off....my gut reaction was disappointment. I guess that should have been enough, but I just kept thinking I would start to like it more.
Since coming back to work...I have been miserable. At first I was just so exhausted that getting through the day was my only focus. But even as I get better and stronger, I'm still not enjoying my work. I have been unsure of my career choice from the start and the deeper I go, the more unsure I get. But, I kept on....I mean, people don't walk away from Heme/Onc fellowships..you would have to be crazy. I even started looking for jobs and I found that a career in Heme/Onc is pretty tough. You either hang out at the V.A and have a great quality of life but make not a lot of money (I could make more as a primary care doc) or you go into private practice, work like a dog, and make lots of money. The more I researched and interviewed and talked to practicing docs...the more I realized the reality of my options. I was nearing the end of the tunnel and I couldn't see a light. And, I was not loving my job (not really even liking it). So, what to do?
Then, my program director called me into his office. He said lots of things...some true, some not. Bottom line...he wanted to know if I was committed to this program. He said things like, "when your on, your on but you aren't on as much anymore." The conversation was long and when I walked out of his office I really started to consider my choices. It is one thing to have an internal struggle but obviously my struggle was not so internal anymore. For the 1st time I REALLY thought about leaving. And so the inner turmoil began. Of course, we were already scheduled to leave for Boston for my board review course (in Heme/Onc) so we went. I tried to forget about everything and just focus on the course. I did talk to a few people about hospitalist and primary care options, as well as, private Heme/Onc options. But, mostly I focused on having fun, learning, and trying to relax. I prayed about it and really tried to let it go..which I was only moderately successful at.
I could finish out the remaining 12-15 months of my fellowship or jump ship. My logic in staying was that I only have a little over a year left and I didn't have to practice Heme/Onc when I was done but I would have to option if I wanted it. But, it is not an easy year. I missed a LOT last year so this would be a year of back to back service (read = hard) months with plenty of call. Basically, it would be the hardest year of my fellowship yet. Not to mention the reading and studying I would need to do to get caught up and ready for full fledged practice. A challenge I could 100% take on....but did I want to? For what? I job I don't really like that much? More money?
At some point in time I just became really obvious that I need to leave. I may regret it later but I can't live my life worrying about regret. I have to do what makes me happy today (and in the near future). I was talking to a friend about it and she said, "what do you really want to do?" and I said (without any thought at all and almost instantly), "I want to take care of dying people." That also got me thinking about palliative care (end of life care/hospice) and why I ever chose Heme/Onc in the first place. Really, end of life care is why I gravitated towards Heme/Onc and it has always been where I excel. There is something so satisfying about helping a patient and their family at the end of life. I know it sounds grim, but it really is so amazing to be a part of the dying process and help make it a peaceful experience.
So...I resigned this week. I took a job working as a Hospitalist (taking care of pts in the hospital) and as a palliative care physician at a local hospital. The work is satisfying (I hope), the hours are good, and the pay is nice. What more could I ask for? Now I just have to make it out of here.......
When I resigned my program director cried. He tried really hard to talk me out of it and in the end made me an offer I couldn't refuse. He offered to relieve me of Heme/Onc duties and let me go do 2 months of palliative care with our palliative care attendings/team. The job I was offered was more than happy to let me wait until Jan before starting, so I accepted the offer to stay for 2 more months. I felt like it was really generous of him to make me such a deal. Of course, today I found out why he made me the offer. He is hoping I will change my mind and stay. He is hoping that in the next 2 months he (or someone else)can convince me to stay. I also found out that he approached a few people and specifically asked them to talk me out of leaving. Which explains the constant onslaught of questions, being told I'm crazy, and me repeating myself over and over and over.....
We will see what the next 2 months holds. I'm done worrying about it. I'm just going to do what fits for me, whatever that might be....call me crazy (and happy).
Friday, October 15, 2010
Sunday, October 10, 2010
Taste of T Street
I complained and bitched and bitched and complained. It took A LOT of her time. I mean, A LOT! There were meetings, more meetings, and more meetings. Let's not forget the last week of her being gone and busy when she was home. I'm not built to do it all. I think I would be a pretty good stay at home mom and I know I'm good at being the working parent (which is what I prefer) but for those of you mothers who do it all....my hat is off to you. Working full time and being a the main parent is not something I enjoy. Not even for a few days. It makes me cranky. But, I digress....
When Mere told me she was going to take on the co chair position for a huge fundraiser for our daughters' school, I was less than thrilled. She was already working full time, which has been a HUGE adjustment, and now she was going to do this to? It all started when the principal of our school called Mere this summer and asked her to come to the school for a meeting. Apparently, she had been at a big fundraising event for another private school and decided we should do the same. No cookie sales, wrapping paper, or chocolates this year. Nope, just one big bang of a fundraiser and that would be it. She also hoped to create a foundation so that our school would be able to give out scholarships, etc. It was VERY ambitious. They only had 5 months to plan it. I'm not going to lie, when she first told me about what they were planning, I was skeptical. BIG plans, 5 months, and a bunch of newbies (except for the event planner that they hired). The plans? Booths run by parents (volunteers only) for food, a HUGE children's area (games, petting zoo, etc), a stage with live entertainment, a killer silent auction, a live art auction (art work done by the kids and framed), and much more.
