I’m A Big Boy Today

Ever since I started residency as a wet-behind-the-ears PGY1 resident, there has been a certain charge nurse on unit 112 who has always looked after me. Nights on call were never as scary if she was on, despite how sick the patients were that we were trying to keep alive overnight. Now that it has become my turn to be a patient on the very same unit, she has gone to extraordinary lengths to make sure my stay is as pleasant possible under the circumstances. In fact, everyone on unit 112 has been amazing. The nursing care I have received has been extraordinary, and delivered with an extra touch of compassion. I guess maybe I wasn’t too much of a jerk to the nurses when I was working as a resident after all, or things might not have gone quite the same way for me

I’m so thankful that I was admitted to unit 112, which is the best unit anywhere in my opinion. In addition to my guardian charge nurse who took it upon herself to take me under her wing both as a resident and now as a patient, the other charge nurses, nurse practitioners, and RNs have been out of this world. I’m not sure if they would feel comfortable with me mentioning their names publicly here, but you know who you are

Although things are looking up now, I have gained a new appreciation for what a post-op neurosurgical patient goes through. I have especially gained an appreciation for the travails of patients assigned to bed rest. In my case I was told to lie flat for 5 days in the hopes of increasing the chances that the dural tear repair will seal and that I won’t have a persistent leak. This would have been unbearable if it were not for my incredible nursing care, my family bringing me gourmet meals from the outside, and the constant flow of visitors. 

Left: My mom feeding me a bowl of pho a few hours after my surgery last Wednesday! I was still coming out of the anesthetic. Right: A nice plate of pad thai and basil seafood to replace what was called “lunch” in the hospital. I’ve been eating like a king every day and haven’t even touched the hospital food until this evening.

In my opinion, being on forced bed rest really challenges the post-op recovery. You just can’t find a position that isn’t painful and you descend into muscle spasms. I felt like I could feel myself getting more and more deconditioned with each passing day. It is basically impossible to sleep. There is no comfortable position. Combined with the noise from the unit, the late night code blues, the unfortunate delirious patients nearby, and the beeping machines and call bells, there isn’t enough zopiclone to stay asleep for long.

But for me it wasn’t the lack of the sleep that was the worst. The worst was having to lay on my incision which was like lying on an axe buried into my back. But a close second was being unable to void once my foley catheter was pulled, which necessitated in-and-out catheterizations. By the end of the first night after my foley had been pulled and I still was unable to void and was on q4h caths, I insisted that the foley be replaced, and it was. It only came out this morning. What can I say? A man needs to stand up to pee. I was not allowed to even sit up. The knowledge of the impending in-and-out caths in the event of failure only added to the stage fright.

I was supposed to lie completely flat for 5 days. However, today (which was only day 4), I hit my limit. With the help of nursing I painstakingly sat up on the edge of the bed with my incision site burning with pain. I was slowly helped to my feet. Magic! Once I was standing, my back pain receded. I was light-headed for a moment, but then started to feel much better. Originally, the plan was to transfer me to a chair, but seeing how well I was doing my nurses asked me if I wanted to take a few steps. Damn right I did! We made it out into the hallway. I walked halfway down the hallway holding onto the nurses initially but by the the end I was walking on my own with the nurses only standing close by for support. I made it back into my room without difficulty. I sat down in the chair. My Mom, Dad, and brother arrived to visit me at that moment as they did every day, pleased to see me sitting up for the first time. 

The nurses left me with my family. However, within moments a wave of nausea hit me. I suddenly felt distinctly unwell and started to get tunnel vision. I slumped backwards. I was later told that the coffee mug I had been holding fell out of my hand onto the floor, my eyes rolled back, and I turned deathly pale. I had lapsed into unconsciousness. All of this happened at the worst possible moment – right in front of my Mom, who went running into the hallway yelling for help. I regained consciousness not knowing who I was or where I was for several agonizing seconds with a room full of strangers staring at me. Luckily I had not fallen out of the chair and the nurses immediately flattened the chair and I slowly recuperated. I began recognizing the people around me. I had hot clammy sweats. But at least I knew where I was!

