The Great Hook Escape

HDU_HookHospitalpics

Hook’s Get Well cards. There were so many, I had to tape some to the window.

As I sit in the hospital cafeteria and dream of life outside the walls of St. David’s, my POW-stricken husband lies in his 5th floor room being poked, prodded, picked, and occasionally pampered.

With a hollowed, gaunt look of someone who has been starved and beaten, Hook’s recovery continues but his appetite struggles to rise above broth status.  His initial plunge into shrimp marinara proved too aggressive and his stomach beat back any hopes of resuming regular consumption of even the most basic of solid foods.   Like coming across a DETOUR sign on a side street and driving down roads never before taken, Hook’s internal system is learning how to maneuver new passages while trying to heal in the process.  Progress has been made but it is slow and arduous.

“Maybe you could just place the Cherrio on your tongue and let it sit there,” I suggest in a desperate attempt to get him to eat even a little bit more.

When I’ve exhausted that parental tactic, I switch to bribery, “If you eat one more spoonful, you can take a nice long nap.”   Knowing Hook has been deprived of a full night’s rest due to middle-of-the-night vital checks and oral pain medication, the promise of sleep is motivation enough for one more spoonful.

Release Date

Our hoped for Tuesday release came and went and now Friday the 21st will be the earliest we are released.   I say We because the closer a Go Home date approaches, the more nurses and technicians and nutritionists and dieticians and physical therapists and home health care personnel and doctors …have I left anyone out?…visit Hook’s room to prepare us for what to expect once we are on our own.   And slowly but surely his plastic appendages are being removed but one outie tube and one innie IV will remain attached when we finally exit these beige walls and the antiseptic smell of healing in progress.   Once home, we’ll entertain daily visits from a nurse and other home care professionals at least through the first week of January.

Since pampering is actually my job and not the nurses, it’s time for me to return to the room and resume my full duties.   But Hook and I have decided, if the surgeon doesn’t set his discharge for Friday, we’re breaking out and pleading insanity.

Regarding visitation, I’ve reverted back to surgery day status and have put on hold any in person visitation for the remainder of 2012.  Feel free to email and call Hook directly and this way he can respond as he feels able.

Friday or bust.

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Getting Back on Schedule

You all must have been praying double-time because from about 7 o’clock yesterday evening to most of today, Hook’s situation has improved:

  • Sunday 7:00PM: A great second shift weekend nurse, Justin, entered the hospital scene.  I was looking forward to having Nurse Daniel back because I didn’t want to break in another night nurse.   But Justin came, started chatting Hook up, asked him about his surgery and what he did for a living so that when I heard Hook crack a sleepy joke to him, I knew everything was going to be all right.  Hook seemed comfortable with Justin so by 8:30, I headed home and got a full eight hours of sleep.  I felt a little bad that I didn’t ask Justin his story about how he came to be in nursing, but I’ll do that tonight since I’ll hang around until after the nurse shift change.
  • Monday 6:30AM:  Nurse Roy took over for Justin and when I saw him, a sense of relief floated over me.  Roy was the back-up to Nurse Michael when Hook was in the real ICU.  When we met the first time around and he asked if there was anything he could get for me, naturally I said, “Margarita, frozen, no salt,” and Roy replied, “Make mine with salt.”   Roy is like the Edward Scissorhands of nurses.  He whipped Hook’s schedule into shape and within one hour gave me status updates on all liquids, physical therapist appointment, when we can expect to see the surgeon, and how the rest of the morning would look.   The room vibrated (I’m not kidding!!!) from his energy as he zipped around pulling sheets off, hooking things up, punching buttons here and there.  It feels so good to be taken care of!  Even Hook said, “He’s good.”  Roy always knew he would be a nurse growing up.  His mom and two brothers are also in healthcare, and he started volunteering in health service settings when he was 15 years old.  He said he’d thought about medical school but changed his mind after his first pre-med course.  The professor in Hook snickered when he heard that.  (The man even snickers when he’s drowsy!)
  • Monday 9:00am:  In walks Joyce, a 30-year, career physical therapist with a witty sense of humor and a joke bank to back it up.  She immediately went into action, giving Hook a play-by-play of how he was going to pull himself up and off the bed and into a standing position and how she would navigate the whole process.   Joyce has raised three sons, all in their 20s, and she said she enjoys her job even more now that she doesn’t have to worry about soccer practices and laundry.  She’s firm and insistent with her instructions to Hook which is exactly what he’ll need for this next physical stage.
  • Monday 10:30am:  A visit with the surgeon and the big spleen debate.   Our surgeon informs us that Hook is hooked up to more tubes than anyone on the floor and that his goal is to start removing a few.
  • Monday 2:30pm:  One of the outie tubes is removed!