Well, it was INCREDIBLE! I should have known that the parents and teachers would come together to make it an amazing event. Our girls go to the coolest school ever....there is always so much love and parental involvement. Seeing it all come together was such a wonderful moment. I get tears in my eyes just thinking about it. It was such an overwhelming success (and I don't even know how much money we raised yet). It is such a honor to be part of the community at our school, we are so blessed.
Most of all, I am proud of my wife. She endured a lot and worked her butt off and it payed off BIG time. Everyone kept coming up to me and telling me how much they love Mere and what a great job she had done. There were a lot of parents that I didn't know who were really involved....I kept introducing myself as Mere's wife and they would be like...."oh yeah! HI! It's so great to meet you Jess, etc, etc." They all just love her. But, what's not to love?
I am glad it is over and happy to have my wife back. I'm sure she will be putting up pics on her site, once she tracks some down (she was WAY to busy to take pics). Oh yeah, you might have to remind of this post next year when she is the CHAIR of the event!
When Mere told me she was going to take on the co chair position for a huge fundraiser for our daughters' school, I was less than thrilled. She was already working full time, which has been a HUGE adjustment, and now she was going to do this to? It all started when the principal of our school called Mere this summer and asked her to come to the school for a meeting. Apparently, she had been at a big fundraising event for another private school and decided we should do the same. No cookie sales, wrapping paper, or chocolates this year. Nope, just one big bang of a fundraiser and that would be it. She also hoped to create a foundation so that our school would be able to give out scholarships, etc. It was VERY ambitious. They only had 5 months to plan it. I'm not going to lie, when she first told me about what they were planning, I was skeptical. BIG plans, 5 months, and a bunch of newbies (except for the event planner that they hired). The plans? Booths run by parents (volunteers only) for food, a HUGE children's area (games, petting zoo, etc), a stage with live entertainment, a killer silent auction, a live art auction (art work done by the kids and framed), and much more.
Well, it was INCREDIBLE! I should have known that the parents and teachers would come together to make it an amazing event. Our girls go to the coolest school ever....there is always so much love and parental involvement. Seeing it all come together was such a wonderful moment. I get tears in my eyes just thinking about it. It was such an overwhelming success (and I don't even know how much money we raised yet). It is such a honor to be part of the community at our school, we are so blessed.
Most of all, I am proud of my wife. She endured a lot and worked her butt off and it payed off BIG time. Everyone kept coming up to me and telling me how much they love Mere and what a great job she had done. There were a lot of parents that I didn't know who were really involved....I kept introducing myself as Mere's wife and they would be like...."oh yeah! HI! It's so great to meet you Jess, etc, etc." They all just love her. But, what's not to love?
I am glad it is over and happy to have my wife back. I'm sure she will be putting up pics on her site, once she tracks some down (she was WAY to busy to take pics). Oh yeah, you might have to remind of this post next year when she is the CHAIR of the event!
Sunday, September 12, 2010
It's About Time
This has been such a wonderful week. I have relished EVERY minute of it. From late nights with a coughing, crying baby to being thrown up on, to a night in a very NOT private room at the Children's Hospital curled up with a restless 3 year old. I'm serious, it has been totally wonderful. So, before you guys come running over here to make sure I haven't totally lost it, let me explain.
From the start Mere was the apple of Layne's eye. Mere stayed home with her and breast fed exclusively, while I worked 100+ hrs/wk. Not to mention the fact that I became VERY self absorbed....getting caught up in depression, infertility woes, and other stuff that just made me unavailable even when I was home. All of this together meant that Layne has grown up with Mere as her primary care giver. Don't get me wrong, she is very much my child and I LOVE her with everything I have and she loves me. But, we have just never had the same time together that I had with Syd when she was a baby/toddler/preschooler. All of that started to change when I got sick. Layne and I spent hours together reading books, coloring, and hanging out while I kept my post on the couch. I realized during that time how much Layne craved my attention and needed time with me and vice versa. Those long days on the couch really led to some wonderful bonding time and all of a sudden Mere was not the one that Layne ran to when she needed comforting. I LOVE the way our relationship has grown over the last year....it is truly one of the blessings that came out of being sick.
Flash forward to this week. Layne had to have her tonsils/adenoids taken out and tubes in her ears. The ENT doc told us to expect a 2 wk recovery which means no school for Layne. Last year I would have taken off a day from work for the surgery and gone straight to work from the hospital the next morning (if all was ok). Mere wasn't working so she would have been the one at home nursing our little patient back to health. But, it is not last year. THIS year Mere is working and I am on a research month (read...easy month) so I only had to do a little tweaking to arrange a week off from work. So, I was the one who stayed home and took care of Layne, I was the one who slept with her, and I was the one she cuddled up to when she wasn't feeling good. And, I LOVED every minute of it. I really, really did. What a wonderful experience (for me, probably not so much her).
