What the doctor ordered . . .

I'm so freakin' clueless to the world around me these days, I didn't even know it was Homecoming at the U this past weekend. (Photos aren't mine, by the way. Stole them form the website, Metromix. I am so gonna get sued. . .) Just thought the U of M had especially hard-core school spirit, as I, in passing, did notice an inordinate number of people milling around in various ensembles of gold and maroon throughout the week. Didn't figure it out until Saturday morning. Penny and Jim had left for the U before I did; left a note to tell me the U would be a zoo, with the homecoming game at 11. At least now I know the reason behind the absence of dignity when I saw fans walking the streets in daylight in gold and maroon striped overalls, harlequin faces in gold and maroon, gold and maroon leg warmers . . .

Friday . . .

Bob had his back incision cleaned out Friday, for the second time. We were told it should take just an hour or so, as it wouldn't be re-sutured this time 'round. I've decided someone needs to come up with a time conversion chart, hospital time:real time, so we can better manage our time. When a doctor says a procedure will take only an hour, count on at least three . . . when a nurse says she'll be in in 5 minutes, don't get your undies in a bunch until after 15 (unless it's a critical issue—then run out into the hallway and grab the first person you see, cry hysterically. Been there, done that, works like a charm). More on that to follow . . .

I absolutely love the plastic surgeon who did Bob's wound re-do. Love, love, love her. Anyone

who scribbles notes all over the pant leg of her scrubs is a-okay in my book. Bob and I met her for the first time a few days ago, Jim met her for the first time yesterday, in the pre-op room. She came ambling in, sportin' a baseball cap, slouchy clothes. Jim thought she was a janitor.

This plastic surgeon possesses the warmest, most laid-back demeanor I've ever encountered in a doc. Not what I'd think f first when I think of plastic surgeons. An unfair assumption perhaps, but in my defense, thanks to Heidi Montag, who else knew there were other facets to plastic surgery than boob jobs and face lifts? (I'm being somewhat facetious here, so please don't answer that in any seriousness . . . ) I looked her up on the U of M website the other day and found that, in addition to all the various plastic surgery specialties in which she engages (pediatric craniofacial, reconstruction, wound care), she also lists Alternative Medicine as an area of interest . . . she gave us the lowdown on what would be happening during the procedure, basically going in to open the incision, wash it out, see if there's any visible signs of infection, pack the wound tightly with dressing and then a topical bandage, but she'll leave it open (i.e., they wouldn't be closing it up with sutures), to encourage healing from deep within. The procedure should only take an hour or so, she tells us.

The "one hour" surgery turned into several hours, when all's said and done. Bob went in at 2, didn't get out until after 5:30. The surgeon came out, pulled up a chair and began sharing with us in great detail what she found and what she had to do. As she started explaining, we pummeled her with a ton of questions and she interrupted, "Hold on, lemme draw you a picture," grabbed a coffee-stained napkin and started sketching Bob's anatomy and what had to be done.

She opened up the entire incision this time, washed out the wound, and didn't find any real infection, per se, but discovered an area of muscle tissue that had been cut through during the first surgery had basically died off, due to lack of blood supply. It's not something anyone would have anticipated, she told us, but she's not surprised by the finding, either. So much had to be cut through during Bob's first surgery, to get to the large tumor and remove it—layers upon layers of various tissues, blood vessels, bone. When the muscles were reattached, their blood supply just didn't recover. Again, for so many reasons—scar tissue from the decades-past radiation that's infiltrated Bob's body, his poor nutrition status, the depth and intensity of the surgery itself. . . she said she's continually surprised at outcomes of drastic surgeries; sometimes very healthy people end up with unforeseen complications, other times, very sick people come through with no issues, hard to say what the outcome will be, for sure . . .