Love is a Many Spleendor Thing 

Since yesterday, when Hook overheard a conversation between one of the weekend nurses and me about the reconstruction of his insides, he has insisted that he still has his spleen.   We’ve been circling this spleen thing ever since.HDU_spleen

You see, even though Hook can answer questions asked of him, he has drifted in and out of a drug stupor for the last five days.   Although he remembers more and more in between his wake-ups, in the first three days, he could recall very little about what was asked of him and what was going on around him.

The first time he asked me how the surgery went, I de-briefed him as the surgeon had de-briefed me.   Hook’s focus then was on the specifics regarding the smaller stomach which made sense given he was looking forward to getting back to eating.  All was fine until yesterday when he piped into my conversation with the nurse and from out of a slumber mumbled,  “No he didn’t,” and I said, “No he didn’t what honey?” and Hook said, “He didn’t take my spleen.”   Then he glanced at me with a sideways look and what I believe to have been a sneer that screamed, you don’t know what you’re talking about.   Then he fell back into a sleep.

Spleens aren’t exactly trending on the internet so here’s a quick paragraph on all you could ever want to know:  http://www.nlm.nih.gov/medlineplus/spleendiseases.html

“The spleen unfortunately was an innocent bystander,” said our surgeon at the 10:30am meeting.  One of the arteries going into the spleen had suspicious looking nodes and leaving them behind was not an option.  When Hook kept on with more questions, asking about the 10% number regarding his pancreas (he questioned the accuracy of my information on that one as well), the surgeon confirmed that yes he cut away more than he had anticipated.  Hook said, “You didn’t leave me much,” and the surgeon replied, “I left you enough.”

And it will be enough because we will make it enough.

If all goes well the rest of today, Hook might be allowed to enjoy something other than ice chips as an entrée like a frozen ice pop, maybe even some broth, or tea.  But we won’t know that until the late evening.

Before I forget, this joke from Joyce the physical therapist is too good not to share:

A man is lying in bed in the hospital with an oxygen mask over his mouth.  A young nurse comes into his room and says she’s there to sponge his hands and feet.  “Nurse,” the man mumbles from behind the mask, “Are my testicles black?” Embarrassed, the young nurse replies, “I don’t know, I’m only here to wash your hands and feet.”  The man struggles to ask again, “Are my testicles black?”  The nurse pulls back the bed covers, raises the patient’s gown, holds his penis in one hand and his testicles in her other hand and looks closely and says, “No, your testicles are not black.”  Finally, the man pulls off his oxygen mask and replies, “That was very nice but, are… my… test… results… back?

My baby is gaining strength and thanks to our new nurses (Justin will be back tonight!) his body is getting back on track and back on schedule.  If it doesn’t, the nurses and the surgeon will have some exspleening to do …  😀 😀 😀

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Musings from an Intensive Care Unit

The first words Hook spoke to me when I saw him in ICU were, “I guess I made it.”  As I rubbed his little, bald head, I whispered, “Of course you did.”   That was the last lucid conversation Hook had with me until this afternoon.

Yesterday, the nurses were kind enough to allow me to spend the night and I’ll stay again tonight.  Kelly Scott relieved me from watchful wife duty from 8-10pm while I rushed home, ate, showered, and returned to the hospital.  But I was in denial about the reality of getting a full night’s rest in an intensive care unit.  The ICU sounds loud because of the way noise travels down the long ICU corridor.  Then there are the hourly checks of vitals and tubes and around the clock patient monitoring which means that sometimes in the middle of the night, the light in the room has to be turned on which feels like megawatts to the eyeballs.  The ICU is also not the most comfortable of places so the night nurse made sure a comfortable lounge chair that folds out was brought into Hook’s room so I could stretch out long instead of being bunched up like a pretzel in a regular hospital chair.

Hook’s Nursing Staff

Hook’s day nurse is Michael and his night nurse is Stephanie.  Michael changed careers a few years ago and went from managing restaurants to managing people’s health.  He’s great aboHDU_goodoctorgreatnurseut updating me on what he’s doing, why he’s doing it, and constantly asking Hook how he feels.  Michael seems to enjoy hearing about Hook’s wasp work and he wants details on how many times Hook has been stung, the names of the -hooki bugs, and how he chose entomology as a career.  I think Michael asks Hook questions as much out of curiosity as he does to make sure Hook understands what’s going on around him.  Nurse Michael was recently stung by a wasp and discovered he’s allergic to them.  What are the odds that someone deathly afraid of wasps is caring for someone so intrigued with them?