Tomorrow I head back to work and she is going to spend the day with a friend (who will treat her like her own) getting spoiled and loved. I'm bummed because I wish I could take another week off to spend with her. It may seem silly, but I will always remember our time together over the last few days when she really needed her mommy. Of course, the truth is....I need her!
From the start Mere was the apple of Layne's eye. Mere stayed home with her and breast fed exclusively, while I worked 100+ hrs/wk. Not to mention the fact that I became VERY self absorbed....getting caught up in depression, infertility woes, and other stuff that just made me unavailable even when I was home. All of this together meant that Layne has grown up with Mere as her primary care giver. Don't get me wrong, she is very much my child and I LOVE her with everything I have and she loves me. But, we have just never had the same time together that I had with Syd when she was a baby/toddler/preschooler. All of that started to change when I got sick. Layne and I spent hours together reading books, coloring, and hanging out while I kept my post on the couch. I realized during that time how much Layne craved my attention and needed time with me and vice versa. Those long days on the couch really led to some wonderful bonding time and all of a sudden Mere was not the one that Layne ran to when she needed comforting. I LOVE the way our relationship has grown over the last year....it is truly one of the blessings that came out of being sick.
Flash forward to this week. Layne had to have her tonsils/adenoids taken out and tubes in her ears. The ENT doc told us to expect a 2 wk recovery which means no school for Layne. Last year I would have taken off a day from work for the surgery and gone straight to work from the hospital the next morning (if all was ok). Mere wasn't working so she would have been the one at home nursing our little patient back to health. But, it is not last year. THIS year Mere is working and I am on a research month (read...easy month) so I only had to do a little tweaking to arrange a week off from work. So, I was the one who stayed home and took care of Layne, I was the one who slept with her, and I was the one she cuddled up to when she wasn't feeling good. And, I LOVED every minute of it. I really, really did. What a wonderful experience (for me, probably not so much her).
Tomorrow I head back to work and she is going to spend the day with a friend (who will treat her like her own) getting spoiled and loved. I'm bummed because I wish I could take another week off to spend with her. It may seem silly, but I will always remember our time together over the last few days when she really needed her mommy. Of course, the truth is....I need her!
Sunday, July 25, 2010
A Long Time
Ok. So I know it has been a LONG time since my last post. Thankfully, life got in the way of me posting. YEAH! That means I actually have a life again. Pretty much everyone in my life knows that all is good, but, I want this all documented...even the end (I hope!) so I don't ever forget.
The last trip to LA was actually, GASP, fun! See Mere's blog for all the details. We drove with the girls, did Disneyland, and even the Grand Canyon! The best part of the entire trip....a NORMAL myelogram. The doctor told me to go home, wean off all of my meds, and work on getting back to life. That is exactly what I have done and it has been great. We have had a fun and busy summer. Am I fixed forever? Who knows! But, it doesn't matter. Today I am happy, healthy, and whole which is all that matters.
Oh yeah, and thank GOD for all of our amazing friends and family. We are so blessed. I think I am the luckiest person I know!!!
The last trip to LA was actually, GASP, fun! See Mere's blog for all the details. We drove with the girls, did Disneyland, and even the Grand Canyon! The best part of the entire trip....a NORMAL myelogram. The doctor told me to go home, wean off all of my meds, and work on getting back to life. That is exactly what I have done and it has been great. We have had a fun and busy summer. Am I fixed forever? Who knows! But, it doesn't matter. Today I am happy, healthy, and whole which is all that matters.
Oh yeah, and thank GOD for all of our amazing friends and family. We are so blessed. I think I am the luckiest person I know!!!
Wednesday, April 21, 2010
Gratitude Post
Yesterday was great. It was really a special birthday. I'm not sure why, but I was just so filled with gratitude and happiness. I know I have another procedure around the corner, but that didn't stop me from being happy. How awesome is that?
After waking up to a special coffee and the coolest gift ever (read below), I got to go spend time with some friends. We went to a yummy lunch and had a lot of fun. Then I came home to rest for awhile because I had been up for several hours. When the family got home we all went to dinner with my mom, sister, BIL, and close family friends. We finished the night up with cake at our house. I got some really nice gifts (including a book about poodles that I am so excited to read!) and had a lot of fun.