She had to remove all the dead muscle tissue, then wash out the site again before packing it with dressing. The procedure itself took less time than did the prepping—the pre-surgery scrub-down, anesthesia, inserting the vent . . . she said Bob did very well throughout, lost a fair amount of blood, but that was expected, given he was still on Plavix and aspirin. He's recovering now, and should be back up to his room within the hour. The wound will be left open, meaning no sutures right now, to try to coax the healing from within first.

The plan is to go back to the OR on Sunday for a followup, to replace the packing, assess how things are going and go from there. They'll still have to put Bob completely under, back on a vent, even though they don't anticipate any issues. I ran home to let the dogs out, took each on a quick walk, just to get away from the joint for a spell. I expected Bob to be all settled in his room by the time I return, but he wasn't. Another hour or so before he was finally wheeled up and reassembled back in his room—he has a special, inflated pressure mattress that needs to be hooked, up, he needs his telemonitor (for his heart) reconnected, his GI tube hooked up, IVs in place, compression wraps back on . . . after saying good night, Penny and Jim headed back to our house once Bob's finally settled, I didn't get home till almost midnight.

Saturday . . .

Crummy day, as a whole. Terrible night, as Bob had to be wakened several times throughout the night, to change his topical dressing and bedding, in pain . . . Tons of bleeding from the surgery site, got so bad that when I got in, in the morning and saw how much, I asked Bob's nurse to call the surgery team back in to see him—his blood pressure's been low all day, hemoglobin dropping by the hour. Every hour or so, his nurses have had to change the topical dressing as well as all the bedding because of they become blood soaked in no time. Bob's miserable, in pain, and to top it off, had a nurse from hell today. A dude, who earned the title Malicious Murse from me, was so rough with any kind of physical contact with Bob—if he had to turn him to change a dressing, switch out bedding—and displayed the most insolent, obnoxious manner to boot, not just with us, but to the other nurses and aides who worked with him, even with the surgeon who came back to assess Bob's wound. Thankfully, there was usually another person available to help in turning Bob and to ease the jerks and bumps, and the other saving grace was that Malicious Murse wasn't around much to manhandle Bob; any time we pressed the call button, an aide (who have been fantastic—so much so that I sometimes can't tell if they're an aide or a "real" nurse) usually responded and was able to help.

In this whole ordeal, we've never had an issue with any of the nurses, but eventually, I asked to talk to the charge nurse and asked that this nurse not be assigned to Bob ever again. Turns out, he's a floating nurse, and has a history of "rough & rude" treatment. What the hell is he doing working with patients at all, then, I wonder aloud, especially on 6B, where with very sick people who require a lot of nursing care? The charge nurse was empathetic, apologetic and said he'd be sure to not assign MM to Bob and also asked me to file a formal complaint on Monday, when the nurse coordinator is back. It's not my mission or desire to get anyone fired, like I have time, energy or interest, but for the love of god, he's a nurse!

Anyhow, lots of bleeding on Saturday. Every time Bob's topical dressing and bedding had to be changed, I watched his face. His eyes stared at the wall or ceiling, expressionless, for the occasional grimace that corresponded with a too-hard pull or jerk, but mostly, he just stared straight ahead. The plastic surgery fellow came back in the afternoon, checked the site, did a "whip stitch" on an edge of the incision, to help seal off the purported site of excessive bleeding, and also peeled out some extra-soaked packed dressing, replacing it with fresh. He said he'll leave explicit instructions for Bob's nurses to check the dressing very regularly, and to keep an eye on his hemoglobin as there does seem to be a lot of blood loss. Not surprising, given that Bob's still on Plavix and aspirin, and to call them, if there are any other questions or concerns.

Bob's night shift nurse, who came on at 7 is an angel, with a beautiful middle eastern name, dark skin, long hair that she ties up in braids, and knows him well. She seemed to be working extra hard for Bob, as though trying to make up for the transgressions of the asshole before her. Docs order extra units of blood and fluids for Bob, in the hopes that will help bring his hemoglobin levels up, his blood pressures up, make sure he's ready for the follow-up procedure in the morning.

