Drama here at Stanford hospital this afternoon
So the doctors team come in every morning, and their job is in part to check if you are ready to go home. (among other things). This morning they were hinting very strongly that today was the day, and I responded by explaining that when the drain comes out that is the day where I feel I will be ready, they have already once sent me home with the drain, and that did not go well. We ended today’s meeting in a kind of a standoff.
What they did change was the PCA medication button that I love, and have been frequently using (I can get up to 0.4 mg Dilaudid with every push, every 15 minutes).
They took it away from me, and instead they made a system where I got 5 mg of Oxycodone from the nurse, when needed and maximum every 4 hours. And then one shot of Dilaudid 0.4mg also max every 4 hours.
Now these painkillers have a very constipating effect, so I will give you a minute to now figure out what happened this afternoon.
1, 2, 3, 4, 5, 6…… 60. Did you figure it out?
Yes, you are right, I had five (5 !!!!) bowel movements before 4 PM where the 1 pm one was a one hour long complete void of my bowels. And as you remember if you listened carefully, now I had to call the nurse every time I needed a shot of painkiller. So every time I now had to rush back to my bed and call the nurse and hold tight until she finally came and gave me the pill or the shot.
So we went from having a well functioning self-administered immediate pain control to having a well functioning way of torturing Kim Kahler.
For some reason my appetite also dropped, so I had a one-hour long fight with a chicken sandwich that refused to appear delicious but kept acting dry and boring until the very last bite.
At 4 pm, I wake up in the middle of Erin Brockovich and a bowel movement. I rush to the bathroom in my superhuman-sized diaper and get this finished up as quickly as possible, and after using half a roll of toilet paper, I am ready to go back to bed again. But already by the sink just outside the bathroom, when washing hands, I feel that this bowel movement was especially painful. I rush over to the bed and call my nurse and ask her to rush to my bed with painkillers. I am now feeling completely blue frozen and shaking like crazy. A nursing assistant sees my problem and offers to give me an extra warm blanket, which she does at light speed.
My nurse also arrives, only to tell me that she has paged a doctor; because I have exhausted my painkiller quota. I ask her to rush the issue, and I am now a solid piece of pain, like a stick hovering 30 inches above my bed with an “I have met death” look on my face. Five minutes goes by, and I call her again, to ask where we are with the medication. She tells me that she is waiting for a doctor to fill in the order for the extraordinary drug. She says that it could be any time now. I let her know that as soon as I have received the pain medication, I need to speak with the doctor. I am considering dialing 911 (can you do this when you are actually in a hospital?), I am thinking of running down to the nursing station and start screaming that I need this dealt with now, but I am fortunately clear enough in my head to realize that if I do, I will destroy any cooperation from the hospital going forward.
Fortunately, before I am about to make a complete fool out of myself, the doctor stops by (she is one of the ones I like). She asks me how my weekend has been, I cut her off and tells her that we need to deal with my immediate pain situation. Once done, I would like to have a discussion with her about the new regiment I am on. She immediately gets it, and she has the nurse come in with a 0.5mg DiLaudin. In the next few minutes, my pain starts to dissipate, and I am now slowly converting back to pleasant/rational Kim again.
The doctor comes back in, and we can now discuss the issue. I explain to her that I feel that they are making a big mistake when they are moving me from a self-controlled IV to a nurse administered regiment of oral drugs. Then a few days later they will discharge me and give me 60 Oxycodone 5 mg that I can administer any way I like. Also the fact that they switch me from a medication where I can take 0.4mg every 15 minutes to now something where I get 5 mg every 4 hours is quite a drop in pain killing. It is such a significant decrease that my constipation immediately has disappeared and sent me to the bathroom all day with loads of new pain to deal with
She agrees that this is a mistake and quickly changes the rule to be so that I will get some painkillers every 6 hours, even if I don’t ask. On top of this I can get the 5mg Oxycodone every 2 hours instead of every 4 hours. I think this is a much better solution, and then I just have to remember to notify the nurse that I am going to the bathroom so that my painkiller will be ready once I come back.
It is now 10:30 pm, and I am back to my good old self. Thankfully this got resolved, what a day….