While everyone was sleeping last night, I broke out the book of my first year of blogging. It kind of makes me sad. In 2008 I worked like a maniac. I NEVER saw my family, except for vacations. Almost every blog I wrote, I wrote while I was at work in the ER. It was a time when I worked all day, came home for 20 minutes, changed clothes, drove to small town AR (2 hrs away), worked a 12 hr shift, drove home and went to work all day. I would be home a few nights a week but I would be EXHAUSTED. Most weekends found me back in small town ER working. I always found a way to justify it. I had a horrible time saying no. Every time they called me and threw more money my way I was in my car, ready to work. We made a lot of money that year. I missed a year with my family. The money wasn't worth it. How much is a year away from your family worth? It is not something you can put a price tag on, but I did. Now I spend all my time with my family. In fact, we are only apart when they are busy at school and work. Or when Mere and I are traveling to LA for treatment. I have a feeling that is why I felt so happy and blessed yesterday. I had 2008 looming in my mind. A year wasted.
I had already slowed down a lot before I got sick. I had quit small town ER and started a local moonlighting gig that NEVER required a night away from the family. I was restructuring and already getting a lot more time with my girls. However, I was no where near the grinding halt that I have been at for the last 6 months. This year I have spent countless hours reading to Layne and Syd, listening to their days, watching them play outside, and just being together. A far cry from 2008. We don't have any money, but we are together and making it work. I didn't want this path for myself or my family, but I am so grateful that we are all here together. I think I should quit now before this starts sounding like a country song.
After waking up to a special coffee and the coolest gift ever (read below), I got to go spend time with some friends. We went to a yummy lunch and had a lot of fun. Then I came home to rest for awhile because I had been up for several hours. When the family got home we all went to dinner with my mom, sister, BIL, and close family friends. We finished the night up with cake at our house. I got some really nice gifts (including a book about poodles that I am so excited to read!) and had a lot of fun.
While everyone was sleeping last night, I broke out the book of my first year of blogging. It kind of makes me sad. In 2008 I worked like a maniac. I NEVER saw my family, except for vacations. Almost every blog I wrote, I wrote while I was at work in the ER. It was a time when I worked all day, came home for 20 minutes, changed clothes, drove to small town AR (2 hrs away), worked a 12 hr shift, drove home and went to work all day. I would be home a few nights a week but I would be EXHAUSTED. Most weekends found me back in small town ER working. I always found a way to justify it. I had a horrible time saying no. Every time they called me and threw more money my way I was in my car, ready to work. We made a lot of money that year. I missed a year with my family. The money wasn't worth it. How much is a year away from your family worth? It is not something you can put a price tag on, but I did. Now I spend all my time with my family. In fact, we are only apart when they are busy at school and work. Or when Mere and I are traveling to LA for treatment. I have a feeling that is why I felt so happy and blessed yesterday. I had 2008 looming in my mind. A year wasted.
I had already slowed down a lot before I got sick. I had quit small town ER and started a local moonlighting gig that NEVER required a night away from the family. I was restructuring and already getting a lot more time with my girls. However, I was no where near the grinding halt that I have been at for the last 6 months. This year I have spent countless hours reading to Layne and Syd, listening to their days, watching them play outside, and just being together. A far cry from 2008. We don't have any money, but we are together and making it work. I didn't want this path for myself or my family, but I am so grateful that we are all here together. I think I should quit now before this starts sounding like a country song.
Tuesday, April 20, 2010
Happy Birthday To Me
What does everyone want for their b-day? Diamonds? Money? Clothes? No, what everyone wants is a blood patch! Well, try to not be to jealous because that is what I am getting. Eat your hearts out peeps. Ok. Seriously, yes I am still leaking. I have been bad about updates because I wanted a plan before I got on the blog. Well, now I have one. Mere and I leave Monday for sunny LA. Tuesday is MRI and appointment with Dr.S, and Wed is blood patch. Thursday we fly home. Is this it? I have NO IDEA. What I do know....no surgery for me for at least another month. I am willing to try his super special large volume blood patch and PRAY beyond PRAYING that is works. But, if it doesn't, I'm holding on surgery until June. That little voice in my head is just telling me that surgery is not a great idea right now.
April has been good. I am managing pain with the help of an awesome palliative care doctor and can be up for considerable periods of time with bearable pain. I haven't gone back to work yet but I'm going to try in May. We will see. I am not overly hopeful that I will make it an entire day, but there is only one way to find out! I am off of the cane and the walker and discharged from physical therapy. My right leg is still pretty weak but I'm the only one who can tell. We have actually been able to do things as a family this month....picnics, bday parties, gathering at friends' houses...it has been great. Even though I'm still not better, I am feeling more normal than I have in 6 months. I'm not ready to trade that for the excruciating pain of surgery and recovery. I just can't do it right now. Oh yeah, and I'm driving again!!!!!
So, onward and upward. I pray that 32 is better than 31. I don't need perfection, I just want to be restored to health again. Keep praying for us because we still need it!
Oh yeah, and guess what my awesome wife got me for my bday? The first year of my blog made into a book and a S.tarbucks coffee waiting for me when I woke up (a luxury that we can no longer afford). The book IS AWESOME and AMAZING and WONDERFUL. It just proves that the best gifts aren't the expensive ones. I love you Mere.