Bob and I sat in silence much of the night, watching a creepy ghost show on the Travel Channel that he's become so fond of. At one point, during a commercial, Bob turned to me and said quietly, "I miss so many things, Jen . . . I miss just being able to walk. I miss that so much . . . I miss pizza . . . I miss going out for a beer. . . believe it or not, I miss working, so much . . . " He said these things, quietly. He didn't cry, didn't expound, didn't have to. I cried for him, and in my head, I expounded. At this point, I have nothing to say, nothing that doesn't sound so ridiculous, so insulting, so insensitive, and I'm sorry if I don't have the right things to say, I blubber. I've run out of things to say, but hope you don't get sick of hearing me say I love you and that I am here with you, for you. I'm not going anywhere . . . more crying . . .

"And I worry about you," Bob continued. God, here we go again. He's the one with all this endless shit happening to him, in him, around him, and he's worried about me . . ."I worry that you're okay, that you're doing okay through all this . . ." I cried harder. Angel nurse came in about then, saw me sniffling in my chair and rushed over to me. "It's okay," she patted my shoulder, "You both have been through so much, I know . . . all you can do, the only thing you can do, is take one day at at time. No more, no more. . ."

Sunday . . .

Penny and Jim left early for the hospital today. They decided they would go early, to be with Bob before the procedure (the wash-out follow-up); I stayed back, to walk and feed the dogs, get a few things done around the house and head in before the procedure was done, to talk to the docs. Around 9:30, on the road, I called Penny to see where they were, she said the docs just came out and were talking to them. Whoa! That was much faster than expected! "Is Doc Writes-on-her-Pants there? Can I talk to her?" I asked, and Penny gave the phone over. Doc Writes-on-her-Pants told me that everything went really well; they were very pleased with what was done on Friday, didn't have too much to clean up today, the "whip stitches" her fellow did seemed to really help slow down the excessive bleeding, and that they'll be in every day for at least the next few days, to check on the wound site, to make sure the nurses are changing the dressings according to their specifications, to observe the healing . . . right now, Bob's in recovery, he's awake, alert, and is doing just fine, and will be moved back to his room soon.

I am glad to hear that they didn't find any more dead muscle tissue, that the procedure went quicker than expected. I then asked her about her interest in Alternative Medicine, if it's specific to her plastic surgery work, or if it's in general. "Oh, it's a real interest in mine, in all areas of health and wellness," she told me. Would it be possible to set up an appointment to talk to you about what you do, what you know, in regard to Bob's situation? I ask. I mean, given his history, all he's been through, he's pretty much SOL, as far as conventional medicine goes, for the most part . . . I have such an interest in health and wellness, and such a passion for nutrition, real nutrition, as medicine . . . "Oh, I could sit and talk to you for hours about this, it's more than just an interest," she said. "You don't have to make an appointment—I can come up to Bob's room, any time, chat with you bedside, if you wish. Just give me a call . . . "

By the time I got to the U, Bob was back in his room, settled in for the day. His nurse was someone new, I haven't seen her before, but she rocks. Possesses that great, delicate balance of leaving him alone long enough to get some real rest, and checking in periodically, as needed. She came in at one point, to reposition him and look at his dressing. Still looks perfect, not one drop of drainage. I noticed the immense swelling in his right foot has all but disappeared. His blood pressure and heart rate has been stable all day. "I apologize if this sounds so stupid, Bob, but I have to say this. Given what you went through yesterday, today is a better day," I said tentatively, looking at him for a reaction. He turned to me. "Has it?" he asked. "You even got a dr Pepper, and your appetite is coming back . . . I think it's a better day. Small things, very small things, I know, but all those small things add up to bigger things . . ." He looked at me for a few moments. "Yeah, you're right," he finally said. Whether or not he believes that at this point, I have no right to say . . .