Nurse Stephanie is just as engaging and she’s firm with Hook which I like.  It was Stephanie who had to introduce Hook to this breathing contraption that measures how well his lungs are expanding (and by default, keeping them fluid free), a task made difficult for Hook because it forces him to use his lower abdominal muscles (ouch!).  Allan is not hooked up to the plastic lung monster rather he randomly decides when to blow into it.  But it’s Stephanie who stays on top of him with reminders, “Are you blowing?  You have to blow.  I know it hurts so I’m going to give you a system to use that will make it easier.”  When Stephanie’s not here, I still leverage her by saying, “Stephanie said you have to do it.”  This way it doesn’t seem like it’s just me torturing Hook.

I’ve learned over the years to trust nurses as much as you would doctors, sometimes even more.  Nurses are the ones who experience the hour-by-hour progress or decline of a patient in a way doctors aren’t able to.  But it’s still our surgeon who has the final say as to whether Hook stays in ICU, and for now, although Hook is progressing better than expected, the surgeon wants him to remain for at least one more night in intensive care.

Staying Out of Pain for Now

Hook understands what’s happening around him and he can respond to questions when asked, he just doesn’t always remember once he falls into a new round of sleep.  So I’m prepared to spend the night again as I do my best not to pester my husband.  If I don’t hear him talk every few hours, I’ll be tempted to wake him to ask if he’s thirsty or to ask if he needs anything or perhaps to hold a mirror under his nose to make sure he’s still breathing.

Closet hysteria is my specialty and as much as I respect and appreciate nurses, I realize they’re only human and they can’t possibly be as tightly wired to the pain of a loved one like a family member can.  And even though Hook is able to self-medicate via his finger clicker, I’m familiar enough with hospitals to know that eventually his finger clicker isn’t going to be enough, and real pain is going to hit.  I only hope that when that happens, either Michael or Stephanie will be in the room.  I’d feel bad if I had a Terms of Endearment moment with the staff.

Reporting live from ICU Room #7 at St. David’s Hospital in Austin, Texas.

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It’s All About the Surgeon

At 9:12am, I received a phone call from the surgical assistant that Hook was anesthetized with all IVs running at full speed and that everything looked good.  Wow!  They call you from—what?—a medium clean room or maybe the cell is in a plastic bag and the surgical assistant is punching the numbers with a gloved hand.  I’ll have to ask him the next time he calls.

HDU_AllAboutTheSurgeonPoor Hook was so hungry when they rolled him away on the gurney this morning at 8am.  He was on a liquid diet all day yesterday with absolutely zero fluids after midnight last night.   When the surgeon came to see us this morning, he assured Hook he could have a juicy hot meal….in about a week.

I take back all the Facebook grief I gave our surgeon for his cell calls, and felt reassured once I saw him this morning looking rested and eager to get to work as he shook our hands.  When Hook got a little emotional just before we parted, I said, “I feel like you’re in good hands.  I think if anyone can do this, he can.”   The anesthesiologist and the surgical assistant were listening to us and piped in with their own feedback:  “He’s good.  He’s very good, and we don’t say that about all of them.  When we don’t say anything then it’s time to worry.”

The next scheduled update from the surgical assistant may be at the halfway mark of 2-ish or they could decide to wait until Hook goes into post-op which could be as early as 4-ish.

Room #:  Still Pending

I did find out that I will not know Hook’s private room number for a couple of days because after post-op, he will remain in ICU for one to two nights which means I won’t be allowed to spend the first night after all.   This also means only immediate family will be allowed in to see him today and tomorrow (Friday).

On Friday/Saturday, the surgeon will determine whether Hook is fine to move out of ICU and into an Intermediate room.  Hook will stay in the Intermediate room until he can get up out of bed with help.  After the Intermediate room, Hook will be assigned his Private Room.

People have asked if there’s anything they can do, and yes, there is and I’ll be forever in your debt (choose 1 or all of the below):

–          Pray for Hook (if you believe in the power of prayer).

–          Follow this blog so updates are automatically pushed out to you.  This will help minimize calls, texts, emails.  I promise to make you chuckle from time to time.

–          Mail a Get Well card if you feel so inclined.  I only mention the Get Well cards because I think Dr. No told people not to send anything, didn’t have time to read darn cards, etc.  Well, yes he will have time and yes, it will mean a lot to him to see cards.   Address:  Allan W. Hook, c/o St. David’s Medical Center, Room #: pending, 919 E 32nd St. Austin, TX 78705 … OR…to our P.O. Box 151240, Austin, TX 78715-1240

Some folks have asked for our physical, home address, and I’m reluctant to give that because a) I will not be at home, and b) If it’s something that can fit into our mailbox then it can fit into our P. O. box which is pretty huge.   If it cannot fit in our home mailbox, then the post office will put a note in our mailbox and I’ll have to go wait in a line to pick it up.  Can you hear me whining about that already?

