Recovery

On Wednesday morning the urological residents rounded bright and early. (The chief resident of the doctor in charge [in this case, Dr Desai] always seems to be the one who does all of the talking/question-asking when the resident doctors round.) The CR asked me how I was feeling (very sore), took a look at me to see how I was looking almost 24 hours post surgery, rattled off a lot of things that went over my head and said that Dr. Desai would be around to talk to me later (since she's ultimately the one who holds all the cards as far as when I would be able to be discharged). She came to talk to me later on that day and said that she didn't feel comfortable having me go home (even though that's what she'd originally told me to plan on) since my white blood cell count was a little high––something that can be indicative of some sort of infection.

Another thing that caused my doctor some concern was the chest x-ray I'd had in the wee hours of Wednesday morning. (X-rays are standard protocol in the hospital, and the techs always come to take the x-rays so early––like 4 AM). My x-ray showed a small pleural effusion (this is when excess fluid builds up between the layers of the lungs). I was told that it could resolve itself, but if it appeared to be growing they would have to put in a chest tube to drain the fluid. I was really disappointed about not being able to go home, but I thought, "Okay, I can handle one more day in the hospital..." I actually wasn't really all that surprised. By now I've gotten used to the fact that my health is quite delicate and it's better to be safe than sorry, although it's always disheartening to find out you'll have to stay in the hospital longer than you were expecting.

Later that morning I had to get a CT scan to take a look at my kidneys to see if they looked clear of stones. The resident doctor that sent the orders for the CT scan goofed and accidentally ordered the scan with dye contrast instead of without, so that kind of messed it up since it made things more difficult to see. It still worked well enough, though, so I didn't have to get it redone. Good… you get lots of radiation from CT scans and I'd rather not get cancer if I can help it. ;)

Something I've failed to mention is that in the surgery my doctor placed an internal stent and also put in a nephrostomy tube to help my kidney drain. [A nephrostomy (depicted in the first two pictures below) is an artificial opening created between the kidney and the skin which allows the kidney to drain. A renal stent (depicted in the third picture) is a thin tube that goes from the inside the kidney through the ureter into the bladder and helps the kidney drain from with in.]

Thursday was my lowest day in the hospital. When my doctor came to see me mid-morning I was hoping for some good news (like that I would be able to go home) but instead I got discouraging news. She said that she still didn't feel good about letting me go home and that it most likely wouldn't be Friday, either. What?! I felt so discouraged! Was this earth shattering news in the long run, obviously not, but it was really demoralizing to have my expectations dashed again. I don't handle disappointment well. I've always been the kind of person that gets really excited about things, so when things don't go according to plan I tend to feel really deflated.

My doctor said that my numbers still weren't quite where they needed to be. My white count was still elevated and I'd had a temperature of 100° when my vitals were taken in the night. (I was kind of warm from being under a sheet and two blankets and I inwardly groaned when I saw my temperature because I knew that the doctors weren't going to like it.) My doctor looked at my chest x-ray and said that my pleural effusion had increased slightly, so she wanted me to go to interventional radiology (IR) to get things checked out.

I was hoping to go to IR sooner than later since I was NPO and unable to eat/drink but they didn't come for me until 2 in the afternoon. I was hoping to be back in my room by 3 so that I could watch Dr Phil (a TV show with a psychologist that helps real people with their problems––it's fascinating and I watch it every afternoon). I knew that being back in an hour was a long shot, but a little wishful thinking never hurts! This was not to be, though. Things took an incredibly long time and I didn't get back to my room until after 6:30! I was taken into the little IR holding area where I waited for two hours. Unfortunately my mom wasn't allowed back there with me so I was alone and bored in the cramped area. The patients on either side of me were quite interesting. On my left side was a young woman (probably around my age) who kept crying. I'm not quite sure what was wrong with her, but I kept hearing her cry and I felt badly for her. The woman on the other side of me seemed like she was high on pain meds (or something) and she kept calling out (loudly) for the for the nurse to bring her things and/or do things for her. My voice was shot (something I'll cover in a later post) so I couldn't get the nurse's attention the few times I tried to ask what time it was/when it was my going to be my turn. Time just seemed to crawl!

I was finally taken back to get my procedure at 4. I was transferred onto the procedure table and turned onto my right side. The nephrostomy tube was taken out of my side and some dye contrast was injected into my kidney. This was done to see if my kidney would drain the way it was supposed to, and it did, so they took the nephrostomy tube out. Next they put in a chest tube so that the fluid in my lung could drain. They took a culture of the fluid to see what kind of fluid it was/if there was any bacteria in it. (There was speculation that it might be urine which would've been bad since that would've meant that my kidney wasn't draining properly. Fortunately it wasn't urine, which was good. It was blood, which probably sounds bad, but it actually wasn't a big deal. It just meant that the nephrostomy tube had likely been irritating my lung.) Since my kidney was draining properly, the nephrostomy tube didn't need to be reinserted and the chest tube was left so that the fluid could drain.

The procedure was finally finished around 5:45 and the patient transport people were called to take me back upstairs. I usually can't complain about how things go in the hospital, but I do have some issues with the patient transporters. It takes them forEVER to get to you. Waiting just seems to be the name of the game when it comes to patient transport, unfortunately. I waited for 40 minutes and finally got back to my room a little after 6:30. I knew my hopes for being back by 3 for Dr. Phil were a little too optimistic, but I never expected to be gone for more than four hours!!

When I got back I was beyond ravenous since I hadn't been able to eat all day. The dinner trays had already come and gone, but my nurse managed to find one of the unclaimed trays. Although I was famished, I really didn't have much of an appetite, but I was hoping for something decent. Not to be. Dry chicken and plain rice it was and some unappealing looking vegetables. Needless to say I went to bed hungry! By this point I was feeling grouchy after a long, disappointing day. 

The one thing I looked forward to was the nurse I would have that evening… Claire. The hospital tries to keep continuity of care by giving nurses the same patients if the patient is still in the hospital the next day/night. Claire was my nurse on Tuesday and Wednesday nights and she was so pleasant and nice and kind. I really liked her a lot and when she left at the end of her shift both mornings she said, "Well, if you're still here tonight, I'll probably be your nurse." I really expected to be going home on Wednesday, and for sure by Thursday, so I didn't expect to see her again. On Thursday morning when I found out that I wouldn't be going home I thought, "Well at least I'll have Claire as my nurse tonight." When I found out that I'd been assigned to a different nurse I was so disappointed and irritated! After I've developed a rapport with someone and they know who I am/how things have to be done for me, I'm resistant to change! 

I will end my synopsis of Wednesday and Thursday here so that this doesn't get any longer, but there will be a few more posts to come.