Below is a picture of the book. Pretty cool, huh?
April has been good. I am managing pain with the help of an awesome palliative care doctor and can be up for considerable periods of time with bearable pain. I haven't gone back to work yet but I'm going to try in May. We will see. I am not overly hopeful that I will make it an entire day, but there is only one way to find out! I am off of the cane and the walker and discharged from physical therapy. My right leg is still pretty weak but I'm the only one who can tell. We have actually been able to do things as a family this month....picnics, bday parties, gathering at friends' houses...it has been great. Even though I'm still not better, I am feeling more normal than I have in 6 months. I'm not ready to trade that for the excruciating pain of surgery and recovery. I just can't do it right now. Oh yeah, and I'm driving again!!!!!
So, onward and upward. I pray that 32 is better than 31. I don't need perfection, I just want to be restored to health again. Keep praying for us because we still need it!
Oh yeah, and guess what my awesome wife got me for my bday? The first year of my blog made into a book and a S.tarbucks coffee waiting for me when I woke up (a luxury that we can no longer afford). The book IS AWESOME and AMAZING and WONDERFUL. It just proves that the best gifts aren't the expensive ones. I love you Mere.
Below is a picture of the book. Pretty cool, huh?
Saturday, March 13, 2010
LA Times
Each time I wake up from surgery, it hurts. There is always pain. This time it was different. Pain is an understatement. It felt like a board had been wedged into my upper back and ANY movement made the pain a million times worse. I don't really know how to describe it besides overwhelming. I just kept pressing the little green button that pumped morphine into my veins and took as many pills as I was allowed. I spent a lot of time crying like a baby.....mostly because of pain but also because of frustration. When you can't do ANYTHING by yourself and doing ANYTHING hurts it just sucks.
The week had begun with the scheduled myelogram. By the time I had the myelogram I had convinced myself that it was all in my head. My leaking was over and I was just crazy. I was expecting the myelogram to be normal, I really, really was. There was a lot of confusion on the morning of the myelogram that resulted in Tommie chasing me all over the hospital while lugging 2 suitcases and my purse. By the time the myelogram was over, we were both exhausted. Luckily, this myelogram was WAY better than the others. They did not sedate me to prevent seizures so the initial sticks hurt (as usual) but nothing to crazy. They used a lighter dye so when they injected it, the pain was minimal (it is usually the worst part). I sat up afterwards so that the dye would drain away from my brain and I was SUPER hydrated. Not long after the procedure, they had us in a room. We settled in and watched A.merican Idol. I felt good. Normally myelograms wipe me out, but not this time. It was about 9pm that the neurosurgery resident (Tommie named him cutie) came in to let me know that they did find another leak and that I would be having surgery the next morning. The next morning Dr. S came in and told me that I had an anterior leak in the T4/T5 region. The plan was so go into my back, remove several discs, saw away at some bone, and access my dura to find the leak. Once the leak was isolated, Dr. S would patch it and then Dr. A (the other neurosurgeon) would put a titatinium plate along my spine to stabilize the area where bone and discs had been removed. Dr. S went on to tell me that this surgery would be significantly more painful and have a longer recovery than the previous surgeries. The surgery was on a Wed and Dr. S made it clear that I would likely not being going home until the following week (I was expecting to be home by Sunday).
The next morning I was wheeled into preop before the surgery. The anethesiologist told me I would wake up in pain but that they would be there and would do everything possible to manage my pain. He said, "you have been on narcotics for awhile, right?" I said, "yes." He said, "you must be pretty tolerant." Me, "yes." He turned to his resident and said, "why don't we give her 20mg of morphine and 10mg of IV methadone?" Me, "uhmm....that sounds like a lot, can we just start with the methadone?" He then proceeded to give me IV methadone. I don't remember much after that.....just that I really didn't care about ANYTHING and the room was hazy. The next thing I knew, I woke up in recovery and IN PAIN.
I was wheeled back into my room and SHOCKED to find out that it was 8pm. The surgery was supposed to take 4 hours but it took more like 8 hours....yikes! I was also suprised to hear that I had a large anterior thoracic leak and they had operated from T2-T9, leaving a very large plate in my back. The parade of surgeons, nurses, and therapists that came into my room over the next week all commented on how big of a surgery I had undergone. I really had no idea it was going to be so major. Or that the recovery would be so long. The first 2 nights were horrible. I had to lay flat (but I could be on my side). The nurses had to turn me every few hours and prop pillows all around me in an effort to find a comfortable position. It didn't matter, I just could not get comfortable. I learned about sponge baths, total helplessness, and humility in ways I could have never imagined. Poor Tommie tried to help but there was nothing anyone could do to make it better.
To top it all off, the first 48 hours after surgery I had a fever up to 104 and was hypotensive (low blood pressure) and tachycardic (fast heart rate). In came the Internal Medicine doctor and Infectious Disease specialist. I was started on antibiotics for a presumed sinus infection and ear infection.