I appreciate your kind thoughts and desires to send stuff but I beg of you to please resist the urge to send anything more than a card unless you can hand deliver it.   #Thankyoufromthebottomofmyheart

Medical Details

I won’t be sharing any of the gory details of Hook’s surgery because, well, ick.  Plus, some of you may be eating like I am right now.  I can share that Hook is not having a Whipple procedure which is the most common type of pancreatic surgery.  Hook’s tumor resides in a most inconvenient place on the pancreas, and our surgeon in his Plan A will remove the tumor and leave the entire pancreas intact.  Plan B is to perform the Whipple.  Plan C is to save what he can of the pancreas.

Yes, You Can Survive Without a Pancreas

I didn’t know that either but yes you can live without a pancreas.  If you remove the pancreas, though, you’ll have to become a diabetic and inject insulin into your body for the rest of your life.  That’s not a result we want to have, but it was reassuring to know that it’s possible to live without a pancreas if we had to.  We.

Medical advancements amaze me yet we still don’t know the big purpose of tonsils and the appendix.   I’m sure hundreds of years from now when we are all long gone, some doctor or scientist will have an Aha moment and all the mysteries of tonsils, appendices, and pancreata will be revealed.

Visiting Hours / Estimated Time in Hospital

There are no visiting hours, ever.   This is what Hook would have me tell you because, bless his heart, he doesn’t want people to see him when he’s not 100%.  Since only family members will be allowed into ICU, those of you who are determined to see Hook in the hospital should plan on waiting until Monday or Tuesday of next week.

Once Hook moves from ICU into an Intermediate room, he’ll still be in a drug-induced, quasi-lucid state via a self-medicating finger clicker.  (If that were me, I’d be clicking that thing into oblivion.)  But when he does move from the Intermediate room into a Private room, Hook will be more open to visitors.

Estimated time in the hospital:  10 days.  It sounds long, I know, but the surgeon said this is normal for this type of surgery.   Hook has to be mobile and a few bodily functions have to be working before he’ll be released.   TMI?  I’m so exhausted I can no longer determine what’s appropriate to share and not to share anymore. Have to take a nap now and will post another update in a few hours.

It’s all about the surgeon right now and I mean exactly right now so pray, pray for that surgeon, and from the bottom of my heart, I thank you for reading.  It makes me feel less alone to know people are reading this and waiting for an update.

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Just How Exciting is Surgery Anyway?

Exciting might be the wrong adjective.  Intense, queasy-filling, thought-vomiting … should I continue?   I had no idea the amount of preparation that goes into even the siHDU_SugeryPreOpPaperworkmplest of surgeries let alone the super duper we-are-going-to-cut-you-MEGAWIDE-open ones.   I had major surgery 15 years ago, so specialized in nature I still can’t pronounce or spell what it was called, but I don’t remember the masochistic surgical paperwork and day long visit to the surgical center before ever checking in.

When the Complex Becomes Even More Complex

In today’s world of surgical pre-op, there are appointments and paper galore, and the telling and re-telling and then telling some more of your medical history.  Has this industry never heard of streamlining the information?  A day full of meeting with surgical internists on what’s going to happen in the surgery room was unenlightening.  In fact, Hook and I probably should have invited them to have appointments with us because it seemed we were correcting their information more than we were being educated.

Thanks to Hook’s surgeon (cell phone manners aside), I can visualize with clarity what’s going to happen in the surgical room.  I know what Hook’s pancreas looks like, I know what it’s supposed to look like, and I know all the different options the surgeon and his surgical co-pilot plan to use.  A good surgeon has a back-up plan going into surgery.   Our surgeon has a plan, a back-up plan, and a back-up to the back-up.  Let’s pray he can execute.

Get Well Cards:  Hospital or Home

For those thinking, ‘Give us details we can use!’ please feel free to send Get Well Dammit cards to:

Allan W. Hook
c/o St. David’s Medical Center
Room #:   pending
919 E 32nd St.
Austin, TX 78705

Or

Allan Hook
P.O. Box 151240
Austin, TX 78715-1240

(Yes, we live in a P.O. Box and there’s not much room for new furniture.)

As soon as I know Hook’s hospital room number, I will update the blog along with some visiting hours information.  I know he will be touched to see get well cards no matter what he may have told folks.   My ornery, old fool can be quite sentimental behind closed doors.

Our schedule tomorrow will look like this:

6:00am:  Check in for surgery

7:00am:  Fawn over Hook and plant quick kisses all over his little curmudgeonly face

8:00am:  Surgery begins

9:00am:  Begin fretting and avoiding contact with the general public and flare my nostrils at every person who answers their cell phone in the waiting room.  Please spare me my phone ringing.  It would be embarrassing to spend an entire morning giving others the evil eye for talking on their cells only to have mine start ringing. 😀

10:00am:  Post blog about how the waiting room needs to be updated ASAP to meet my needs

Surgery exciting?  No, but it is excitable and not the good kind either.  Oh man do I wish I were a crying sort of woman.

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