That was my first adventure. My second would come later in the day. Throughout the afternoon I slowly worked up enough courage to go on another expedition. My main motivation was to avoid yet more in-and-out catheterizations as my (second) foley had been removed that morning. My patient and compassionate nurse coaxed me to the bathroom and gave me ample time to void into a jug. He even turned on the tap to simulate the sound of a waterfall and left me in peace. I thought for sure I would eventually be able to go. It couldn’t be worse than the stage fright of trying to take a piss at a rock concert or hockey arena with crowds of jeering yahoos pushing up behind and somehow I had been able to overcome such adversity on these occasions. 

Unfortunately, after a half an hour I had to admit defeat. It just wasn’t going to happen. Another in-and-out cath was coming my way. Just as we were about to leave the bathroom to make the return trek to my bed, the world started closing in on me again, much as it had that morning when I had fainted right in front of my mother. I told my nurse I wasn’t feeling well and he helped me gently down to the ground and told me to take deep breaths. I concentrated on breathing but I could feel the same cold clammy sweats and again I felt light-headed and my vision started closing in. I thought for sure I was going to faint. Maybe it was the feeling of the cold bathroom floor on my bare butt, or the cold ceramic toilet bowl on my leg, but this time I was able to cling to reality. Eventually I was able to stand up and use the IV pole for support and hobble back to bed. It would not have been the first time I had passed out on a bathroom floor, but I seem to recall more fun in the lead-up to the previous occasions. Still, I vowed “I’m never getting spine surgery again!” We’ll see how long that lasts.

I have to admit I was discouraged. I had fainted in front of my family. I had almost fainted a second time ha
lf naked on the bathroom floor next to a toilet with a piss jug in my hand. I couldn’t even take a piss. To be sure, what I was going through was so much better than what I thought I would be facing that it didn’t seem right to feel down. I had even overheard the nice elderly palliative lady in the room next to mine discussing with her sons how she would like to pursue the Sue Rodriguez option. When they explained that that wasn’t an option for her, her sorrow made me cry quietly into my pillow. And yet, I could not help feeling a bit sorry for myself. Only Phil was optimistic, telling me that he still thought that I could be discharged the next day (as I had been hoping). My guardian charge nurse, however, was more realistic and reassured my parents that I wouldn’t be going anywhere until it was safe for me to do so. Still, I like the optimism. Thanks Phil.

My nurse told I was actually doing well and to have patience. He had seen this before. I was not the first, nor would I be the last, to go through this. He had been working on the unit 18 years. It was normal for post-operative patients to faint and have trouble voiding, especially those on bed rest. Bless him. I went ahead and got catheterized once again. It actually wasn’t so bad. Maybe you can get used to it after all.

My family stayed with me for the rest of the evening and we chatted and watched TV. My brother had flown in from Saskatoon for the weekend. It was great to see him. I had even got a chance to FaceTime with my twin nieces from the hospital room the previous evening. 

Above: My brother Cailen, my Mom Susan, and my Dad Walter have been pampering me almost as much as the nurses. The little dog I call spot was picked out by one of my twin nieces, Ella. Below: My brother and I in the Harris Tweed hats I brought back from Scotland and my twin nieces Ella and Lily:

We had been drinking a lot of tea, coffee, and water over the course of the evening. I was on a mission. If all else failed, I planned on cracking a can or two of beer that a dear friend had snuck unto my room earlier that evening. Beer has been scientifically proven to break the seal, right? But I suddenly had a good feeling. Just before visiting hours were over, I shooed my family out of the room. I grabbed the piss jug. I pulled myself to the edge of the bed. And finally, finally, I felt the sweet sweet flow of success. I’m a big boy today! Things are definitely looking up, although there are still a few more important missions to accomplish.

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