I learned that nurses really need to get educated about pain. It seemed like every other nurse was afraid to give me my pain meds as prescribed because they were afraid it was to much. Hello...the pain regimen was prescribed by a very experienced pain team! After the 1st night I learned that the pain team was available 24/7 (despite what the nurses led me to believe) and would adjust my meds anytime. The pain team was incredible. But, from them to the nurses things tended to get lost in translation. The nurses also had a really hard time with the PCA (patient controlled anethesia). It must be really difficult to operate because it was a problem for every shift. One night I kept telling Tommie that the PCA was not working. No matter how much I pushed it, it didn't seem to be helping. I asked the nurses to check the PCA...2 different nurses came in a checked. Everything was fine. Ok. About a hour later, the pain team nurse came in and checked my settings. I had been put on a setting of 0.6mg/hr instead of 6mg/hr and my lockout was set at 0.3mg/8 minutes instead of 3mg/8 minutes...no wonder it didn't seem to be working! The entire experience was eye opening for Tommie and me.
Don't get me wrong, there were also good things. I had a lot of great nurses and all of the doctors were AMAZING. But, the little things really do matter. For example, closing the curtain in front of the door during a sponge bath so that when people walk in the door they don't see you laying completely naked in the bed. I always appreciated the nurses that took into account shift change and checked on you before it started. I know Tommie and Mere appreciated the nurses and techs that were quiet at night.
After a few nights, it became clear that I would be in the hospital well past Sunday. On Friday, Tommie called her mom and found out that she was sick. She had taken to her bed and was just not doing well at all. Since Tommie is all that her mom has, she really needed to get back to LR to take care of her. So we arranged for Mere to come in on Sat and Tommie to leave. The girls stayed at our house with my mom. Of course, she was threatened with her life if she did anything with our house!
In the few hours that I was alone (Tommie was on her way home and Mere was on her way to LA), they let me get out of bed. A PT (physical therapist) came and put a walker in front of me. I laughed....I don't need a walker! So, I stood up and promptly fell down (the therapist was there to catch me). My right leg had no strength and I couldn't really tell where it was in space. I also got shooting pains down both my legs when I flexed a the waist. The therapist managed to get me up with the walker and we walked a few feet before I couldn't do anymore. I was so frustrated and a little scared. They had also taken the foley catheter out and I found that I couldn't go to the bathroom. Great. My legs don't work and my bladder doesn't work. Not looking good for the home team. Dr. S ordered high dose steroids and scans to see what was happening. Now I had a physiatrist (physical medicine and rehabilitation doctor) and urologist added to the mix of specialists trying to put me back together. Mere arrived not long after the PT left so she was there for the onslaught of new doctors and tests.
The next few days was spent with me trying to get up and around more. Mere helped me shower and I tried to sit in a chair for a few hours/day. I was starting to feel better. My fever was long gone and my pain was getting better. I was off of the PCA and managing well with oral meds. The MRI had not showed much and I was getting a little better with the high dose steroids. The physiatrist wanted me to go to inpatient rehab in California. I opted a big fat NO on that one but agreed to do outpatient therapy in Little Rock. I spent the day on the phone finding out the best place for spinal cord injuries in LR and working out the details of what I needed to do to get started. We were hoping to go home on Wed or Thurs.
Then, the results of the CT scan came. There was a screw that was protruding into my spinal canal on the left side (the right side was the one with the problem). Dr. S didn't think that the screw was causing my problems but was worried that it could become problematic with time. He felt that the best course of action was to go in and remove the screw. The surgery would be much smaller than the previous one but the pain and recovery would start all over again. Cutting into all the muscles of the back and retracting them during surgery causes a lot of post op pain. Ughhh!!!!
So, I went back to the OR on Wed. The surgery was quick and uneventful. The next 2 days were spent in severe pain, with the PCA, in bed, and generally miserable. On day 3, I was able to start getting up, showering, etc. I was PCA free and the foley catheter was out again. All the things needed to start talking about a discharge date. Somewhere along the line, my liver function tests got out of whack so I was got to have an ultrasound on my liver (which was pretty nonspecific). Luckily, my numbers returned to normal towards the end of my hospital stay.
By Friday, Dr. S was willing to set Sunday as a go home date. Meanwhile, my mom had bought a shower seat for the house and Tommie had found a walker for me to use at home. We bought our tickets and Mere got all of my prescriptions filled on Friday so we were ready for Sunday. Sunday morning went well and we made it to the airport without any problems. The flight was challenging and left us both exhausted. But, we were so happy to be home on Sunday night and with our girls. We let Syd stay home from school on Monday so we could all just chill out together.
I am getting better by the day. My legs are getting stronger and my pain is getting more manageable. I start physical therapy next week....yeah! Dr. S assumes that I am done leaking for now. Of course, we never know until I get off pain meds and over the surgery. Either way, I need a break from surgery and LA for awhile. My doctors are anticipating about 4-6 weeks of recovery.
