Last month I underwent lower back surgery to hopefully correct some issues and lessen the pain in my lower back. For nine years I have more or less managed the pain with injections, meds, nerve blocks, acupuncture, PT and message. But when things worsened earlier this spring, both my pain management doc and surgeon agreed that it was time to act. To be sure, I consider myself among the fortunate who entered the hospital for what amounted to corrective surgery with a hopeful outcome. As we know, not all hospital patients have such a luxury. Still, and as anticipated, my post-op hospital stay was especially painful which was managed with liberal doses of pain medication. Laying there in my little drug haze, I managed a few observations that I kept thinking of as my own Post-Surgery Notes for what they are worth.
Brigham and Woman’s Hospital in Boston is a Harvard affiliated teaching hospital. This means there are people, lots of people, coming and going at all hours of the day, and from my observation, performing at various levels of proficiency. I met most of them. On certain days it seemed like everyone was training someone, except at 2 AM. That’s why I’ll take the overnight nurses any day. Here’s why:
Susie Wanna Be RN: My biggest mistake with Susie Wanna Be, who is a third-year college nursing student, was that I like people, especially young people who are committed to learning new skills. Susie knew I was approachable, which meant she came in with her energetic ear-to-ear smile about every ten minutes during the day to take my vitals. It took her forever, but hey, where was I going anyway? My druggy mind kept thinking I could have used my teeth and opposite hand to get the blood pressure cup onto my arm faster than she did. So we chatted and exhausted entire topics in the time it took Susie to register a BP reading. I learned too that Susie especially liked thermometers. She’d jam that thing down under my tongue like she was spear fishing until I finally wised up and said, “Le me hold that for you.” Still, I liked her enthusiasm, especially when she came in at 4 PM to say good-bye for the day and that she’d see me tomorrow.
“I need Ice!”
When my day-shift nurse came in, along with a newly minted RN colleague who was new to the unit, to ask me if I needed anything, I asked for ice for my back. “I’ll get the PCA to get that for you right away, Mr. Lee,” she said. Minutes passed, maybe lunch hour, I’m not sure, until I heard marching footsteps coming down the hall. Even the Personal Care Assistants came in doubles. One was taller and more determined than the other and she was holding the bag of ice with both hands.
“Where do you want the ice?” she asked. Now this struck me as funny since the entire floor was filled with patients recovering from lumbar surgery. “On my lower back,” I said. I barely had enough time to grown my way onto my side, before PCA holding the goods rounded my bed and with two thrusting hands shoved the ice bag up against the length of my surgery site. Good lord! I thought she was going to knock me clear off the bed as she said, “Can we get you anything else?” Catching my breath, I said no, and watched them trotting off in lockstep out the door and on to their next victim. Safe to say that I didn’t ask for ice again.
Fellows working for surgeons seem to run the place. Or at least they do if the charge nurse agrees. They arrived, at every inopportune moment seemingly out of thin air. But then, maybe it was the Dilaudid, I’m not sure. My doc walked in every time ram rod straight, square-chinned and wearing scrubs. He looked ex-military. I wasn’t able to stand at attention when he entered, but I did feel like saluting. He asked, “How’s the pain?” I said, “Hurts like hell.” He responded, “That’s expected. We did a lot of house cleaning in there. Now wiggle your toes for me,” he said next. “Are you walking? Walking is good. We want you to walk, walk, walk! Don’t let anyone tell you that you’re walking too much, okay?” Roger that.
During the overnight hours my nurses came in on cue with meds to keep their favorite patient comfortable. The floor was darkened and quiet. Most of the time after washing down the meds I’d fall back to sleep. Until I didn’t. They’d say, “If you need anything, just press the handset.” But in my crystal-clear mindset I took that to mean, don’t bug us. And besides, G.I. Joe doc told me to walk, walk, walk, and sometimes at 2 AM I felt the urge to explore, and well yes, to pee.
Early each night they left a new plastic urinal on my tray like it was some kind of an invitation. I never used it. Instead, I saw it as a catalyst to get up, grab my walker, and shuffle off to the bathroom. One night, I slide whatever body parts would move to the edge of my bed, sat up, reached for my “wheels, “ and staggered off to pee.
That night something felt strange, like I wasn’t alone in my little trek across my room. I got to the bathroom door and looked back, and there in the shafts of limited light I noticed that the rear peg of my walker had somehow snagged onto my bed sheets and as I walked had totally stripped my bed from head-to-foot. It looked like a long white train off the back of a wedding gown from the bed to the tip of my walker. “Oh shit,” I thought to myself. While at the toilet, I pulled that little cord that tells you to do just that if you need help. I always wanted to pull one of those cords to see if anything happened. My nurse walked in and in a voice higher than what’s needed at 2 AM said, “Oh my god, what’s happening here?”
Spills and Thrills
Another night, same time, same urge. (My wife says it was the same night, but what does she know? I was the happily medicated patient, so I should know.) The man does learn, so I made sure that no bed sheet hangers-on were following my walker this time. At three days post-op and totally juiced there is a lot to think about going from flat to sitting and from sitting to standing with hopefully legs to follow. I had this annoying drainage tube that ran from my back to a contraption that looked like, in my perfectly astute mind, a 1980’s Walkman, until one looked closely to see that it was full of red stuff that expanded like an accordion as it filled. I always forgot this damn thing. No matter.
Duty called and off I went with my two-wheeled wonder until I felt a tug in my back and heard a crash on the floor. My Walkman imposter hit the floor as I shuffled onward and the tube from my back to the contraption disconnected, splattering liquid that looked, there on the floor, like a crime scene. Damn! But the mission continued. I came out of the bathroom armed with a giant wad of paper towels, tossed them on the floor and moved my slippers in impressive fashion around like a pro mopping up the scene and left the soggy red wad in the corner for my favorite nurse and went back to bed.
About an hour or maybe a day later my nighttime nurse came in, looked at the wad of towels on the floor, gasped, and then looked at me. When she noticed that I had reattached the tube to the “Walkman” before going back to bed, she smiled. I think that’s when we became friends.
By the fifth day, having walked with my walker all over the place and after passing my “stairs climbing” test, the PT signed off and I was released to head home. I remain grateful for the excellent care that I received while hospitalized and hopeful that my recovery will return my back to good health over time.
Text and images by K. Lee