Without the generosity of friends, family, and our church....we would be in so much trouble. The entire time we were both in LA, our church brought dinner for my mom and the girls. They continued to bring meals to us after we returned home. They have been so generous with their time, money, and love. It has truly been overwhelming and reminds us both of how important it is to pay it forward. A good friend of mine and her husband (both fellows) also donated money, which blew us both away....their generosity brought us both to tears (and still does every time I think about it). Mere has started picking up some substitute teaching gigs at Syd's school but she can't work full time because I can't be left alone for long periods of time (since I am still VERY limited in what I can do). Plus, I need someone to take me back and forth to PT. I am hoping and praying that I can go back to work in April....PLEASE!!!!!!
Ok, I need to end this super long post. Thanks for hanging in to the end (if you are still reading)!
The week had begun with the scheduled myelogram. By the time I had the myelogram I had convinced myself that it was all in my head. My leaking was over and I was just crazy. I was expecting the myelogram to be normal, I really, really was. There was a lot of confusion on the morning of the myelogram that resulted in Tommie chasing me all over the hospital while lugging 2 suitcases and my purse. By the time the myelogram was over, we were both exhausted. Luckily, this myelogram was WAY better than the others. They did not sedate me to prevent seizures so the initial sticks hurt (as usual) but nothing to crazy. They used a lighter dye so when they injected it, the pain was minimal (it is usually the worst part). I sat up afterwards so that the dye would drain away from my brain and I was SUPER hydrated. Not long after the procedure, they had us in a room. We settled in and watched A.merican Idol. I felt good. Normally myelograms wipe me out, but not this time. It was about 9pm that the neurosurgery resident (Tommie named him cutie) came in to let me know that they did find another leak and that I would be having surgery the next morning. The next morning Dr. S came in and told me that I had an anterior leak in the T4/T5 region. The plan was so go into my back, remove several discs, saw away at some bone, and access my dura to find the leak. Once the leak was isolated, Dr. S would patch it and then Dr. A (the other neurosurgeon) would put a titatinium plate along my spine to stabilize the area where bone and discs had been removed. Dr. S went on to tell me that this surgery would be significantly more painful and have a longer recovery than the previous surgeries. The surgery was on a Wed and Dr. S made it clear that I would likely not being going home until the following week (I was expecting to be home by Sunday).
The next morning I was wheeled into preop before the surgery. The anethesiologist told me I would wake up in pain but that they would be there and would do everything possible to manage my pain. He said, "you have been on narcotics for awhile, right?" I said, "yes." He said, "you must be pretty tolerant." Me, "yes." He turned to his resident and said, "why don't we give her 20mg of morphine and 10mg of IV methadone?" Me, "uhmm....that sounds like a lot, can we just start with the methadone?" He then proceeded to give me IV methadone. I don't remember much after that.....just that I really didn't care about ANYTHING and the room was hazy. The next thing I knew, I woke up in recovery and IN PAIN.
I was wheeled back into my room and SHOCKED to find out that it was 8pm. The surgery was supposed to take 4 hours but it took more like 8 hours....yikes! I was also suprised to hear that I had a large anterior thoracic leak and they had operated from T2-T9, leaving a very large plate in my back. The parade of surgeons, nurses, and therapists that came into my room over the next week all commented on how big of a surgery I had undergone. I really had no idea it was going to be so major. Or that the recovery would be so long. The first 2 nights were horrible. I had to lay flat (but I could be on my side). The nurses had to turn me every few hours and prop pillows all around me in an effort to find a comfortable position. It didn't matter, I just could not get comfortable. I learned about sponge baths, total helplessness, and humility in ways I could have never imagined. Poor Tommie tried to help but there was nothing anyone could do to make it better.
To top it all off, the first 48 hours after surgery I had a fever up to 104 and was hypotensive (low blood pressure) and tachycardic (fast heart rate). In came the Internal Medicine doctor and Infectious Disease specialist. I was started on antibiotics for a presumed sinus infection and ear infection.
I learned that nurses really need to get educated about pain. It seemed like every other nurse was afraid to give me my pain meds as prescribed because they were afraid it was to much. Hello...the pain regimen was prescribed by a very experienced pain team! After the 1st night I learned that the pain team was available 24/7 (despite what the nurses led me to believe) and would adjust my meds anytime. The pain team was incredible. But, from them to the nurses things tended to get lost in translation. The nurses also had a really hard time with the PCA (patient controlled anethesia). It must be really difficult to operate because it was a problem for every shift. One night I kept telling Tommie that the PCA was not working. No matter how much I pushed it, it didn't seem to be helping. I asked the nurses to check the PCA...2 different nurses came in a checked. Everything was fine. Ok. About a hour later, the pain team nurse came in and checked my settings. I had been put on a setting of 0.6mg/hr instead of 6mg/hr and my lockout was set at 0.3mg/8 minutes instead of 3mg/8 minutes...no wonder it didn't seem to be working! The entire experience was eye opening for Tommie and me.
Don't get me wrong, there were also good things. I had a lot of great nurses and all of the doctors were AMAZING. But, the little things really do matter. For example, closing the curtain in front of the door during a sponge bath so that when people walk in the door they don't see you laying completely naked in the bed. I always appreciated the nurses that took into account shift change and checked on you before it started. I know Tommie and Mere appreciated the nurses and techs that were quiet at night.
After a few nights, it became clear that I would be in the hospital well past Sunday. On Friday, Tommie called her mom and found out that she was sick. She had taken to her bed and was just not doing well at all. Since Tommie is all that her mom has, she really needed to get back to LR to take care of her. So we arranged for Mere to come in on Sat and Tommie to leave. The girls stayed at our house with my mom. Of course, she was threatened with her life if she did anything with our house!
In the few hours that I was alone (Tommie was on her way home and Mere was on her way to LA), they let me get out of bed. A PT (physical therapist) came and put a walker in front of me. I laughed....I don't need a walker! So, I stood up and promptly fell down (the therapist was there to catch me). My right leg had no strength and I couldn't really tell where it was in space. I also got shooting pains down both my legs when I flexed a the waist. The therapist managed to get me up with the walker and we walked a few feet before I couldn't do anymore. I was so frustrated and a little scared. They had also taken the foley catheter out and I found that I couldn't go to the bathroom. Great. My legs don't work and my bladder doesn't work. Not looking good for the home team. Dr. S ordered high dose steroids and scans to see what was happening. Now I had a physiatrist (physical medicine and rehabilitation doctor) and urologist added to the mix of specialists trying to put me back together. Mere arrived not long after the PT left so she was there for the onslaught of new doctors and tests.
The next few days was spent with me trying to get up and around more. Mere helped me shower and I tried to sit in a chair for a few hours/day. I was starting to feel better. My fever was long gone and my pain was getting better. I was off of the PCA and managing well with oral meds. The MRI had not showed much and I was getting a little better with the high dose steroids. The physiatrist wanted me to go to inpatient rehab in California. I opted a big fat NO on that one but agreed to do outpatient therapy in Little Rock. I spent the day on the phone finding out the best place for spinal cord injuries in LR and working out the details of what I needed to do to get started. We were hoping to go home on Wed or Thurs.
Then, the results of the CT scan came. There was a screw that was protruding into my spinal canal on the left side (the right side was the one with the problem). Dr. S didn't think that the screw was causing my problems but was worried that it could become problematic with time. He felt that the best course of action was to go in and remove the screw. The surgery would be much smaller than the previous one but the pain and recovery would start all over again. Cutting into all the muscles of the back and retracting them during surgery causes a lot of post op pain. Ughhh!!!!
So, I went back to the OR on Wed. The surgery was quick and uneventful. The next 2 days were spent in severe pain, with the PCA, in bed, and generally miserable. On day 3, I was able to start getting up, showering, etc. I was PCA free and the foley catheter was out again. All the things needed to start talking about a discharge date. Somewhere along the line, my liver function tests got out of whack so I was got to have an ultrasound on my liver (which was pretty nonspecific). Luckily, my numbers returned to normal towards the end of my hospital stay.
By Friday, Dr. S was willing to set Sunday as a go home date. Meanwhile, my mom had bought a shower seat for the house and Tommie had found a walker for me to use at home. We bought our tickets and Mere got all of my prescriptions filled on Friday so we were ready for Sunday. Sunday morning went well and we made it to the airport without any problems. The flight was challenging and left us both exhausted. But, we were so happy to be home on Sunday night and with our girls. We let Syd stay home from school on Monday so we could all just chill out together.
I am getting better by the day. My legs are getting stronger and my pain is getting more manageable. I start physical therapy next week....yeah! Dr. S assumes that I am done leaking for now. Of course, we never know until I get off pain meds and over the surgery. Either way, I need a break from surgery and LA for awhile. My doctors are anticipating about 4-6 weeks of recovery.
Without the generosity of friends, family, and our church....we would be in so much trouble. The entire time we were both in LA, our church brought dinner for my mom and the girls. They continued to bring meals to us after we returned home. They have been so generous with their time, money, and love. It has truly been overwhelming and reminds us both of how important it is to pay it forward. A good friend of mine and her husband (both fellows) also donated money, which blew us both away....their generosity brought us both to tears (and still does every time I think about it). Mere has started picking up some substitute teaching gigs at Syd's school but she can't work full time because I can't be left alone for long periods of time (since I am still VERY limited in what I can do). Plus, I need someone to take me back and forth to PT. I am hoping and praying that I can go back to work in April....PLEASE!!!!!!
Ok, I need to end this super long post. Thanks for hanging in to the end (if you are still reading)!
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